Catharsis venting and the talking cure

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bullet  Relevance of emotional processing to psychological therapy
bullet  Reprint of article ‘Emotional processing model for counselling and psychotherapy: a way forward’ from Counselling in Primary Care
bullet  Is it possible to bottle up emotions?
bullet  Core components for an emotion therapy
bullet Is behaviour therapy really emotion therapy in disguise?
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One of the shared procedures of nearly all psychological therapies is that the patient talks, shares, explores or explains.  Verbalisation is central.  Patients talk and therapists listen.  This takes us back to the beginning of psychological therapy.  In 1880, Breuer told Freud about the treatment of a woman with hysterical symptoms, involving paralysis, fits and states of mental confusion.  His treatment had ‘allowed him to penetrate deeply into the causation and significance of hysterical symptoms‘ (Freud 1910).  Breuer discovered that the patient could be relieved of her symptoms by expressing what was troubling her whilst under hypnosis.  Freud and Breuer worked together producing a preliminary communication ‘On the psychological mechanism of hysterical phenomena’ in 1893 and a book ‘Studies in Hysteria’ in 1885.  Their method was referred to as the “Cathartic Method”.

The patient herself referred to this process as her ‘talking cure’.  Freud later dropped the hypnotic element of the therapy, concentrating on talking.  However, Freud regarded this theory as ‘unpretentious’ and saw the cathartic method as a transition to ‘psychoanalysis proper’, where the emphasis shifted from expressing thoughts and feelings to uncovering the hidden unconscious conflicts underlying symptoms.  Conscious insight became the primary goal of psychoanalysis rather than catharsis.

The idea of catharsis can be traced back to Aristotle’s definition of a tragedy as being a dramatic work ‘with incidents arousing pity and fear, wherewith to accomplish its catharsis of such emotions’.  Experiencing powerful emotions in vicarious form could purge, purify, release or morally re-educate those watching the tragedy.  Milton, Montaigne, Boswell and other literary figures refer to this concept of ‘purging the mind of those (pity and fear) and such life passions, that is to temper and reduce them to just measure’ (Milton).  The Greek word katharsis comes from kathairein (to purge) and from katharos (pure).  The meaning of purging the stomach or the bowels of impurities with purgatives and laxatives has been a major medical sense in which the word has been used over the centuries.  It has been Freud’s writings that have further developed the psychological concept of purging emotions, originally proposed by Aristotle.

The idea that expressing our feelings is healing and restorative, whilst bottling up, suppressing or hiding them is a danger to our health, is a widely held belief in the west.  It is common for psychological therapists to hear patients talk of the relief of sharing their feelings and to see many examples of how unearthing and talking about traumas and hurts, previously suppressed, can bring much relief to patients.  Although different psychological therapies may have varying understandings of how expressing emotions may operate, most endorse or encourage expression.  Some therapies (Gestalt, Reichian, Primal Scream) emphasise the element of discharging affect; others emphasise the explanation or understanding of events involved in emotional expression (emotional focusing, person centred therapy); others the act of putting emotions into words (structured guided therapy); others exposure to noxious memories, affects or emotional stimuli (exposure therapy); and yet others as a vehicle for reconstructing cognitions (rational emotive therapy) or reconstructing relationships (object relations therapy).

In ‘Expressing Emotions‘ 1999 Kennedy-Moore & Watson proposed a venting hypothesis which refers to the idea that expressing emotion reduces negative emotional experience and psychological arousal, assuming that the bigger the expression of distress the greater the relief.  The beneficial effects are immediate and are the direct result of expression rather than operating in a cognitive or interpersonal level.  This is presented as a sort of operationalisation of the catharsis concept, allowing it to be experimentally tested.  The emotional venting hypothesis attempts to capture the essence of the ‘hydraulic model of emotion’ which is that it is important to ‘let emotions out’ rather than ‘bottle them up’.

A geyser spewing water --- Image by © Royalty-Free/Corbis
A geyser spewing water — Image by © Royalty-Free/Corbis

The venting hypothesis appears to have been particularly applied to the expression of anger.  The Kennedy-Moore & Watson review in the book (1999), review by Bushman (2002) and the influential writings of Tavris (1984, 1989) suggests that at the experiential, behavioural or physiological level, short term expression of anger does not bring relief but often the contrary – it heightens tension.  The title of the chapter in which Kennedy-Moore & Watson propose the venting hypothesis is ‘The myth of emotional venting’ so the overall purposes of operationising catharsis seems to enable it to be disproved.

Another stream of debate about catharsis comes from a different perspective; an anthropological approach in which ritual was argued (by some such as Malinowski) to help individuals process cultural losses and uncertainties: whereas others (such as Evans-Prichard and Levi-Strauss) disagreed.  Similar to the venting controversy, it was argued that vicarious or symbolic events leading to emotional feeling could be just as destructive as they could be purging.

One of the problems with the venting hypothesis is whether it is an adequate operationalisation of catharsis.  It is certainly equated with catharsis (Kennedy-Moore & Watson 1999) and conclusions about the ineffectiveness of venting are taken to apply to the ineffectiveness of catharsis.  In the psychotherapy literature, catharsis applies to the reliving of significant traumatic events, often from childhood, which have not been adequately emotionally processed and which are addressed during the process of therapy.  These are significant personal events re-lived or re-experienced, often with strong emotional reactions.  Patients may feel immediate relief in one session but often require a number of sessions in order to fully work through the event.  Therapists may instruct patients that they may feel worse at first, before the material is properly explored and while further memories are being retrieved, but that over a period of time, there will be resolution and relief.

Venting, whilst not excluding this, seems to refer to more short term daily hassles rather than long term significant personal events.  It is not set within a psychotherapeutic context, but applies more to everyday living and experimental psychology paradigms.  Venting differs from catharsis in being closer in time to the trigger event (hours rather than years), less severe (an argument rather than say sexual or physical abuse) and with no reference to it having previously been suppressed, not dealt with, or inadequately processed, probably over a period of years.  It is not surprising that the experimental psychology literature on venting can be at variance with the psychotherapist’s understanding of catharsis.  Catharsis may still be relevant as a concept if attention was paid to what factors make an emotional discharge therapeutic and what factors make it unhelpful or non-therapeutic.