Friday, August 15, 2008

A New Paradigm for Psychology: Revolution in 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 evasion 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.

Thus far, we have been talking to the wrong brain! Unfortunately, that brain doesn’t talk, doesn’t understand English and, as a matter of fact, doesn’t understand words. The correct brain is one that contains our history, our pain; the lower brain that processes our deep feelings that can finally liberate us. It does understand feelings; we need to speak that language—one without words. No one can be cured until we understand the profound underpinnings of emotional and mental illness. Words are the province of the top-level neocortex, evolved much later than the feeling brain. There is a lifetime of experience buried below that top level that governs our behavior and the development of symptoms. Therein lies the rub. For it means flouting the warning about plunging patients into the deep unconscious, an unconscious, they implore, that will irrevocably disturb the psyche. And it is this caveat, among many equally wrong, that have kept the practice of psychotherapy in the dark ages, literally, believing there are dark forces that propel us here and there beyond our control.

Psychotherapists often bow to history but only as a token. Yet history, the patient’s past, is medicine, and it is the only medicine that is curative. The past is a duty for the therapist; without it we are again in the old psychotherapy of the early 1900’s. 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.

Once we have a firm grasp of history and its evolution we will know that addressing mental illness is not a matter of just understanding it but being immersed in it; submerged in our history, in its feelings, ceding to its power until words (our top-level brain) will no longer suffice; only feelings can. Words will simply not do it; in fact, words are the antithesis of cure, inimical to any therapeutic progress, as odd as that sounds, because they are too often used for a defense. As a matter of fact, in many situations the more the intellectual brain is active the more suppressed the feeling centers are.

I practiced Freudian-oriented psychotherapy for many years. One key reason was that there was relatively nothing else for the practice of dynamic psychotherapy. At least Freud posited an unconscious, and were he alive today I am sure he would not be a Freudian.

Let me start with my first important observation in therapy. A young man in conventional group therapy was recounting a visit he made in New York to see Raphael Ortiz in the theater of the absurd. He said that Ortiz was marching up and down the stage shouting mama! And inviting the audience to do the same. When they did many people in the audience began to cry and scream. I encouraged this young man to do the same. He refused but I insisted. Finally he began to scream mama!, fell off the chair and was writhing in pain on the floor. It went on for a half hour, something I had never seen before. When he came out of it he touched the carpet and said, “I can feel!” He felt different. I taped this session and for years afterward I listened to it to see what secrets this held. I also tried this again on other patients with very much the same result. I knew that I saw something that therapists practically never see but I did not know what it meant. I finally figured out what it meant only years later. I tried to see what these patients had in common. It was feelings—access to feelings that made the difference. It would take another twenty five years to figure out what was going on inside the person and her brain; but there was some basic truth I had uncovered. The result, I believe, is a new paradigm in psychotherapy; and it is not just a belief.

Obviously, if we allow patients to go deeply into their past without any intellectual interference we can learn so much. There lies a sequestered reality undreamed of in our field. And there lies the cure. By “cure” I mean arriving at ultimate causes. If we see time after time that those with migraine often relive oxygen deprivation at birth we begin to realize that perhaps oxygen deprivation may be one “cause” of later migraine. Particularly when those migraine begin to disappear after many relivings. This without a fixed theoretical mind-set. The same is true of many symptoms. Until we see in therapy the relationship between high blood pressure and traumatic events around birth we cannot alter it significantly. “Cure” means addressing and reliving the ultimate cause of our behavior and physical problems. We cannot do that until we acknowledge that very early events, even before birth, are imprinted and endure for a lifetime; that in order to eradicate serious even life-threatening symptoms we need to go back and relive those suffering aspects of an imprint that could not be experienced originally due to their load of pain. In my book, Primal Healing, I document the many, many studies that confirm the enduring power of early imprints.

There is no Jungian unconscious or shadow forces to blind us to the patient’s reality, no id nor other mystical notions. We can observe and later, we may draw some conclusions. Those conclusions would follow our observations. The problem is the need to absorb current observations within some kind of pre-established theory in order to make sense out of it. Some of the past trauma makes no “sense” in the ordinary scheme of things. there are no words nor scenes to put to it. I saw birth reliving for months and told my patients this was absolute nonsense because a local university neurologic department said that it was not possible. But they continued on and I had to reorient my thinking. Not only is it possible but we have seen it now with hundreds of patients from many countries of the world including those individuals who never read about it in my books. It is a measureable event. And we have researched it at the UCLA Pulmonary Laboratory as well in several brainwave studies.

Thomas Kuhn wrote that in the evolution of science there are periodic shifts or jumps that represent major changes in the direction of a particular scientific discipline. He labeled these jumps Paradigm Shifts. In our view, Primal Therapy and Primal Theory represent a major paradigm shift in the science of psychology. And in the course of this new perspective I want to demonstrate how a brain system designed to allow us to function under stress is in fact at the root of our mental problems. It is the story of the evolution of the brain and feelings. And evolution cannot be ignored in the therapy of human beings. Let’s take the case of deep depression. There are now modern techniques to ameliorate it—from tranquilizers and pain killers to drilling holes in the brain and probing deep down. The reason that we have had to used drugs and surgery is because there is no therapy extant that can go deep enough to affect the areas specifically involved in processing emotional pain. We can and we do. It is why we can use the word “cure.”

We in the profession and as patients may have a hard time embracing a feeling approach that seems to contradict what we think is correct. Namely, the value of ideas, insights and beliefs in assessing progress in psychotherapy. Therapists take the patient’s word for it. That should be the last thing we should be doing; for the left-brain intellectual side can imagine all sorts of cures and epiphanies while the subtext, the unconscious, is riddled with agonies. Neurosis is not due to a lack of insights nor cured by them. What is curative is an experiential therapy not a cognitive one.

If all we do in psychotherapy is no better than a religious epiphany, we have not gained much. In religious states the person often does feel much better, is more optimistic and ready to function. At least our field has made some important progress in understanding the life-long impact of early non-verbal or pre-verbal events on adult behavior. And we need to measure those preverbal events with non-verbal methods; those machines and blood tests that tell us what is lodged in the deep recesses of the brain.

Each week brings new confirmation of our position: a study of newborn rats who received just a small series of pain pricks showed greater preference for alcohol as adults. None of this is a mystery any more. The question remains, what to do about it? “It” is the imprint. What to do is to understand that the suffering component of early pre-verbal pain has never been felt and integrated; rather, it was coded and stored waiting for its chance to meet up with prefrontal brain cells for integration. We must go back slowly in therapy, neurosis in reverse, to events that carry such a load of pain that only pieces of it can be experienced at any one time; that is what is necessary. As I mentioned, it is neurosis in reverse, a reverse where we must not skip steps in retracing evolution. We cannot go back immediately to the birth trauma.

What seems to have happened early on was that the pain of birth or being left alone for hours right birth or not being touched in the first months of life caused great pain. The suffering component of this pain is sheared off and placed in storage while the precise memory of it may be stored elsewhere. That is why a patient can recall in detail an event, “They gave my dog away,” and yet take months to feel the pain of it. What we do is recapture the hidden pain, the part that was sheared off, and help the patient experience it over time. Never in one session, but in many sessions over months and months. Anything else defies evolution and the understanding of the valence of pain that resides on the deepest levels of the unconscious.

A study by Finnish scientists M. Huttunen and P. Niskanen investigated children whose fathers died either while the mother was carrying or during the first year of the child’s life. The offspring were examined over a thirty-five year period using documentary evidence. Only those who lost their father while the child was in the womb were at increased risk of mental diseases, alcoholism/addiction, or criminal behavior. Clearly, the emotional state of the mother was affected and that possibly had lifelong deleterious affects on the child. The results of this study suggest that the emotional state of the pregnant mother has more long-term effects on the child than the emotional state of the mother during the years following birth. And when we are investigating addiction we must pay attention to womb-life.

Until there is a science of psychotherapy, one that coalesces with modern neuroscience, there will be human suffering with no real chance at relief and cure. Depressions, anxiety, phobias and obsessions will go on ad infinitum. We need a new orientation to what we are doing, to open up our frame of reference. We need to get away from the perspective that views man as some kind of decorticate brain bereft of a body and its hormones. We need to merge psychology with neurology and biology so that man is not dissected into small pieces for study. And once dissected each aspect becomes a subject for statistical analysis which does not seem to advance psychotherapy as a science. We need a radically new paradigm in psychology and psychotherapy; one that is based on evolution, feelings and imprinted memory. Everywhere we have looked, with thousands of patients from some twenty countries we have found pain at the bottom of it all.

The question is how do we get rid of the pain? Up until now our only recourse was to squelch it with tranquilizers or talk it to death with myriad insights. We know now that the task is not to avoid that unconscious pain, but to be awash in it. First we must go back and relive the past memory in sequential order, a bit at a time, as it was laid down. We need to be submerged in old painful feelings, let them control us for a moment, and dialectically, we can then control them; no longer the unconscious force driving our behavior and symptoms. There is a way to be rid of the unconscious forces that give us nightmares, high blood pressure and a myriad of act-outs, not the least of which are sexual. We need to let that unconscious rise to the surface, shake us, makes us cry and scream amid waves of pain and then, lo and behold, we are free! And that freedom, that ability to feel, is ineffable. We can (and have) measured it in the blood, in saliva and in the brain. And finally, it is evident in the comportment of the patient. But the testimony of patients is only one aspect of what we look at.

If we feel unloved by our parents to the depths of our soul we open the channels finally to accept love—because we can feel. Until that time the imprint will lock-in defenses and block feelings from getting out or in. If we can feel hidden pain, and its context—its origins--we give patients back their feelings, the most important gift any therapist can offer them. This cannot happen if we think the unconscious is some immutable power lurking in the dark antipodes of the mind waiting to destroy us; some unthinking malevolent force of evil. After all, when the disguise is ripped away from this so-called theory, it is just another mystical notion devoid of any reality. Patients will never get well based on mysticism.

I have taken my patients as deep and as remote in their past as possible and I have never found a demon or dark, evil force. All I have ever seen is sequestered pain. All that is there is pure need left over from infancy when those needs should have been fulfilled. They are here now because they were never fulfilled and resolved back then. They drive us now as a reminder of a true lack of fulfillment early on. We act-out now trying to find fulfillment but all we can ever find is symbolic, hollow fulfillment that does nothing about the real need. We must go back and feel that need in its original context and original form; only then will we be free of it. We will have transformed the “need for” (drugs, food, sex) into pure early need for love when it was a matter of life itself.

How can we fight an enemy if we never know what it looks like? Are feelings an enemy? Their force is. They remain an alien power because they could not be integrated at the time; their valence was far too strong. We are older and stronger now and can manage to face it.

I do use the word “cure,” which is not to be treated with opprobrium, but rather a state to be sought after assiduously. If we are able to travel back and down to the earliest days of life and undo and redo imprinted history we can then use the term “cure.” We have arrived at ultimate causes. If we do not travel back to the far reaches of the unconscious we cannot use the term “cure.” We are but skimming the surface, leaving a massive dark force intact. We need to insist on the goal of cure and the avenues that get us there. Insights in therapy will never get us there. Neurosis isn’t caused by a lack of insights and cured by proferring them. It is not enough to state that we want a cure for our patients; we need to see the proof, not just in their statements but in the various changes in hormones, in other biologic changes and in the brain function. In short, we must not leave the body out of the equation, which too often happens in modern day psychotherapy.

So what is it about reliving that is so important, indeed, the sine qua non of any effective psychotherapy? It means acknowledging the evolution of the brain. It means taking into consideration the role of feelings in therapy. If it is done in a systematic fashion over many months it is not at all dangerous. But then the problem is that the the psychoanalytic view of the unconscious is a turn on the old religious notion of the 1800s—dark and demonic forces (also known as the id or shadow forces) marauding on levels beyond our reach. That is one reason they stay away from it. But if they were ever to disregard that warning, bypass that intellectual, insightful brain, and let patients slip into their past they would see what lies in the unconscious. What they would find is nothing more than our history, laid out in order from the present to the most remote including birth and womb-life. And it would not be approximate; it would be precise; memories lying in storage waiting their turn to be connected to conscious awareness We need to understand that the suffering component of early pre-verbal pain has never been felt and integrated; rather, it was coded and stored waiting for its chance to meet up with prefrontal brain cells for integration. We must go back slowly in therapy, neurosis and evolution in reverse, to events that carry such a load of pain that only pieces of it can be experienced at any one time; that is what is necessary. That is what cures.


  1. Some half-ass ideas on how to expand Janov's Primal Therapy:
    (Feel free to criticise or add more thoughts)

    1. Set up the non-profit Arthur Janov Children's Center. Parentless children will live at the center, receive private schooling and Primal Therapy which will be paid for by donations and government assistance. Some of these children will grow to become competent Primal Therapists. Any negative criticism will be strongly contradicted by the happy faces of children who have been well cared for.

    2. Set up a non-profit Shrink Club. Shrinks from all around California can get together in a friendly relaxed environment and discuss ideas with each other in a less formal way. As more personal relationships begin to form, shrinks will make more time for friendly conversation. It might create better opportunities for Primal Therapy.

    3. Create worldwide controversy. Do not try to sell Primal Therapy through mass-marketing. Instead, aggressively advertise the hazards of mainstream therapies and fake primal therapies. Fear is one of the most effective marketing tools used in the advertising industry. The result of this negative mass-marketing might be:
    * a new public perception of psychotherapy in general.
    * annoyed therapists asking Dr. Janov (or whoever) to put his money where his mouth is.
    * increased interest from government due to increased public interest/fear.

    4. Change the name of the therapy and trademark the name to create a better platform for future marketing. Make the transition gentle by continuing to refer to previously published books containing the term 'Primal'.

    5. Create a TV documentary about life inside the womb, birth, imprints and the effects on personality. Avoid the topic of Primal Therapy. Keep it blunt and provocative. Use a voice that is commanding and intelligent, but not too deep (we don't want super-stars of wrestling). Add computer graphics to show oxytocin moving from mother to fetus. Show scenes of children refusing to be hugged. All of this will remove the rediculous component in Janov's words. (should be the kind of documentary where the broadcaster issues a statement: "...we do not necessarily share the views expressed in the following documentary....")

  2. Dr Janov.

    I have looked through critisims of primal therapy with respect to what I have found online, and I notice that no-one confronts what I consider to be the two big questions:

    1. Is it true that traumatic-level pain is repressed into the system and finds its symbolic release through compulsions, and essentially leading to the essense of neurosis as we know it?

    2. Assuming that the first assertion is true, then is it likewise possible to integrate blocked emotional/physiological pain by de-repression, so as to allow ourselves to carry on where we left off, which basically means letting the originally blocked pain run through its course so we can naturally "get over it" like we eventually do for other pains in life, and in turn having old trauma be left in the past?

    If those 2 premises are true* or at least can be considered quite possibly true, then that is all a RATIONAL scientific psychology world should require to make a serious investigation. Not an investigation into Janov or your particular brand of therapy as such, but an investigation into the process and function of the Imprint.

    Instead we get all this trivial bullshit on "..Janov's therapy may help here or there for some or many.." of which suggests that the researchers or critics have missed the real points. If it's true that people can and do integrated blocked pains then that's the concern - NOT the successes and/or failures of Janov's particular brand of regression-assisting therapy, be what they may.

    Maybe you should ram this message home to critics and potential researchers? Maybe they'll be less distracted by possible issues that are actually beside the point? Maybe this will help to get us faster on the road to a revolution in psychotherapy - if it is to happen.

    *I agree with much confidence in the first premise, and the second at least in part...but I have yet to personally validate our ultimate capacity to integrate more profound pains. The latter will take some personal experience with the primal process.


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.