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.

5 comments:

  1. I’m glad you mentioned: «…this is only hypothesis …», because bases on my 30 years experience in primalling, this idea of a «critical window» in a primal session should be thrown out the window! Also, all notions like: «… when the therapist does not strike at the critical moment…» (therapists are there to help, not to strike) or «… the feeling slides away …» are counterproductive to learn how to feel and have good sessions.

    In a session, we need to relax, to be spontaneous, to trust and accept whatever feelings we might have without any censorships (i.e. our feelings have the absolute right to be irrational, illogic, immoral, unrealistic, exaggerated, etc.) and without any attempt to decide where we want to go. We don’t need the stress of missing a «critical window» or the fear that «the» feeling might slides away. The motto: «It’s now or … later!» is a much better one. Feelings do not get away like that; it takes years to get rid of them.

    If we learn to get conscious about how we feel «now» and what situation has made us feel like this (sometimes, when did it started? Will help us remember the exact situation). Then, describing the situation will help us to go back there, to set the «theater of operation»: who was there? what happen? what hurt me? (or what hurt me the most?) Tell him, or her, or them what this makes to you; do them what you feel like doing to them. You don’t want to talk to them? Tell them that; tell them you won’t talk to them and why. The crucial part is getting to the point where we can express the feelings we needed to express and we could not because we hurt too much or the multiplicity of feelings was creating confusion. With the primal technique, we have a second, or a third, or (whatever is needed) chance to express it (which is required to feel it completely) and thereby do the proper connections. We need help from a therapist to learn that process and to learn to recognize the many ways in which we will be tempted to escape from the feeling.

    … continued in part 2 (sorry, maximum 4,096 characters)

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  2. … continuation from part 1.

    Of course, as all primalling people know, expressing our feelings in a recent situation will very often awake our memories and some others situations from the past will be brought to our attention because they are related to that same feeling. It is the emotional path that will lead us gradually to more and more ancient repressed feelings. Since feelings has no notion of time, our «emotional now» will travel in time and we will cycle back into: describing the situation, who was there, what happen, what hurt me, tell him, her or them, etc. These passages from one scene to the next are critical moments in the process. We should not be «watching out for them» or ask ourselves what this situation remind me of? this would be driving the process with our head (cognitive brain). We should not «jump» on any flash that cross our mind or we loose focus, get lost and avoid feeling. If we concentrate on staying in a scene, letting ourselves feel everything that’s there for us and express it intensely, if there is a related scene this scene should impose itself to us ready to be «played».

    If we get lost and realize we do not even know why we are crying about (I know, this could be the feeling.) sometimes going back to the original situation we started the session with will allow us to find our way back and go further.

    I never tried the vital signs test to check out if a session was productive. But, a good way to check out if it was, is to think back about the original situation that was making us feel «uneasy»; our trigger. If we did useful work, we should clearly see the relationship between what we felt about and this original trigger. If we could not see the link, we were probably out in the woods somewhere. We should also feel «different» about it, more in peace. That is normally an indication that we did a good job. It may also happen that something is still bugging us about the said situation. This simply an indication that there is something else (or more of the same) thing left for us to be felt.

    The more we learn the process and learn to trust our ability to feel and to trust the validity of what we feel, the less any therapist (mocked or not), will be able to interfere with our process. Learning the process and gaining confidence in our ability to do it successfully is where most professional help is needed.

    Charles-Gilles Massé

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  3. Charles-Gilles: Sorry we cannot get rid of the critical period because it is a biologic fact, not a supposition. and if the need is not filled in that time it can never be filled again; except thru primal. That is why there are act-outs, symbolic behavior; trying to fill again what was not fulfilled earlier on. art janov

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  4. Art: Sorry I didn't mentioned it explicitly in my comment: I was not disputing the biologic fact that critical periods do exist in the human development but rather your hypothesis that the same kind of critical periods were reproduced in a psychotherapy session.

    Charles-Gilles Massé

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  5. But you see when we go back to a specific time to feel the need we are in fact returning to the critical period. This makes the experience all the more effective and encompassing. You feel the early need as it actually and then feel the pain of lack of fulfillment. In everyday life you do not necessarily feel the need but the pain longers on forever. You see if it were not like that it would not be a real primal. It would be the adult and adult brain looking at the child. A whole other thing. art janov

    ReplyDelete

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Editor