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Abreaction

Lakehead Psychiatric Hospital, PO Box 2930, Station P, 580 Algoma Street North, Thunder Bay ON P7B 5G4, Canada

Sir: The efficacy of barbiturate-facilitated abreaction in the investigation and treatment of mental disorders has been well documented since 1930, when Bleckwenn carried out his pioneer work. Dysken et al (1979), reviewing the North American literature, cited 52 studies in which the procedure was found to be useful, and there have been no reports of permanent harm. If this valuable technique were to disappear from the therapeutic armamentarium, as suggested by the results of the Wilson survey (Psychiatric Bulletin, February 2002, 26, 58-60), it would be a most unfortunate development.

An explanation for the disuse of abreaction may be found in the nature of the procedure as it is usually performed. Psychiatrists are unskilled in parenteral administration and lack confidence in their ability to cope with respiratory depression or laryngospasm. These hazards are eliminated if the necessary drugs are given by mouth.

We have found that the oral administration of up to 300 mg of amobarbital with 80 mg of methylphenidate produces an abreactive state in which the patient can talk freely about sensitive issues and release the corresponding emotions. Addition of the stimulant to the barbiturate combats somnolence and promotes a smooth flow of speech. Employing this method we have enjoyed a number of successes in the treatment of post-traumatic stress disorder.

We believe that abreaction is a unique therapeutic instrument that should be preserved and used more widely than at present.

References

BLECKWENN, W. J. (1930) Narcosis as therapy in neuropsychiatric conditions. JAMA, 95, 1168-1171.

DYSKEN, M. W., CHANG, S. S., CASPER, R. C., et al (1979) Barbiturate-facilitated interviewing. Biological Psychiatry, 14, 421-432.[Medline]

This Article Submit an eLetter Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Denson, R. Search for Related Content PubMed Articles by Denson, R.