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Catharsis: a literature review.

A review of the catharsis literature by its nature must begin with an examination of its development from emotion. This allows us to understand why so much controversy surrounds catharsis as a therapeutic notion. The study of emotion and its various facets, such as the role of language and gender differences, are discussed. Definitions of catharsis and an examination of the evidence for the three major forms of catharsis follow. This enables the relevance of catharsis as a stress management technique in the self-care of nurses and other healthcare professionals to be examined. The review concludes that there is a paucity of mental health nursing evidence to support the value of catharsis as a skilled nursing intervention. The existing inconclusive evidence from other sources, such as psychology, does tend to support the use of catharsis in some situations. Finally, recommendations for particular aspects of future catharsis research are also suggested.

Catharsis

Catharsis: an investigation of its meaning and nature.

Nurses commonly use catharsis and cathartic techniques as part of their clinical practice to enable clients and themselves to release emotion, to feel better and to facilitate coping. However, the literature does not provide clinical nursing evidence for its use. The main purpose of the investigation is to examine the beliefs about and understanding of catharsis which two groups of nurses hold: one group of nurse teachers and one group of nursing students. One hundred and forty-two respondents completed self-administered questionnaires asking about their understanding of and beliefs about catharsis as being beneficial, social, negative or psychotherapeutic in nature. The possible relationship of their answers to age, sex, philosophical orientation and qualifications was deemed to be important. The results suggest nurses understand that catharsis is related to emotion and has a psychotherapeutic purpose. However, there appear to be gaps in their understanding. Nurses also seem to believe that the release and expression of emotions is more acceptable for women than for men. There is also evidence that the more experienced nurses think differently from less experienced nurses, placing more emphasis on behaviour rather than emotion as they grow older. The problems associated with catharsis are discussed along with the implications for research and practice.

Adolescent

Effects of viewed violence and aggression: stimulation and catharsis.

Tests of the catharsis hypothesis involving viewed violence have led to conflicting results. It was suggested that the inconsistencies were due in part to the use of two different types of response measures, aggressive responses and hostile responses. This study involved a direct comparison of the two types of responses under conditions of instigation versus no instigation and aggressive versus neutral film. It was hypothesized that viewing an aggressive film would lead to a decrease in hostile responses (catharsis) and an increase in aggressive responses (stimulation) when compared with a neutral film condition. It was also hypothesized that both stimulation and catharsis effects would be enhanced under instigation conditions. A main effect of instigation was found with subjects in the instigation condition having higher scores than those in the noninstigated condition. A main effect of film was found with subjects having lower scores in the aggressive film condition than in the neutral film condition. A significant Film times Response Outlet interaction was found which offered support for the predicted catharsis effect on the hostility measure. There was no support for the predicted stimulation effect on the aggression measure. The results of the study offer support for the main thesis that in examining the effects of viewed violence, separation of hostile responses and aggressive responses is necessary for full understanding.

Abreaction

Catharsis reconsidered.

Mainstream psychiatry and psychotherapy have held for many years that cathartic psychotherapies involving powerful emotional expression have limited value. The conventional wisdom is that they are either dangerous, or ineffective, or that their effectiveness is short-lived. This paper reviews the origins of this conventional wisdom and makes two findings. Firstly, that there is remarkably little serious research into cathartic psychotherapies, but what there is tends to support catharsis. Secondly, that the periods in the last 200 years when cathartic methods have fallen into disrepute have often coincided with threatened or actual scandals involving prominent practitioners of cathartic psychotherapy. Four models of catharsis are described; the "Hydraulic", the "Pavlovian", the "Cathexis", and the "Holographic". The discussion suggests situations in which catharsis would be likely to prove useful, and indicates potential risks.

Adaptation, Psychological

Catharsis and abreaction in the history of psychological healing.

With roots in ancient religious practices of purification and cleansing and in ancient medicine's purgings, Plato evolved a verbal catharsis for diseases of the soul, and Aristotle developed a catharsis of the passions through tragic drama. Through the centuries, most cultures have had recognized contexts in which emotions were evoked, heightened in intensity, and ultimately released or discharged; and cathartic procedures can be detected in many cultures' healing practices. The late decades of the nineteenth century saw the emergence of numerous psychological healings with a cathartic basis. Catharsis came to mean the lively remembering of a traumatic experience in addition to the emotional release; and the term abreaction frequently was used to refer to the emotional release. Subsequently, the notion that the recovered traumatic memories needed to be integrated with the rest of the patient's mental life became a third significant element. The significance of these three factors has been debated vigorously; but, whether it has been some combination of them or merely the emotional discharge, there has been a cathartic element in many twentieth-century approaches to psychological healing.

Abreaction

Catharsis, aggression, and persuasive influence: self-fulfilling or self-defeating prophecies?

Does media endorsement for catharsis produce a self-fulfilling or a self-defeating prophecy? In Study 1, participants who read a procatharsis message (claiming that aggressive action is a good way to relax and reduce anger) subsequently expressed a greater desire to hit a punching bag than did participants who read an anticatharsis message. In Study 2, participants read the same messages and then actually did hit a punching bag. This exercise was followed by an opportunity to engage in laboratory aggression. Contrary to the catharsis hypothesis and to the self-fulfilling prophecy prediction, people who read the procatharsis message and then hit the punching bag were subsequently more aggressive than were people who read the anticatharsis message.

Aggression

A survey of psychologists' perspectives on catharsis.

A questionnaire assessing endorsement of the hostility catharsis hypothesis was developed and administered to 102 undergraduate students and 131 American and Canadian psychologists (randomly selected from 4 divisions of APA). Results indicated that students scored higher on endorsement of the catharsis hypothesis than did psychologists; females in general scored higher than males; psychologists not recently involved in research scored higher than psychologists who were so involved; and Freudian and Humanistic theorists scored higher than Behavioral theorists.

Abreaction

Sorbitol catharsis does not enhance efficacy of charcoal in a simulated acetaminophen overdose.

The use of a 70% sorbitol solution has recently been advocated as an adjunct to activated charcoal. This results in rapid and profuse catharsis that could possibly cause fluid and electrolyte imbalance. An investigation was undertaken to determine if sorbitol catharsis enhanced the antidotal efficacy of activated charcoal. Eight healthy volunteers participated in a randomized, crossover trial. Subjects ingested 3 g of acetaminophen followed by either no intervention, 50 g of plain activated charcoal at one hour, or 50 g activated charcoal-sorbitol solution at one hour. Serial acetaminophen levels were determined at intervals over eight hours and side effects noted. Both interventions significantly reduced the area under the curve versus control (P less than .05). The addition of sorbitol did not enhance the efficacy of activated charcoal but did increase the side effects noted. Sorbitol has not been proven effective in enhancing drug removal and has side effects that can be significant in a poisoned patient. Current data do not warrant its use, and further investigations should be carried out with other ingested drugs.

Acetaminophen

Idiopathic bile acid catharsis.

In the course of extensive routine screening for bile acid malabsorption a few patients were detected in whom chronic diarrhoea was apparently induced by excess bile acid loss which was neither associated with demonstrable conventional ileopathy nor with any other disorder allied to diarrhoea. In three patients subjected to scrutiny the results obtained were in harmony with a concept of idiopathic bile acid catharsis. Ingestion of cholestyramine was followed by immediate relief, but the diarrhoea recurred whenever this treatment was withdrawn. It it suggested that idiopathic bile acid catharsis should be suspected in patients with unexplained chronic diarrhoea and especially in those with a diagnosis of irritable colon with diarrhoea.

Adult

The facilitation of aggression by aggression: evidence against the catharsis hypothesis.

Nnety male subjects were either attacked or treated in a more neutral manner by a male confederate. On a subsequent maze-learning task, one third of the subjects shocked the confederate, one third observed as the experimenter shocked the confederate, and one third waited for a period of time during which the confederate was not shocked. Finally, all subjects shocked the confederate as part of a code-learning task. Subjects who had been attacked and had shocked the confederate during the maze task delivered shocks of greater intensity on the code task did subjects in the other two conditions, and the former subjects also experienced a greater reduction in diastolic blood pressure than did the latter. The results contradict the hypothesis of aggression catharsis and are discussed in terms of feelings of restraint against aggressing that a subject experiences after committing an aggressive act.

Abreaction

The Censorship of pornography: catharsis or learning?

Contemporary research on pornography reveals an impasse between the models of catharsis and learning. Preference for the latter by a recent government report is based on ideological rather than scientific considerations. The breakdown in the liberal tradition, current pornography research based on behaviorism, and two major theoretical problems are discussed. The interface among psychology, sociology, and literary criticism is suggested as a positive direction for understanding pornography; censorship, however, may obstruct research and fail to advance feminist goals.

Abreaction

The irrationality of the catharsis theory of aggression as justification for educators' support of interscholastic football.

The notion that hostile feelings can be catharted from the psyche by playing football or other aggressive sports was virtually destroyed by behavioral scientists several decades ago. Nonetheless educators continue to support interscholastic football as a means of venting the aggressive emotions that supposedly characterize adolescence. This work examines this phenomenon, concluding that educators realize the sport actually increases aggression but hide behind the outdated hypothesis about catharsis to perpetuate the sport--an activity which gives them much pleasure.

Adolescent

[Physiological reactions in catharsis].

By employing catharsis as a psychotherapeutic method after Krestnikoff, respiration, pulse rate, blood pressure, body temperature, sweat secretion and urinary constituents were studied in groups of different numbers of patients. While the values of respiration, pulse rate and sweat secretion were found to be subject to a pronounced influence, blood pressure and body temperature were relatively stable. Urinalysis showed in many cases an increase in excretion with a decrease in the specific weight and a change from the acid to a slightly alkaline milieu.

Abreaction

Magnesium toxicity secondary to catharsis during management of theophylline poisoning.

Multiple doses of oral activated charcoal are used increasingly to promote elimination of toxins that have already reached the bloodstream; this is often referred to as gastrointestinal dialysis. Cathartics usually are used in conjunction to hasten transit of the charcoal-adsorbed toxin. In the present case, a regimen of activated charcoal and magnesium citrate was used to treat a patient with theophylline poisoning. It was effective in lowering the patient's serum theophylline concentration but produced an elevated magnesium level associated with decreased responsiveness, confusion, and diminished deep tendon reflexes. Magnesium citrate may not be the optimal cathartic for use in gastrointestinal dialysis, at least in selected patients. Sorbitol has been shown to produce a more rapid catharsis without disturbing magnesium serum concentrations. Therefore, the use of sorbitol in place of magnesium citrate, at least in selected patients, may be preferred.

Aged

Magnesium-induced catharsis in chicks.

High magnesium (Mg) diets induce diarrhea in chicks. Addition of 0.3, 0.5 or 0.9% Mg (as MgO) to a corn-soy basal diet caused a dose-related lower gut passage time (GPT) (the first appearance of colored markers from feed in excreta), with the threshold for catharsis being approximately the 0.3% addition. Supplementation of the high Mg diets with a water-absorbent clay did not change the chicks' GPT. The beta-adrenergic blocking agent propranolol (1.68 mg/kg body wt) or the alpha-adrenergic blocking agent phenoxybenzamine (0.28 mg/kg body wt) did not effect the GPT of chicks fed high Mg diets. However, both the muscarinic blocker methscopolamine (0.12 mg/kg body wt) and the serotonergic blocker methysergide (0.2 mg/kg body wt) resulted in a higher GPT of chicks fed high Mg diets compared to corn-soy fed control chicks. Analysis of the osmotic load of excreta or intestinal contents of high Mg-fed chicks showed no differences from osmotic loads of control-fed chicks. When the osmotic loads observed were partitioned into mineral cationic and anionic components, the Mg content was found to be higher in intestines of chicks, but this higher Mg was paralleled and/or surpassed by chloride (Cl) content. From these data the authors conclude that Mg-induced cartharsis is due not simply to the hyperosmotic effect of Mg per se but to neural or endocrine arcs that affect the secretion or absorption of Cl as well.

Animals

Stability of radiothyroxine plasma disappearance curve despite catharsis and unblocked thyroidal uptake of radioiodide.

Plasma radioactivity was measured over 21 days after an intravenous injection of 50 muCi of 125I-T4 in eight normal men. No thyroid-blocking medication was given. Four subjects (castor oil group) received 30 ml of castor oil on each of Days 13, 14, and 15, while the other four subjects (control group) were studied without medication. After A 5-day equilibration period, plasma 125I-T4 was measured on Days 5-13 in order to calculate the disappearance curve for each subject and to derive the mean for each experimental group. The curves were then extrapolated to Day 21. Measured radioactivity did not depart significantly from the extrapolated line, either during the castor oil period (Days 14, 15, and 16) or during the recovery period (Days 17, 19, and 21). The castor oil, therefore, had no observable effect on the clearance of plasma radioactivity. None of the subjects had a late increase in plasma radioactivity to suggest recirculation of radioiodide or buildup of iodoproteins. In normal subjects, radiothyroxine plasma levels up to 21 days are not significantly affected by short-term catharsis or by failure to block thyroidal radioiodide uptake.

Adult

[Circadian rhythms of mice to the catharsis of radix et rhizoma Rhei].

Circadian rhythms have been observed obviously for both normal and pathological mice when Radix et Rhizoma Rhei is given. As a rule, the catharsis becomes stronger when Radix et Rhizoma Rhei is given at night than during the day. The rhythms vary with different pathological models. Compared with the normal mice, the circadian rhythms tend to be clearer for those mice excited by thyroidization. However, thyroidization makes the mice less sensitive to the dosage change of Radix et Rhizoma Rhei, while the mice weakened by tabazole administration show the reverse reaction.

Animals