Monday, December 29, 2008

The Dialectics of Hopelessness

I have come to believe that apart from fear and anger the primary key enduring feelings are hopelessness and helplessness. These are two ineffable feelings that are installed long before we have words for them. Yet they drive much of our adult lives; and more, they turn into their opposite, hope and help, and that then drives us. The process by which this happens is neuro-biologic. In the womb there are no behavioral options when the mother is drinking three cups of coffee or four cokes a day; nor when she is hyperexcitable. Her excited state transfers to the baby. The input to the fetus is too much. It is truly hopelessness and he is helpless. All his system can do is deal with the input. Serotonin is summoned but it is often insufficient. The fetus suffers. Then a birth with massive anesthetic that doesn’t allow the fetus to participate in his own exit leaves him with that same feeling. And then to compound it all there are parents who allow the child no freedom and no behavioral options except to obey. Of the epileptics I have seen this has all too often been the case.

So what happens to these feelings? There is a surge of serotonin/endorphins and other neuro-inhibitors that quell the pain. The feelings are dampened but as the child develops some of the energy manages to slip through. So part of the hopeless/helpless feeling traverses vertically to the prefrontal cortex, and also across the corpus callosum to the left frontal area where these painful feelings should be but are too much to acknowledge; so what happens? Hope. And where does that go? Into ideas and, above all, behavior. The hope is embedded into behavior. And it is but a thin sliver that manages to insert itself wherever the possibility of fulfillment exist. If one parent is a bit more human than the other, the hope will go to that parent. If there is no love at all, or if parents inculcate religion into the child, then the hope will go to God who will fulfill all the needs symbolically. There is still the feelings of hopelessness because the fulfillment, so-called, is symbolic.

But it is also more subtle than that. Right now we are treating an obsessive cleaner. She spends hours a day cleaning her house and it never feels right, never feels complete. She only got “love” for helping mother keep a clean house. That is where hopelessness drove the hope. It wasn’t really love, though. Her real needs were not being met—hence the hopelessness. She acted symbolically to get what looked like love. It is biologic; hopelessness drives hope in whatever avenue it takes. When basic needs are not met, it is obligatory and biologic that hopelessness sets in. It does not have to be articulated. Why does hopelessness turn into its opposite? Because hope means survival and hopelessness can be the end of life. Total utter hopelessness as a newborn or infant can mean death. Institutional children do die or else suffer from learning disorders, emotional problems, physical afflictions and do not grow physically to their normal height. Hope points the way to fulfillment of need which spells survival. It guides behavior like an unconscious radar. We are fixated on a warm teacher because there is hope of love. Or later, we are inexorably attached to a partner because of the hope. When someone dashes that hope, watch out! Hope can mean survival so when that is withdrawn the person is in great danger; of the original feeling and its meaning—hopelessness. So, many of us are in a mad dash away from that feeling. Hope is the carrot that leads to “love” and salvation.

There is always the obvious hope such as belief in a deity who will love, protect and watch over us. But most of us hope is more devious. It lies in our very structure. We are alienated and reserved because hope means not causing any trouble nor risking any disapproval. So our hope lies not so much in getting love but in avoiding criticism or disapproval. Or there are those who continually in hope by being kind, generous, meek, undemanding and accommodating. Their personality structure is wound around personality and says with every breath, “love me.” Literally, we are the embodiment of hope. One thing we must do in therapy is help the patient feel what exists in every fiber of her being; get her to first feel the hopelessness by going to the original basic need and hope. Remember, it is lack of fulfillment of need that spells hopelessness. An aside: I believe that it is deep repression of that hopelessness, established very early, that is behind so many serious diseases later on. It is not that hopelessness leads to depression and cancer, as some of the literature has it; it is that repression of it can be fatal.

Saturday, December 20, 2008

Original Conflict: The Biologic Motor That Drives Us

We in clinical psychology today are in a strange position. We see people, both in and outside of our practices, suffering from some insidious condition that cannot be seen, tasted, touched, or pinpointed in any single location. The condition is often called mental illness or neurosis. A few question whether the suffering is real, describing the experience as a "trip" to be savored, and terming mental illness a "myth." Others see mental illness as merely a function of distorted thinking, something that will disappear with new thoughts. Among schools of psychotherapy that do admit the existence of mental illness, each one has very different ideas about neurosis and its genesis. Indeed, in no other area of medicine is there such disagreement about the nature of a disease, what its symptoms are, and how it manifests itself, not to mention its causes.

In short, the field of psychotherapy today is nothing less than chaotic. Why?

First, I believe, events that may cause mental illness or neurosis begin so very, very early, and remain so barricaded in unconsciousness, that the notion that early trauma affects how we act at the age of, say, 45, is beyond ordinary imagination. Second, we react with incredible diversity to early trauma, and we may imagine that phobias, migraines, compulsions, obsessions, depression, addictions, etc. must all have different functions. Third, psychologists themselves have blind spots of a function of their own neuroses - they cannot see, cannot bear to see, their patients' deepest pain - and find themselves gladly distracted by symptoms and by ideologies that do not directly address pain.

As a result, the field of psychotherapy may be characterized by a remarkable absence of cohesion, and patients' pain is addressed diffusely at best. Some psychotherapists will consistently prescribe anti-anxiety and antidepressant drugs for varying neuroses, in essence trying to kill patients' pain, but not identifying the pain or where it comes from. Others may manage symptoms through various techniques associated with different schools of psychotherapy: They may have the patient "dissociate from" a symptom in hypnotherapy; cognitively "analyze" it into oblivion; "act -out" the symptom symbolically in gestalt-type therapy; beat it back with mild shock as in conditioning therapy; chalk it up to "faulty beliefs" which simply need to be willfully changed, as in rational-emotive therapy; "control" it in biofeedback therapy; or reroute it in directive daydreaming and imagery therapy.

The myriad approaches in psychotherapy are treatments rather than cures. They all focus on the symptoms of neurosis instead of probing for its cause. It is possible that they all help somewhat; they do not cure, however. They may help control the symptom, not the disease.

The only hope for cohesion, and lasting help for patients, is to address the generating sources of neurosis or mental illness. What and where are these sources? I believe that the conflict between the imprinted Pain of early trauma and its repression is the central contradiction that generates neurotic reactions both internally (physiologically) and externally in the form of behavior. Repression, or the loss of access to feelings and sensations, is an evolved function that allows us to survive unmitigated pain early in life. The pain, however, stays in the body, unavoidably - as unavoidable as the experiences that originally caused the pain. And the pain will perpetually fuel a dislocation of mental and physical functioning to keep itself unfelt, for as long as it remains unfelt.

Therapies that do not address this original, central conflict at the root of neurosis may succeed in reconfiguring a symptom pattern, but cannot eliminate the fundamental illness. Why do therapies and therapists not go deep? Because of our Freudian legacy, which dictates that fooling around in the unconscious is dangerous and must not be done. And it is true that without a proper scientific theory and therapy it can be dangerous; witness the many mock primal therapies damaging patients every day by plunging them into rebirthing and other dangerous ploys. It has taken some thirty years to figure out this theory and therapy so I don’t wonder that many therapists avoid it altogether. But it is essential if we want to put an end to neurosis as we have seen it for one hundred years.

Monday, December 15, 2008

It's All in Your Head: No It's Not.

We have all heard the complaint; “Stop whining. Get over it. It’s just in your head”. Well, that latter phrase is just not true. Someone who is suffering emotional pain, “She hurt my feelings. He ignored me”, is using the same lower brain pathways as with physical pain. It is not just in the head but also in the deep brain processes that affect many organs of the body. Those pathways do not distinguish between physical and emotional pain. Hurt is hurt. And it hurts the same whether a smack on the face or an insult of rejection. Unfortunately, we cannot just “get over it” as some implore. Or just change our attitude, because those admonitions are fighting deep brain processes.

What some may mean in “get over it,” and change your attitude, is that emotional hurt is not really physical; it is just somewhere in space without physiologic effects. All late research reports that it is. A slight insult may set off earlier ones so that the reaction may be inordinate and out of keeping with the importance of the insult. The way to get over it is to not accept reassurance or means of distraction from others, and feel the root pain that lies just under that feeling that produced the attitude, in the first place. Too often current therapy tries to change ideas and attitudes without changing the underlying feeling; the feeling that gives rise to the attitude. “It’s all in your head.” Where else would it be? What most mean by that phrase is that it is in your imagination which you can change. Ah no! It is lodged deep in the brain where psychologic access is impenetrable. And until those feelings are addressed and integrated we cannot get “over it.”

The problem is that there are antecedents to an attitude. Even when the feeling is deeply sequestered, its raw emotional content continues to drive attitudes. Thus someone who is pro-war may have deep rage inside. Or those who are fearful see danger everywhere. They cannot just get over it. None of this may be conscious. Consciousness is what is required for integration yet so many therapies function in suppressing it, mostly because it means being aware of one’s sequestered pain. Consciousness, in one respect, is the main force for integration and resolution. It means having access to various separated neural functions.

Think about it; pain has so many diverse dimensions. We have to be aware of it so the neocortex is involved. There are feelings involved so that the cingulate and other limbic/feeling structures are included. And there is the force or valence/intensity of the pain, which involves the brainstem and some limbic areas. All go into making the pain experience; and to treat only one dimension, the ideational, is to leave the other two very busy, gnawing away at the physical system. All of this is going on unconsciously.

Pain is perceived as less intense if there are distractions going on. This help explains EMDR (Eye Movement Desensitization and Reprocessing), which helps through suggestion to make the deep feeling seem “alienated” (their word). It means alienating oneself from one’s feelings. Usually that is a definition of one kind of neurosis, not one of health. It is well known now that there are descending pathways from the top-level cortex to the limbic/feeling areas that help repress feelings and keep them unconscious. Those nerve pathways help control feelings so that they do not emerge and rise to the cortical level. They are partly responsible for dissociation. Similar ascending pathways are used to translate emotional pain/feelings to the top-level cortex to make us aware.

Friday, December 5, 2008

Pregnant Mothers and Neurotic Children


More and more research is helping us understand who we are. Although the thrust of current psychologic thought maintains that genetics play a big part in our development, I claim that the state of mind of a carrying mother is very, very important.

If she is depressed or anxious the baby and the developing child will have high stress hormone/cortisol levels. Think of the implications. The mother’s emotional state may dictate how our lives unfold. (See Early Human Development. April 2008. 84(4) pages 249-256). This also helps explain why so many of our beginning patients have consistently high cortisol levels (secreted by the adrenal glands). In studies of anxious or depressed mothers (mood-based changes) compared to “normal” mothers the offspring had high stress hormone levels and more activity in the emotional right frontal brain. Anxious and depressed mothers are important predictors how we will do in school and later in life. Don’t forget the fetus has an environment; that environment is the mother and her status. That environment sculpts the fetal brain. The mother doesn’t have to say a word to her baby; her physiology does it for her. That sculpture plays heavily on our future behavior. It is a good predictor of the baby’s temperament. And of course, who we are later, as well. We must remember that the stress hormones of the mother can pass through the placenta into the fetus and affect all kinds of hormone balances. And this mixture becomes the crucible for later development and personality. It is here that we can start life already handicapped. And how we react to birth may be predetermined by womb-life.

We do know that womb-life maternal anxiety can affect the sex hormone level of the offspring. It all happens so early that when a homosexual says that it is genetic or a natural state he/she isn’t aware of the impact of the mother’s state on her fetus/baby’s development. It also explains why so many of us believe that who and what we are is normal. The deviation has begun so very early, before we had an operational thinking brain that the deviation seems normal; we have nothing else to compare it to. Moreover, when we look for causes of later Alzheimer’s disease or Parkinson’s affliction we never would imagine that our life in the womb could be a major contributing factor. So we don’t look there, hence avoiding important information. We need to study brain dementia cases and check their womb-life, when possible. Several European countries already have that information. It dictates how we react later on. Do we have a predisposition to threat; that is, are we too ready for attack and therefore on a chronic high state of alert all of the time? All this based on an “attack” by mother’s high levels of stress hormones while she is carrying; that raised the cortisol level and made hyper-vigilance a steady state. And when we need constant tranquilizers as adults we cannot imagine that womb-life is the culprit. But if we see through research that stress hormones are chronically high in emotionally disturbed patients we see why they seek out pain-killing drugs.

Saturday, November 29, 2008

I Promise I Will Be Faithful: No You Won’t

Now why can’t some men and women keep that promise? Well there are many reasons but if we ignore the imprint then we are forced to look at the present for all the answers; whereas the current situation may provide only a few elements.

So what does that mean, the imprint? It means, say, for a man, that he needed love from his mother but all he got was indifference. That lack is imprinted, sealed by the unfulfilled need permanently. It lies on a lower strata so that no matter how loving the girlfriend is, he needs more. Why? Because the nagging, “I am not loved” lies below, agitating him to go elsewhere. And he will become known as a womanizer because he needs to seduce many women, all for the same ending, more infidelity. That, “I am not loved,” drives him every day.

With a woman who was never wanted by her father; that is, who left her feeling unwanted because he was so bound up in his own pain, she is a “sucker” for anyone who really shows he wants her. That need, “I am not wanted,” drives her and makes her give in immediately when a man looks at her and says he finds her beautiful. And yet, no matter how much a man wants her, she needs to seek out other men because “I am not wanted” continually drives her. She needs constant reassurance and assuaging.

A promise is a top level cortical expression; never a match for a deep-lying survival force. How do we know? Because when patients feel that need in all of its agony, they no longer have to promise anything; their body will do it for them. And when we see the huge amount of pain/force involved in experiencing the feeling we know how big a motivator it is.

None of this is conscious. The old need remains pristine pure but the person is never aware of it. The “promise to be faithful” sits on top of, “I can’t be faithful until my mother loves me.” After a sexual encounter, there is that nagging feeling of malaise, not being satisfied. And the person won’t be until he or she feels the real need in its exact early context. Every so-called fulfillment, every affair, after the time of the critical emotional window when need had to be fulfilled is, by definition, a symbolic fulfillment. That is why it is not really satisfying. Remember, that need in the first months of life meant survival as an intact human being. It had to be gated and repressed. Meanwhile, the feeling/need circulates in a sort of reverberating circuit seeking connection and never making it. If it were not symbolic, then one love affair should be satisfying.

That is why all compulsive behavior has to be repeated time and again. It doesn’t matter if its food, pain-killers or sex. Need dominates. It is a way of papering over pain. And because it is a temporary palliative, like a tranquilizer, it has to be done ad infinitum. Of course there are any number of other reasons. But many marital guide books cover those. It is just the imprint that is missing.

Saturday, November 22, 2008

Life before birth (revised):

How Experience in the Womb can Affect Our Lives Forever


When I first wrote about how the birth trauma and prenatal experience affect adult behavior it was considered “New Agey.” Now, there are literally hundreds of studies verifying this proposition. There seems to be little question now that a pregnant woman’s mood and physiology can produce long-term effects on the offspring. That means us.

Let’s start with a simple bit of research; Dr. Daniel Schacter, psychologist of Harvard University has reported on a study where subjects watched bits of a TV series and then had their brainwaves measured. (see: Science, Sept. 2008).

They found when the subject remembered the event, the single brain cell signature was the same as in the first viewing. They reported that it seemed like a reliving; which of course, has been my position. What do you call it when a memory brings up one’s exact history with its precise early physiology? This happens to our patients every day. When there are certain triggers, the brain conjures up its history, intact. That is why our behavior is so compulsive and unwavering; our history motivates us all of the time. We are largely victims of our deep unconscious brain.

In Schacter’s research on epileptic surgery patients, they threaded fine electrodes down in the brain of the subject. These electrodes could pinpoint small brain storms at their origins. And they could make minute measurements during recall. The lesson? We can relive past events in their entirety, precisely as they occurred. What is very new in all of this is how early an experience can affect our later life. Think of the implications: that old memories reside in the same neurons (nerve cells) as were involved originally. That is why the neurotic cannot distinguish between past and present and sees reality through the prism of the past.

Let’s go back to the notion I discussed earlier of epigenetics. One genotype, a single genetic predisposition, can give rise to many phenotypes depending on what happens to those genes during gestation. So what we might imagine is genetic is genetic-plus what happens to us in the womb. So much happens to us in the womb; so much as been ignored in terms of their long-term effects that many diseases remain a mystery because we are looking at the wrong place at the wrong time with the wrong tools.

What I am learning is that events in the womb explain so much about later life. If you bend an emerging twig you are bound to get a distorted tree. The question has always been, “how early is early?”

There is increasing interest in epigenetics. A group at Washington State University (led by Matthew Amway) found that gestational experience in animals that sways the genetic unfolding can show effects for three generations. They found that exposing pregnant adult rats to stress resulted in defective sperm in the offspring. Some resulting effects included cancer in adult animals. Females avoided mating with other rats who were also exposed during gestation. And this went on, not only for the life of the adult, but also with their offspring, as well. It seems that the system itself knows how to behave given certain biologic deficiencies, and it is always in terms of what is best for heredity; what gives us the best shot of succeeding in life. So when we cannot explain some trait in adults by heredity we may have to reach back several generations to explain it. This gives us a new perspective on so-called psychological problems in adults. We are, of course, extrapolating from animal experiments but it can well be predictive of human behavior, as well.

We can now only guess as to what traumas occurring to the pregnant mother continue their effects on grandchildren. It isn’t just that the mothers underwent trauma but that trauma alters her basic physiology, and that alteration may have lifetime effects. And so when a grandchild develops heart problems or cancer in his twenties we may have to rethink the probable causes; seeing what kind of pregnancy his grandmother underwent. Was it wartime? Or were the prospective (grand) parents fighting all the time? Was grandma depressed? Was she a heavy smoker or drinker during her pregnancy? There is a whole host of new variables to consider. It all looks like the discarded theory of the inheritance of acquired characteristics, but if we look closely it is not based on heredity but of epigenetics; of what happened to the unfolding of those genes when trauma inserted itself.

Here is the way one patient reported it. It is almost a duplicate of how many patients state the same thing: In my very last session I felt myself totally helpless. I could not move or speak. I felt stuck and weak. I could not breathe, something heavy pressing on my chest. I cannot do anything and no one can help me. I don’t think that the idea of hope even existed back then. It seems like nobody exists during that time. There were no words, scenes, no people and no parents. All alone. Extremely uncomfortable.

Another example which includes reliving of the birth trauma:

My knowledge of any correlation between my prenatal life and my life in general is limited to my mom’s diet at that time which was almost completely based on the consumption of peanuts as this was her only source of food. I always crave for peanuts.

My earliest sensation in the course of re experiencing my birth primal was of “its time to go “sensation which expresses it self also in a physical sensation of a “kick” in my lower back. At this stage there was only a sense of my self-arching forward without any other feeling attached to it. In the process of moving forward towards an opening I felt my self resting a few times until the same “kick” in my lower back drove me to keep on moving.

My next sensations are of my self feeling crushed from all sides in which I make a great effort to move forward, a sense of urgency followed by brief periods of hopelessness manifest its self in a “Doom day” sensation. At this stage I panic, there is no way out, every thing is against me, and in addition to that my mother was given anesthesia that caused me to be physically lethargic (its smell and taste are coming up in every very early primal I have). At the same time amplified my panic. I was very close to really completely give up but I made one last effort.

I was all alone in my experience; no one could help me. My imprint from birth, first of all, is: I do not trust woman, I have to do everything by my self, I am lonely, in extreme circumstances I function very well, but it does not feel good to be alive. Here again are the feelings of helplessness and helplessness. In ineffable sense of gloom and doom.

An example: Someone is born with all kinds of allergies from birth on. A history of emergency clinic visits for all kinds of infections, asthma, breathing problems due to allergies, and in general, a very deficient immune system. Here is where we need to push back the envelope and direct our attention to those early months in the womb. When we do, we often find out that the mother was quite anxious and/or depressed. Or often, the marriage is falling apart. Or in one case, as her belly got big the husband was turned off and sought out an affair. The mother was crestfallen, fell into a depression, and we had a baby that was impacted by all this and was born with a diminished immune system, something that got its start early on in the pregnancy. Don’t forget that the immune system, in some respects, is our first inchoate nervous system, sussing out dangers and menaces and organizing defenses against them. This includes secreting some of the pain-killing neurotransmitters we know about today. What starts out to defend us ends up hurting us. If the immune system is compromised there is a good chance that natural killers cells will be, as well.

That fact that we normalize this basic physiologic system means that patients do indeed relive very early origins. I believe that no cognitive/insight therapy could ever alter the natural killer cell system.

Huot and colleagues have shown that a mother’s depression when pregnant negatively impacts the baby. (R.L Huot, et al. “Negative Affect in Offspring of Depressed Mothers is Predicted by Infant Levels at 6 Months, and Maternal Depression during Pregnancy but Not Post-Partum.” N.Y. Academy of Science 1032, 2004. 234-236).

This is not the case of a mother who is depressed when she gives birth. They could predict behavior later on depending on whether the pregnant woman was depressed. The investigators found that stress hormone levels reacting to a minor stress stimulus (arm restraint) predicted negative responses in infants. There was a particularly negative effect if the woman was depressed during the first two trimesters. In short, the effects on in utero life endure. And it is predictive, given certain kinds of adverse events that impact the fetus. And, it seems the earlier the trauma, the more devastating. Here again we see how important events that happen during womb-life are more important than post-birth experience. It has been a saying of mine for decades: The more devastating the trauma, the more devastating the symptom. In order to understand the possible origins of a symptom is to see how overwhelming it is; how completely it blocks functioning. This often tells us how early and how hurtful the imprint is. Its depth in the physical system is another indictor of how early the trauma, i.e., colitis.

Because the baby can be born with higher than normal stress hormone levels, and because the immune system works in seesaw fashion with cortisol (high stress—low immune function) the fetus has possibly set the stage for a lifetime of immune problems. Here is where genetics plays a role; high stress in the fetus will affect those areas with genetic vulnerabilities. After all, what is the meaning of high levels of stress hormone during fetal life? It means an input that agitates the system to be chronically alert. And when the system can shut off that input longer, we have the makings of an enduring primal imprint. That input is maternally induced. So we have a newborn with a high level of agitation already set in place many weeks earlier. Here is ADDHD (attention deficit disorder) waiting to happen. Over time, the deleterious results can range from impulsive tendencies to migraine and high blood pressure (to hold down the imprinted input). It is then no mystery when the child cannot concentrate or sit still. It is not enough to know that there are high levels of stress hormones in the baby, but what causes it, in the first place?

We change natural killer cells after one year of our therapy into normal levels. These cells’ key function is to watch out for cancer-developing cells and pounce on them in an effort to contain them. So a mother’s distress while pregnant can spell life-endangering effects on her baby, not the least of which is later cancer. The earlier the trauma occurs during womb life, the more disastrous the effects. That is our important secret life.

What can be done about this? Treating it first and foremost, then make sure it will not come back? How do we do the latter? By reliving the earliest womb-life events. How do we do that? Well, luckily, each new harmful or adverse experience that remains un-integrated is re-represented later on in a higher level of the nervous system and is noted as the outsider or enemy. It is indeed a threat to the organism. I believe that there are specific frequencies that tie these events together. When we explore these ramified events and begin to relive them, we are also reliving deeper and earlier aspects of the feeling and/or pain. And that is how we relive pure physiologic brain-stem responses without ever acknowledging it.

When there are certain kinds of triggers, the brain conjures up its related history, intact. That is why our behavior is so compulsive and unwavering; our history motivates us all of the time. We are largely victims of our deep unconscious brain. We can only reach deeper into the remote past as we gain more and more access to deeper levels of brain activity. We need to have real good access to our feelings first; then very early brainstem events. That takes time but it can be done.

And what about cancer? The beginning deformity of cells can well begin in the womb with mother’s anxiety due to her own history or due to her marital circumstances. In any case, the fetal system needs to gather its resources to shut down excessive input. Here is where many cells are evolving and gathering their identity, but instead there is massive repression and, ultimately, physiologic deviation, even at the cellular level.

One patient had three siblings all “messed up” and depressed. It remained a mystery why all of them were so disturbed (her parents were indeed loving), until she had very early primals (a systematic reliving of early trauma). She learned that there was a civil war in South America, which lasted many years. The father left the family to go and fight, coming home occasionally to make babies. The mother was in desperate straits with no money, no one to turn to, and fearful of the constant raids into her village. The children, even in fetal life, suffered. She was a loving mother whom the children adored, but with a neglected womb-life, which should not be ignored. It had far-reaching effects. It therefore is an indicator of what went on during fetal life. Can we imagine a doctor learning about a stroke with her patient and then examining his fetal life?

Low birth weight is associated with slow fetal growth and lack of development of various physical systems. If the newborn is abnormal in any respect, even birth weight, we may assume that something abnormal may have happened during gestation. Babies of depressed mothers are more often of low birth weight. At least, let’s consider it. Babies with low birth weight lack muscle, something that follows her into adulthood. Here is a quote from the Helsinki Birth Cohort Study: “(we) have shown that the risk for coronary heart disease and type 2-diabetes or impaired glucose tolerance is further increased in 60- to 70-year-olds who were small at birth, thin or short in infancy, but put on weight rapidly between 2 and 11 years of age. A similar growth trajectory has been shown to predispose to type-2 diabetes or impaired glucose tolerance.”

People who suffer stroke tend to be thin or short at 2 years. There is evidence that these early events can lead to hypertension later on, which is an important risk factor for both coronary heart disease and stroke. The point is that when a child is born out of the curve of normalcy (too fat or too thin), it may be an indication of some abnormality during gestation. I will discuss in a moment the now-significant amount of research on high stress levels in the pregnant woman and its effect on the heart of the baby whose physiology closely adheres to the mother.

We need to study Alzheimer’s disease as it relates to gestational trauma as well as birth difficulties.

Certain height and weight problems at 2 years of age are a well accepted indicator of childhood emotional problems. Why is this so? There are a number of answers. Growth of the fetus relies heavily on adequate oxygen supplies. Because of the large brain, which uses a good deal of oxygen, there is a physiologic demand for more and more. If these supplies become limited for any number of reasons, the body growth will slow down so that the brain can be left intact. Hence, lower fetal weight. Let us keep in mind that cancer can develop and live without oxygen, and maybe that adapting to lower levels of oxygen in the womb is part of an explanation for later cancer. Deprive a cell of a majority of what oxygen it requires and you have one key element in the origin of some cancers. This can only be a hypothesis.

In experimental animals it was found that anything, which increased fetal stress hormone levels, could result later on in elevated blood pressure, anxiety and hyperglycemia. And when we fiddle with stress hormone levels, we increase the likelihood of later cardiac crises. And cortisol levels are also heavily implicated in signaling the birth process to begin.

Cortisol is a stress hormone because it sets in motion the alarm signals to combat too much and too strong an input. When it goes on for a long time it accelerates the possibility of dementia and a whole host of other diseases. Primal imprints do exactly that; maintain a high level of cortisol for a lifetime.

In nearly every study of prenatal life, there is the implication that high stress hormone levels in the pregnant woman can result in hypertension and cardiac problems later on in the offspring. Infants of mothers, who were diagnosed as anxious before pregnancy, had significantly higher stress hormone levels. Neuro-psychologist Paula Thomson explains: “Prenatal stress responses are dependent on the mother’s stress level. But how babies show it is through a limited physiologic vocabulary.” She believes that the fetal stress response is already skewed and, given later stress, the earlier stress response does not change. It can be blocked, diverted, covered over, but it remains pristine clear.

She believes that stress states in the pre-nate and neonate can be recognized by elevated heart rate, and greater activity levels (gross body, single and multiple limbs with higher reflex activation). The pre-nate and neonate may show mistimed diffuse movement and overt grimacing; and will be rather clumsy and have a lack of coordination. All this can be a predictor of later heart disease. That is only if we look at the problem in a gestalt overview.

Thomson: “One overarching goal of this article is to help clinicians understand the potential deleterious effects of prenatal stress. (See Thomson. “Down Will Come Baby.” Journal of Trauma and Dissociation. Vol. 8(3) 2007).

She adds: “It is hoped that increased knowledge of prenatal stress will inform psychotherapeutic treatment protocols, especially when treating severely traumatized and dissociative patients who may themselves have suffered early pre-nate stress. Further, when these patients become pregnant, appropriate treatment for the mother may benefit the offspring. When clinicians provide therapeutic intervention to a pregnant woman the pre-nate may also be affected.” (Field, 2001; Ponirakis, Susman & Stifer, 1998.) (My emphasis)

Let us not forget that (Thomson): One of the most dramatic changes occurs in the first moment of conception. The primitive cell carries the blueprint for an individual who has never existed before and will never exist again. While in the womb, he is having the most important experiences in his life, because nearly all of it is of life-and-death significance. This is what Freud should have addressed when he was developing his theory of psychoanalysis. Here lies the deep unconscious; a dark place with no exit and no words. Biologic responses dominate. In order to relive, we have to include all of our physiologic processes, not just cerebral memory. The first step is to acknowledge these facts; a much more difficult step is to fashion a therapy for them. I think we have done that.

One of the key factors in high levels of maternal cortisol is the increase in the chances of a lost baby; or at the least some kind of prematurity. Again, those levels descend into the fetal system and change the baby in ways we are still learning about. Babies born to depressed mothers have higher levels of cortisol than normal. Here was what Lauren Kaplan and colleagues have to say about this: “In utero environment sculpts the uniquely plastic fetal brain resulting in long-term maladaptive patterns of behavior and physiology.”

(Lauren Kaplan, et al, “Effects of Mother’s Prenatal Psychiatric Status and Postnatal Caregiving on Infant Biobehavioral Regulation.” Early Human Dev. 2008 April; 84 (4) 249-256)

What researchers are now saying over and over again is that womb-life can inalterably affect the lifetime of the offspring. And, it is not only behavior that is altered but the physiology, as well. Does this mean a change in Primal Theory? Absolutely, it pushes the envelope much earlier for when imprints start and for their widespread enduring effects. It means that how the birth trauma is played out, and reacted to, depends on earlier life circumstances.

Information is now amassing as research continues into a heretofore unexplored area. There is an article in the November 14, 1998 of BMJ by Marc Bygdeman and B. Jacobson entitled “Obstetric Care and Proneness of Offspring to Suicide as Adults (Case-control study. Pages 1346-49. See: BMJ Vol. 317. Website: www.bmj.com) that suggests that “through a process of imprinting certain individuals might subconsciously create a traumatic situation during the act of suicide that produces a sensation similar to that experienced during birth.” (Page 1346) This could be a quote from one of my books (and indeed, one of the scientific contributors was a student of mine). What they found was that those who committed suicide violently were more often exposed to complications during birth. Strangely, those mothers who were drugged did not result in suicide by the offspring. But there is the implication that the adult may be more likely to be addicted to drugs. The implication seems to be that opiates given during birth reduce the impact of the trauma and are, hence, less likely to produce suicide-prone individuals.

What my theory states is that when provoked by a certain hopelessness in the present, which is not overwhelming in itself, it can trigger off—resonate—with earlier imprinted hopelessness during birth and sets off an attempted suicide; because it not only triggers the original traumatic feeling but all of the circumstances around it. Thus, suicide, to try to put an end to the agony. And when drugs were given to the mother to ease her pain it also at the same time eased the suffering of the baby. Thus, later on, one turns to drugs to ease pain; a replication of the earlier event. It worked when it was a matter of

The reason that current psychotherapy has been such a failure is the factors that produce current behavior are far, far earlier than we might have imagined. To ignore all of this research is dangerous for the patient because it means she stands little chance of resolving suicidal feelings (and perhaps suicide) without this understanding. So, it can again mean life-and-death for the patient.

I want to emphasize the role of serotonin production in the fetus. For the first few months of gestation, the fetus does not fulfill its quota of serotonin. (This neuro-juice often acts like a pain-killing drug.) It must "borrow" some from the mother. That is assuming she has adequate supplies, which is not always the case in chronically depressed and anxious mothers. If she doesn't, the fetus cannot go to a pharmacy and take out a loan. The mother may be low on stock if she is chronically affected by depression or anxiety or if the circumstance around her pregnancy is unhappy or worrisome. The system stamps-in this event and then permanently alters any number of set-points, including serotonin. A low level of it remains fixed as memory; it is an aspect of the overall memory experience. This is partly the basis for a later free-floating anxiety or depression—a seemingly mysterious state that befalls one without any seeming cause. These afflictions occur because there is a systemic lack of proper repression (serotonin is basically a pain/feeling suppressor). No one can see this; and indeed no one will see it until the constant grinding pain produces a serious symptom. Then the person will be treated for the symptom while he remains basically the same. The system is always ready to spew out another symptom. There is a big difference between the treatment of the human being and the treatment of a symptom. Symptoms are idiosyncratic; underlying pain is just that—underlying. Lack of touch produces similar pain among those who were not touched; where that pain alights is an individual matter; some in behavior, others in physical symptoms. So a person may always sense a feeling of gloom and doom in growing up but never know how early that feeling began or what caused it. To reiterate: womb-life leaves a trace memory of uncontained pain (assuming there was any). The person seems to have been born with fragile defenses, and we may wonder how that happened because there was a loving, caring family around him. Yet even the slightest physical insult can produce a damaging effect in the person. The imprint is of a non-contained fear that leaves one with panic or anxiety attacks later in life. There may be inadequate physical development because chronically low serotonin is known to affect physical progress. Serotonin is as essential as food; it is food for the fetus. We often see, what in the early days of psychiatry was called hysteria, in these individuals. They are easily hurt because they have insufficient defenses; and they exaggerate reactions because there is a seething caldron of fear and pain surging toward the surface. Their reactions are inordinate because they always sit on top of a heavy, dense load of pain.

We now know that a difficult birth can deplete the baby of adequate serotonin/inhibition levels. Later, all kinds of impulse neurotics—criminals—addicts, are low in serotonin, and obviously, low in inhibition. I don’t think we need to stop at birth for adverse effects on serotonin. It can happen as serotonin begins to function adequately, even in the last few months of pregnancy. Again, many of my patients are low in serotonin at the start of therapy but normalize after a year; therefore, it is a reversible phenomenon. (See a full discussion of this in my Primal Healing). It isn’t only serotonin; there is ample research now to show that the neocortical inhibitory prefrontal neurons are low in number due to a trauma at or before birth. These are poor inhibitors from the time of birth on. These individuals cannot wait, lose patience, have attention deficit disorder lash out with little provocation and want what they want NOW! They will interrupt because they cannot wait their turn to speak. All this means that we can be born with a tendency to ADD. It is not heredity but the experiences during womb-life that impacted that heredity. It seems like we are born with it but mostly we are not.

Now let’s push the envelope even further back.

In a recent experiment, a scientist raised some rats after knocking out some of the building blocks for serotonin (the key element in Prozac), which is key for gating or repression; the animal did not have the wherewithal to construct a serotonin structure. (We call that gating; which is no more than blocking pain chemically so that the message of suffering does not reach full conscious/awareness.) He then let the females mature, get pregnant and have babies. Of the 43 mouse embryos tested, 37 displayed abnormalities and brain malfunction. This indicates that the animal mother’s state affects the development of the baby’s brain. Her levels of serotonin can determine how her offspring mature. So, when a pregnant woman is chronically depressed, and hence low on serotonin, the baby’s entire life may be adversely affected. And the changes in her as a result of “heredity” will determine what kind of mothers the offspring will be. Later childhood environment does count a lot but not as much as when the baby’s brain is rapidly evolving. In gestation, it is essential that the mother be normal in every way possible. Otherwise, she cannot fulfill the needs of her baby in the womb. And one definition of love is helping to fulfill the needs of the child. No fulfilling needs—no love.

What is very important for us to realize was that a mouse fetus does not make her own serotonin until the third trimester. It seems like the mother supplies what is needed until the baby can take over. But when the mother is low on supplies, she cannot fulfill what the developing baby lacks. Therefore, the baby carries around a load of pain. Now if we apply that to humans, there seems to be a time in gestation when pain or noxious stimuli impinge, but we are not yet able to produce enough of our own gating chemicals, leading to un-gated pain. This residue will continue and may lead to bouts of anxiety later on in life. It becomes free-floating fear or terror. This is not due to heredity but rather to experience in the womb. This is why we should never neglect womb-life when addressing neurosis. Part of our in utero life, therefore, takes on hurt at a time when our system can do nothing about it. Nevertheless, it affects all later development. At 30, we may suffer from panic attacks (as excessive agitation) that began its life in the very early months of our mother’s pregnancy. It is pristine and free-floating, ready to spring forth whenever we are vulnerable or our defenses are weak. No talk therapy can make a dent in it. It leaves us fragile for a lifetime so that any insult in infancy and childhood weakens us all the more. Demanding and/or aloof parents can easily compound an allergic tendency, for example.

Catherine Monk and her associates studied anxiety in pregnant mothers. (Monk, C. et al.“Effects of Women’s Stress-Elicited Physiological Activity and Chronic Anxiety on Fetal Heart Rate.” Developmental and Behavioral Pediatrics, 2003. Lippincott Publishers. Their conclusion was: “Women’s emotion-based physiological activity can affect the fetus and may be important to fetal development.” To think that there is a significant physiologic change but no later psychological one would be to ignore the human brain.

Now as to the enduring effects of pre-birth and birth trauma: Alyx Taylor has shown that the baby’s stress response to an inoculation at eight weeks was largely determined by the “mode of delivery” of the newborn. Those who reacted the most were birthed by assisted delivery. Cesarean showed the least response. The central finding was that the stress-response circuits (HPA circuit) in the brain help to determine how a baby will respond to future stress.

I am not going to cite any number of relevant studies but one such article is a review of many related ones. Nicole Talge and her colleagues reviewed the data on what happens to the babies of stressed mothers. (“Antenatal Maternal Stress and Long-Term Effects on Child Neurodevelopment. How and Why.” Journal of Child Psychology and Psychiatry. 48:3/4 4 (2007) pp 245-261.)

Nearly all studies claim an effect of the mother on the fetus. I suppose the real question is, “What can we do about it?”. Years later, it seems an impossible task, but it is not. Once there is an imprinted trauma during womb-life, the brain system closes down on the pain through inhibition/gating. Thereafter the effects are life-long.

The best that anyone can do after that is treat the symptom. In order to treat the cause we must go back to the originating source and undo the trauma. The way we do that is to relive the trauma and open the gates. It can be done, as I have explained elsewhere, by reliving emotional trauma during childhood, which has at its roots the pre-birth event. When we fully relive the childhood event it incorporates the earlier trauma; each new related trauma is re-represented on higher levels. And when these later traumas are relived, we see the disappearance (or reduction in the severity) of the symptom, as for example: high blood pressure. That is because the earlier trauma may only be expressed through specific physiologic reactions such as blood pressure or heart rate. To relive the physiologic responses can be enough given other variables. If we connect to the related childhood feeling in our therapy it automatically (given the person having deeper access), includes the earlier physiologic component of the feeling. I want to reiterate that there is a timetable of needs that must be fulfilled at that time and no other. Once the fetus has been impacted due to a high level of stress hormones that is it; the system gates it as best as it can and no other mode of treatment except reliving can change it.

This is a change in our paradigm. It means that trauma that has life-long effects can occur during womb-life, and thereafter has profound effects on our later behavior and symptoms. How, therefore, can we possibly attack allergies, migraine and high blood pressure without an acknowledgment of the deep and remote origins of the problem? I have been writing about this for decades. The difference is that research has now caught up and begins to confirm our theory. And now we see why after one year of our therapy there is a normalization of natural killer cells; as I pointed out, these are cells on the lookout for newly forming cancer cells, and attacks them. So we might say that one way to help forestall cancer is to make sure that our immune system is intact and strong. Although I have written extensively about the value and efficacy of reliving in many books, research is now bolstering this position. From News In Science (June 4, 2008) comes this statement: “The Archives of General Psychiatry is the latest to show the value of using so-called prolonged exposure therapy (reliving) for post-traumatic stress disorder (PTSD).” The study was of individuals classified as PTSD who received three different kinds of therapy. One was cognitive restructuring (altering thinking patterns). The second was Reliving. The last third getting neither form of therapy. Reliving here is defined as being exposed over time to the problem that originally caused the condition. The results were that one-third of long-exposure group developed PTSD. Almost two-thirds of the cognitive group became PTSD, while almost 80 percent of the no-therapy group was diagnosed as PTSD. Six months after therapy again one-third of the Reliving group were still PTSD while the cognitive group was at 63 percent. The researchers summarized as follows: “The current findings suggest that direct activation of trauma memories is particularly useful for prevention of PTSD symptoms.” They point out that PTSD usually does not set in for some several months after the originating trauma. The only difference with my theory is that the traumas occurred far earlier than expected. Meanwhile they point out that there is a “growing trend” toward exposure therapy. Maybe all our efforts for the past 40 years have not been in vain.

Here is what Alexander Jones and colleagues have said about his research on prenatal life: (“Fetal Growth and the Adrenocortical Respnse to Psychological Stress.” Jones, et al. J. Clin. Endoc. Metabolism. Feb. 7, 2006 10:1210/jc. 2005-7.)

I paraphrase to make scientific lingo a bit more understandable: Animal studies show that the stress response changes the set-points of several hormone systems; and that will impact later in terms of how we respond later to harsh environment. A report by K.L. Thornburg and S. Louey (“Fetal Roots of Cardiac Disease.” Heart 2005; 91:867-868.), discusses how stress to the fetus can result in heart disease later in life. When the newborn is underweight (often indicating adverse events in the womb), there is a greater tendency for problems in the endothelium (the lining of the heart) later on in life. There is an indication that lower oxygen during gestation is yet another traumatic factor affecting the heart. Whenever we compromise the endothelium, we run a risk of heart problems, this is obviously true for damage during gestation. It stands to reason that pre-natal traumas are generally all encompassing; we should find damage almost everywhere we look. The problem is that without an all-encompassing theory that directs us where to look we would never put together heart attacks at 50 with a trauma at minus six weeks. I arrived there years ago from observation, which is also a valid part of the scientific method. Research now helps to confirm.

There are several studies that have looked into fetal hypoxia (reduced oxygen) and the results systematically seem to be severe emotional illness later in life. (See: “Behavioral Alterations in Rats Following Neonatal Hypoxia and Effects of Clozapine.” Fendt.M., et al., Pharmacopsychiatry Jul, 2008; 41 (4) 138-45) (Also see: “Decreased Neurotrophic Response to Birth Hypozia in the Etiology of Schizophrenia.” T.D. Cannon, et al., Biological Psychiatry. Vol 64, Issue 9 Nov, 2008. Pgs. 797-802.) There is more and more information about the later ill effects of traumas at birth and before. It behooves us to look into this as those entrusted to heal mentally ill patients. Without this understanding we will not know where to look in order to heal patients. The information is out there; it is up to us in the healing professions to seek it out.

The question is, “Why hypoxia in schizophrenia?” There are several explanations. What I have witnessed over and again is that the fetus is in danger of dying from lack of oxygen and then does not have the wherewithal to combat the trauma (a mother smoking, for example). Lack of sufficient oxygen is a terrible stressor. If it continues, death is in the offing. Further, it leaves the fetus and baby with insufficient resources to combat future stress. The danger remains as a substrate so that any later trauma can set it off; hence breathing problems. So anxiety reactions to seemingly non-toxic situation are inordinate and out of keeping with the gravity of the current situation. They have simply reawakened the almost dying while in the womb. It is never a matter of changing attitudes, as the cognitivists would have it; it is a matter of what shaped those attitudes, in the first place.

I have discussed the notion of the “critical window” in my other works; it simply is that time in life when needs must be fulfilled, and at no other time. We can hug a child all day at age ten but it will not erase the lack of touch for the first four months of life which seriously deregulated the whole system and left a legacy of internally imprinted pain; a pain for which one must constantly take painkillers. And it remains a mystery to the loving adoptive parents who took the child from an orphanage at the age of 12 weeks.

There is no way to make up for that loss except when going back to relive the original trauma. There is no way to “make up for” this deficit as much as we might want to. It is set in altered biologic set-points. We can treat the damage this does (kidney disease) but not its causes. The whole nervous system must retreat to the time when the trauma occurred; it can never be a matter of “remembering.” It has to be organic and systemic memory. That is, part of the precise memory lies in those new set-points. And they are wedded to how they first developed, in the first place.

There is a critical window for healthy functioning kidneys. It is sometime in the last trimester of gestation that most kidney cells (nephrons) are developing (up to the 36thweek). Nephron development begins just after the eighth week. Trauma here, however subtle, may result in later kidney disease, with no apparent immediate cause. Once that damage is done we can only treat its symptoms (unless and until we address origins).

Physiologic reactions are the base for later feelings. What distorts those physiologic responses will ultimately distort psychological reactions, as well. If the system is highly activated due to early trauma, chances are we will have a hyperactive individual who will search out projects to keep herself active and busy. If dopamine and other alerting chemicals are in short supply, we may later have so meone who is phlegmatic, concocts reasons for not doing anything, for not following through. It is not a one-to-one relationship, but we can see how the platform of physiology will eventually direct our psychology. If we don’t have all of the mobilizing chemicals we need, it stands to reason that the adult, in order to keep matters ego-syntonic (comfortable to the person), will rationalize why he doesn’t try and doesn’t persist.

One may rightly question how anyone can relive events in the womb with no scenes or words. Luckily, that part of the imprint is totally physiological. We don’t need verbal acknowledgment. That deep brainstem is also a very important part of our central nervous system and gives the oomph or push to a feeling. A single feeling will encompass all three levels of brain function. Again, there is no exit here except entering into the most profound of unconscious states, which, dialectically, automatically transmutes into consciousness. Remember, each level has its own consciousness, and its own contribution to make. When we arrive down there we are communicating with a level that has an identity all of its own. One level is pure instinct, another pure feelings and still another pure thought. Put them all together and we get pure feeling. A therapy of feeling must take into account all levels of consciousness. And any proper psychotherapy must understand that addressing the most recent top thinking brain level alone must eventually fail. It is overwhelming feelings/pain that caused the problems (say, of addiction), in the first place.
If we strip feelings away from thoughts we get someone who might be a psychopath; going through the motions of being human but without the humanity. The deeper we go into the unconscious the more conscious we become. In a curious dialectic when in therapy we descend to other levels of consciousness (deemed the unconscious) we are both unconscious and conscious at the same time. As we descend down, the unconscious automatically becomes conscious-- at that point we can finally meet our maker—us.

Friday, November 14, 2008

Let's Stop Talking to the Wrong Brain!

A New Paradigm for Psychotherapy

In over one hundred years of psychotherapy very little has changed, except cosmetically. It is still the fifty-minute hour, the sit-up face-to-face-talk with a plethora of insights swaddled in the gentle and dulcet tones of a concerned therapist. There is still the horror of the unconscious as a place of ill-defined demons—something to be avoided at all costs. No one says it, but it is implied in the careful steering the patient into the present and away from the past. The Freudians now call it ego-psychology but it is still psychoanalysis with a slightly different focus; an habiliment—antique get-up with a modern facade. Sadly, in the name of progress they have moved away from the past into a more present approach. The same is true for all of the cognitive/behavior therapies. There is an apotheosis of the present, of the here-and-now, and a move away from the one thing that is curative--history. We are historic beings, imprinted neuro-physiologically with our past. Any proper treatment must address that history. More sadly, for one hundred years we have been talking to the wrong brain! It is that brain that prevents any hope of a cure for emotional illness. Talking to the brain that talks was fine a century ago but now we know so much more about the brain and what it contains; and we know that the damage done to us is imprinted on lower levels of consciousness—far below where words live. We need to learn a new language—that of the unconscious—a language with no words, just feelings and sensations. I submit that psychotherapy has not changed radically in all this time because we always believed that words could help us make profound change in patients; after all, we call it “mental illness.” And, in fact, words often are the defense against feeling. Our goal is to produce feeling human beings, not mental giants.

Now why is that so important? Because we can only heal where we were wounded. We know now that emotional wounds lie deep in the brain out of conscious/awareness. Although the lower brain “talks” to us all of the time, we have never learned how to talk to it. It talks to us in our nightmares, in our high blood pressure and migraines, in our sexual difficulties and in our inability to get along with others. Our history is asserting itself in our every waking moment; yet we go to psychotherapists who want to concentrate solely on the here-and-now. Yet we are walking archives, living in the there-and-`then. We have focused on the present and words because it is the easiest to access and takes no great effort. On top of that, we have not known how to access history. We do now. To get better we need to take the emotional trip to our history and undo the damage through reliving—what I call a “primal.” The trip is not difficult because we can ride the vehicle of feeling back into the past. There is where our problems begin and there is where resolution resides. Knowing how to get on the vehicle of feeling is a little more complicated. If we get on the right train every stop we make will be the right one. If we get on the wrong train, every stop will be wrong.

How do I know that the past is engraved in our brains for a lifetime? And how do I know that reliving changes things for the better? There are now hundreds of studies in the scientific literature documenting the effects of pre-birth and birth traumas on later symptoms and behavior. Allow me to relate one research experiment we did to verify my point. It was at the UCLA Pulmonary Laboratory. We wired two patients to a number of instruments, oxygen levels, carbon dioxide, and blood samples every 3 minutes while they relived, as it turned out, oxygen deficit at birth, something we had not planned at all. Neither patient observed the other so we had a rather pure experience on the part of both men. After the reliving, we did another experiment where each patient mimicked the primal in every way (same movements and breathing) except being in the past. Both almost fainted after 3 or 4 minutes in what was clearly a hyperventilation syndrome (clawed hands). While in the past feeling they breathed very deeply (I call this “locomotive breathing” because that is what it sounds like and seems to emanate from the brainstem--medulla), for about twenty minutes with no hyperventilation. What the researchers from the pulmonary laboratory found was that when the patient was back in the old feeling and its context of anoxia at birth the body needed oxygen; the patient was “back there” in every way, not the least of which was physiologically. It was evidence of the veracity of reliving; that patients can and do go back in time. And they not only go back psychologically but in a complete biologic state. The corollary to this is that the early need for love stays the same and does not change throughout our lifetime. We seek symbolic, substitute fulfillment but it is never fulfilling and compels us to go on seeking more and more, always in vain. The critical time when need must be fulfilled has past.

What we found at UCLA was that despite the heavy prolonged breathing the acid-alkaline balance did not change. The conclusion of the investigators, who were not Primal, was that no other factor other than memory could account for the results. In short, the life-and-death memory was real. It was imprinted. Despite the fact that the blood oxygen was normal in the room the brain was sending signals of a great lack of oxygen, and the heavy breathing ensued. There was no hyperventilation syndrome because the whole system was back in history re-experiencing a key trauma and urgent need.

Why is this so important? Because it can open up a whole universe to us about the depths of man’s unconscious. It confirms that very early experience is impressed into us, not just as a memory but as a wound that needs healing. It endures. Reliving is a real event; the baby-cries during a session can never be repeated by the patient after it. The marks that originally appeared during the birth trauma may again appear in a later session. It is clearly not a simulation. In other words, the past and its neurobiology remains encapsulated inside of us. This can account for a number of lingering diseases in adult life. What is remarkable is that it never changes; it is impervious to experience. No matter how much approval an actor gets he always needs more. It is why I maintain that only being in the context of an old traumatic memory can be curative. Consider, in the session, despite the adequate oxygen in the room the brain is signaling a serious lack of it and the body responds accordingly, it is gasping for air, all to do with the memory and not reality. Therein lies the tale. We are continually responding to old imprinted memory (reality) despite current reality.

The body smokes to kill the pain of anoxia or it takes drugs beyond all control of the upper reaches of the cortex. It is reacting to internal events. That is why lectures on smoking do very little good. The little girl inside the woman is taking drugs to kill her pain, something we never see. Something the person never sees, being disconnected that youth and its feelings.

Here is a seeming paradox: If I were to bring in cold, indifferent momma into the session and have her hug and touch her son during the session absolutely nothing would happen. But if the patient relives her lack of love, everything happens; there is a normalization of so many parameters. So if mother loves the child originally or he feels the lack of it now after thirty years the result is the same. Strange but true. In other words, we are dominated by history, and the way to resolve past pain is by being immersed in it again. We have done vital sign studies on literally thousands of patients to make that definitive statement.
Why is it urgent that we heed this advice? To end needless suffering. Let me offer an example. A new treatment for depression, aside from the endless amount of antidepressives prescribed, is brain surgery where they drill holds in the brain insert wires into the deeper recesses and can send signals to certain centers to alleviate depression. It often helps. But at what price? Brain surgery? The reason they resort to that is because all current therapies have no way to access the deep reaches of the brain where depression may be organized; hence surgery. I submit that we can access those deeper brain areas with very good results with depression. If that is true then brain surgery, a rather drastic affair, can be and should be avoided. This is not to blame the surgeons. They are doing their best to alleviate suffering. But there is another way, which is far less drastic, without the use of medication or surgery. We need to go far deeper to see and experience feelings. That is what is resolving. It means exploring and experiencing ultimate causes. That is what I call “cure.”

Theories have an evolution, and the truest will survive. Let us not stay stuck in the past to a theory frozen in time that has not basically changed or advanced. Freudian theory has very little changed in one hundred years. The attempt to take a current theory and attach it to a past frame of reference is taking a new science and attaching it to an old theory that is not longer valid. That is not progress. If Freud were alive today I doubt if he would be a Freudian. Can we imagine any other branch of medicine still in the grips of the science of 1920? Freud wrote his major, “Interpretation of Dreams,” at the beginning of the last century. Surely there is a bit of progress since then.

Let us not abandon the past in an effort to modernize current practice. Memory is medicine. Let us not eschew critical medicine in order to cure our ails.

Saturday, November 8, 2008

On Why we Can't Express our Feelings

Having feelings and expressing them are two different animals; and I choose those words carefully because having feelings means having access to the feeling structures of the limbic system in the brain. Expressing feelings means access to the thinking neocortex. The only time expressing feelings is important is if the state of having feelings precedes the expression of them. Then the comprehension is an evolutionary outgrowth of those feelings.

Unfortunately, when I was doing insight/psychoanalytic therapy I thought that expressing feelings in a session was tantamount to having them. Not the case. In fact, too often expressing feelings can act as a defense against experiencing them; smothering feelings in a flurry of abstract ideas. When I say “it is two different animals,” it literally is: the primate (monkey) feeling brain versus the human thinking one. Animals feel even when they have no means to expressing them.

I have been writing about this for the last forty years, and just now, new research is coming to the fore to verify this. Early on I posited the notion that one aspect of expressing feelings was the proper connection between the right and left brain hemispheres. Now it turns out that this is basically true; (see Science Daily, May 27, 2008. “Why Are Some People Unable to Express Their Emotions.”) Italian investigators have found that there is a deficit in interhemispheric transfer with those who cannot express their feelings. What that means is that the feelings lying on the right lower brain do not make the trip across the corpus callosum (where emotional information is transferred from one side to the other) to the left understanding, comprehending verbal side. Since eighty percent of all emotional information cross the corpus callosum from one side to the other, it seems logical that there is one key locus for the problem of alexithymia, or the inability to express emotions. It seems obvious now that for help in expressing true feelings one needs access to right side lower brain sites. It does not help to engage oneself in a therapy that is primarily intellectual; an interaction through the realm of ideas. Expressing feelings in words is not feeling those feelings. One can express feelings precisely but cannot necessarily feel them. What is required is a therapist who has access to her feelings and who can know when someone has access or not. So we need a therapy of feeling; one that takes feelings into account, and just as important, a psychological theory based on need.
What seems to be the problem is a dysfunctional cortical frontal-limbic circuits. In particular, the orbitofrontal area. As I have written elsewhere the right orbitofrontal area (behind the orbits of the eye) contains a map of our emotional life and emotional history. It is internally oriented. The left, on the other hand, is externally focused. It is interesting that panic attacks often accompany this condition (alexithymia). These attacks usually emanate from deep in the brain (the brain stem) and are associated with trauma in the first few months of gestation.

A new study (Brain’s Gray Cells Appear to be Changed by Trauma of Major Events. Science Daily June 4, 2008) indicates something I have maintained for decades: “ This suggests that really bad experiences may have lasting effects on the brain.” I believe that the earlier the trauma, (especially during gestation) the more widespread and long-lasting the effects. It seems that the set-points for many physiologic functions are established in gestational life. These dislocations of function remain fixed and unalterable; whereas trauma after birth can often be compensated for. In short, there is a permanent deficit in gray matter when traumas occur while we are being carried in the womb.

We can’t get well just expressing our feelings; we can only get well by experiencing them.

Friday, October 31, 2008

The Critical Window in Psychotherapy

In many of my books I have discussed the critical window, the time in which certain needs require fulfillment. After that, there can be no real fulfillment because the critical time has passed. The need and its pain are sealed away never again to be experienced until someone finds a way to access the deep reaches of the unconscious. Thereafter, those needs can only be fulfilled symbolically. That is, if we need touch, cuddling and warmth immediately after birth and for the first few months of life, fulfillment must occur then. If we are touched after the critical period it will do nothing to alter the basic imprint of being “unloved.” If a mother drinks during pregnancy, no amount of abstinence will do any good later on; even later on during the pregnancy. Once the imprint is in force it endures for a lifetime. Nothing will change it except going back to relive the need and its pain due to a lack of fulfillment.

The same biologic law applies to psychotherapy. There is a critical window during a session when the patient brings in a certain feeling, say, helplessness. If the therapist does not act to help the person delve in the feeling it will be too late, later on in the session. When the therapist does not strike at the critical moment, the specific feeling/frequency she came in with is now gone, and what the patient will be left with is abreaction. The discharge of a secondary feeling, not the key one she brought in.

What I think may happen, and this is only hypothesis, is that when the feeling and its frequency are left unaddressed the patient slips into a secondary feeling with a different brain pattern and frequency. Even though she may look like she connected and resolved the feeling there is a good chance that it is abreaction. It is simply the discharge of the energy of the feeling without connection.

Let me make this clear because so many so-called primal therapists make this fundamental error. There is a time in the session when that feeling is very near conscious/awareness. Without professional help the feeling slides away and the patient, now floundering, manages to get into a different feeling, one that may belong to the therapist’s agenda, not the patient’s. That is because the therapist did not pick up on the entering feeling and then projects his own needs and feelings onto the patient. The patient then goes where the therapist decides, which has nothing to do with attacking the basic need and resolving it. Too often, the patient goes where the therapist tacitly is interested. The patient senses that and becomes a “good girl.’ The unconscious of the therapist implicitly directs the patient.

The pain of lack of fulfillment is always an adjunct to a specific need. To address the wrong need is to forego proper connection and resolution; it is feeling the wrong pain at the wrong time. A depressed patient comes in feeling hopeless and helpless. The therapist may perceive latent anger and urges the patient to hit the wall. The release does offer some relief and they both may think there was resolution. But it was only temporary. The real feeling will return again and again only to be waylaid. Or the therapist may say, “tell your mother!” It may have nothing to do with mother; indeed, the feeling may date back to a time before words. So expressing the feeling is a false route. It is tricky business. A sound knowledge of the evolution of consciousness will help here.

We found that in abreaction the vital signs rise and descend in sporadic fashion, indicating an unconnected unresolved feeling. Too often it looks like a feeling but it is not the central important one. Neurologic connection is the be-all and end-all of the reliving process.

Friday, October 24, 2008

Prenatal Life and its Later Effects

When I first wrote about how the birth trauma and prenatal experience affect adult behavior it was considered “New Agey.” Now, there are literally hundreds of studies verifying this proposition. There seems to be little question now that the carrying mother’s mood and physiology can produce long-term effects on the offspring. That means us.

Let’s start with a simple bit of research; Dr. Daniel Schacter, psychologist of Harvard University has reported on a study where subjects watched bits of a TV series and then had their brainwaves measured. (see: Science, Sept. 2008).

They found when the subject remembered the event, the single brain cell signature was the same as in the first viewing. They reported that it seemed like a reliving; which of course, has been my position. What do you call it when a memory brings up one’s exact history with its precise early physiology. This happens to our patients every day. When there are certain triggers the brain conjures up its history, intact. That is why our behavior is so compulsive and unwavering; our history motivates us all of the time. We are largely victims of our deep unconscious brain.

In Schacter’s research on epileptic surgery patients, they threaded fine electrodes down in the brain of the subject. These electrodes could pin-point small brain storms at their origins. And they could make minute measurements during recall. The lesson? We can relive past events in their entirety, precisely as they occurred. What is very new in all of this is how early an experience can be to affect our later life. Think of the implications: that old memories reside in the same neurons (nerve cells) as were involved originally. That is why the neurotic cannot distinguish between past and present and sees reality through the prism of the past.

Let’s go back to the notion I discussed earlier of epigenetics. One genotype, a single genetic predisposition, can give rise to many phenotypes depending on what happens to those genes during gestation. So what we might imagine is genetic is genetic-plus what happens to us in the womb. So much happens to us in the womb; so much as been ignored in terms of the their long-term effects that many diseases remain a mystery because we are looking at the wrong place at the wrong time with the wrong tools.

What I am learning is that events in the womb explain so much about later life. If you bend an emerging twig you are bound to get a distorted tree. The question has always been, “how’/ early is early?”

An example: someone is born with all kinds of allergies from birth on. A history of emergency clinic visits for all kinds of infections, asthma, breathing problems due to allergies, and in general, a very deficient immune system. Here is where we need to push back the envelope and direct our attention to those early months in the womb. When we do, we often find out that the mother was quite anxious and/or depressed. Or often, the marriage is falling apart. Or in one case, as her belly got big the husband was turned off and sought out an affair. The mother was crestfallen, fell into a depression, and we had a baby that was impacted by all this and was born with a diminished immune system, something that got its start early on in the pregnancy. Don’t forget that the immune system, in some respects, is our first inchoate nervous system, sussing out dangers and menaces and organizing defenses against them. This includes secreting some of the pain-killing neurotransmitters we know about today. What starts out to defend us ends up hurting us. If the immune system is comprised there is a good chance that natural killers cells will be diminished and weakened.

Because the baby can be born with higher than normal stress hormone levels, and because the immune system works in see-saw fashion with cortisol (high stress—low immune function) the fetus has possibly set the stage for a lifetime of immune problems. Here is where genetics plays a role; high stress in the fetus will affect those areas with genetic vulnerabilities. After all, what is the meaning of high levels of stress hormone during fetal life? It means an input that agitates the system to be chronically alert. And when the system can longer shut off that input we have the makings of an enduring primal imprint. That input is maternally induced. So we have a newborn with a high level of agitation already set in place many weeks earlier. Here is ADDHD (attenton deficity disorder) waiting to happen. Over time the deleterious results can range from impulsive tendencies to migraine and high blood pressure (to hold down the imprinted input). It is then no mystery when the child cannot concentrate or sit still. It is not enough to know that there are high levels of stress hormones in the baby, but what causes it, in the first place.

We change natural killer cells after one year of our therapy into normal levels. These cells have as a key function, watching out for cancer developing cells and pouncing on them in an effort to contain them. So a mother’s distress while pregnant can spell life-endangering effects on her baby, not the least of which is later cancer. The earlier the trauma during womb life the more disastrous the effects. That is our important secret life.

What can be done about this? Treating it first and foremost, then make sure it will not come back? How do we do the latter? Reliving the earliest womb-life events. How do we do that? Well, luckily, each new harmful or adverse experience that remains unintegrated is re-represented later on a higher level of the nervous system and is noted as the outsider or enemy. It is indeed a threat to the organism. I believe that there are specific frequencies that tie these events together. When we explore these ramified events and begin to relive them we are also reliving deeper and earlier aspects of the feeling and/or pain. And that is how we relive pure physiologic brain-stem responses without ever acknowledging it.

When there are certain kinds of triggers, the brain conjures up its related history, intact. That is why our behavior is so compulsive and unwavering; our history motivates us all of the time. We are largely victims of our deep unconscious brain. We can only reach deeper into the remote past as we gain more and more access to deeper levels of brain activity. We need to have real good access to our feelings first; then very early brainstem events. That takes time but it can be done.

And what about cancer? The beginning deformity of cells can well begin in the womb with mother’s anxiety due to her own history or due to her marital circumstances. In any case, the fetal system needs to gather its resources to shut down excessive input. Here is where many cells are evolving and gathering their identity, but instead there is massive repression and, ultimately, physiologic deviation, even at the cellular level.

One patient had three siblings all “messed up” and depressed. It remained a mystery why all of them were so disturbed, her parents were indeed loving; until she had very early primals (a systematic reliving of early trauma). She learned that in South America, for many years, there was a civil war. The father left to fight, coming home occasionally to make babies. The mother was in desperate straights, had no money and no one to turn to, fearful of the constant raids into her village. The children, even in fetal life, suffered. She was a loving mother whom the children adored, but neglect womb-life, which should not be ignored. It had far-reaching effects. It therefore is an indicator of what went on during fetal life. Can we imagine a doctor learning about a stroke with her patient and then examining his fetal life?

Low birth weight is associated with slow fetal growth and lack of development of various physical systems. If the newborn is abnormal in any respect, even birth weight, we may assume that something abnormal may have happened during gestation. Babies of depressed mothers are more often of low birth weight. At least, let’s consider it. Babies with low birth rate lack muscle, something that follows her into adulthood. Here is a quote from the Helsinki Birth Cohort Study: (we) have shown that the risk for coronary heart disease and type 2 diabetes or impaired glucose tolerance is further increased in 60-to 70-year-olds who were small at birth, thin or short in infancy, but put on weight rapidly between 2 and 11 years ofage.2, (55) A similar growth trajectory has been shown to predispose to type 2 diabetes or impaired glucose tolerance. “

People who suffer stroke tend to be thin or short at 2 years. There is evidence that these early events can lead to hypertension later on, which is an important risk factor for both coronary heart disease and stroke. A number of mechanisms have been suggested to explain these links.

We need to study Alzheimer’s disease as it relates to gestational trauma as well as birth difficulties.

Certain height and weight problems at 2 years of age is a well accepted indicator of childhood emotional problems. Why is this so? There are a number of answers. Growth of the fetus relies heavily on adequate oxygen supplies. Because of the large brain, which uses a good deal of oxygen, there is a physiologic demand from more and more. If these supplies become limited for any number of reasons the body growth will slow down so that the brain can be left intact. Hence, lower fetal weight. Let us keep in mind that cancer can develop and live without oxygen, and maybe that adapting to lower levels of oxygen in the womb is part of an explanation for later cancer. Deprive a cell of a majority of what oxygen it requires and you have one key element in the origin of some cancers. This an only be a hypothesis.

In experimental animals it was found that anything that increased fetal stress hormone levels could result later on in elevated blood pressure, anxiety and hyperglycemia. And when we fiddle with stress hormone levels we increase the likelihood of later cardiac crises. And cortisol level is also heavily implicated in signaling the birth process to begin.

Cortisol is a stress hormone because it sets in motion the alarm signals to combat too much and too strong an input. When it goes on for a long time it accelerates again, the possibility of dementia and a whole host of other diseases. Primal imprints do exactly that; maintain a high level of cortisol for a lifetime.

In nearly every study of prenatal life there is the implication that high stress hormone levels in the carrying mother can result in hypertension and cardiac problems later on in the offspring. Infants of mothers who were diagnosed as anxious before pregnancy had significantly higher stress hormone levels. What neuro-psychologist Paula Thompson has explained: “prenatal stress responses are dependent on mother’s stress level. But how babies show it is through a limited physiologic vocabulary.” She believes that the fetal stress response is already skewed and, given later stress, the earlier stress response does not change. It can be blocked, diverted, covered over, but it remains pristine clear.

She believes that stress states in the pre-nate and neonate can be recognized by elevated heart rate, greater activity levels (gross body, single and multiple limb-higher reflex activation (Field et al. 2006). The pre-nate and neonate may show mistimed diffuse movement and overt grimacing. Will be rather clumsy and has a lack coordination. All this can be a predictor of later heart disease. That is only if we look at the problem in a gestalt overview.
Thompson: “One overarching goal of this article is to help clinicians understand the potential deleterious effects of prenatal stress. (See Thompson. “Down Will Come Baby.” Journal of Trauma and Dissociation. Vol. 8(3) 2007) She adds: it is hoped that increased knowledge of prenatal stress will inform psychotherapeutic treatment protocols, especially when treating severely traumatized and dissociative patients who may themselves have suffered early prenate stress. Further, when these patients become pregnant, appropriate treatment for the mother may benefit the offspring. When clinicians provide therapeutic intervention to a pregnant woman the pre-nate may also be affected”(Field, 2001; Ponirakis, Susman & Stifer, 1998. (My emphasis)

Let us not forget that (Thompson): one of the most dramatic changes occurs in the first moment of conception. The primitive cell carries the blueprint for an individual who has never existed before and will never exist again. While in the womb he is having the most important experiences in his life, because nearly all of it is of life-and-death significance. This is what Freud should have meant when he was developing his theory of psychoanalysis. Here lies the deep unconscious; a dark place with no exit and no words. Biologic responses dominate. In order to relive we have to include all of our physiologic processes, not just cerebral memory. The first step is to acknowledge these facts; a much more difficult step is to fashion a therapy for them. I think we have done that.

One of the key factors in high levels of maternal cortisol is the increase in the chances of a lost baby; or at the least some kind of prematurity. Again, those levels descend into the fetal system and change the baby in ways we are still learning about. Babies born to depressed mothers have higher levels of cortisol than normal. Here was what Lauren Kaplan and colleagues have to say about this: “in utero environment sculpts the uniquely plastic fetal brain resulting in long-term maladaptive patterns of behavior and physiology.” (Lauren Kaplan, et al, “Effects of Mother’s Prenatal Psychiatric Status and Postnatal Caregiving on Infant Biobehavioral Regulation.” Early Human Dev. 2008 April; 84 (4) 249-256)

What researchers are now saying over and over again is that womb-life can inalterably affect the lifetime of the offspring. And, it is not only behavior that is altered but the physiology, as well. Does this mean a change in Primal Theory? Absolutely, it pushes the envelope much earlier for when imprints start and for their widespread enduring effects. It means that how the birth trauma is played out and reacted to depends on earlier life circumstances.

I want to reiterate my point about serotonin production in the fetus. For the first few months of gestation the fetus must “borrow” serotonin from momma; that is, if she (mother) has adequate levels. If she doesn’t, the fetus can’t go to the pharmacy bank and make a loan. She can be low in stock if she already has a chronic depression that depletes supplies. What is stamped in is a lack of adequate repression by the fetus and the beginning of a free-floating panic or anxiety, which only becomes evident years later as the defense system is under constant attack. This terror cannot be fully contained because of inadequate supplies of serotonin. Then we have panic attacks that are originated far earlier than we have ever imagined. But also these low levels of serotonin affect and retard development. It is as essential as food; it is food for the fetus.

We now know that a difficult birth can deplete the baby of adequate serotonin/inhibition levels. Later, all kinds of impulse neurotics—criminals—addicts, are low in serotonin, and obviously, low in inhibition. I don’t think we need to stop at birth for adverse effects on serotonin. It can happen as serotonin begins to function adequately, even in the last few months of pregnancy. Again, many of my patients are low in serotonin at the start of therapy but normalize after a year; therefore, it is a reversible phenomenon. (see a full discussion of this in my Primal Healing). It isn’t only serotonin; there is ample research now to show that the neocortical inhibitory prefrontal neurons are low in number due to a trauma at or before birth. These are poor inhibitors from the time of birth on. These individuals cannot wait, lose patience, have attention deficit disorder lash out with little provocation and want what they want NOW! They will interrupt because they cannot wait their turn to speak. All this means that we can be born with a tendency to Attention Deficit Disorder. It is not heredity but the experiences during womb-life that impacted that heredity. It seems like we are born with it but mostly we are not.

Now let’s push the envelope even further back. In a recent experiment, a scientist raised some rats after knocking out some of the building blocks for serotonin (the key element in Prozac), which is key for gating or repression. He then let the females mature, get pregnant and have babies. Of the 43 mouse embryos tested, 37 displayed abnormalities and brain malfunction. This indicates that the animal mother’s state affects the development of the baby’s brain. Her levels of serotonin can determine how her offspring mature. So, when a pregnant woman is chronically depressed, and hence low on serotonin, the baby’s entire life may be adversely affected. And the changes in her as a result of “heredity” will determine what kind of mother the offspring will be. Later childhood environment does count a lot but not as much as when the baby’s brain is rapidly evolving. In gestation, it is essential that the mother be normal in every way possible. Otherwise, she cannot fulfill the needs of her baby in the womb. And one definition of love is helping to fulfill the needs of the child. No fulfilling needs—no love.

What is very important for us to realize was that a mouse fetus does not make her own serotonin until the third trimester. It seems like the mother supplies what is needed until the baby can take over. But when the mother is low on supplies, she cannot fulfill what the developing baby lacks. Therefore, the baby carries around a load of pain. Now if we apply that to humans, there seems to be a time in gestation when pain or noxious stimuli impinge, but we are not yet able to produce enough of our own gating chemicals, leading to ungated pain. This residue will continue and may lead to bouts of anxiety later on in life. It becomes free-floating fear or terror. This is not due to heredity but rather to experience in the womb. This is why we should never neglect womb-life when addressing neurosis. Part of our in-utero life, therefore, takes on hurt at a time when our system can do nothing about it. Nevertheless, it affects all later development. At thirty we may suffer from panic attacks (as excessive agitation) that began its life in the very early months of our mother’s pregnancy. It is pristine and free-floating, ready to spring forth whenever we are vulnerable or our defenses are weak. No talk therapy can make a dent in it. It leaves us fragile for a lifetime so that any insult in infancy and childhood weakens us all the more. Demanding and/or aloof parents can easily compound an allergic tendency, for example.

Catherine Monk and her associates studied anxiety in pregnant mothers. (Monk, C. et al.“Effects of Women’s Stress-elicited Physiological Activity and Chronic anxiety on Fetal Heart Rate.” Developmental and Behavioral Pediatrics, 2003. Lippincott publishers. Their conclusion was: “women’s emotion based physiological activity can affect the fetus and may be important to fetal development.” To think that there is a significant physiologic change but no later psychologic one would be to ignore the human brain.

Now as to the enduring effects of pre-birth and birth trauma. Alyx Taylor has shown that the baby’s stress response to an inoculation at eight weeks was largely determined by the “mode of delivery” of the newborn. Those who reacted the most were birthed by assisted delivery. Cesarean showed the least response. The central finding is that the stress response circuits (HPA circuit) in the brain help determine how a baby will response to future stress.

I am not going to cite any number of relevant studies but one such article is of a review if many related ones. Nicole Talge and her colleagues reviewed the data on what happens to the babies of stressed mothers. (“Antenatal Maternal Stress and Long-term effects on Child Neurodevelopment. How and Why.” J. of Child Psychology and Psychiatry. 48:3/4 4 (2007) pp 245-261)

Nearly all studies claim an effect of the mother on the fetus. I suppose the real question is, “what can we do about it.” Years later it seems an impossible task, but it is not. Once there is an imprinted trauma during womb-life, the brain system closes down on the pain through inhibition/gating. Thereafter the effects are life-long. What we must do is go back to the originating source and undo the trauma. The way we do that is to relive the trauma and open the gates. It can be done, as I have explained elsewhere, is by reliving emotional trauma during childhood, which has at its roots the pre-birth event. When we fully relive the childhood event it incorporates the earlier trauma; each new related trauma is re-represented on higher levels. And when these later traumas are relived we see the disappearance (or reduction in the severity) of the symptom, as for example, high blood pressure. That is because the earlier trauma may only be expressed through specific physiologic reactions such as blood pressure or heart rate. To relive the physiologic responses can be enough given other variables. If we latch onto the related childhood feeling in our therapy it automatically (given deeper access) includes the earlier physiologic component of the feeling. I want to reiterate that there is a timetable of needs that must be fulfilled at that time and no other. Once the fetus has been impacted due to a high level of stress hormones that is it; the system gates it as best as it can, and no other mode of treatment except reliving can change it.

This is a change in our paradigm. It means that trauma that has life-long effects can occur during womb-life, and thereafter has profound effects on our later behavior and symptoms. How, therefore, can we possibly attack allergies, migraine and high blood pressure without an acknowledgment of the deep and remote origins of the problem? I have been writing about this for decades. The difference is that research has now caught up and begins to confirm our theory. And now we see why after one year of our therapy there is a normalization of natural killer cells; as I pointed out, these are cells on the lookout for newly forming cancer cells, and attack them. So we might say that one way to help forestall cancer is to make sure that our immune system is intact and strong.

One may rightly question how anyone can relive events in the womb with no scenes or words. Luckily, that part of the imprint is totally physiological. We don’t need verbal acknowledgment. That deep brainstem is also a very important part of our central nervous system and gives the oomph or push to a feeling. A single feeling will encompass all three levels of brain function. Again, there is no exit here except entering into the most profound of unconscious states as possible.

Review of "Beyond Belief"

This thought-provoking and important book shows how people are drawn toward dangerous beliefs.
“Belief can manifest itself in world-changing ways—and did, in some of history’s ugliest moments, from the rise of Adolf Hitler to the Jonestown mass suicide in 1979. Arthur Janov, a renowned psychologist who penned The Primal Scream, fearlessly tackles the subject of why and how strong believers willingly embrace even the most deranged leaders.
Beyond Belief begins with a lucid explanation of belief systems that, writes Janov, “are maps, something to help us navigate through life more effectively.” While belief systems are not presented as inherently bad, the author concentrates not just on why people adopt belief systems, but why “alienated individuals” in particular seek out “belief systems on the fringes.” The result is a book that is both illuminating and sobering. It explores, for example, how a strongly-held belief can lead radical Islamist jihadists to murder others in suicide acts. Janov writes, “I believe if people had more love in this life, they would not be so anxious to end it in favor of some imaginary existence.”
One of the most compelling aspects of Beyond Belief is the author’s liberal use of case studies, most of which are related in the first person by individuals whose lives were dramatically affected by their involvement in cults. These stories offer an exceptional perspective on the manner in which belief systems can take hold and shape one’s experiences. Joan’s tale, for instance, both engaging and disturbing, describes what it was like to join the Hare Krishnas. Even though she left the sect, observing that participants “are stunted in spiritual awareness,” Joan considers returning someday because “there’s a certain protection there.”
Janov’s great insight into cultish leaders is particularly interesting; he believes such people have had childhoods in which they were “rejected and unloved,” because “only unloved people want to become the wise man or woman (although it is usually male) imparting words of wisdom to others.” This is just one reason why Beyond Belief is such a thought-provoking, important book.”
Barry Silverstein, Freelance Writer

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