Treatment of psychoneurosis; modified CO2 abreactive technique.
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Humans↗
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Psychological treatment in skin disorders, with special reference to abreactive techniques.
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Humans↗
Successful hypnotic abreaction after twenty years.
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Combat Disorders↗
Trauma-induced dissociative amnesia in World War I combat soldiers. II. Treatment dimensions.
OBJECTIVE: This is the second part of a study of posttraumatic amnesia in World War I (WW I) soldiers. It moves beyond diagnostic validation of posttraumatic amnesia (PTA), to examine treatment findings, and relates these to contemporary treatment of dissociative amnesia, including treatment of victims of civilian trauma (e.g. childhood sexual abuse). METHOD: Key WW I studies are surveyed which focus on the treatment of PTA and traumatic memories. The dissociation-integration and repression-abreaction models are contrasted. RESULTS: Descriptive evidence is cited in support of preferring Myers' and McDougalls' dissociation-integration treatment approach over Brown's repression-abreaction model. CONCLUSION: Therapeutic findings in this paper complement diagnostic data from the first report. Although effective treatment includes elements of both the dissociative-integrative and abreactive treatment approaches, cognitive integration of dissociated traumatic memories and personality functions is primary, while emotional release is secondary.
Abreaction↗
The use of imagery in the treatment of posttraumatic stress disorder.
The role of visual imagery in the symptomatology of posttraumatic stress disorder (PTSD) has not been fully appreciated. The occurrence of intrusive recollections of a traumatic event in the form of flashbacks is very common and may suggest a possible approach to treatment for many individuals with PTSD. A case is presented in which a combat veteran in psychodynamic psychotherapy for PTSD was successfully treated by capitalizing on his tendency to have flashbacks. In this instance, abreaction and subsequent working through of affective reactions to the abreaction resolved his disorder. Technical considerations and patient selection are discussed, and it is suggested that further study of the efficacy of this approach is warranted.
Abreaction↗
The great escape: a neuropsychological study of psychogenic amnesia.
This paper describes the neuropsychological test performance of a patient who experienced a "fugue" episode (functional retrograde amnesia) lasting 7 days, but who continued to complain of a virtually complete loss of autobiographical memory for well over a year. Subsequent evidence revealed that she had been at least partially simulating her amnesia during this prolonged period. Neuropsychological testing took place soon after admission to hospital, at intervals thereafter, and after an Amytal abreaction, which produced a substantial recovery of her memories. On various anterograde tests, designed to detect simulation, the patient's performance was unimpaired, including recognition memory tasks, word-stem completion priming for "neutral" word-lists and for post-onset autobiographical material, and some aspects of semantic memory. However, her pattern of performance on an autobiographical and a remote News Event test differentiated her from patients with organic amnesia, because she showed a grossly disproportionate autobiographical memory loss and an extreme recency effect. In addition, a rating scale, on which she showed impaired feelings-of-knowing for items from her autobiographical memory, suggested simulation. On a word-completion task for pre-onset autobiographical material, she showed absent "priming" relative to "baseline" material. However, following the Amytal abreaction, there was a substantial improvement on this task, relative to recognition and cued recall performance. This finding has been interpreted within an hierarchical model of awareness in memory, derived from studies of normal memory and organic amnesia; and it is suggested that patients with "psychogenic amnesia" may manifest different levels of awareness for differing memories.
Adult↗
Diagnosis, management and prognosis of a group of 128 patients with non-epileptic attack disorder. Part II. Previous childhood sexual abuse in the aetiology of these disorders.
In a group of female in-patients clinically diagnosed as having non-epileptic attack disorder there was an increased incidence of a proven previous history of sexual abuse in childhood, when compared with a group of women with epilepsy and a group of women with other psychiatric disorders admitted to the same ward. This was particularly true of women with the 'swoon' and 'abreactive' type of non-epileptic attack disorder (see Part I). The incidence of a history of previous abuse was similar to the two control groups for other types of non-epileptic attack disorder. The swoon was seen as a cut-off phenomenon: the abreactive attack as a kind of acting out the memory of the abuse, part of a post-traumatic stress disorder. Both may respond to counselling for the abuse although it is too early to be certain, and there is a risk of further episodes of the non-epileptic attack disorder during periods of stress. Some patients with epilepsy, however, also had a history of previous sexual abuse: in some the stress of the abuse may have precipitated the epileptic seizures.
Adolescent↗
The psychodynamic treatment of combat neuroses (PTSD) with hypnosis during World War II.
In a large Army hospital during World War II, a full-time program in hypnotherapy for battle trauma cases was developed. Symptoms included severe anxiety, phobias, conversions, hysterias, and dissociations. Many hypnoanalytic techniques were used, especially including abreactions. Good therapeutic results were frequent, as demonstrated by typical cases. There was no evidence that the abreactive procedure tended to retraumatize patients or initiate psychotic reactions.
Combat Disorders↗
Expressive therapy in conjunction with psychotherapy in the treatment of persons with multiple personality disorder.
This article examines the prevalence and complexity of multiple personality disorder as well as the contributions that psychiatry and occupational therapy make in its treatment. The value of activity is that it serves as a nonverbal mediator of communication. Activities are also useful in helping the therapist to obtain a patient's history, which is necessary for abreaction (i.e., the patient's reliving and recalling of the original abuse). Abreaction is a precursor to the integration of the abusive memories into the patient's current life.
Dissociative Identity Disorder↗
Delboeuf and Janet as influences in Freud's treatment of Emmy von N.
An analysis is made of Freud's treatment of the patient known as Emmy von N. in which for the first time he used what he called "Breuer's technique of investigation under hypnosis." It is shown that the main component of Freud's therapy owed nothing to Breuer: the patient's traumatic memories were altered by direct suggestion under hypnosis. The abreaction which did take place seems to have resulted from Freud's expectation that it should occur. Two cases published by Delboeuf and Janet in late 1888 and early 1889 were treated by a then unusual method which analysis demonstrates to have been virtually identical to the technique used by Freud. Evidence is presented that the Delboeuf and Janet cases could have been known to Freud before he began his treatment of Emmy von N.
Abreaction↗
Gender-related differences in non-epileptic attacks: a study of patients' cases in the literature.
Gender-related differences for disorders of consciousness other than true epilepsy usually point to a larger number of women suffering especially from non-epileptic attacks or pseudoseizures. Recently, sexual abuse has been suggested as a possible cause for this increased prevalence in women. It has, however, not been very clear if women have a different phenomenology of these type of seizures from men. In the present study, patients' cases as published in the literature are analysed in a detailed way, using a working classification by Betts et al to look for gender-specificity. Of the 62 cases, 76% concern women and 24% men; a percentage comparable to those published elsewhere. Ages range from 14 to 77 years-of-age, but 89% of patients are younger than 40. Sexual abuse was proven in 18 cases, all women. The phenomenology of the attacks was divided into tonic-clonic type and complex partial type of attack, or a combination of the two. Also, special types of attacks (swoons, tantrums, abreactive attacks and forthright simulation) were looked for. Males tended to suffer especially from tonic-clonic type seizures (80% of cases), while in women as many tonic-clonic type as complex partial type attacks were observed. Special types of attacks were observed at the same frequency in both sexes. The group of sexual abuse victims did not differ from the total group of women in this respect. The clinically more impressive nature of a tonic-clonic-type attack, that is more easily suspected to be 'real', might make this type of seizure a more male form of acting out. A prospective study on the incidence and phenomenology of pseudo-epileptic seizures in the general population is suggested to answer the new questions raised in this survey.
Abreaction↗
Neurolinguistic programming as an adjunct to other psychotherapeutic/hypnotherapeutic interventions.
The therapeutic dissociative techniques of "anchoring" and "three-part dissociation," neurolinguistic programming (NLP) treatment paradigms incorporating the idea of division into ego states, are effective in crisis intervention and as a stimulus for catharsis. Using the anchoring technique in the first session, a patient with severe anxiety, manifested by episodes of hyperactivity, was able to superimpose inner resources upon the situations which led to the episodes. Utilizing three-part dissociation, the patient experienced the hyperactive episodes "for the very last time" and terminated them permanently. Hypnotic exploration and ideomotor signaling were used with a patient presenting with uncomfortable feelings associated with intense anger. After the origin of the anger was determined, a three-part dissociation produced an abreaction and catharsis. Interaction at a cognitive level integrated the feelings and knowledge into personal consciousness.
Abreaction↗
Through a glass darkly: the psychoanalytic use of hypnosis with post-traumatic stress disorder.
A severe case of post-traumatic stress disorder stemming from consciousness (with auditory and pain perception) during surgery was treated with 8 sessions of hypnosis. Abreaction and revivification used alone initially retraumatized the patient, and her symptoms worsened. Ego-mastery techniques were then added; emphasis was placed on the role of the therapist as a new object presence to be internalized in restructuring the traumatic memory; memory consolidation and working-through techniques were instituted. The patient's symptoms abated and her condition remitted. The similarities between hypnotic and analytic work are highlighted. In addition, the case material provides a clinical example of the existence and potential traumatic effects of conscious awareness during surgery. It is like through glass, and you see movement and color and stuff--like you see thick glass--and now the glass is real thick and I can see a mass of colors that are not moving or nothing, like a wall. I can't remember anything past that [The Patient]. In the great majority of cases it is not possible to establish the point of origin by a simple interrogation of the patient, however thoroughly it may be carried out. This is in part because what is in question is often some experience which the patient dislikes discussing; but principally because he is genuinely unable to recollect it and often has no suspicion of the causal connection between the precipitating event and the pathological phenomenon. As a rule it is necessary to hypnotize the patient and to arouse his memories under hypnosis of the time at which the symptom made its first appearance; when this has been done, it becomes possible to demonstrate the connection in the clearest and most convincing fashion [Breuer & Freud, 1893/1955, p. 3].
Abreaction↗
Brief simultaneous couple hypnotherapy with a rape victim and her spouse: a brief communication.
This paper presents a case involving a rape victim and her emotionally affected spouse. Although the assault occurred before the couple met, the husband was too upset to concentrate when the victim wanted to share her rape-related feelings, nor could he provide the much needed empathy and support. This, apparently, was due to his difficulties in handling his own rage. Simultaneous couple hypnotherapy was used to allow the victim to share her experience under conditions safe for both her and her spouse. As he imagined in trance the rape account described by his age-regressed wife, he learned to identify his emotions and experience them in a controlled manner. During subsequent sessions, the husband was encouraged to include himself in his wife's abreaction and reshape the traumatic scene for both of them. The husband's rescuing behavior and the expressions of violent anger towards the perpetrator had several positive consequences. Not only did they change the abandonment component of the victim's traumatic memory, but they also helped the husband deal in better ways with his own feelings of anger. It also provided the couple with a helpful coping mechanism they later effectively applied under different circumstances.
Abreaction↗
Some additional light on the childhood sexual abuse-psychopathology axis.
This exposition is an attempt to unravel the complexities of the relationship between childhood sexual abuse and adult psychopathology. Four facets of the relationship are examined in some detail: (a) the extent of childhood sexual abuse; (b) the probability that sexual abuse in childhood will result in psychopathology in the adult; (c) the reliability of early life memories in later life; and (d) the role of recovered memory of trauma in the healing process. The conclusions of this logico-empirical analysis are that first, government statistics tend to underestimate the extent of childhood sexual abuse, whereas independent surveys tend to overestimate it. Estimating prevalence is further complicated by variations in the definitions of key terms. Possibly the only safe conclusion is that true prevalence cannot be reliably determined. Second, empirical investigations of childhood sexual abuse conclude that not all victims are emotionally injured. A substantial number of these investigations find that a majority of victims suffer no extensive harm. Other variables such as family dynamics are involved; there may be only a few cases in which emotional harm results from sexual abuse as a single factor. Third, memory research suggests that memory in general is a dynamic, reconstructive process and that recall of childhood events is particularly vulnerable to distortion. Memory cannot dependably produce historical truth. Last, there is some clinical evidence that abreaction of a traumatic event in adulthood may have a remediative effect. Similar evidence for childhood trauma is lacking. The belief in the healing effect of recalling and reliving a childhood trauma depends on the therapist's orientation.
Abreaction↗
Treating the traumatic memories of patients with dissociative identity disorder.
OBJECTIVE: The author uses clinical experience informed by research findings to suggest approaches to the treatment of the traumatic memories of patients with dissociative identity disorder. METHOD: Recent findings in the treatment of patients with this disorder and current considerations with regard to memories of childhood trauma are used to develop recommended approaches. RESULTS: Treatment of traumatic memories appears crucial in the recovery of patients with dissociative identity disorder, even though the reported memories may not be historically accurate. Criteria are available for determining whether a patient with the disorder is able to undertake such efforts, and methods such as fractionated abreaction have been developed to make the process less unsettling. CONCLUSIONS: Despite the difficulties posed by the vulnerability of patients with dissociative identity disorder to decompensation when working with traumatic material and the vicissitudes of autobiographical memory, modern therapeutic approaches allow the processing of such patients' traumatic material in a manner that reduces the likelihood of disruptive events and the misuse of recovered material.
Abreaction↗
Play, fantasy, and symbols: drama with emotionally disturbed children.
This paper discusses the developmental continuum of play and its relationship to drama. The functions of drama therapy as a form of child psychotherapy are illustrated through case material, focusing on wish fulfillment, psychic integration, reenactment of past traumatic experiences, transformation from passivity to activity, separation of fantasy and reality, fusion with the idealized or hated parent, defense and mastery. The value of drama therapy is not only in the abreaction it provides, but in the chance to articulate the fantasies through play, experience the working through of the conflicts, and connect the past to the present.
Abreaction↗
Evaluation of group therapy: correlations between clients' and observers' assessments.
An attempt to compare observers' evaluations of aspects of group psychotherapy with the patients' assessments of the same selected variables (i.e. 'acceptance', 'abreaction'and 'improvement') is described. Correlation coefficients between the observers' and clients' rankings of these factors were obtained, and the implications of the findings are discussed in relation to each group.
Abreaction↗