This is the first of a series of 15 articles I wrote on the difference between abreaction and feeling in therapy. It is a crucial point in Primal Therapy.
The ability to distinguish between abreaction and a genuine feeling is an essential skill of good Primal Therapy. The difference between the two is stark, but in practice it still can be deceiving. Feeling is the key to cure, while with abreaction there is no chance of getting well. Yet, despite this crucial difference, the therapist is often unaware of what is going on, and certainly the patient is equally unaware. The insidious part is that abreaction feels like a primal, looks like a primal and smells like a primal, but is far from a genuine Primal. In clinical terms, abreaction is "the devil" because it doesn't allow patients to get better. They remain forever "prisoners of their pain" in an abominable, endless loop of hurt and hopelessness. Once abreaction sets in, it becomes a neurosis on top of another neurosis. And it is unshakeable. It takes months to even try to undo it. The danger cannot be overstated. We have now seen many patients who have gone to mock primal therapy and are stuck so badly in abreaction that it is almost impossible to extricate them from it. If left unchecked, abreaction can even lead to pre-psychosis and psychosis.
It is the job of the therapist to distinguish between abreaction and real feeling. To some extent, that is a skill based on the instincts of a trained clinician and acquired by experience. For some patients who are mired in abreaction, that skill can mean the difference between successful therapy and staying stuck in mock primals that lead nowhere. The good news is that there are also scientific ways to know the difference. We can often tell how if a real feeling has been resolved by changes in cortisol levels, vital signs and other biochemical indicators.
First, to avoid confusion, a definition is in order. Within Primal Therapy, the term “abreaction” means something quite different from its original meaning within Freudian psychoanalysis. In this psychoanalytic sense, abreaction is simply defined as the process of releasing repressed emotions by reliving an old traumatic experience(1). On the face of it, that classic definition is close to what we would call a Primal, although true “reliving” in our therapy is far beyond what Freud had imagined. In Primal terms, abreaction has nothing to do with any genuine reliving experience. On the contrary, for us abreaction is destructive to any feeling therapy because it becomes a defense against real feeling, as I shall explain in detail shortly.
I must emphasize that abreaction is a non-feeling event. It looks like feeling, often to both the patient and therapist, but there is a qualitative difference. It produces awareness without consciousness, a difference I shall explore in detail in a moment. To a well-trained therapist there is a hollow ring to abreaction. It doesn’t “smell” right. A patient may unconsciously use abreaction as a defense against feeling, slipping into crying the minute she lies down, or simulating a birth primal. The key difference between abreaction and a true Primal, of course, is connection, which takes place in a Primal but never in abreaction.
Before we delve into this, however, let me briefly review some of the basic principles of Primal Therapy. These theoretical cornerstones provide the framework needed to understand abreaction as a deviation from a successful coarse of treatment.
(1): Gordon Marshall. "abreaction." A Dictionary of Sociology. 1998. Encyclopedia.com. (July 2, 2015).http://www.encyclopedia.com/doc/1O88-abreaction.html