As time goes on and I learn more about the human condition, I have decided to share some of my thoughts on what we are all about. I will publish my reflections on this blog, hopefully to enlarge our understanding of what makes us human. Art Janov

Tuesday, April 22, 2014

On the Rationale for a Diagnosis


There is an article on attention problems in the NY Times (April 13/2014. “Idea of a new attention disorder spurs research.”; http://www.nytimes.com/2014/04/12/health/idea-of-new-attention-disorder-spurs-research-and-debate.html) There is the claim of an entirely new diagnostic category: Cognitive, Sluggish Tempo (CST). The brain seems not to be active enough to focus and concentrate; another facet of ADD.
 So what is wrong with that? A new category? Everything is wrong with it. .

First of all the diagnosis should inform us, not simply describe. So OK the person’s mind works slowly, does that help tell us why? Which brain is sluggish and where? The same can be said for ADD. She can’t pay attention. OK. Anyone on the street can make that diagnosis: He muses; she seems too active, her mind is racing and she cannot sit still. So what? Is that indeed a separate category? In what way?

Description alone is not a proper diagnosis. The bacteria below infection is. So if I say, he sweats, has a high continuous fever, shakes and often seems to chill that is still a description; not a diagnsos…….no cause. If I say he is depressed, that is not a diagnosis; it is a description. What is depression? What is behind it? Oh, I see, he seems sad and down, has no energy and moves in labored fashion; is that any different from what the ice cream vendor could say about him? I doubt it. If we find that the vendor’s description parallels the doctor’s, throw them both out; no, save the vendor’s.

And there is then the other type of error in diagnosis. “His locus ceruleus is too active and there is an anomaly in his hippocampus”. In short, he is only a bunch of neurons and some seem deviated. No connection to his life, now or previously, no human touch; pure neurology. What’s wrong? It is a diagnosis in a vacuum. The same for biochemistry. We are not just cortisol; we are humans who respond to EVENTS with changes in biochemistry. No event, no real diagnosis. Unless we really do live in a vacuum.

And how about psychology?

Yes we have made all the diagnoses and see that the brain runs too fast and with far too high amplitude……he is therefore “”. And once we are certain of our diagnosis we rush to give drugs that are proven to slow down the brain? And they do achieve that and the person is far less anxious.
I forgot to ask, does he have a history? Traumas, lack of love, etc? Was there a key traumatic experience? Was there a trauma at birth or during gestation? When we have no frame of reference on the human level we are wandering in the dark, acting on half truths. …seeing only part of the brain and only part of the human.

We need a diagnosis, especially in psychology that is more encompassing; that goes below the obviously observable. That really explains and tries to find origins. It is not enough to find medicine to ease anxiety without ever knowing what it is and how to deactivate and decouple if from pushing our brain so hard. Until we do that we are forever in danger of recidivism; of it coming back again and again so long as the cause remains intact.

Worse, so long as the primal source remains intact there will be a need to drug the symptom and that is partially what this discussion is about: drugs for symptoms. Big Pharma at work. They have no incentive to find causes and put themselves out of business; so long as they dominate research and medication we become the losers. The source is what provokes the symptoms into life. The problem is that the source and origins are imprinted and can stay for a lifetime. And that is not just in the brain; the cells are found throughout the system, which is why cognitive therapy is lame against early imprints. It is not just ideas; it is in the lungs and kidneys, in the heart and blood vessels.

Let me tell you about a sluggish brain. In my earlier books I describe 2 kinds of birth; sympathetic nervous system dominance due to child successfully struggling to get out; and the parasympathetic birth where there was no possibility to move through the canal easily—a blockage. This describes the active person with an active brain versus a slugish person with a sluggish brain and that works more slowly….the sympath versus the parasympath. This is a complete systemic event and is not limited to brain function.

 There is more: a mother taking drugs or painkillers or tranquilizers while carrying can produce a down loaded baby who is very sluggish; I have seen it so many times during relivings. And that same mother drinking a lot of coffee or cokes can up load the baby and make him hyperactive. It becomes imprinted as a normal way of life, first for the mother and then the baby. The baby begins to adapt to his environment, which in this case means either too much stimulation or too little. It becomes “normal” and he adapts accordingly. So “sluggish” has very early effects. And a diagnosis needs to include that possibility.

 Oh my! Did I mention that this new diagnostic category is supported by Eli Lilly? That means financial support. They also pay him for speaking tours. It is good for them that a diagnosis requires drugs, but not so good for us. We need a real diagnosis not supported by drug companies.

Saturday, April 19, 2014

On Dreams and Nightmares


Have you wondered why my patients have less nightmares and have dreams that increasingly become more and more real and present? No?  Oh dear, I had better explain.  What does it mean to dream?  It means that the limbic system is actively processing feelings as it does during the day when we are feeling something. Except at night it is going over feelings from the past and trying to integrate what? Not the dream: the feeling.  It may have been events from way back that were traumatic and could not be integrated at the time.  We were too young and fragile and perhaps non-verbal.  It is a mass of vague sensations and discomfort.  They bubble up when there is not too much external input and put pressure on the neo-cortex to do something with those feelings.  The cortex accommodates and provides images and thoughts.  The limbic system joins the cortex to mount a story to rationalize and  make the feeling coherent. This is what our therapy is about.  Dream processes lay bare the evolutionary path that we must follow in therapy; evolution in reverse.  We do not go straight to the emotional past; we anchor the patient in the present and focus her feelings in the present; from there the brain takes its own piste below.  Ideas, then go to meet their maker; they go to where the feeling is cemented in; where it began.  I dreamed for years about being chased by the Nazis and could not escape. The feeling? My father was unrelenting in his chastisement and would not let up.  He was always after me: sit up straight, don’t talk through your nose, why are you lying around and not doing something useful?  That dream disappeared with those felt feelings.

I could not escape the Nazis because I could not escape the feeling; someone was after me and trying to harm me.  It was never the Nazis; they were only a symbol for my feelings.  See, a symbol for my feelings; and that is how we develop dream symbols; same process.  I never knew it was my father because my system only knew the feelings, not the source.  Until I had a developed cortex I could not know what was wrong.  The feelings predated cognition and were properly registered limbically.  We must pay attention to that evolution when we do therapy:  feelings first, long before our ability to think.  In therapy feelings first, long before insights.  There is no defying evolution.

  So how do we explain this?  The imprints form a prism through which we see the world; they distort reality and give us symbolic dreams.  The first distortion is from our true feelings and then it moves up the neuraxis to the neo-cortex which joins the distortion with ideas.  Hence, “They are out to get me”.  But it is not that just because we dream that they are automatically distorted and symbolic. It is because repression holds back the pain and produces distortions; awake and asleep.  As we experience the imprinted pain and lift the gating force that keeps pain locked away there will be diminished  distortion awake and asleep.  Neurosis is systemic, not sleep determined. We carry it around always. It won’t let go.

Patients have more real dreams because they are more real;  they are less repressed and more open.

And of course we can spot where dreams come from.  First line dreams rarely have elaborate symbols; they are direct and short—“I am stuck in a washing machine and I can’t stop it.”  “I am in a  dark cave and cannot find a light to show me the way out.”  Pre-psychotics are awash in first-line pain and continue to have first-line dreams and frequent delusions.

Second line dreams are more intricate have a more coherent structure, contain some but not a lot of words, but they are more difficult to understand. “ I went to see my old teacher and tried to talk to him but I could not make him understand me.”  The real feeling was, “I could never get through to my parents and could not make them understand me.”

So more direct, non-symbolic dreams is a good index of a patient getting well.  We corroborate with vital signs, cortisol levels, behavior changes and a host of other measures. We get well systemically.
Yahoo News!

Arthur Janov Suggests that Stress During Pregnancy Leaves a Distinct Cellular Imprint that Predicts Mental Illness and Serious Disease

In his new book, 'Life Before Birth' (NTI Upstream, Nov. 2011), Arthur Janov makes the case that events during pregnancy and the first years of life leave a distinct cellular imprint that predicts mental illness and serious disease.



Quotes for "Life Before Birth"

“Life Before Birth is a thrilling journey of discovery, a real joy to read. Janov writes like no one else on the human mind—engaging, brilliant, passionate, and honest.
He is the best writer today on what makes us human—he shows us how the mind works, how it goes wrong, and how to put it right . . . He presents a brand-new approach to dealing with depression, emotional pain, anxiety, and addiction.”
Paul Thompson, PhD, Professor of Neurology, UCLA School of Medicine

Art Janov, one of the pioneers of fetal and early infant experiences and future mental health issues, offers a robust vision of how the earliest traumas of life can percolate through the brains, minds and lives of individuals. He focuses on both the shifting tides of brain emotional systems and the life-long consequences that can result, as well as the novel interventions, and clinical understanding, that need to be implemented in order to bring about the brain-mind changes that can restore affective equanimity. The transitions from feelings of persistent affective turmoil to psychological wholeness, requires both an understanding of the brain changes and a therapist that can work with the affective mind at primary-process levels. Life Before Birth, is a manifesto that provides a robust argument for increasing attention to the neuro-mental lives of fetuses and infants, and the widespread ramifications on mental health if we do not. Without an accurate developmental history of troubled minds, coordinated with a recognition of the primal emotional powers of the lowest ancestral regions of the human brain, therapists will be lost in their attempt to restore psychological balance.
Jaak Panksepp, Ph.D.
Bailey Endowed Chair of Animal Well Being Science
Washington State University

Dr. Janov’s essential insight—that our earliest experiences strongly influence later well being—is no longer in doubt. Thanks to advances in neuroscience, immunology, and epigenetics, we can now see some of the mechanisms of action at the heart of these developmental processes. His long-held belief that the brain, human development, and psychological well being need to studied in the context of evolution—from the brainstem up—now lies at the heart of the integration of neuroscience and psychotherapy.
Grounded in these two principles, Dr. Janov continues to explore the lifelong impact of prenatal, birth, and early experiences on our brains and minds. Simultaneously “old school” and revolutionary, he synthesizes traditional psychodynamic theories with cutting-edge science while consistently highlighting the limitations of a strict, “top-down” talking cure. Whether or not you agree with his philosophical assumptions, therapeutic practices, or theoretical conclusions, I promise you an interesting and thought-provoking journey.
Lou Cozolino, PsyD, Professor of Psychology, Pepperdine University


In Life Before Birth Dr. Arthur Janov illuminates the sources of much that happens during life after birth. Lucidly, the pioneer of primal therapy provides the scientific rationale for treatments that take us through our original, non-verbal memories—to essential depths of experience that the superficial cognitive-behavioral modalities currently in fashion cannot possibly touch, let alone transform.
Gabor Maté MD, author of In The Realm of Hungry Ghosts: Close Encounters With Addiction

An expansive analysis! This book attempts to explain the impact of critical developmental windows in the past, implores us to improve the lives of pregnant women in the present, and has implications for understanding our children, ourselves, and our collective future. I’m not sure whether primal therapy works or not, but it certainly deserves systematic testing in well-designed, assessor-blinded, randomized controlled clinical trials.
K.J.S. Anand, MBBS, D. Phil, FAACP, FCCM, FRCPCH, Professor of Pediatrics, Anesthesiology, Anatomy & Neurobiology, Senior Scholar, Center for Excellence in Faith and Health, Methodist Le Bonheur Healthcare System


A baby's brain grows more while in the womb than at any time in a child's life. Life Before Birth: The Hidden Script That Rules Our Lives is a valuable guide to creating healthier babies and offers insight into healing our early primal wounds. Dr. Janov integrates the most recent scientific research about prenatal development with the psychobiological reality that these early experiences do cast a long shadow over our entire lifespan. With a wealth of experience and a history of successful psychotherapeutic treatment, Dr. Janov is well positioned to speak with clarity and precision on a topic that remains critically important.
Paula Thomson, PsyD, Associate Professor, California State University, Northridge & Professor Emeritus, York University

"I am enthralled.
Dr. Janov has crafted a compelling and prophetic opus that could rightly dictate
PhD thesis topics for decades to come. Devoid of any "New Age" pseudoscience,
this work never strays from scientific orthodoxy and yet is perfectly accessible and
downright fascinating to any lay person interested in the mysteries of the human psyche."
Dr. Bernard Park, MD, MPH

His new book “Life Before Birth: The Hidden Script that Rules Our Lives” shows that primal therapy, the lower-brain therapeutic method popularized in the 1970’s international bestseller “Primal Scream” and his early work with John Lennon, may help alleviate depression and anxiety disorders, normalize blood pressure and serotonin levels, and improve the functioning of the immune system.
One of the book’s most intriguing theories is that fetal imprinting, an evolutionary strategy to prepare children to cope with life, establishes a permanent set-point in a child's physiology. Baby's born to mothers highly anxious during pregnancy, whether from war, natural disasters, failed marriages, or other stressful life conditions, may thus be prone to mental illness and brain dysfunction later in life. Early traumatic events such as low oxygen at birth, painkillers and antidepressants administered to the mother during pregnancy, poor maternal nutrition, and a lack of parental affection in the first years of life may compound the effect.
In making the case for a brand-new, unified field theory of psychotherapy, Dr. Janov weaves together the evolutionary theories of Jean Baptiste Larmarck, the fetal development studies of Vivette Glover and K.J.S. Anand, and fascinating new research by the psychiatrist Elissa Epel suggesting that telomeres—a region of repetitive DNA critical in predicting life expectancy—may be significantly altered during pregnancy.
After explaining how hormonal and neurologic processes in the womb provide a blueprint for later mental illness and disease, Dr. Janov charts a revolutionary new course for psychotherapy. He provides a sharp critique of cognitive behavioral therapy, psychoanalysis, and other popular “talk therapy” models for treating addiction and mental illness, which he argues do not reach the limbic system and brainstem, where the effects of early trauma are registered in the nervous system.
“Life Before Birth: The Hidden Script that Rules Our Lives” is scheduled to be published by NTI Upstream in October 2011, and has tremendous implications for the future of modern psychology, pediatrics, pregnancy, and women’s health.
Editor
About our Therapy

Our therapy is constantly evolving. If a therapist has not had additional training in the past 3-5 years she is not up to date. The basic principles are the same but the actual therapy has taken a radical turn. It is much more precise, predictable and mathematical in practice. We have tried to tighten up what we do in keeping with current neurology and physiology. It is a constant learning experience. It is finally for the well-being of the patient who now has a much better chance of doing well. Yes, it was good before, but there is less time wasted now because the techniques are honed and the theory takes on more and more precision. We see patients from some thirty countries in the world, each with different cultures. It is up to us to continue the refining process so that the patient has the best chance of improving.

Training in Primal Therapy

The clear understanding and application of the theoretical and clinical aspects of Primal Therapy are essential in order to provide effective therapy. Citing the most current findings from the field of neurology, trainees will learn the role that the physiology of the brain plays in the shaping of mental illness. The training will thoroughly examine the scientific basis for Primal Therapy and discuss the unique clinical approaches employed in the treatment of various emotional and personality disorders.
For our first year students, the training will entail extensive work in the understanding of the basis for Primal Therapy. On the theoretical level, there will be an examination of issues that range from the nature of the unconscious to the nature of traumatic imprints and their lifelong effects on physical and mental health. On the clinical level, trainees will have the opportunity to learn proper diagnostic and therapeutic procedures as they relate to Primal Therapy.
Furthermore, first year students will be mentored by our third year students in order to ensure that the key concepts in Primal Therapy are clearly understood. There will be an extensive library of training notes and taped lectures from the past two years available as well.
For our second year students, the training will provide a unique and varied opportunity to gain more clinical experience. Through closely supervised clinical sessions, trainees will gain a deeper understanding of the various applied therapeutic methods and hone their skills as future therapists. In addition, second year trainees will have the opportunity to work with first year students thru discussion groups, tape reviews, and clinical sessions.
Our third year students will continue to hone their clinical skills through a rigorous series of didactic clinical sessions. These sessions will be video taped and will be reviewed by Dr. France Janov and our senior therapists.
Dr. Janov’s books have been translated in some 26 languages, have been bestsellers in many countries, and his theory is taught at many universities. He has combined decades of clinical practice with the latest in research. It is the therapy of the future.

To apply, please visit our website at http://www.primaltherapy.com/primal-center-application.php and select the ‘trainee’ option when filling out the questionnaire. For further information, please feel free to call us us at (310) 392-2003 or email us at
primalctr@earthlink.net


We look forward to another exiting year of training. We hope you will join us.

My best,

Dr. Arthur Janov
Founder & Director