ABREACTIONS, TRANSFERENCE AND COUNTERTRANSFERENCE
By Jimmy Petruzzi
An abreaction is defined as “the expression and consequent release of a previously repressed emotion, achieved through reliving the experience that caused it (typically through hypnosis or suggestion)”. As a type of catharsis, it is a method of becoming conscious of repressed traumatic events. The concept was introduced by Sigmund Freud in 1893.
In therapeutic settings, abreaction therapy is akin to exposure therapy in the treatment of post-traumatic stress. As can be imagined, reliving an extremely traumatic experience can be highly distressing as the person is retraumatized.
During hypnosis, an abreaction is a negative response that is caused by bringing unpleasant or uncomfortable memories into awareness. Such a response can involve crying or anger. Some hypnotists seek to limit these experiences while others utilize it as part of the therapy process. If the decision is to use it, the set-ting must be controlled and the abreaction acknowledged by address-ing the concerns of the client.
It is important to emphasize that hypnosis is a voluntary act and patients always remain in control of their actions and can end the hypnotic state at any time of their choosing. Abreaction therapy is mostly used with victims of child abuse and chronic PTSD, as it is helpful in recovering dissociated or repressed traumatic material, reconnecting missing affect with recalled material and for transforming traumatic memories (Putnam, 1992).
In these cases, abreactions are induced with the prior consent of the client and help to elicit information or stimulate memory. When an intense induced or spontaneous abreaction occurs, the hypnotherapist calmly confirms that the client is safe and guides them to a more com
fortable place. A spontaneous abreaction is very common in daily life as a sensation, a chord of music, a smell, takes us unexpectedly back to a memory of a specific moment.
To manage unwanted abreactions, the hypnotist sets up a resource anchor, which is a trigger for some powerfully positive emotion. S/he also helps the client to dissociate from the abreaction by moving them to another scene in their mind.
Transference and Countertransference
Transference is defined as an unconscious redirection of feelings from one person to another, or, in the Freudian sense, “the inappropriate repetition in the present of a relationship that was important in a per-son’s childhood”. It is natural to have some form of entanglement when people interact, including a hypnotherapist and client. In therapeutic settings, the most common transference dynamic is when the client redirects feelings for a significant person to the therapist.
These can include attraction, anger, hatred, mistrust, dependence, or awe.
Where psychotherapists typically try to avoid transference developing in therapy, evidence of the projection of certain feelings by the client can be very helpful to explore underlying issues. The hypnotherapist should accept it and not resist it. When transference issues become evident, explore and clarify it by careful questioning. These aspects are dealt with during the pre-talk and education about hypnosis, before the hypnotherapy gets fully underway.
One of the dangers of transference developing in hypnotherapy is that the client may become dependent upon the therapy or therapist, which has the potential to derail the effectiveness of the hypnosis as the client will not be inclined to accept responsibility, which is an important part of hypnosis and its outcome.
In contrast, countertransference is defined as redirection of a therapist’s feelings toward a patient, or more generally, as a therapist’s emotional entanglement with a patient. People tend to make instinctive assessments of someone else based on their experiences and beliefs—hypnotherapists are no different, although more aware of possible biases and assumptions. A hypnotist should avoid impressing any unwanted thoughts or feelings on to the client. Always remember how important it is to stay on script and have words and body language fully consistent with the intended message. Otherwise, there will be contradictions and ambiguous messages that will counter the effective-ness of the hypnosis.
This article is for educational purposes only
Putnam, F. W. (1992). Using hypnosis for therapeutic abreactions. Psychiatric Medicine, 10(1), 51-65.