Tuesday, August 25, 2015
We Are Specialists of Joy, Not Pain
Primal Therapy is no quick fix. We are attempting to redo someone’s entire life. It will be done in a slow methodical manner so as to never overwhelm the patient and make him suffer all over again, as happens with abreaction. If he can experience just enough to have a full experience that is enough for a session. We do not want him to suffer any more than necessary. He will suffer when the pain comes up arbitrarily, prematurely so that he cannot integrate it; the pain hangs there in an ego-dystonic fashion (Freud again), meaning alien and apart with pure pain that cannot be made ego-syntonic or integrated.
So why do we have to trace back our evolution again? One reason is that we never sever anything permanently in our evolution; we suppress the old and add on the new. Sometimes the primal pain vestige is so powerful that it exerts a constant force that disrupts our functioning. In my patois, the first line erupts and surges higher. Then it has to be dealt with and relived. I call it “intrusion,” an imprint so strong that it interferes with our personal evolution and our current functioning. We see it in physical symptoms and deformation of organs and growth; we see it in diseases such as hypertension, cancer and heart failure that are actually offshoots of the central damaging memory, locked in as an imprint, out of reach and out of touch. This is also the case with Attention Deficit Disorder where forceful imprints constantly surge toward the top level to disrupt concentration and attention processes. Remember, earlier, I explained that evolution always moves the imprint higher so that first-line damage may be expressed on the upper levels of brain function, where attention and concentration are mustered. Training a person how to concentrate is not the answer; feeling the force that scatters thoughts is the answer.
Once we lift the repressive lid (done in orderly fashion) there is no longer unconscious forces driving behavior and symptoms. And as repression lifts, the patient’s truth becomes self-revealing. Bit by bit his unconscious tells him what he needs to know, but not too much, just enough to integrate the pain and its information. His orderly descent into feelings eventually informs him of what it all means. Everything he needs to learn is already lying inside of him, waiting for discovery. It must come from inside, never outside, just as the feelings were laid down by the system and not by executive order.
The aim is not insights; it is change in all aspects of the person: his behavior, biochemistry, neurology and feelings. We are after total change because there was total change at the time of the imprints. We want normalization of the whole person. We are not there to give love; we are there, paradoxically, to help patients feel unloved so that they recapture the ability to feel and then can feel love when it is there.
If a therapist needs to be loved he will act out on the patient and give him what he, the therapist, never got. He has become a “pal” not his doctor. The patient feels loved, it feels good…and he loses! Or there are great discussions about music and art and politics, and the patient becomes an intellectual pal, and again he loses. He has been transformed from a patient who needs treatment into a good friend. Nice idea but very wrong. We are not there to give love; we offer kindness and caring but also science. We don’t replace science with pseudo caring. We adhere to key principles. The patient begins to suffer; we do not rush in to stop it and make him feel better. We don’t do him any favors suffocating the pain with “love.” His feelings are about real suffering. It must not be tampered with. That is the part he has kept hidden for years; it must come out and be experienced. Then we will be free; free of that pain which has made him depressed or anxious for so long. The patient is himself at last.
It is dialectic; he has to feel unloved so as to unlock the feeling gates. He will never do that with therapeutic approval and warmth and understanding. He will get that after the feeling, not before. When he has made a breakthrough, we rejoice with him. It is not just about pain; it is about contentment, ease and relaxation. It is about joy. It is what we want too for them; why else do the therapy? I received over fifty letters on my birthday thanking me and my staff for saving their lives or improving them greatly. That is the reward and the meaning of our lives. We are not pain specialists; we are joy specialists who need pain to help joy along.
There is a reason the patient has to feel unloved. He needs to go back to the open sensory window when “unloved” dominated. That is the essence of our therapy; travelling back in time and undoing the original damage. We cannot do any better than that.
Thursday, August 20, 2015
The First Science of Psychotherapy
The task of normalizing a patient’s entire system is a complex proposition because not all nervous systems are created equal. In the case of parasympaths – those low-energy types predominantly controlled by the parasympathetic nervous system due to re-shaping events in the womb and at birth – reactivity slows down. They remain passive and lethargic throughout life, permanently stuck in the energy conservation mode. That mode of operation becomes stamped in, imprinted as a life-saving device. This imprint is a memory of what the whole system did under threat in order, for example, to conserve oxygen, bind energy and slow down the metabolism to combat the deleterious effects of a mother taking drugs, drinking or a hundred other kinds of abuse. It differs from the revved-up sympath who is dominated by the sympathetic nervous system, the alerting, aggressive, fight (to get out) and battle system to save one’s life. For the patient who is a sympath, a typical session begins with higher vital signs, and tends to militate to lower levels as therapy goes on and feelings are experienced and connected. Not so with the parasympath whose body temperature often drops into the area of 96.0 degrees, steadily moving higher over months. It is the key distinguishing mark to differentiate the person with different kinds of nervous system dominance. And it is the marker for progress in Primal Therapy. Each nervous system tends to move toward normalization in our therapy; the parasympath toward higher levels, while the sympath, lower. This is what we expect to see over time in our patients. We cannot fool our biology. When we try to fool our nature, we put the patient in danger.
The parasympathetic system, as the energy conserver, is dominant in feeling. We can see this dynamic played out in sports, especially at the end of games when athletes often show emotion. It happens to many tennis players, win or lose, after long, grueling matches. Some just collapse on the court in tears. In one famous case, Roger Federer was so crushed by defeat following a hard-fought, four-hour-plus tournament in 2009 that he could barely talk during a press conference. He cried so hard and for so long that observers at the Australian Open were shocked and felt uncomfortable. With a “torrent of tears” streaming down his face, as one writer described it, the only thing the defeated champion managed to say was, “It’s killing me.” What happens is that athletes gear up for battle and maintain an intense, fighting (sympathetic) stance during the game. When it’s over, the activation dials down and they are able to feel, so emotions overwhelm them. The neurological pendulum has swung to the parasympathetic side.
The importance of the sympathetic/parasympathetic dominance is that it provides us with a biological basis for understanding personality development. At last we can leave abstraction and metaphor behind, and replace the vagaries of speculation with the precision of verifiable processes. We no longer need to talk about the "will to power" or the "will to meaning" or the "transcendent function." Instead, we can talk about the precise ways in which the brain and nervous system react to concrete events, and how those reactions become the physiological basis for the elaboration of personality. The precision of the theory and therapy leads to a precise knowledge of what is happening in sessions; we have a better fix on what may go wrong. If the theory is imprecise so will be the measures taken in therapy. It is why I call Primal Therapy the first science of psychotherapy. We don’t have to rely on patient reports to see if there is progress; there are many neurologic and biologic tools that can inform us.
For example, when the sympath is reliving first line, we see high vital signs and accelerated brain wave frequency as well as higher amplitude waves. As we descend deeper we find the limbic system at work and then, further down, the brainstem and its cohorts. So one way we see evolution at work is by which nervous system dominates. If there is crying, chances are it is limbic and not brainstem. If there are grunts and no tears, we see a nervous system at work that predates limbic evolution. We cannot deceive the brain because it tells us in its own ineffable neurologic way what we are dealing with.
What we have found is that very early events in life determine the settings of our nervous systems. What sways the two key nervous systems – both under the aegis of the hypothalamus – is the kind of biologic and neurologic reaction that is forced on us and our brains while under specific kinds of threats very early in life, during gestation and birth. There is the struggle-and-succeed syndrome, the sympath, and the struggle-and-fail syndrome, the parasympath. This latter gives up easily and smells failure. Not so the sympath who tries and tries and does not give up. And when a new patient struggles to feel even when he is not ready, we generally have a sympath on our hands. The parasympath comes in listless, down regulated, worn out, unmotivated and depressed. He sees no point in anything. This is where the therapist needs his full capacity to meet the challenge. Should he be encouraged? These are the questions we take up constantly in our staff meetings. We often bring the patient in and ask him what works. He sometimes knows and sometimes does not. With long-time patients I ask them if I made a mistake and what was it? I get good answers and I learn.
One key problem in therapy is when the doctor tries to force the patient onto a nervous system that is not his. For example, the therapist may try to get the patient to act more aggressively with his boss when his whole system, the one that helped him survive, is in the energy conservative, passive unaggressive mode. So it is like deciding that someone should be right-handed and we force him not to use his left hand. We are confounding nervous systems (run by the hypothalamus) with terrible results later, such as stuttering and cross in reading and writing. In therapy, a comparable situation is created by abreaction: forcing the wrong nervous system into action.
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.