Durham E-Theses Catharsis in psychotherapy Hawkins, Peter John How to cite: Hawkins, Peter John (1986) Catharsis in psychotherapy, Durham theses, Durham University. Available at Durham E-Theses Online: http://etheses.dur.ac.uk/6884/ Use policy The full-text may be used and/or reproduced, and given to third parties in any format or medium, without prior permission or charge, for personal research or study, educational, or not-for-prot purposes provided that: • a full bibliographic reference is made to the original source • a link is made to the metadata record in Durham E-Theses • the full-text is not changed in any way The full-text must not be sold in any format or medium without the formal permission of the copyright holders. Please consult the full Durham E-Theses policy for further details. Academic Support Oce, Durham University, University Oce, Old Elvet, Durham DH1 3HP e-mail: [email protected] Tel: +44 0191 334 6107 http://etheses.dur.ac.uk CATHARSIS IN PSYCHOTHERAPY Thesis submitted for the degree of Ph.D. University of Durham by Peter John Hawkins May, 1986 The copyright of this thesis rests with the author. No quotation from it should be published without his prior written consent and information derived from it should be acknowledged. -·', .. ACKNOWLEDGEMENTS Throughout the time of the preparation of this thesis I have been actively encouraged, and wisely counselled by my supervisor Dr. Arthur Still. I warmly appreciate his active support. Special thanks must also go to all the co-researchers who attended the weekly research sessions. Without their enthusiastic and consistent support the research inquiries would not have been possible. i CONTENTS Acknowledgements ................................... i Abstract ......................................... iii List of Figures .................................... v List of Tables .................................... vi Chapter One Catharsis in Retrospect ............ l Chapter Two Catharsis in Psychotherapy ........ 21 Chapter Three The Effectiveness of Catharsis - Research Evidence ............•.... 95 Chapter Four Research Inquiry One ............. l38 Chapter Five Research Inquiry Two ............. l87 Chapter Six Catharsis: Clinical Application .. 239 Appendix One Catharsis Research Schedule ...... 263 Appendix Two Techniques .............•......... 271 Appendix Three Tab 1 e s •..••.....••.•.•••.......•. 2 8 6 Appendix Four Physiological Data: Inquiry One .. 294 Appendix Five Physiological Data: Inquiry Two .. 302 Appendix Six California Personality Inventory: Scale Descriptions, Profile Sheets, & Results ............•... 313 Appendix Seven Personal Reports ................. 328 References • •..•..........•....................... 3 4 0 ii ABSTRACT Catharsis in The historical context of catharsis in psychotherapy is discussed, with particular reference to drama and ritual. The 'cathartic technique' of Freud and Breuer is then presented as part of the continuing development of approaches that advocate feeling-expression as a way of promoting personal change. The contemporary approaches considered include Rei~hian therapy, bioenergetics, primal therapy, and reevaluation counselling. Heron's theory of catharsis in human development is emphasized, and is central to the two experiential research inquiries presented later. The evidence for the efficacy of catharsis is reviewed from the perspective of the various 'schools' of emotionally-expressive therapy, and reference to the psychosomatic and bereavement literature is also made. Two research inquiries are presented which investigate the effects of catharsis on human functioning. A new paradigm experiential approach was adopted in which co-researchers engaged in a collaborative inquiry. 'Inside' measures of subjective experiencing, contingent upon emotional catharsis, were gathered through self-report, as well as 'outside' measures of blood pressure, pulse rate, and personality functioning. Results suggest that iii physiologic tension decreases following somatic emotional catharsis, but that longer term changes in psycho-somatic functioning require the development of insight into ~he genesis of the 'symptom', as well as complementary therapeutic strategems. It is further suggested that the development of insight is contingent upon historical somatic catharsis. The results also show that where cognitive catharsis occurs without affective release, an increase in psycho-physiologic tension is effected, as shown in both the physiological measures and subjective experiencing. Finally, the implications of catharsis for therapeutic practice are discussed. iv TABLES Table 1 Changes in blood pressure following emotional catharsis- Inquiry One ........... 286 Table 2 Changes in pulse rate following emotional catharsis- Inquiry One ........... 287 Table 3 Total number of cathartic events ............ 288 Table 4 Changes in blood pressure following emotional catharsis- Inquiry Two ........... 289 Table 5 Changes in pulse rate following emotional catharsis- Inquiry Two •.......... 290 Table 6 Catharsis: Summary- Inquiry Two ............ 291 Table 7 Total cathartic events- Inquiry Two •....... 291 Table 8 Changes in baseline blood pressure .......... 292 Table 9 Changes in baseline pulse rate ....•.•.••.... 292 Table 10 Differences in standard scores between pre- & post- inquiry measures on the CPI ......... 293 Table 11 Incidence of somatic emotional catharsis (historical), insight, & mean changes on the CPI scales .............................. 293 FIGURES Figure 1 Summary chart of Heron's theory of Catharsis in Human Development ........... 88 Figure 2 Relationship between insight and mean changes on the CPI scale ................ 224 Figure 3 Relationship between number of somatic emotional cathartic events and mean changes on the CPI scale ................ 225 Figure 4 A model for change ...•.................. 252 vi CHAPTER ONE CATHARSIS IN RETROSPECT And with tears of blood he cleansed the hand, The hand that held the steel hlAArl For onlv- ---..I. blood can wipe out ....,,..._,.._, ...... , And only tears can he a 1 ........... (Oscar Wilde) Emotional occasions, especially violent ones, are extremely important in precipitating mental rearrangements. (William James) Catharsis derives from the Greek katharsis me~ning 'to clean or purify'. However, the term has taken on different meanings in different contexts. In a medical context, it referred to purgation, or the elimination of offensive humours. In a religious context it means rebirth or initiation, and in a moral and spiritual context it refers to relief of the soul and spirit by purification. Thus its semantic origins suggest that catharsis has always included two ideas: purgation or purification; and rebirth or initiation into a new state. Inherent within this view of catharsis is that of emotional discharge which brings relief to emotional tension, and a concomitant or consequent change in the individual's state of being, with 1 appropriate emphasis given to somatic, psychological or spritual dimensions. The value of catharsis has been debated for more than 2000 years, commencing with Aristotle's response to Plato's condemnation of drama for arousing the passions. Aristotle, in writing of catharsis achieved through art, music and drama, emphasized its aspect of purgation. These art forms drive the passions to a peak and then exorcise them. Tragedy arouses pity and fear, and purges these emotions; it is therefore of value despite the attacks of certain moralists and philosophers. In the Poetics he wrote, "Tragedy, then, is the representation of an action that is serious, complete, and of a certain magnitude; in language pleasurably and variously embellished suitably to different parts of the play; in the form of actions directly presented, not narrated; with incidents arousing pity and fear in such a way as to accomplish a purgation (katharsis) of such emotions." It should be noted at this point that Aristotle did not state that a similar purging of hostile and angry feelings may also occur and may not even have believed it possible, although many modern writers (e.g. Feshbach, 1961) have made such an assumption. Emotions are aroused and then purged because the audience is able to identify with the tragic hero to the extent that his pain has relevance and meaning to them. The 2 Aristotelian concept of tragedy is thus not simply a passive intellectual exercise, but a profound upheaval, charged with emotion through similarities tragic hero's experience and the audience's experiences. The shock of the emotional arousal and purgation helps to rearrange perception and so leads to a modification of the audience's self concept and world view. Aristotle believed that the powerful intellectual and affective experience of having anxiety dissolve in tears fosters personal exploration and development. However, Aristotle did not define catharsis nor did he describe very clearly the conditions under which it occurs and the specific consequences it may have. Whatever Aristotle's intention may have been, his doctrine of tragic catharsis has been conscripted as a rationalization of Western man's inability to accept emotions as natural, and the resultant need to approach the affects through ritual which is supposed to serve some 'higher' purpose. Plato had already banished poets from his Republic, making his gravest charge that by writing tragedy the poet gratifies and indulges the natural instinct for tears and the desire to give full vent to our sorrows, and thereby has a terrible