Abreaction in Somatic Therapy: Healing Release or Re-Traumatisation?

Emotional expression during a therapeutic session — often called abreaction — is defined by the Oxford online dictionary as “the expression and consequent release of a previously repressed emotion, achieved through reliving the experience that caused it.” In simple terms, it is when old feelings rise to the surface and find release through crying, shaking, yelling, or other emotional outbursts. The image of cathartic release has been romanticised in many healing traditions, but the real question remains: how desirable is this in practice? Can abreaction in somatic therapy always be seen as healing, or can it sometimes be destabilising?

Understanding the Nervous System: Window of Tolerance and Polyvagal Roots

To explore this question, it’s useful to look at the nervous system. Dan Siegel’s concept of the Window of Tolerance (1999), which has strong connections with Stephen Porges’s Polyvagal Theory, describes the optimal state in which we can process experiences without becoming overwhelmed. Within this window, our nervous systems naturally fluctuate: for example, we may feel alert when a door suddenly opens, then calm again as we settle back into reading a book. These micro-shifts are healthy and normal.

“Trauma is not what happens to us, but what we hold inside in the absence of an empathetic witness.” — Peter A. Levine

For those who have experienced trauma, however, this flexibility can be compromised. Their nervous systems may swing rapidly into states of hyperarousal (fight-or-flight) or hypoarousal (shutdown, numbness). When abreaction occurs outside the Window of Tolerance, the client is not simply “releasing emotion” — they may be reliving traumatic memories in a way that overwhelms the body and mind. What might appear as catharsis on the outside can in fact reinforce patterns of fear and helplessness on the inside.

Why Uncontained Abreaction Can Be Unhelpful — or Re-Traumatising

When I was first trained, I was encouraged to facilitate strong emotional releases. The theory was that “stuck energy” needed to be shaken loose, and that loud sobbing, screaming, or shaking was evidence of deep healing. But in practice, many clients returned to me reporting the same problems, unchanged. Some even reported feeling unsettled after sessions.

Over time and with further training, I began to understand that not all expressions of emotion are therapeutic. If a client is pushed — or inadvertently allowed — to go far outside their Window of Tolerance, the nervous system doesn’t integrate the experience; instead, it becomes flooded. The individual may walk away re-traumatised rather than relieved.

This insight shifted my approach. I now pay careful attention to the arousal levels of the nervous system throughout sessions. Rather than striving for “big release moments,” I focus on helping clients cultivate down-regulation skills — tools they can use to soothe and anchor themselves if overwhelming emotions arise. This ensures that they leave a session with more stability, not less. Here are 5 tips to down-regulate your own nervous system out of states of hyperarousal.

When Abreaction Can Be Healing

That said, emotional expression is not inherently harmful. In fact, when approached with sensitivity, abreaction can become an important doorway to healing. The key lies in pacing and containment.

A client does not need to avoid emotional expression altogether. The therapeutic value comes from helping them stay close to their Window of Tolerance, or to stretch it gradually, rather than catapulting them far beyond it. This gentle expansion allows difficult feelings to surface without overwhelming the system.

The Role of Titration and Pendulation

Two concepts that guide this process are titration and pendulation. Titration means introducing small doses of emotional activation, like adding one drop of medicine at a time rather than flooding the system. Pendulation means intentionally moving between states of activation and calm — allowing the body to feel a difficult emotion briefly, and then guiding it back toward a sense of safety and grounding.

Did you know? In psychotherapy, abreaction refers to the release of repressed emotions. While it can provide temporary relief, most therapists emphasise that integration, grounding, and safety are essential for lasting healing.

Together, these practices create a rhythm in which healing becomes possible. Instead of being swept away by a tidal wave of emotion, the client learns that they can dip into the waters of their past and return safely to shore. This rhythm builds resilience and supports integration. Over time, the nervous system develops a greater capacity to process intensity without shutting down or spiralling out of control.

One client who carried early childhood fear would begin to tremble when recalling certain memories. By encouraging them to notice a comforting physical sensation — a blanket’s warmth, the steadiness of their breath — we practiced pendulation. The trembling no longer swallowed them whole; instead, they could touch the fear briefly and then return to safety. This built a growing sense of mastery and self-trust.

Expanding the Healing Process: Practical Considerations

There are several additional aspects that can make abreaction safer and more effective within somatic sex therapy (also known as tantric healing or therapeutic tantric bodywork). Encouraging clients to track sensations such as breath, heart rate, or muscle tension gives them real-time indicators of whether they are within their Window of Tolerance. This kind of somatic awareness becomes a compass in the session.

It is equally important to offer clear education: emotional release alone does not equal healing. Healing comes when experiences are integrated into a larger sense of safety and self-understanding. Therapists must also be attentive to their own regulation. If we, as practitioners, become anxious or swept away, we cannot hold the grounded presence that allows the client to feel safe.

What happens after a session is just as vital as the work that unfolds within it. Gentle aftercare practices — such as journaling, grounding walks, or creative expression — allow the nervous system to continue processing and integrating what has arisen. Another powerful tool is the practice of gratitude. By consciously turning attention toward what is working in our lives, even in small ways, gratitude helps to anchor positive shifts and stabilise the healing process. It offers the nervous system a sense of safety and resourcefulness, which can secure any changes made during the session. At the same time, cultural sensitivity is essential. For some clients, emotional expression is quieter and more internal, and it is important to honour these subtler forms of integration rather than assume that louder or more dramatic release is more effective.

Simple practices such as checking in with clients — “Is this pace OK?” — give them agency and strengthen trust. Finally, rooting bodywork in wider trauma research reinforces that healing is about integration, containment, and growth, rather than spectacle.

Conclusion

Abreaction can be both a gift and a risk. When emotions are expressed within the safety of the Window of Tolerance, with careful pacing and support, they can lead to powerful reconnection and growth. But when pushed too far or too fast, abreaction risks reinforcing trauma rather than resolving it.

As practitioners, our role is not to chase emotional fireworks but to create spaces where clients can meet themselves gently, with containment and respect. Through titration, pendulation, and a commitment to trauma-informed practice, abreaction can transform from a raw discharge into a deeply healing experience. 

Trauma-Informed Somatic Therapy and Emotional Safety