See Postabortion Counseling.

Abortion Counseling

Abortion Counseling

See Postabortion Counseling.

Abraham, Karl

Abraham, Karl

(1877-1925). Pioneer German psychoanalyst and founder of the Berlin Society of Psychoanalysis (1908). Abraham was born in Bremen into a well-established and highly cultured Jewish family. His father gave up being a teacher of Hebrew religion for economic reasons, and Karl early abandoned the Jewish faith. His writings reflect no interest in religion, this being in marked contrast to his friend and mentor, Sigmund Freud.

Following the standard German preparatory education Abraham received his medical degree from the University of Freiburg in 1901. Thereafter he became deeply interested in philology and linguistics, and he learned to speak five languages, read several others, and even analyzed some patients in English.

Abraham's first position was at Burgholzi Mental Hospital in Zurich. He became assistant to Eugen Bleuler and studied with Carl Gustav Jung, who in 1907 introduced him to Freud. In that same year Abraham published his first paper, which began with the phrase "according to Freud." It was a prophetic beginning. Abraham, among all Freud's disciples, never deviated either from personal loyalty to Freud or from the classical principles of psychoanalysis. However, he was soon alienated by Jung's personality and by what he saw as Jung's threats to the scientific status of psychoanalysis. Despite Freud's pleadings the two men were never reconciled, and Abraham soon left Zurich to establish a practice in Berlin. This practice flourished, and among his analysands were several who became respected analysts, including Karen Horney, Sandor Rado, Helene Deutsch, Melanie Klein, and two American physicians, James Glover and Edward Glover. Thus Abraham brought to the fledgling psychoanalytic movement considerable prestige, and his contributions have lasted far beyond his own brief lifetime.

Abraham's total literary output was fewer than 700 pages, consisting of 4 short books and 49 papers, all but 8 of which dealt with the theory and practice of psychoanalysis. Nevertheless, he made important contributions to the psychology of sexuality, character development, myths, dreams, symbolism, and folk psychology. His most important theoretical contribution was his delineation of the etiology and dynamics of bipolar disorder.

Q. R. De Young



A psychotherapeutic process wherein previously repressed feelings are brought to conscious awareness and given expression. These feelings are usually associated with past traumatic experiences. Their expression, therefore, is usually accompanied by considerable emotional discharge. Getting rid of these pent-up emotions may provide the patient with insight into the causes of unrealistic or immature behavior and allow these behaviors to be modified or eliminated.

Reliving the repressed experiences is sometimes aided by hypnosis or by drugs such as sodium amytal (see Narcotherapy). Specialized techniques in Gestalt therapy, primal therapy, and psychodrama are also often useful in achieving abreaction.

The method used to bring about abreaction is called catharsis. Abreaction refers to the end result. Abreaction and catharsis are, however, often used synonymously.

G. A. Johnston

See Catharsis; Emotion.

Abstinence, Sexual

Abstinence, Sexual

Contrary to popular opinion, refraining from sexual activity is not psychologically harmful. Sexual energy can be strong, but its expression is not essential for maintaining physical or emotional health.

Sexual abstinence is the only foolproof way to avoid both unwanted pregnancies and sexually transmitted diseases (STDs). However, trying to force abstinence on sexually active persons for these reasons will almost certainly fail.

Sexual abstinence is not normative for human beings. For most people sexual partnership and family life are the best choices. Although sexual abstinence can be a healthy way of life for spiritual reasons, some motives for it are faulty.

Various fears of or repugnance for sexuality lead to abstinence in some people. Such sexual abstinence is usually not psychologically healthy. All who practice abstinence out of such motives are best served by counseling that will relieve their misperceptions or troubled emotions.

Some people refrain from sex out of fear of the opposite sex. Some have been abused as children and shun sexuality because it brings up painful emotions that have not been adequately processed. Others refrain because of fear of disease or pregnancy. People with excessively puritanical upbringing may equate sexuality with evil or dirtiness. Their disinclination to sexual activity is also not healthy.

Some people choose sexual abstinence for moral reasons. Those who consider all sexual activity outside of marriage sinful usually try to practice abstinence. Most often this is temporary until they marry. Those who remain unmarried but consider abstinence the moral choice may have periods of great conflict over their desires.

Moral demands sometimes make sexual expression within marriage problematic. Sometimes sexual activity during pregnancy is contraindicated. For health reasons women ought to refrain from sexual activity for some weeks after giving birth. Those who consider contraception immoral must practice periodic abstinence to avoid inopportune pregnancies. Known carriers of sexually transmitted diseases may need to be abstinent out of consideration for a disease-free spouse.

Choosing sexual abstinence as a lifelong option for spiritual reasons holds a venerable place in many world religions. When the motive is to have more time either for spiritual practice or to serve other people, it can be a positive and life-fulfilling choice.

Monasteries and convents have long existed for those who retire from worldly activity to live lives of prayer. Some develop deep concern for and sensitivity to the suffering in the world and live truly self-sacrificial lives in prayer for others. Some sisterhoods and brotherhoods that practice sexual abstinence are devoted to missions of special service to others, such as teaching or nursing. Freedom from family responsibilities makes one's entire life available for a chosen service.

While failing to relieve sexual tension is not harmful, dishonesty with oneself about sexual feelings and urges can be. People unable to recognize their sexual urges may be pushed to act upon them without realizing what is moving them until they pass the point of stopping. Some who try to stay sexually abstinent by distorting awareness of their urges fail; they may resort to abusive or hidden ways of relieving sexual tensions.

Abstinence is easiest when motives for it are appropriate and one is in touch with what one is feeling. Those practicing either permanent or temporary abstinence for wholesome motives must be honest with themselves about sexual feelings and attractions if they are to be healthily abstinent.

M. J. Meadow

See Sexuality; Celibacy; Postabortion Counseling; Premarital Counseling.

Abstinence, Therapeutic Rule of

Abstinence, Therapeutic Rule of

Therapeutic abstinence is activity of the therapist's carefully refraining from meeting the unconscious infantile emotional demands of patients, thus allowing patients to project their own feelings upon the therapist. Abstinence is central to the process of psychoanalytic technique, but it is used in some form in all systems of therapy.

When people submit themselves to the care of a psychotherapist, they come to the therapeutic setting with mixed feelings. Patients seemingly come to therapy seeking to be cured or improved, but generally they are full of shame, desperately afraid of being discovered, and afraid of change. Therapy patients both want to change and want not to change. Patients consciously will ask for advice and seek to change, but unconsciously they wish to avoid personal change and wish for the world to change to accommodate their unrealistic expectations and fantasies. Unconsciously or consciously patients will seek to have the therapist meet these unrealistic desires and thus protect these desires from the onslaught of reality. The psychoanalytic approach proposes that the therapist refrain from meeting these emotional demands but help patients to understand them and have an unencumbered opportunity to see the unrealistic nature of these desires.

The strictest application of the rule of abstinence results in the analyst not responding to (gratifying) any of the patient's attempts to relate socially. Thus Brenner (1976) advises against shaking hands or engaging in social conversation or other social amenities within therapy. Colby (1951) moderates this absolute rule by saying that the therapist is a person as well as a therapist and that rigid attempts to avoid social and practical interaction with the patient artificially induce feelings of rejection rather than bring them to the surface. Colby agrees, however, that there is a temptation for the therapist to be seduced by patients personal interest in them. While the patients seducing includes sexuality, it is not exclusively sexual. More often patients want the therapist to agree with them and seek this agreement by covert seduction and overt asking for approval. Experts disagree as to how to deal with patients' questions; some (e.g., Greenson, 1967) believe that all questions are rhetorical and hence seductive, while others (e.g., Glickauf-Hughes & Chance, 1995) suggest that the therapist carefully differentiate among patients' questions, answering those that are practical in nature. The therapist's own narcissistic needs, including the need to be seen as kind, reasonable, and beneficent, often make it difficult to resist such attempts to enter into a neurotic alliance rather than a therapeutic alliance with patients.


Brenner, C. (1976). Psychoanalytic technique and psychic conflict. New York: International Universities Press.

Colby, K. M. (1951). A primer for psychotherapists. New York: Ronald.

Glickauf-Hughes, C., & Chance, S. (1995). Answering clients' questions. Psychotherapy, 32 (3), 375-380.

Greenson, R. (1967). The technique and practice of psychoanalysis (Vol. 1). Madison, CT: International Universities Press.

R. B. Johnson

See Psychoanalysis: Technique; Psychoanalysis: Theory; Psychoanalytic Psychotherapy.

Abuse and Neglect

Abuse, Child