Anda di halaman 1dari 28

Abreaction and Deep Emotional Connection

in Psychotherapy and Psychoanalysis:

The Last Taboo
by Leonard S. Rosenbaum
1.0 Preverbal and Subcortical Trauma.........................................................................................................4
1.1 Stored in the Body.............................................................................................................................4
1.2 Reliving.............................................................................................................................................4
2.0 Curative Factors in Therapy..................................................................................................................5

I.Preverbal and Subcortical Trauma
A.Stored in the Body
II.Curative Factors in Therapy
A.Putting Emotional Experience into Words and the Problem of Preverbal Trauma
B.The Therapeutic Relationship
C.Insight vs. Psychophysiological Emotional Connection
1.Defense, Disconnection, and Reconnection
D.Relaxation of Defenses and the Antiregressive Function
1.Confrontation and Defense Interpretation vs. Holding Environment and Containment
a.Case of Bernie.
b.Discussion and conclusions.
E.Abreaction and Catharsis
1.From Psychoanalysis to Experiential Therapy
a.Direct reliving vs. transference and talking to therapist.
2.History of Abreaction in Psychotherapy
e.Other psychoanalytic clinicians.
3.Catharsis vs. Abreaction (and Flashbacks) vs. Primalling
4.Primal Therapy and Primalling
a.The subjective experience of primalling.
5.The Power of Tears
6.Integration, Working Through, and Insight
a.Insight as a result of emotional experience.
7.Is Repatterning Also Needed?
III.Back to the Couch
A.Ways for Analysts to Avoid Doing Real Therapeutic Work (The Basic Principles of Traditional
Psychoanalytic Technique)
1.Free Association
2.Acting Out
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a.Defense Interpretation.
4.Other Problems With Traditional Analytic Technique
B.Can Deep-Feeling Regression Work Be Incorporated Into Psychoanalytic Treatment?
1.The Analytic Environment
2.Technique of Deep-Feeling Work

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Abreaction and Deep Emotional Connection

in Psychotherapy and Psychoanalysis:
The Last Taboo
Leonard S. Rosenbaum
Board of Dirs. & Past-President, Intl. Primal Assn. (IPA)
Board of Dirs., Amer. Soc. for Bonding Psychotherapy (ASBP)
4220 Alton Pl. NW
Washington, DC 20016-2018
800-Leonard/202-393-2885 phone
202-364-3314 fax
February 14, 2015

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Abreaction and Deep Emotional Connection

in Psychotherapy and Psychoanalysis:
The Last Taboo


Preverbal and Subcortical Trauma

1.1 Stored in the Body

Much evidence suggests that deep preverbal trauma 1 is at least partially stored in, connected to, or
associated with the body. Some neurological evidence suggests that due to lack of complete myelination of the
brain, trauma during the earliest stages of infancy cannot be stored as a representational memory and accordingly
remains only a biological "imprint" (Konrad Lorenz) or partial sensory imprint.2
Because first-line development predates emotions, we cannot cry tears when it is manifest. Nor can we
speak, as language is a higher-level function that comes later. When patients relive very early traumas,
there are never any words involved. The first line can, however, store the cataclysmic sensations of
approaching death, the frenzied breathing and body movements. These memories, unseen but active
physiologically, tax the organism (Janov, 1996, p. 44).

1.2 Reliving
We often see patients who feel as though they are going crazy as they begin to gain access to very
early imprints. What is actually happening is that the original terror and frenzy are mounting. Because the
memory was laid down before there was a rational cortex, there is no conceptual handle on the terror. The
feeling simply is of going crazy; everything is mixed up, confused, and out of control. Brainstem cells,
where early terror is imprinted, send signals of panic and approaching death upward so that the limbic
circuits recognize a feeling of impending doom, while the cells of the cortex might be saying, "I don't know
what's happening to me. This doesn't make any sense!" The patient cannot say what he is terrified of. The

Note: Freud (cited in Nunberg & Federn, 1963) suggested that birth
trauma may be the origin of anxiety.
He said this in reference to
Rank's discussion of Myth of the Birth of the Hero.

This is one of the reasons that physical touch can be critical in

accessing and working with deep, preverbal material.
See Rosenbaum
(1999) for an extensive review and analysis of the use of touch in
psychotherapy and psychoanalysis.

person has no idea why he suddenly feels as though he is dying. It's because too much or too little
reactivity originally meant death (Janov, 1996, pp. 238-239).
When reliving early, preverbal trauma, patients typically do not experience a cognitive recalling of the
experience, an experience of watching a videotape of the trauma, or any images or representations of the trauma,
perhaps due to lack of complete myelination of the brain at the time of the trauma. They are not "recalling" the
trauma. They often do not even know what is happening to them until months after beginning to relive the
experience (Janov, 1996, p. 240).
Patients report being "in" the trauma; it's as if the trauma is happening again (Or, more accurately, they are
fully consciously experiencing it for the first time, since defenses and a fragile ego did not allow it to be fully
experienced when it happened originally). Although adults generally maintain their observing ego while relive early
trauma, the part of them that is reliving the trauma is reliving it psychophysiologically and speaking (or is unable to
speak) as an infant.
There is no way (initially) to "remember" very early trauma except "organismically" (Janov & Holden,
1975, p. 191). When an adult is reliving an early trauma, "It is common to hear the exact voice of the age being
relived--the lisp, the baby talk, and, eventually, the infantile cry" (Janov, 1970, p. 88). The adult will "cry like an
infant, indeed as an infant" (Janov, 1996, p. 45). For example, adult patients reliving oxygen deprivation at birth are
observed "losing their breath, bringing up copious fluid, and choking, gasping, and coughing...predictable changes
in body temperature, pulse, and blood pressure accompany this state" (Janov, 1996, p. 41).
The appearance of birthmarks when patients relive their birth trauma is an example of specific level of
memory. Forceps marks[3] will reappear on the forehead or wherever else they originally left a mark.
Pressure applied to certain spots, for example, where an adult was severely beaten as a child, can awaken
the memory of the event with all of its painful meaning and provoke the bruises that go with it. It is almost
as if the spot on the back "remembers" and "recalls" when the stimulus is appropriate (Janov, 1991, p. 63).


Curative Factors in Therapy

Putting Emotional Experience into Words

and the Problem of Preverbal Trauma

See photographs in Janov (1996, p. 210).


A traditional goal (and tenet) of psychoanalysis has been putting emotional experience into words. 4
However, it should not be assumed that this is immediately possible, nor should it be assumed that even if one
hypothetically could put a preverbal traumatic experience into words, that it would heal the trauma.
Neurotic adult patients' observing ego does usually maintain the cognitive and linguistic capacity to
describe their feelings, even when they are severely regressed. Also, their eventually putting their infantile feelings
(from their regressed states) into words is a critical therapeutic process.
However, patients first need to get fully in touch with and fully emotionally connect with their unconscious
infantile material, which cannot initially be done through words (see previous section on Preverbal Trauma). And
initially the observing ego may be emotionally disconnected from the infantile material. In fact, much experience
occurring after full language development (e.g., severe trauma during adulthood, such as war combat and sexual
assault) is not (yet) emotionally connected with language (even if the emotional experience can be described
verbally). Furthermore, even if the patient's feelings about a traumatic experience are fully verbal, this does not
mean that the patient's emotional experience of the trauma itself is yet at the verbal level.
Accordingly, the patient first needs to get fully in touch with and fully emotionally connect with the
repressed experience or material. Then the experience can be (and needs to be) put into words.5
The Therapeutic Relationship
Following Ferenczi and Rank's (1925/1986) discovery of the crucial role of the therapeutic relationship in
the healing process, it took the mainstream psychoanalytic community 60 years to rediscover this fact. A discussion
of the role of the therapeutic relationship would be beyond the scope of this paper. However, it is relevant that the
therapeutic relationship (including the therapist's bodily experience), particularly as a holding environment and
container, is one place where preverbal material can be reactivated, relived, and reworked (see Rockwell, 1984,
1999; Winnicott, 1965; and the Case of Bernie discussed later in this paper).
Insight vs. Deep Psychophysiological Emotional Connection
In a certain kind of aphasia, a person can express his feelings but he cannot explain them. He can say
"Shit!" with feeling, but he could not tell you why he said it[ 6]....This kind of aphasia is an indication that

The centrality of this process in the healing process is a complex

issue that is addressed in part elsewhere in this paper.

This is one of the reasons that physical touch can be critical in

accessing and working with deep, preverbal material.
See Rosenbaum
(1999) for an extensive review and analysis of the use of touch in
psychotherapy and psychoanalysis.

Perhaps the concept of nonsymbolic language, in contrast to

symbolic language (see Rockwell, 1998, 1999) is related to this type
of aphasia.


expressions of feeling are recorded on a level of the brain which is closer to the feeling centers. The ability
to explain feelings would seem to be a more distant and higher function. One of the problems with
psychoanalysis and other insight therapies is that those higher centers dealing with explanation are engaged,
not the lower ones intimately associated with feeling. In other words, the conventional therapist deals with
the defensive areas of the cortex and his patient becomes an inverted aphasic; he can explain feelings but
not feel them.
The problem of any insight therapy is that it does not produce those painful connections from the
cotex [sic] to the lower brain centers. In order to produce the connection which is usually an infantile or
early childhood set of experiences, the patient must be allowed to be that little child so that his early
feelings are connected. An adult explaining feelings cannot produce the connections to the reverberating
Primal circuits. The only unifying therapeutic experience, then, is reliving the early unresolved pains
(Janov, 1971, p. 64).
There is no way to remember being strangled on the [umbilical] cord except organismically--by reliving the
experience physically just as it happened. There is no way to bring that event into third-line consciousness
by any act of will. The event exists on its own level of consciousness and can only be resolved on that
level; which is precisely why understanding on the third line is meaningless....So we see that not only are
there levels of Pain but there are levels of insights which exist on the stratum of consciousness as the Pain.
They are the understanding of the Pain, but they evolve from it....Psychoanalysis offers third-line insights
(Janov & Holden, 1975, p. 191).
Defense, Disconnection, and Reconnection
Trauma and pathological conflict do not result from lack of insight, even from lack of emotional insight.
They result from an overwhelming distressful affective experience (e.g., pain, rage, terror, frustration, or
overwhelming stimulation), which triggers a defense--which is usually some type of "splitting" (whether vertical,
horizontal, or other) or disconnection (e.g., disconnection from consciousness [repression], disconnection of one
conscious state from another [splitting, dissociation, isolation], disconnection of cognition from emotion
[intellectualization], disconnection of affect from the self-representation [projection], disconnection of affect from
its object [displacement], etc.).
Disconnection is healed by reversing the process--namely emotional reconnection.

Because of the

disconnection (whether it resulted from a breakdown/fracturing of mental functioning or whether it was invoked as
a defensive, protective measure by the ego), traumatic incidents were not fully consciously experienced when they
occurred. To be healed, they first must be relived and reexperienced (or, more accurately, experienced for the first


Relaxation of Defenses and the Antiregressive Function
Confrontation and Defense Interpretation vs. Holding Environment and Containment
Case of Bernie.
Bernie, a man in his early thirties, was interviewed about his experiences in analysis and experiential
regression therapy. He was in analysis for 10 years with Dr. L, a classical, ego-psychology oriented analyst, who
was a respected training analyst at an orthodox institute. Bernie described Dr. L as an extremely relaxed, gentle,
empathic, accepting, and nonthreatening man. Although Bernie strictly obeyed the fundamental rule of free
association, he never got very deeply into any emotional material, never fully relived any painful childhood
traumatic experience, and never fully regressed deeply, even though he reported that he had desperately wanted
these things to happen and believed that they were amongst the most critical factors for healing. Nor did he believe
he made much progress or change. He attributed this to his intellectual and obsessional defenses simply being too
thick and rigid to penetrate.
Subsequently, he saw a deep-feeling therapist and got into a much deeper level of emotional experience,
even regressing to a preverbal stage, and more fully relived traumatic experiences in this early stage in the 1st few
minutes of his first session than he had in the entire 10-year analysis. What provocative, assaultive, manipulative, or
magical technique did the therapist use to achieve this? Harsh attack? Group confrontation? Sensory deprivation?
Hypnosis? Narcosynthesis? LSD?
The therapist's magical intervention was as follows: She casually commented to Bernie, "Why don't you go
downstairs into the therapy room and start getting into your feelings. I'll be down in a few minutes." Could these
words have softened, loosened, or opened up more "layers of the onion" (levels of defenses) than 10 years of free
association and systematic defense analysis? Apparently they did, although Bernie added that the therapist had
previously conveyed (mostly nonverbally) to him, in a friendly manner, "We're here to FEEL, to get into your
feelings. Intellectualizing isn't allowed. Fritz Perls referred to intellectualizing as `mindfucking.'" The patient said
he was expecting to do, and felt expected to do, serious emotional work, not explore and understand symbolic
meanings of his associations. Also, he sensed that this therapist, unlike Dr. L, had experienced deeply regressed
states and had felt her deepest, most primitive feelings and consequently was comfortable with such material. He
said that in retrospect, he sensed that Dr. L didn't really want to go beyond a rather shallow depth of feeling.
Subsequently, in his first session with another deep-feeling therapist, within a few minutes he appeared to
fully regress back to age 3 and was crying and screaming at his mother, while also experiencing a powerful
preoedipal maternal transference, as well as intense feelings of idealization of and falling in love with his therapist.
What induction technique did this therapist use? In addition to instructing him to lie down and then putting
her warm hands on his chest and stomach, he said she might have made a casual remark like, "Just relax and see
what feelings come up." However, he added that from the warm touch of her hands and her warm personality and
deep presence, he felt the most powerful and deepest field of safety and warmth he had ever felt, like he was being
held in a 360-degree enclosed "container" [Bion] [holding environment] completely safe and protected, largely

because he sensed that the therapist would remain comfortable and stay present, connected, and "right there with
him" no matter how deeply he regressed and no matter what intense pain or rage he got into. For the 1st time, he
felt safe enough to completely let go and let himself fall....["fall down," "fall apart," "break down,"
"surrender" (see Maroda, 1999)]. This case illustrates how the "relaxation of the antiregressive function" in
treatment depends much more on the depth of the holding environment than on abstinence and other principles of
traditional psychoanalytic technique.7
Bernie reported feeling much better, and his friends and colleagues noticed a major change in him following
just a few sessions (No one noticed him change during any period of his analysis.). A couple of years later, he
reported his experiences in a paper criticizing traditional psychoanalytic treatment from a deep-feeling, experiential
Discussion and conclusions.
Other such patients who were previously analyzed reported similar, though less dramatic, comparisons of
the two experiences. The typical response from such patients who obtain such therapy following analysis is that
analysis "barely scratched the surface."
Note: A few sessions of such therapies can have a powerful effect, particularly in opening up the defense
system, but these changes are usually temporary. To make these initial changes permanent, continued therapy is
necessary to maintain the new openness, restructure the defense system, and integrate the emotional material and
personality changes (i.e., the working through phase of treatment).
I believe that the most influential factor on the depth of work achieved in analysis is the extent to which
patients are or become able to and decide volitionally to choose to let go of their controls (defenses and
resistances), surrendering (see Maroda, 1999), and allowing themselves to regress and sink or even "fall" into
their deepest psychophysiological emotional states and traumas.
As can be seen in the case of Bernie, deep regressive, abreactive work does not require (and optimally does
not entail) breaking down or disrespecting the patient's defenses. Nor are years of defense analysis necessary or
sufficient to reach the underlying traumas and overwhelming anxiety, rage, frustration, and depressive affect.
Furthermore, I believe that the most powerful determinant(s) of the extent to which a patient is able to let go and
regress into the far depths of their traumatic experiences is (above everything else put together, including the most
comprehensive defense analysis) the human presence, strength, solidity/solidarity, stability, dependability, depth,
safety, security, containing function, and warmth of the human therapeutic holding environment.

The level and depth of emotional work done, the level of regression achieved, and the depth and
intensity of reliving trauma (abreaction), depend critically upon the therapist's conscious and unconscious
comfort with the patient's experience, as can be seen with Bernie's experience.


Abreaction and Catharsis
From Psychoanalysis to Experiential Regression Therapy
[After practicing psychoanalytic therapy 17 years I was treating a patient named Gary, who] was relating
with great feeling how his parents had always criticized him, had never loved him, and had generally
messed up his life. I urged him to call out for them; he demurred. He "knew" that they didn't love him, so
what was the point? I asked him to indulge the whim. Halfheartedly, he started calling for Mommy and
Daddy. Soon I noticed he was breathing faster and deeper. His calling turned into an involuntary act that
led to writhing, near convulsions, and finally to a scream....Gary was flooded with insights. He told me that
his whole life seemed to have suddenly fallen into place. This ordinarily unsophisticated man began
transforming himself in front of my eyes into what was virtually another human being. He became alert;
his sensorium opened up; he seemed to understand himself.
This therapist was Arthur Janov. This is how he discovered primal therapy (Janov, 1970, pp. 11-13).
Bernie's first deep-feeling therapist (described above) was a primal therapist, and his postanalytic treatment
experience illustrates much of the essence of primal therapy.
Direct reliving vs. transference and talking to therapist.
At some point, patients start (a) telling the therapist about how much they hate their parent and/or (b)
transferring their hatred toward their parent onto the analyst (i.e., transference). At this point, Arthur Janov 8 directs
the patient to talk (in the therapy room) directly to their parent (as he did with Gary):
I will sometimes have the patient talk only to his parents. To tell me about them automatically
removes the patient one step from his feelings. So the patient may say something like, "Dad, remember
the time when you...dunked me under[water]." At this point the patient might turn to me with anger and
say, "Can you imagine that stupid son of a bitch dunking a six-year-old under the water?" I say, "Tell him
what you feel!" And he does, unloosing a tirade and screaming his fear as that six-year-old (Janov, 1970,
pp. 84-85).
Powerful as the transference relationship is, and powerful (and crucial) as is the value of developing a new
real relationship (hopefully beginning a new pattern of relatedness) with the analyst, the transference is still a
displaced, secondary, and thus diluted expression. Furthermore, analysts are unaware of many of the subtle yet
powerful ways in which they encourage the development of transference, often at the expense of patients'

Surely he was not the first to do this.

I believe Fritz Perls
also did this.
It is similar to the "empty chair" technique in
Gestalt therapy (having patients pretend their parent is sitting in an
empty chair and talk to their "parent in the chair").



experiencing their feelings in the transference (a displaced expression) rather than experiencing them directly
toward their parents.
Why do analysts encourage transference but rarely encourage directly talking to one's parents in analytic
sessions? Are analysts frightened of (as with Janov's patient) "unloosing a tirade and screaming?" Do analysts have
a narcissistic need for the patient's emotions to directed at them and accordingly for the transference (and thus the
analyst) to be the "center of the [treatment] universe?"
On the other hand, the transference is more real in that the therapist is in the room but the parents are not.
Unlike Janov, I believe that directly re-living a trauma or conflictual object relation and reenacting and working
through the traumatic reenacted relationship in the transference are both important for optimal healing.
History of Abreaction in Psychotherapy
Abreaction and catharsis can be found in shamanism (Pierce et al., 1983, pp. 29-30); ceremonial healing
(Ellenberger, 1970, pp. 28-29) and religious/spiritual rituals and revivals; exorcisms (Ellenberger, 1970); peyote











narcoanalysis/narcosynthesis; Holotropic and other breathwork (involving hyperventilation); hypnotic regression

and hypnoanalysis; mesmeric therapy (Ellenberger, 1970); the abreactive/cathartic method of Janet, Charcot, and
Breuer and Freud (Breuer & Freud, 1893-1895/1955); Ferenczi's active and relaxation techniques (Ferenczi,
1932/1988, 1955; Lowen, 1971, pp. 10-11), and occasionally in traditional psychoanalytic treatment; primal therapy
and related deep feeling therapies (e.g., T. S. Alexander, 1996; Hart et al., 1975; Sidney Rose); rebirthing (Leonard
Orr) and birth regression (William Emerson; Ludwig Janus, 1997?); past-life regression; Dianetics (Hubbard);
EMDR; transactional analysis; ego-state therapy; psychodrama, drama therapy, method acting, and training in
method acting; Gestalt therapy (Mandelbaum, 1998, pp. 212-215); Synanon (Casriel) and similar confrontative
inpatient treatment programs for character-disordered and drug-addicted patients in denial; New Identity Process
(NIP; Casriel, 1972), rage reduction/holding therapy for unattached children (Cline, 1979, 1991; Magid &
McKelvey, 1987; Welch, 1989); autogenic therapy; re-evaluation counseling; implosive therapy; Orgone
therapy/vegetotherapy (Reich, 1942, 1949; Smith, 1998, p. 11; Smith, 1985), bioenergetics (Lowen, 1967, 1975;
Lowen & Lowen, 1977), core energetics, and Pathwork; bodywork (e.g., Rolfing, Hellerwork) and body
psychotherapy. For reviews of the various abreactive methods used throughout the history of psychotherapy (such
as those listed above) see Ellenberger (1970, pp. 150, 151, 484), Hart et al. (1975, pp. 59-60, 455n.7), Khamsi
(1984), Nichols and Zax (1977), Pierce et al. (1983, pp. 28-35), and Prochaska (1979).
Janet (1925) developed a treatment for hysteria which was remarkably similar to Freud and Breuer's
cathartic method, but with a greater emphasis on emotional expression....At first, Janet hypnotized patients



and suggested that they forget their unpleasant experiences.[ 9] When results this technique proved to be
disappointing, he developed a cathartic procedure that he called "mental liquidation"....Janet believed that
hypnotizing patients and encouraging expression of the repressed feelings provides not only catharsis but
also reassimilation or liquidation of the traumatic memory (Pierce et al., 1983, pp. 31-32).
Janet wrote about the cathartic procedure as early as 1889 (Ellenberger, 1970, p. 485; Khamsi, 1984, p. 11)
and in fact "claimed priority in having discovered the cathartic cure of neuroses" (Ellenberger, 1970, p. 344).
Breuer stumbled upon the cathartic method, in treating Anna O., as early as 1880 (Khamsi, 1984, p. 11).
Freud, in his early work with hysteria, used massage to the neck and head to facilitate emotional expression
and age regression in his patients (Forer, 1969; Levitan & Johnson, 1986; Wilson, 1982).
Both hypnosis and the cathartic method concealed resistances, thereby obstructing the analyst's insight into
such mental processes (Khamsi, 1984, p. 13; Ricoeur, 1970, p. 407), whereas free association allowed him
tremendous insight into psychodynamics. Thus, the cathartic method may have represented a threat to Freud's
understanding of the mind (Khamsi, 1984, p. 13).
Was Freud frightened away from the cathartic method? "Freud turned away from hypnosis and catharsis
when a patient had thrown her arms around him and a servant had walked in and caught them; the prospect of a
scandal was anathema to him" (Schoenewolf, 1990, p. 153).
Interestingly, in treating Emmy von N., Freud first used a technique of disconnection, attempting to remove
his patient's ability to know her own past (Rand & Torok, 1997, pp. 108-114).
Furthermore, "Freud's cathartic technique...was always more intellectual than emotional" (Pierce et al.,
1983, p. 31).
Freud...believed in the overpowering role of the mind, i.e., of the intellect as against emotions. You know
his basic attitude toward emotions. Not that emotions are bad, but you have to get them out of the way.
You have to control everything (Reich, 1967, p. 93).
Freud was anti-emotional, very anti-emotional. Freud was for intellect only (Reich, 1967, p. 64).
"His biography [Jones, 1953] suggests that [Freud] himself was uneasy in the presence of strong emotional
expression" (Pierce et al., 1983, p. 31).

Freud also attempted to treat hysteria in this exact manner before

using the cathartic method (Rand & Torok, 1997, pp. 108-114).



See Ferenczi (1919) and Lowen (1971, pp. 10-11).
Reich realized that the therapeutic effect of interpretation was limited (Khamsi, 1984, p. 14). Furthermore,
he made the transition from talking about feelings to physical discharge of emotions...he recognized the
physical embodiment of "psychological" defenses (Khamsi, 1984, p. 13).
"Reich explains that muscular rigidity is not simply a result of repression, but represents the most essential
part of the process of repression" (Janov, 1970, p. 223). "While Freud's method began at the surface and worked its
way inward, Reich went directly to the deepest layers of character, trying to get energy moving, muscles relaxed,
libido flowing" (Schoenewolf, 1990, p. 195). Reich emphasized libidinal energy locked in the body but appeared to
neglect trauma and anxiety.
In addition to doing pioneering work on character armor and muscular armor, he developed procedures for
relinquishing them (Reich, 1942). In fact, many primal therapy techniques were pioneered by Reich, as well as Fritz
Perls (Kaufmann, 1974, p. 54; Keen, 1972, pp. 88-89; Kelley, 1972; Khamsi, 1984, pp. 21-22; Nichols & Zax, 1977,
p. 142; Pierce et al., 1983, pp. 33-35), such as the "empty-chair" technique in Gestalt therapy. Techniques used by
modern orgonomic therapists (e.g., Barbara Gutman) are similar to those of primal therapy (H. Lawrence King,
personal communication, 1999). After reviewing several recent abreactive/cathartic therapies, Nichols and Zax
(1977) conclude, "With the exception of Perls' Gestalt therapy, cathartic approaches add little to Reich's
formulations; instead, they tend to stress various aspects of his work" (p. 151).
One day Reich was treating a masochistic patient. "One day the patient began kicking the couch as he
shouted the usual "No, I won't!'" (Schoenewolf, 1990, p. 184). Reich instructed, "Do that again...Let yourself go
completely" (p. 184). Finally the patient "plucked up his courage and began thrashing around on the couch, crying
in defiance and bellowing "inarticulate animal-like sounds" (p. 184).
Other psychoanalytic clinicians.
Other psychoanalytic clinicians who have emphasized the importance of abreaction include F. M.
Alexander (1935), Benedek (1946, pp. 204-205), Fodor (1949), Adelaide Johnson (1946), Nunberg, Simmel,
Fromm-Reichmann (1943/1959, pp. 56-59), Winnicott (1965), Volkan et al. (1976)?, Alice Miller (198?), Ludwig
Janus (1997)?, Charles Olsen, Richard Chefetz (in press), and other psychoanalytic clinicians who have worked
with severely traumatized patients.
Catharsis vs. Abreaction (and Flashbacks) vs. Primalling



The term abreaction, and to a lesser extent the term catharsis, traditionally has encompassed the concept of
the reliving of traumatic experience (e.g., Breuer & Freud, 1893-1895/1955). However, the terms have developed
negative connotations, emphasizing the venting and acting out of pent up emotion; meanwhile the concept of
actually reliving traumatic experiences has become obscured in the process.
Most primal therapists do not even use the terms, and most of those who do (e.g., Janov, 1991, 1996; Janov
& Holden, 1975) use them only to refer to what primal therapy is not--namely, the acting out and venting of pent-up
emotion. Instead of abreaction and catharsis, Janov and other primal therapists use the term primalling (see the
section Primal Therapy and Primalling below for a detailed definition and description) to refer what happens in
primal therapy.
I believe that the term abreaction should be reclaimed as referring to the reliving of trauma. While it does
not include the concept of connecting to one's related feelings, it distinguishes actual emotionally reliving from
catharsis, which tends to refer to the acting out of a traumatic experience or otherwise venting pent up emotion.
A flashback, which is a type of abreaction, entails an uncontrolled, involuntary reliving of a traumatic
experience. There is no emotional connection between past and present and no integration; consequently, little or no
healing occurs (H. Lawrence King, personal communication, 1999).
Regardless of terminology, the confusion of and failure to distinguish between the three concepts, (a)
venting and acting out (catharsis), (b) reliving without full emotional connection (abreaction, as well as flashbacks),
and (c) reliving and fully emotionally connecting (primalling), account for a myriad of problems, including (a) the
ineffectiveness (as well as the harmfulness) of many of the modalities listed above in History of Abreaction in
Psychotherapy, (b) the consequent dismissal of these modalities, (c) dismissal of the crucial role of abreaction in
psychoanalytic treatment. The failure of Breuer, Freud, Ferenczi, and others to fully distinguish between the two
and to fully understand the differences is, I believe, part of the reason the baby (abreaction) has been with the
bathwater (catharsis) of their abreactive methods.
Even primal therapists are susceptible to confusing these three processes, particularly in the heat of a
therapy session. It requires the closest examination not only of each particular type of therapy but of each individual
therapist and patient to determine whether patients are truly reliving/re-experiencing, and whether full emotional
connection is occurring. The extent to which each of these processes is occurring often varies from minute to
minute (even from second to second), even in analytic sessions, requiring the keenest emotional attunement to
differentiate them. One of the most crucial things in primal therapy training is teaching therapists to distinguish
between these processes (Janov, 1991).
Janov discusses the differences between these processes10:

Although I agree with Arthur Janov's (1991, 1996) assertions about

these concepts, please note that he uses the term abreaction to refer



A patient who uses swear words while reliving an event he experienced at the age of four is having an
abreactive rather than a real experience. Most four-year-olds do not say, "Shit!" (Janov, 1996, pp. 242-243).
One Ph.D., for example, said during his Primal, "Daddy, I ascared." To me, this indicated that he was not
playacting. If, however, the patient yells profanity, such as "Daddy, you bastard!" during a Primal, there
is a good chance that this is a pre-Primal (Janov, 1970, p. 91).
Janov uses the term abreaction to refer to the noncurative release of feelings[11]:
We have distinguished the primal response from the physiological changes occurring in abreaction and
uncompleted primals.

Abreaction is an emotional outpouring, sometimes with tears, in which an

individual cries about his sufferings without ever actually descending into the actual memory. It is simply
the discharge of the energy of the feeling. The difference between abreaction and a primal can be
recognized by whether resolution occurred in physiological terms, whether the vital signs followed the
characteristic pattern caused by trauma.
....Abreaction often looks like a primal, except the vital signs change erratically during the session
and do not fall below their baseline values afterward....What happens neurologically in abreaction? Just
what always happens in neurosis: Usually, the energy of a feeling from one level of consciousness is
discharged on another level.[12] The energy from the reverberating limbic circuit is released in nonconnected, helter-skelter fashion, through crying, pounding, and screaming.

There is no cortical

connection. When the patient has distress about an event rather than being in the event reliving it, he is not
in the feeling zone, not on the level where the wound is, and no healing can take place. "My mommy
always hated me!" when accompanied by adult tears is very different from "Mommy, please don't hate
me!" in a tearful, five-year-old voice. In the first case, pain from below powers a third-line behavior. In
the second, pain finds its connection to consciousness. Or, birth pains intrude on a feeling of, "It's so
hopeless to ever be loved;" the feeling is driven by the birth pains that are not felt for what they dangerous to the individual if allowed to go on, because a "groove" develops so that

to what I use the term catharsis to refer to.

Janov (mis)uses the term abreaction where I would use the term
catharsis, and he appears to use the term(s) primal/primalling where I
would use the terms abreaction with emotional connection.
regardless of the choice of words, I agree with his critically
important ideas about these processes.

"Abreaction...does not involve reliving and connection across the

levels of consciousness" (Janov & Holden, 1975, p. 222).



each time a feeling comes up it is rerouted into specific, symbolic channels. Soon the person will just
discharge energy of the feeling automatically, believing he is getting better. The problem is that like
jogging and meditation, one has to keep on doing it to get relief, whereas with a primal, once a piece of a
feeling is felt and connected, it never has to be felt again[13]. (Janov, 1996, pp. 231-233)
Primal Therapy and Primalling
The subjective experience of primalling.
During a primal, one makes contact with a past memory and the feeling connected with it, and has the
experience of "descending." A person "goes with" the feeling, lets it expand and become "big," surrenders
to it, and gives in to her body-movements. In letting go, she is aware that she is really allowing feeling
rather than blocking. A person often experiences oneself as lost in feeling, but at the same time there is a
part of oneself "watching"[14] as one primals. She knows she can come out of it if she wants to...During
feeling, one loses track of time. One feeling leads to another and, after a while, feelings seem to emerge
When a person makes contact with a feeling, there is often a sense of "rightness" about it, as if one
has arrived at something true and real. Having contacted a feeling, a primaler often experiences the
emergence of sudden insights....At the end of the cycle one tends to feel lighter, as if having given up a
weight. At the conclusion of a session, the person has the sense of having truly made contact with his
feelings--and thereby with a "realer" or truer self. The insights that then emerge are experienced as solid
and indisputable (Witty & Khamsi, 1995, p. 25).
In the preprimal phase, one suffers and experiences a crescendo of anguish. This reaches a maximum
level when defenses give way and the early painful event breaks through to consciousness. There is a vivid
memory, sometimes with visual, auditory, or olfactory components, or all three, from early life experience.
At the end of the primal sequence, one is lucid and profoundly relaxed, and insights connecting present
behavior with the trauma just experienced flow easily....After [a] feeling is connected, the tension in the

Regretably, many of Janov's claims (particularly his therapeutic

claims) are exaggurated, sometimes exaggurated out of recognition.
However, I believe that most of his ideas and assertions that I have
cited in this paper, even if quantitatively exaggurated, are at make
qualitatively valid points, and they have genenerally been confirmed
as such (as qualitatively valid points) by other primal therapists and
patient reports.

A degree of observing ego remains in this regression in the

service of the ego, which is less common in malignant regression.



muscles of the forehead and neck...drops significantly. The energy has been appropriately connected
instead of neurotically rerouted (Janov, 1996, pp.230-231).
A patient may not know exactly what she is going through until months after she has begun reliving an
infantile trauma in therapy (Janov, 1996, p. 240).
This is because she will only feel a piece of the original trauma at a time, just enough to be integrated.
Later, the trauma will begin to make overall sense as more and more of it is experienced (Janov, 1996, p.
The psychodynamics of a primal.
A Deep Feeling/Primal is...a connected total descent into the emotional reality of a past traumatic event.
This means the patient returns, in the feeling, to the moment of trauma and experiences the emotion of that
time (T. S. Alexander, 1996, p. 156).
The awareness of the hurt of early deprivation is gated, while the unmet need is preserved in pristine form
for later connection. Hence, it is not enough to feel the hurt; one must go further and feel the basic need. A
patient who is able to feel about a parent, in context, "Why do you hate me so much?"[ 15] This is what
healing is about. Without this step, the distress and tears are never-ending because the basic unmet need,
the agonizing trauma that is the reason for repression in the first place, remains intact.[16]
So many will cry out their pain of neglect, of an erratic, undependable father or a weak, ineffective
mother for weeks or months. Then, when I say in session, "Ask your father to be nice. Say it like a little
girl, with the little girl's voice." At first it is an effort for her to mimic a little girl. Once locked into the
feeling, however, the baby talk comes out naturally. It has a different sound; the child's brain is now in
charge. The pain gushes forth again as the patient is suffering the agony of a need left unmet years ago.
Most often, it is not necessary to help guide the patient into being the little child. The current feelings
themselves become a vehicle to carry the person back in time to childhood. (Janov, 1996, pp. 242-243)
The neurophysiology of a primal.

I think Janov's point would be clearer if he used the example of

the person screaming, "Why don't you love me? I need you to love me!
Please love me!"

This brings up the controversial and discomforting question of

whether developmental deficits require (a) a "corrective emotional
experience" and/or (b) the therapist to satisfy (e.g., through
nurturance, or "reparenting) the basic unmet need. Janov, along with
most traditional analysts, do not believe these are necessary, but
they do not seriously address the issue.



A primal is a vivid psychophysiological reexperiencing of a painful event from infancy or childhood. It has
a biphasic response pattern that starts with an escalating sympathetic nervous system crisis. It is no surprise
that it is a fight-or-flight, sympathetic nervous system crisis that begins the feeling. The vital signs rise to a
peak in concert and then fall during the crying, the parasympathetic recovery phase. In a completed primal
the vital signs fall in concert to below-baseline values at the end of the therapy session (Janov, 1996,
When suffering moves upward and finally connects with cortical centers, it becomes specific pain. The full
extent of the imprint is now conscious. The first-line sensations of anxiety--a state that some experience as
butterflies in the stomach, losing one's breath, and a tightness in the chest--are experienced. With the
resulting explosion in a primal, the anxiety turns into feeling. (Janov, 1996, pp.235-236)
The Power of Tears
....Psychotherapists who feel uncomfortable with weeping may try to cut off these displays with explanation
and insights and take the patient out of crucial feelings....Tears...dissolve repression, breaking down the
barriers to consciousness....We have found in our research that the deeper the cries, the more profound the
changes that occur. (Janov, 1996, p. 241)
Integration, Working Through, and Insight
Deep Feeling/primal therapist Theresa Sheppard Alexander explains:
There is a definite awareness of what the past trauma was and, as well, a clear sense of the activating event
in the present, if there is one. Often this clarity arises after the beginning of the feeling process, but in order
for the deepest healing to take place, understanding is necessary....With deeper access to the levels of the
feeling, understanding does come (T. S. Alexander, 1996, p. 155).
It is in the interaction between several crucial elements that change comes about: deep feeling, insight and
integration of those insights, being heard with true interest and personal care, the transference of childhood
feelings onto the therapist, and working them through (T. S. Alexander, 1996, p. 146).
Healing requires multiple components: insight, understanding, working through transference issues, and the
full body experience of your deepest emotions. When a person's body as well as his or her mind has been
traumatized...the person's body needs to experience and release this trauma...It is through the therapeutic
cojoining of all these elements that it is possible to reconnect the mind and the body at the deepest levels (T.
S. Alexander, 1996, p. 144).



According to Janov (1970), often on the second day of primal therapy
The patient walks in spouting insights. "It's like my whole mind exploded," he may say. "I figured out so
much last night..."....He tells me about memories he has forgotten...discussing memories and insights
interchangeably (pp. ).
"Primal a matter of integration:...Each and every feeling must be connected and integrated or
else the person is not Primalling" (Janov & Holden, 1975, p. 424). "Insights are one very important index of
integration" (Janov & Holden, 1975, p. 433).
Insight as a result of emotional experience.
With good support[17] from the therapist, a person in pain will naturally, over time, clearly see and feel what
happened to him, and develop insights about the long-term effects of the early trauma (T. S. Alexander,
1996, p. 156).
The earlier the trauma, the more global the insights. Many patients report that such insights carry more
conviction than almost anything else they have ever learned. One patient remarked: "I know these things
more surely than I know anything else in this whole stinking mess of my life!" This quality of surety is a
second major indication of a true primal experience. (Janov, 1996, pp.230-231)
The person has the sense of having truly made contact with his feelings--and thereby with a "realer" or truer
self. The insights that then emerge are experienced as solid and indisputable (Witty & Khamsi, 1995, p.
There will be insights (the perception arising out of a primal feeling), but healing doesn't depend on
insights; rather, insights are a sign of healing.

It is the primal feelings that provide true insight.

Connection not insight, is the vehicle of healing. Disconnection is what the wound is about. (Janov, 1996,
"Whatever explanation is needed will be provided later by the patient" (Janov, 1996, pp. 242-243).
"Insight that does not emanate from a patient's deep feeling is a defense. Insight does nothing to lift
repression. Instead it bolsters it" (Janov, 1996, p. 171).
Is Repatterning Also Needed?


support being more important than interpretation



Primal therapist Mickel Adzema (1995) considers whether primalling is even theoretically sufficient for
healing trauma or if something else is also needed:
Janov (1970) originally postulated the concept of a "Primal Pool" of Pain which could be "emptied."
Subsequently, even he was forced to abandon this concept as it appeared that some Pains refused to go
away....But I say it is not that there is always some old energy stored in a pool left to be leaked out; rather,
that the patterns are still there, intact though less energized, and the energy from a new situation can and
does flow through them for lack of some alternative "route"....Jules and Helen Roth 18...used to speak of a
"run-off of neurological sequences"....though you have been feeling, you might not have been growing.
The difference centers around the concept of whether the neurological sequences are both pattern and
energy or just pattern....I think a better conceptualization or model is that we have "patterns in the brain"
[metaphorically] by which we constantly block energy in the "body" from moving freely, which therefore
causes energy to "build up" in those areas, and which, therefore, are felt as tension areas. I believe that in
Primal one reenters those "patterns in the brain" and alters them so that energy in the "body" is unblocked
and able to move freely again--but this does not dissolve the [Stanislav] Grof...has let us know,
for the resolution of an issue to needs to be able to connect with the feelings of the perpetrator,
in the traumatizing event....growing into the state of forgiveness and self-forgiveness...allows the person to
finally let go of the past and feel peace about it (pp. 74-77).
Is some type of "corrective emotional experience" needed to repattern the brain and personality? Is
reparenting needed to fill in developmental deficits?
In order to change our deepest negative patterns, I believe it is necessary to have access to our deepest
positive patterns...This I contend we cannot do unless we have felt back and through to the time before the
first "shutdown" and reunited with the positive experiences that have set the patterns through which it is
possible for us to feel joy and happiness (Adzema, 1995, p. 81).
When one begins accessing and reuniting with the deeper self...growth occurs by simply following
one's deepest desires, wants, and feelings (p. 78).
Back to the Couch
Four Ways for Analysts to Avoid Doing Real Therapeutic Work
(The Basic Principles of Traditional Psychoanalytic Technique)
Free Association

primal therapists at Arthur Janov's Primal Institute and later at

the Denver Primal Center (now the Denver Counseling Center)



Imagine if a person, while attending a party, having an intimate experience with a loved one, meditating, or
going through a religious ceremony or ritual, was required to speak into a microphone constantly reporting
immediately everything he or she thinks, feels, sees, and hears. Wouldn't this limit the depth of the person's
experience. Despite its enormous value, the fundamental rule can have this detrimental effect of diluting, inhibiting,
and limiting emotional experience. Nothing aids or serves certain defenses as well as the fundamental rule of free
In addition, invariable insistence on endless free association, by ensuring that the patient is constantly
talking, prevents full psychophysiological regression and inhibits preverbal material, let alone regression into
preverbal states.
When a approaching a deep pain or traumatic memory,
a patient's defenses will activate most intensely...It is often at this moment that the patient wants to begin a
theoretical discussion about therapy, or remembers a funny story about his childhood that must be told now
(T. S. Alexander, 1996, p. 165).
What could possibly play into such resistance better than being technically required to report (theoretically)
every theoretical thought one has and every word of the funny story that one thinks of?
Free association can be very useful for bringing up painful emotional verbal (though not preverbal)
material, and is especially useful when it evokes painful, shameful, embarrassing thoughts, feelings, and desires.
When a patient strongly wants to dismiss or not verbalize an association, it is usually most critical for him or her to
express it. But once intense emotional material has been brought up, endlessly verbalizing all of one's
thoughts defends against experiencing the emotional material, it prevents patients from getting too deeply into
anything because other associations will distract them and take them out of the experience.
Acting Out
Very ironically, the problem of nontherapeutic acting out and discharging (catharting) emotions, rather than
connecting with them, appears greater in psychodynamic therapies than in some experiential therapies:


experiential therapies, when strong affect is reached (e.g., regarding abuse during childhood), the patient is
encouraged and facilitated to delve deeper into the experience and relive the actual experience with the perpetrator.
In psychoanalytic treatment, the patient is instructed to keep free associating and telling the analyst about the
experience. To the extent that the trauma was preverbal or reached preverbal levels of the psyche, free associating19
and verbal emotional expression can cathartically release some of the emotion and tension but do not allow (and can

Free association can be exceptionally effective in facilitating

acting out (rather than feeling and deeply connecting with) one's



even defend against) the nonverbal reliving of and reconnection with the traumatic experience. Interpretation can
implicitly cue the patient to talk about his or her experience, to tell the analyst about the experience and his or her
current emotions, which can impede or defend against immersion into and feeling the emotions. Accordingly, there
is the problem of re-enacting the abusive experience with the therapist (which can be analyzed and worked through)
rather than directly re-living and re-experiencing the actual trauma with the (actual object-image or introject of the)
perpetrator, so that the trauma can then be released.
The ultimate purpose of interpretations should be (a) deepening patients' affective experience in the
uncovering phase of analytic work and (b) facilitating emotional connections in the working through and integration
phase. Intellectual insight by itself is not curative. Analysts are aware of this fact in theory, but often lose sight of it
in the midst of analytic sessions doing analytic work. However, in practice, psychoanalytic treatment ends up
consisting predominantly of interpreting symbolic material to understand its meanings--to put it bluntly, intellectual
masturbation, divorced from any serious goal of structural personality change.
Interpretations can be assessed on the basis of the extent to which they deepen a patient's experience
versus the extent to which they bring the patient out of their emotional experience and into their intellect. In
practice, analysts often ceaselessly make interpretations, particularly when the analyst starts feeling anxious in
regard to patients' affective and/or bodily experience and wishes to takes patients "out of body and into their head."
Even asking a patient, "What are you feeling?" (particularly if said from a detached, intellectual stance) can have the
effect of taking the patient out of his or her emotional experience. Where an analyst will typically ask a patient to
think about, observe, reflect on, and try to figure out what's going on in their unconscious, an experiential regression
therapist may say, "get out of your head [stop trying to think]; stay in your body [stay in your psychophysiological
emotional experience]."
Suppose a patient is getting in touch with a primitive fear of his mother and the analyst interprets, "Perhaps
you have a fear of your mother killing you," and the patient replies, "You know, I think you're right: My fear
reminds me of death, and that would explain my fear of visiting her at home and never leaving. And I just had an
association of her holding a knife, which reminds me of the dream last night in which she bought a gun for no
apparent reason."
By traditional standards, the interpretation was exceptionally successful: the patient gained insight and had
associations and a dream confirming the interpretation. I would argue that the interpretation in fact was not only
miserably unsuccessful but counterproductive: unsuccessful because neither an intellectual understanding (even if
accompanied by some emotion) of one's fear nor a few relevant associations are of much value, and
counterproductive to the therapeutic process because the interpretation took the patient out of his/her bodily
emotional experience of the fear into a state of intellectualizing about it. Such insight and associations produce a


feeling of satisfaction (they are what some analysts live for--intellectually masturbating and exploring symbolic
meanings) but do not produce personality change.
Suppose the analyst (metaphorically) reached down to the patient's level and asked (talking to the patient's
child-self), "Are you scared Mommy's gonna kill you?" and the patient starts shaking convulsively and screams
(in a 3-yr-old's voice), "No, no Mommy! Please don't kill me! Please don't kill me!" as the patient begins reliving a
traumatic memory of his mother screeching at him with a murderous rage in her eyes. This is what analysts should
ultimately be striving for. And this should speak for itself in clarifying what is lacking in the results of the 1st
interpretation above.
Defense Interpretation.
Although the metaphor of "peeling the layers of the onion," as a model of defense analysis and the
uncovering process of analytic work, makes perfect sense in theory, two highly related aspects of this process can be
misleading or subject to misunderstanding, and would benefit from clarification and further examination:
(1) Defense interpretations are immensely more effective in peeling layers of (or opening the pores of) the onion if
they facilitate the patient's fully emotionally experiencing (i.e., feeling) the distressful affect motivating the
defense rather than simply giving the patient an intellectual understanding of the mechanisms and intricacies of the
patient's defenses.
(2) The layers of the onion need not necessarily be peeled from the outside inward, and an individual onion layer
can more effectively be peeled from the inside, as explained in (1). Attempting to first analyze away a defense, in
order to then reach the underlying anxiety or conflict is fighting an uphill battle (against the power of the anxiety
that is motivating the defense)20. Moreover, if one can facilitate the patient to fully experience and reconnect with
the core anxiety, thus dissipating the energy motivating and maintaining the defense, the defensive structure will
change much more easily.
One "defense interpretation" that I believe to be immensely useful is, "You're trying to figure out rather
than experience and feel" (Jennifer Stuart, 1998).
However, even some defense interpretations, such as interpretations of intellectualization, tend to reinforce
the defenses, because interpretation has a tendency to encourage patients to retreat from emotionally experiencing to
Other Problems With Traditional Analytic Technique
Several other miscellaneous factors that prevent the emergence of deep, primitive emotional material in
psychoanalytic treatment: (a) nonresponsiveness of the analyst, which can function as an extinction schedule; (b)

like trying to stop a tidal wave by studying a textbook on the

laws of momentum



discouragement of intense emotional expression (often through critical-sounding interpretations) and dismissing it
as "acting out" (even when it is not acting out, in the psychodynamic sense); (c) the analyst's formality; (d) the
"blank-screen," emotionless stance of the traditional analyst; (e) the taboo on self-disclosure and emotional
expression; and (f) the failure to notice or respond appropriately when a patient has achieved only intellectual
insight (which is often the case), with little or no emotional insight or deep emotional connection.
Can Deep-Feeling Regression Work Be
Incorporated Into Psychoanalytic Treatment?
The Analytic Environment
It is difficult, if not impossible, to facilitate extensive primalling and to fully access preverbal,
prerepresentational imprints verbally through free association and the symbolic language21 of interpretations.
However, I believe that the psychophysiological resistances and antiregressive function can be and often are
effectively relaxed (without any use of suggestion) through many aspects of the psychoanalytic situation: the use of
the couch22, which facilitates psychophysiological relaxation and regression, and, most importantly, the warm,
empathic, trusting, "360 degree" holding environment (and container/containment) of the personal, human analystpatient relationship. This includes the analyst's conveying (nonverbally) that he or she (a) is present with the
patient on a personal, human level and will not retaliate, or withdraw into a formal, detached professional role in
response to anxiety if the patient reaches an intensely emotional, fragile, regressed infantile state; (b) has felt and
emotionally connected with his/her own deepest pains; and (c) is emotionally open (not to be confused with selfdisclosure and emotional expression).
Technique of Deep-Feeling Work

The distinction between symbolic language, which communicates

conceptual content to the listener, and nonsymbolic language, which is
used to directly influence (or projectively identify emotional content
into) the listener (see Rockwell, 1998, 1999), may be critical in
therapist-patient communication while a patient is primalling and/or
deeply regressed.

By emphasizing the use of the couch, I do not wish to minimize the

therapeutic importance of occasional face-to-face sessions in
classical analysis to bring out anxiety provoking material that might
not come out so long as the patient remains on the couch.



Asking patients "Can you say what if feels like in your body?" (Rockwell, 1998) will help bring their
bodily experience more deeply into awareness (see also David Rose). 23 What is most important is not describing
one's bodily experience, but rather feeling it and connecting with it.
When patients say they are feeling a particular emotion, the therapist may ask, "Where in your body do
you feel the emotion? What body movement or body posture [e.g., pulling one's shoulders inward] expresses the
emotion? Now, intensify/exaggerate that movement/posture, allow yourself to feel it, and descend into the
emotion." If a patient moves away from his or her bodily experience and starts intellectualizing, a deep feeling
therapist may suggest to the patient, "Get out of your head; stay in your body."
Another method is to ask patients what they are feeling and then to ask them to allow themselves to fully
feel the emotion/desire/need in their body, to sink into the emotion, and connect with the emotion (assuming this
won't be overwhelming).
In doing this, whatever insights would have emerged from attempting to directly analyze the feeling often
come to the patient spontaneously, either during or after the experience. Furthermore, after "sinking all the way into
the feeling" and connecting with it psychophysiologically, he or she may then spontaneously get in touch with
deeper feelings and conflicts.
Suppose a patient incessantly criticizes and verbally attacks his therapist. Instead of the patient's
verbally acting out his or her urge to criticize/attack the therapist (which free association can encourage), the
therapist may encourage him or her to allow him/herself to fully feel the urge to attack and put down the therapist,
to sink into the feeling/urge, to allow him/herself to fully feel the urge in his body, and allow him/herself to "let go"
(cf. Maroda, 1999) and sink down into the urge and whatever feelings underlie the urge24 (This may even happen by
This is perhaps the most basic and fundamental technique of primal therapy and in principle can be used
with almost any emotional material that arises in therapy.

See Rosenbaum (1999) for an extensive review and analysis of the

use of touch in psychotherapy and psychoanalysis, including its role
in bringing bodily experience into consciousness.

such as envy, rage, hatred, self-hatred, self-disgust, guilt, or

feeling persecuted by a parental introject



Adzema, M. D. (1995). Reunion with the positive (self), Part 1: The other half of "the cure." Primal
Renaissance: The J. of Primal Psychology, 1(2), 72-85.
Alexander, F. M. (1935). The problem of psychoanalytic technique. Psychoanalytic Quarterly, 4, 588-611.
Alexander, T. S. (1996). Facing the wolf: Inside the process of Deep Feeling Therapy. New York:
Benedek, T. (1946). Control of the transference relationship. In F. M. Alexander & T. M. French (Eds),
Psychoanalytic therapy (pp. 173-206). New York: Ronald Press.
Breuer, J., & Freud, S. (1893-1895/1955). Studies in hysteria. In J. Strachey (Ed. and Trans.), The
standard edition of the complete psychological works of Sigmund Freud (Vol. 2). London: Hogarth Press.
Casriel, D. (1972). A scream away from happiness. New York: Grosser & Dunlap.
Chefetz, R. A. (in press [1999 or 2000]). Abreaction as therapeutic action: baby or bathwater?
Cline, F. (1979). Understanding and treating the severely disturbed child. Evergreen, CO:
Evergreen Consultants in Human Behavior.
Cline, F. (1991). Hope for high risk and rage filled children: Attachment theory and therapy.
Evergreen, CO: Evergreen Consultants in Human Behavior.
Ellenberger, H. F. (1970). The discovery of the unconscious. New York: Basic Books.
Ehrenberg, D. B. (1992). The intimate edge. New York: Norton.26
Ehrenberg, D. B. (in progress). Vulnerability and Desire in the Psychoanalytic Relationship. Book
in preparation.
Ferenczi, S. (1919)
Ferenczi, S. (1932/1988). The clinical diary of Sndor Ferenczi, Ed. J. Dupont (Trans. M. Balint &
N. Z. Jackson). Cambridge, MA: Harvard Univ. Press.
Ferenczi, S. (1955). Final contributions to the problems and methods of psychoanalysis: The selected
papers of Sandor Ferenczi, M.D., Vol. 3, (trans. E. Mosbacher). New York: Basic Books.
Ferenczi, S., & Rank, O. (1925/1986). The development of psychoanalysis. Madison, CT: International
Universities Press.
Fodor, N. (1949). <birth regression in psychoanalysis>
Forer, B. R. (1969). The taboo against touching in psychotherapy. Psychotherapy: Theory, Research, and
Practice, 6, 229-231.
Fromm-Reichmann, F. (1949/1959). Insight into psychotic mechanisms and emergency psychotherapy. In
Psychoanalysis and psychotherapy: Selected Papers (pp. 55-62). Chicago: University of Chicago Press.
Hart, J., Corriere, R., & Binder, J. (1975). Going sane: An introduction to feeling therapy. New York:
Janet, P. (1925). Psychological healing: A historical and clinical study. Vols. I and II. New York:
Janov, A. (1970). The primal scream: Primal Therapy: The cure for neurosis. New York: Dell.
Janov, A. (1971). The anatomy of mental illness: The scientific basis of primal therapy. New York:
Janov, A. (1991). The new primal scream: Primal Therapy 20 years on. Wilmington, DE:
Janov, A. (1996). Why you get sick and how you get well: The healing power of feelings. West
Hollywood, CA: Dove Books.
Janov, A., & Holden, E. M. (1975). Primal man: The new consciousness. New York: Crowell.

Recommendations for further reading are in bold.

One of the best books on psychoanalytic treatment I have ever




Janus, L. (1997). The enduring effects of prenatal experience: Echoes from the womb. New York:
Jones, E. (1953). The life and work of Sigmund Freud (Vol. 1). New York: Basic Books.
Johnson, A. (1946). Variations in goal and technique. In F. M. Alexander & T. M. French (Eds),
Psychoanalytic therapy (pp. 291-324). New York: Ronald Press.
Kaufmann, W. (1974). An anatomy of the primal revolution. J. of Humanistic Psychology, 14, 49-62.
Keen, S. (1972, February). Janov and primal therapy: The screaming cure. Psychology Today, 43-44, 46,
86, 88-89.
Kelley, C. R. (1972). Post-primal and genital character: A critique of Janov and Reich. J. of Humanistic
Psychology, 12, 61-73.
Khamsi, S. (1984). Primal perspectives in psychotherapy. Aesthema, 4, 7-24.
Levitan, A., & Johnson, J. (1986). The role of touch in healing and hypnotherapy. American J. of Clinical
Hypnosis, 28, 218-223.
Lowen, A. (1967). Betrayal of the body. New York: Collier.
Lowen, A. (1971). The language of the body. New York: Collier.
Lowen, A. (1975). Bioenergetics. New York: Coward, McCann, & Geoghagan.
Lowen, A., & Lowen, L. (1977). The way to vibrant health. New York: Harper & Row.
Magid, K., & McKelvey, C. A. (1987). High risk: Children without a conscience. New York: Bantam
Books. (a popular paperback based on Foster Cline's work)
Mandelbaum, D. (1998). The impact of physical touch on professional development. In E. W. L. Smith, P.
R. Clance, & S. Imes (Eds.), Touch in psychotherapy: Theory, research, and practice (pp. 211-219). New York:
Guilford Press.
Maroda, K. J. (1999). Seduction, surrender, and transformation: Emotional engagement in the
analytic process. Hillsdale, NJ: Analytic Press.27
Miller, A. (1984). Thou shalt not be aware: Society's betrayal of the child. New York: Farrar, Straus
& Giroux.
Miller, A. (1994). The drama of the gifted child: The Search for the true self, completed revised and
updated (trans. by Ruth Ward). New York: Basic Books.
Nichols, M. P., & Zax, M. (1977). Catharsis in psychotherapy. New York: Gardner Press.
Nunberg, H., & Federn, E. (1963). Minutes of the Vienna Psychoanalytic Society. IUP.
Pierce, R. A., Nichols, M. P., & Dubrin, J. R. (1983). Emotional expression in psychotherapy. New York:
Gardner Press.
Prochaska, J. O. (1979). Systems of psychotherapy: A transtheoretical analysis. Homewood, IL: Dorsey
Rand, N., & Torok, M. (1997). Questions for Freud: The secret history of psychoanalysis. Cambridge,
MA: Harvard University Press.
Reich, W. (1942). Discovery of the Orgone: Vol. 1, The Function of the orgasm, 2nd ed. (Trans. T. P.
Wolfe). New York: Orgone Institute Press.
Reich, W. (1949). Character analysis, 3rd ed. Trans. V. R. Carfagno. New York: Touchstone Books.
Reich, W. (1967). Reich speaks of Freud. Farrar, Straus & Giroux.
Ricoeur, P. (1970). Freud and philosophy. Hew Haven, CT: Yale Univ. Press.
Rockwell, S. (1984). Fantasy and the self. Contemporary Psychotherapy Review, 2, 80-96.
Rockwell, S. (1998). Modern Kleinians of London: The "experience near" approach. Seminar of the New
York Freudian Society, Washington, DC.
Rosenbaum, L. (2000). Use of touch in psychotherapy and psychoanalysis. Unpublished manuscript.
Schoenewolf, G. (1990). Turning points in analytic therapy: The classic cases. Northvale, NJ: Aronson.
Stuart, J. (1998). The Analyst's Pregnancy. In S. Lazar (Chair), Discussion Group at American
Psychoanalytic Association Fall Meeting in New York.

One of the best books on psychoanalytic treatment I have ever




Vereshack, P. (1999). The psychotherapy of the deepest self, 4th ed. Toronto: Life Perspectives.28
Volkan, V. D., Cilluffo, A. F., & Sarvay, T. L., Jr. (1976). Re-grief therapy and the function of the linking
object as a key to stimulate emotionality. In P. Olsen, J. Fosshage, K. A. Frank et al. (Eds.), Emotional flooding (pp.
179-224). New York: Human Sciences Press.
Welch, M. (1989). Holding time. New York: Simon & Schuster. Wilson, J. M. (1982). The value of
touch in psychotherapy. American J. of Orthopsychiatry, 52(1), 65-72.
Winnicott, D. W. (1965). Maturational processes and the facilitating environment. New York:
International Universities Press.
Witty, S. K., & Khamsi, S. K. (1995). The seven stages of primal therapy. Primal Renaissance: The J. of
Primal Psychology, 1(2), 22-33.
Other Writings on the Use of Abreaction in Psychotherapy
Wright, C. (1999, Fall). <article in> Pathways29.

abreaction...................................................9, 14, 15

organismically...............................................5, 7, 29

acting out............................................14, 22, 24, 26

Primalling..............................................1, 14, 16, 19

Catharsis................................................1, 10, 14, 28

reconnection.....................................................7, 22

connecting.....................................14, 17, 22, 25, 26

regressed...................................................6, 8, 9, 25

disconnection...................................................7, 12

reliving........1, 5, 7, 9, 10, 14, 15, 16, 17, 22, 23, 29

observing ego................................................5, 6, 16


organismically--by reliving the experience physically just as it happened.

Janov discovery
Patients report being "in" the trauma; it's as if the trauma is happening again
getting into your feelings
first needs to get fully in touch with and fully emotionally connect with the repressed experience or material.


available on Internet


local magazine in Washington, DC