Thursday, September 25, 2008

On the Nature of Insight

Having practiced insight/psychoanalytic therapy for many years, having been trained in a Freudian clinic where the doctors (mostly Viennese) were either students, patients or colleagues of Freud, the notion of insights was the untouchable touchstone. No one ever really questioned it or defined it. It was just a “given.” An article of faith, and when a say “faith” I mean faith—something with no proof, whatsoever. So let’s see what it is.

Mark Jung-Beeman, the name Jung should already prepare us, is a neuroscientist at Northwestern University who studies insight. He began searching the right hemisphere for clues to insight. Why there? Because the left deals with specific denotation while the right is largely concerned with connotation, the meaning, sense and feeling/emotional charge of something. Subjects were given puzzles to solve. Many did not. A few did and had an aha! Experience—an insight. Mind you, this was an intellectual insight. It wasn’t an insight about one’s own behavior and what feelings drove it. First there was an activity in the prefrontal area, thinking and calculating. This was the preparatory phase. The second phase was the right hemisphere; a small fold of tissue on the surface was activated just before the insight. In short, it takes two to tango; both hemispheres play and part in insight but, I submit, without a significant contribution of thre right hemisphere the insight remins cerebral and not life changing. Further, I believe, not yet proved, that the insight about feeling motivation must involve the right hemisphere which then provokes the left hemisphere into activity, hence, the insight. But if the insight defies evolution and begins with the left, thinking hemisphere, there will be not significant change in either symptoms or behavior.

What scientists are saying is that the nerve cells in the right hemisphere are more broadly tuned than the left with a further reach, more dendrites and longer axon branches.

This means, among other things, that neurons on the right are collecting information from a larger area of the cortex; and that means more input into the insight. Specifically, more feeling input, hence a deeper insight. The impetus, then, for the insight is right brain. And, as I have written, grosso modo, the right is the feeling brain, the left is the thinking brain. We need both but the brain must follow evolution and start with feelings. Thinking came along after, a long time after. We cannot expect the insight to be purely left brain.

But here is the crucial part. The researchers claim that to have insights we need relaxation, not a hyper-stimulated left brain, something that happens in insight therapy. The claim is that the drowsy brain is disorganized and open to new input—an insight. The sine qua non for an insight is a mind that is not too focused, a mind that wanders. Trying to force an insight, which is what happens in cognitive/insight therapy is counterproductive. We need to suppress the thinking brain at some point in order to gather up insights. This is exactly what does not happen in insight therapy. I know. I did it. Why are pre-psychotics so insightful? Their whole perceptual thinking apparatus is deranged. Scientific insights nearly always happen when the person is not focused but relaxed and reposed. So the almighty prefrontal cortex is not so “ay ay ay” after all, as my mother used to say. Again, there is not significant change with intellectual insight; only the belief that there is; a state of self-deception that endures so long as the person continues to go back for more insights, often the same ones. We have two sides of the brain, and we need them both if we are to change. Here is what Jonah Lehrer says of all this: “The brain is an infinite library of associations, a cacophony of competing ideas, and yet, as soon as the right association appears, we know.” (see. “The Eureka Hunt.” New Yorker. July 28, 2008) He describes a “rush of gamma (very fast) waves on the right. Then the epiphany. Once you have both sides participating it all seems obvious. But suppose you are an intellectual, a scientist, heavily left-side dominant, then it never seems obvious; something like a feeling insight is out of reach and non-comprehensible. The therapy of feelings arouses only suspicion and distrust. And when you speak of pre-verbal imprints all is lost.

With right brain input the prefrontal area leaning against the inside of the forehead goes into action and correlates and corroborates it all. It is the final switchboard where it is all plugged in. And it has input and export to many areas of the brain so it has an overall impact. It can work “bottom-up.” Feelings first then thoughts and comprehension. When that area is too active it can shut-down many feeling areas and block insight—a top-down event. And that is what happens in insight therapy; using the top level to contain and repress feeling areas so that profound insights never happen. The person is content with intellectual ones. So it all depends on whether the top pre-frontal area can turn on versus suppress feelings. Real insight depends on a turn-on. And that means suppression for a brief time of cortical rumination. What Lehrer says is that when the right hemisphere generates the necessary association, the pre-frontal cortex is “able to identify it instantly, and the insight erupts into awareness.” (page 45) A more accurate description of what happens in Primal Therapy does not exist. So an insight is a matter of reconfiguring information; putting it all together, feelings and their understanding. That is the kind of insight we cannot undo. We can undo the intellectual insight because it is not anchored.

What we would need eventually is a MEG study (real-time magnetic resonance) to measure where insights are and where they come from. We will need to perfect our machinery before we can do that. But, happily, we have our human machinery that offers a good number of answers. Let us trust it and evolution and we won’t go wrong.

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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.