Abreaction

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Abreaction is the release of strong emotion that comes when a memory you had pushed away, usually of something frightening or painful, is brought back and felt again. The word comes from early psychoanalysis, where it was thought that this release, called catharsis, was itself the cure. Today it is seen as something that can happen in therapy, not a treatment on its own.

Also called: catharsis (the release itself); emotional discharge; “abreaction therapy” (an older name for treatments built around it, including hypnosis-based and drug-assisted sessions in hospitals).

How it works

In the 1890s Josef Breuer and Sigmund Freud treated people whose physical symptoms had no medical cause by helping them, often under hypnosis, to recall the event behind the symptom and to feel what they had not been able to feel at the time. Their 1895 book, Studies on Hysteria, called this the cathartic method. Catharsis came to mean two things together: vividly remembering the event, and releasing the emotion tied to it. “Abreaction” was the name for the release.

Freud soon found the effect did not last. Hypnosis let the memory out but went around the person’s resistance instead of dealing with it, and symptoms came back. He gave up hypnosis for free association and for the slow process of working through. A third element was added to the picture over the following decades: the memory, once recovered, has to be made sense of and fitted into the rest of your life. Most modern trauma treatments keep all three parts in some form, but under careful control and with the emphasis on the third.

Abreactions still happen in therapy. Someone describing an accident, a death or an assault may suddenly shake, weep or feel the fear of that day. A good therapist slows things down, keeps you grounded in the room, and helps you put words to what came up. What they do not do is push you to relive the event for its own sake.

Risks

  • Reliving without processing can make things worse. Retelling or re-experiencing a trauma without preparation, safety and follow-up can leave you more distressed than before. Our entry on retraumatisation explains why.
  • Catharsis alone is not treatment. NICE’s guideline on PTSD says not to offer “psychologically-focused debriefing”, the single-session talk-it-all-out approach, to prevent or treat PTSD, and recommends trauma-focused CBT or EMDR instead.
  • The evidence for induced abreaction is weak. A 2010 review of drug-assisted “abreaction” for conversion disorder found 55 papers going back to 1920 and not one with a proper control group.
  • Suggestion does much of the work. In the same review, the use of suggestion during the session was itself linked with recovery, so it is hard to tell what helped, which is one reason the approach fell out of favour.

In Nigeria

Intense emotional release is familiar here, in deliverance services, in wailing at a burial, in the moment a story finally comes out at a family meeting. The release can bring real relief, and there is nothing wrong with it. The caution is the same as in the clinic: if the thing that happened to you keeps coming back in flashbacks, nightmares or a body that will not settle, the release on its own will not stop it, and being made to relive it in public, or being told to “just cry it out”, can do harm. A trained trauma therapist works at your pace and does not need every detail.

Abreaction vs working through

An abreaction is a single, intense release tied to one memory. Working through is the repeated, slower work of understanding a pattern and changing it over many sessions. Freud moved from the first to the second because the first did not hold. Psychoanalysis and modern trauma therapies share that lesson.

When to get help

If you are in crisis now, call 112 (or 767 in Lagos), or Safe Place Nigeria on 0800 800 2000. The full list is on our helplines page. If something that happened months or years ago still intrudes on your days or nights, you can book a licensed therapist on Mytherapist.ng who works with trauma and PTSD. You will not be asked to relive anything in the first session; our guide to PTSD in adults explains how treatment is paced.

Read next

This entry is awaiting clinical review. It’s based on published research and health guidelines, and we’ll update it once a clinician has reviewed it.

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