Abreaction

Abstract: I will end by summarizing the four main points of the hypothesis I have put forward: The final result of psycho-analytic therapy is to enable the neurotic patient's whole mental organization, which is held in check at an infantile stage of development, to continue its progress towards a normal adult state. The principal effective alteration consists in a profound qualitative modification of the patient's super-ego, from which the other alterations follow in the main automatically. This modification of the patient's super-ego is brought about in a series of innumerable small steps by the agency of mutative interpretations, which are effected by the analyst in virtue of his position as object of the patient's id-impulses and as auxiliary super-ego. The fact that the mutative interpretation is the ultimate operative factor in the therapeutic action of psycho-analysis does not imply the exclusion of many other procedures (such as suggestion, reassurance, abreaction, etc.) as elements in the treatment of any particular patient.

Abstract: The authors review the evidence for the efficacy of the sodium amytal interview with particular reference to psychiatric emergencies and rapid assessment and treatment. Amytal interviews have a valid role in the assessment and initial management of catatonia, hysterical stupor, and unexplained muteness as well as in distinguishing between depressive, schizophrenic, and organic stuporous states. Valid therapeutic indications include the abreaction of traumatic neurosis, recovery of memory in amnesic and fugue states, and recovery of function in conversion disorders. The authors offer a protocol for application of the amytal interview in emergency settings.