Wednesday, August 27, 2008
When we think about a song, we can have all of the related emotions all over again. It has been engraved in the brain and can be recalled at any time. The grand orchestrator seems to gather up all the disparate facets of memory, assembles them into a meaningful event and remembers it entirely. The memory is a network of brain circuits joining in an assembly of nerve cells to fill out previous experience. Thus any feeling in the present has the ability to trigger a whole host of memories and feelings that resonate with the present and glide along the same neuronal frequency. In this way a pain now, a rejection, can resonate with serious past rejection from our parents and thereby produce an anxiety attack. It gives weight to the present reaction, which may seem inordinate, but in reality is the bottom rung of a neuronal circuit.
It is in this way that we can summon up the memory of love, feel love and offer it to others. If we never had it, we cannot offer it to anyone, because the feeling is not there. Pain in the present, a humiliation, sets off an old memory; the gates rush in to block the resonating circuits to keep our reactions under control. The circuits involved are all part of the entire experience. We can block part of it from our past so we can function in the present.
My work involves getting below the gating, which keeps old memories at bay, to penetrate the antipodes of the unconscious and allow individuals to heal because they have felt all of the old pain that has gnawed away at them for decades. Suppose the circuits of the mirror neurons evolve early in our lives, even before birth, and are adversely affected by womb life. That may mean that the ability to empathize, to feel what others feel may be impaired. The person grows up without those abilities. The mother's body, which was the whole world to the fetus, has shaped a being with diminished capacity of mirror neurons - for now a supposition. Imagine that she was depressed and transmitted her pain through her hormones to the fetus who suffered. He could not feel what she felt because it was too painful. He withdraws. One way he may do that is through diminished mirror neurons. We will wait to see about this.
On the evolutionary scale, the feelings in music are much older than words, which came along millions of years later. It is why music can move us far more than words. It therefore has a greater impact; hence the singing commercials, which did not come into being until after World War II.
The discovery of these neurons was made by an Italian team of scientists who used brain imaging techniques to find an entirely new class of neurons that become active when we are. Feeling what someone else is feeling is extraordinarily important for us to become humans who care for and about others. These nerve cells are found in the parietal lobe and allow us to imitate unconsciously the actions of our parent. So in some cases a male child will have an effeminate walk as his mirror neurons pick up clues from his mother. This is another way of saying that he identifies more with his mother than with his father. In essence, mirror neurons match actions and feelings of others with our own. It shows we are social animals, otherwise why these neurons? If we were social isolates we would not need mirror neurons.
So we can undergo what others undergo. We should high-five. We feel what they feel. It is a way we live through others; and it is a way we can block our own painful feelings through what others achieve in life. We therefore have a greater interest in baseball and football than what would be expected, because that is us out there.
Let me explain. When something happens in the present it triggers off related feelings or memories on lower levels of consciousness—in the unconscious. It is what I term “resonance.” ( It may be that the nerve or neuronal circuits have the same frequency so that when one feels neglected or ignored it sets off memories of the parents neglecting us and we “overreact” to the slight in the present). It seems like an overreaction but it is not; what we are reacting to is just hidden from sight. That same feeling can resonate with being ignored in infancy; (no one comes when the baby is crying in the crib). What seems to be happening is that the synaptic weight of the memory is commensurate with the valence of the very early painful imprint. Each level of consciousness contributes its share to the total feeling that will coalesce to produce a unified, cohesive neuronal circuit, finally offering meaning and power to the event. It is that meaning/power that can drive one to kill when a girlfriend leaves her lover—“I feel abandoned (by mother). I can’t live without her.” Murder is clearly an overreaction but when placed in context we can at least understand it. Think of present-day trigger as a dredge that digs deeper and deeper widening access to the most powerful and remote memories. That dredge goes where the feeling leads it. It seeks out related events associated by feeling.
Although the resonance/frequency connects all the top and lower level circuits the weights of the memory are not the same. The valence of some memories is greater than others and become more powerful as we descend down the chain of feeling to the level of birth memories or even to events in the womb.
The deeper circuits provide the impulsive, importuning force for some of our uncontrollable behavior, forcing us to “overreact”. We will scream and yell or even punch someone. The point is that when we approach the lower levels of imprinted pain we are also approaching the shark brain with all of its possibility for murderous rage. In my experience it is very rare that events in childhood can trigger off anything more than terrible anger and tantrums. In other words, when we start off life with heavy trauma at or before birth our later criminal/psychotic tendencies are given a boost and are better understood. Since those memories are so remote and sequestered we usually have no access to them; thus our current reactions remain a mystery. So something in the present sets off a gathering of these weights on each level which ultimately merge under the rubric of a feeling. The deepest levels of brain organization engender the most heavily weighted memory; it has to be because on that deep-lying level lives our survival mechanisms. On that level lives life-and-death events that require life-and-death reactions, including rage. It is the level we can only arrive at after one has integrated smaller less life-endangering events. The need to be picked up just after birth is primordial. That thwarted—unfulfilled need can turn into rage. Or at least it can be the trampoline that adds volatile fuel to the mix later in life. We can judge from someone’s behavior how deep the memory/imprint is. If there is uncontrolled rageful, violent behavior we can be fairly certain that very early imprints, often during gestation and around birth, are behind it. In short, anger has levels. The most recent causes would not involve murderous behavior. But when coupled with traumas on even lower levels it can adumbrate into violent tendencies. It is when a current mild event sets off exaggerated reactions that we know how deep the imprinted painful memories go back. And when I discuss behavior it can also encompass symptoms—raging or violent headaches, for example. I had a patient who suffered from migraines. She took aspirins for it, and called these pills her little bullets. It is pretty clear symbolism.
In most current psychotherapies the focus of each session is the act-out of the feeling rather than on the feeling/need itself. This analysis of the by-ways of behavior is an interminal task, skimming the surface reactions. Focusing on the deep internal imprinted reality finally makes it all have sense. The problem is that we cannot approach that deep-lying force with words. We must speak the language encased in our most primitive nervous system. It is for this reason that psychotic rage cannot be treated with conventional psychotherapy. Thus a slight misunderstanding can provoke a massive outburst of behavior. In order to make a dent in our raging behavior we need to delve deep in the brain and its unconscious where the organization of rage gets its start. We can see why it is not a good idea to plunge people in remote and painful memories in psychotherapy because the system is not ready to integrate them. The patient will tumble into overload and the result is a scattered, dysfunctional human being. lost in symbolism. It is also not a good idea to keep all focus on the present when there are icebergs of feelings lying deep ready to disrupt our forward progress. In my patois,severe overreactions are when third line current events set off first-line, brainstem reactions. The feeling may be identical on all levels of brain function but their driving force is quite different. There is no way that a here-and-now behavioral approach is going to solve deep-lying historical tendencies.
Thursday, August 21, 2008
Let’s start with the imprint. There are events very early in life, even while being carried in the womb that are engraved into the total system—blood, muscle, joints, brain and nerves. They happen when certain needs must be fulfilled and are not. How we react to that event becomes a prototype and determines our reactions, in part, thereafter. The prototype is an adaptive mechanism in the service of survival. It endures because it is the first major adaptation in life and helped us live. To do that there had to be compensatory behavior, dislocations of function that also endures. The dislocations endure as a necessity for the fact that the imprint is indelibly impressed into the whole system. So, for example, the serotonin inhibitory system may be compromised, and becomes deficient. Or the thyroid secretion may be diminished. There is always a compensation and dislocation, and that occurs in the most vulnerable areas, places where genetics may play a part. The imprint prevents the physiologic system from functioning normally, all because basic need is not fulfilled. When there is insufficient oxygen in the womb or at birth it is impressed. And when all that occurs before birth the dislocation of function will endure for a lifetime; the pre-birth system is not equipped to make up for lacks. The post-birth system is.
Now the imprint, by defintion is early and remains in the deep unconscious. Yet it has the force of survival. A pretty hefty force. What it does is create behavior, external (acr-out) and internal, (act-in) that still attempts fulfillment of those basic needs. That is why we are driven by it. And we need to make those behaviors rational; hence we develop rationales for what we do. Remember that I wrote about an experiment where in a split brain experiment the scientist input stimuli on the right side. The left brain had no idea what had happened yet to justify his behavior he needed to develop a rationale: “I am laughing because of your funny white coat.” That is the basic paradigm I am discussing. We have input from the right brain input (the emotional brain stores many of our imprints). Then due to repression and the inability to access our feelings we need to “explain” our beliefs and behavior. Once we get access to that brain we are no longer driven by the unconscious and are finally in control of ourselves.
Example: during the birth process there is no help. The baby is drugged by the anesthesia given to the mother and cannot help out to get born. It is “all too much”---the imprint. Even when there are no words to describe it is still imprinted. Much later when we have words and concepts we will put an explanation to it; but it will always be inadequate because until we arrive there we have no real idea what the feeling is that is driving us. Later, with parents who won’t help the child, who drive her to accomplish and do, the feeling is reinforce—there is no help. The feeling is also, “I have to do it all on my own.” It seems “right” to the person not to ask for help (and therefore not to get it). Not asking for help means “doing it all on my own.” And this is due to a feeling and need that is unconscious, deeply buried out of sight of conscious/awareness. Another example: a pregnant mother is depressed and drinks coffee constantly during pregnancy. She is low on many of her hormone levels. The baby is being over-stimulated. He cannot combat this input: “nothing I can do will make a difference.” At birth being drugged by painkillers given to the mother and again, “nothing I do will make a difference,” In college he drops out because it is too much and it seems like no matter what he does it is not enough. This has been compounded by parents who never praise, always criticized, and the child cannot please no matter what he does. He gives up easily because at birth the drug stopped all efforts; later he gave up because no one cared that he tried and did good, and now he is married to a hyper-critical wife who never lets up. She calls him a “loser.” He has no idea where the base of all this is; he just keeps giving up in the face of adversity, doesn’t even try for approval because inside he is sure it will never come. In a self- fulfilling prophecy he does become a loser. He is sexually impotent because the minute there is excitement he loses his drive and his will. Nothing he will do will turn out right. Total defeatism.
Another example: a child is born after a mad struggle to get out. He has learned aggression as a key mode of behavior. His passive parents give into him because he is so assertive. He takes on chores that are very heavy and he does not recognize real obstacles in his way. He does too much and does not know when to back off. To give up is to die, in his physiologic equation. He pursues a woman who really does not want him. He cannot see that because he has learned aggression as a survival technique. He thinks the woman just needs coaxing, but he does not know when to stop.
In these cases the left prefrontal area is just a large rationale-concocting apparatus to keep behavior ego-syntonic— comfortable to the self. It also keeps the feeling unconscious and unexamined.
A child with the same birth configuration as above is left feeling all alone—no one to help. His parents are emotionally distant and he learns to be alone. Right after birth there was a sick mother so that he was not cuddled right after birth. He grows feeling alienated, keeps himself removed from others and doesn’t notice his isolation. He is acting-out “all alone.” The force comes from birth and before, the emotional focus comes from how life experiences channels him. He is slightly reserved and not cuddly, so he gets less love. He can rationalize this how he wishes but he is still victim of his imprint.
The imprint endures for a lifetime. It is stuck in the need— unfulfilled mode. It can only be undone when it is no longer useful. What does that mean? It means that so long as the load of pain is inordinate and needs repression the imprint goes on. But when we feel the original need in context with all of its emotional force it no longer serves any purpose and is done with. To get there we need to take a slow, orderly descent down to origins; but not before we have felt the top level portion of it. We need, in short, to feel and integrate the least noxious part of the feeling first. Third-line (current) pains are rarely if ever life-threatening. As we descend down the brain we come to pains, such as a lack of oxygen at birth, that are life endangering. If we go below that top level part and plunge into the lower level pains it will all be too much to integrate. Suppose we have a level ten childhood/infancy pain lying below a level ten adult-level pain. The level twenty is too much to integrate. But if we have felt the top level pain first and then go lower the overall level will not be too overwhelming. Whenever we try to relive very early pains without seeing what lies on top we are bound to fail. Our gating system is masterful; it allows us to feel just enough and not so much as to be shattering.
Our act-out is just as unconscious as the feeling living inside of us. We are driven by the imprint until we are free from it. Then we are in the driver’s seat. It is the difference between being driven and driving. We will no longer be passengers on our wordly peregrinations.
A key structure in the feeling area of the brain is known as the hypothalamus. It contains two divisions of two very different nervous systems—the sympathetic (alerting/vigilance) and parasympathetic (rest and repose). Getting turned on sexually is parasympathetic; ejaculation, however, is sympathetic. It seems that all ejaculation, including a mother’s milk, can be inhibited by an over-producing parasympathetic nervous system and under-producing sympathetic system. When the parasympathetic system is predominant in our systems it prevents quick arousal. In sex, we see it when it takes a great amount of stimulation to get a partner going sexually. It's typical for the parasympath to have less interest in sex than the sympath. In essence, the parasympath has numbed feelings, is difficult to stimulate, and is very slow to become aroused. The numbness from anesthesia at birth may very well have established the prototype response of going numb during the sex act. The system veers away from quick over-excitation as a survival mechanism – as a means to avoid the original imprint. Avoidance of sex, or passivity in sex, is like the phobic avoidance of elevators: it becomes an external means of manipulating internal pain, and happens unconsciously.
As I use the term, imprints are a special category of memory; experiences that because they are too painful to integrate, are repressed, in a sense "put on hold," below the level of conscious awareness. They are put on hold in terms of our whole physiology and not just as a brain event. An imprint is a memory that unlike cerebral recall, which is a cortical event, can be "remembered" by every system of the organism because it is fixed in these systems exactly how the event was laid down originally – the same blood pressure, body temperature and heart rate. If there were a rapidly beating heart of 160 beats per minute during the experience when the memory or imprint was created, then when the memory of that event is provoked, there will again be the same heart rate. The imprint means that part of the traumatic event was experienced while another large part was not; it is yet to be felt. It is not an inert force but something continually active. Aspects of the imprint are, by definition, unconscious. They will become conscious when they are felt fully and connected to higher brain centers.
Once the imprint is blocked away from conscious-awareness, it is always a danger, a "foreign element" to be reckoned with. The danger is that it will intrude upon awareness and send the vital signs skyrocketing. The alien intrusion, such as being abused or abandoned by one's father, for example, makes the child feel unwanted, unloved, and unsafe. Under the experience created during the child's early years, the child becomes terrorized and repressed. Trauma then creates a splitting of the self – it drives a wedge between the real pained self and the unreal, or unfeeling, repressed self; the self presented to the public. Because of the split or disconnection we can no longer will our bodies to do our bidding. In sex, that means the body is out of our control. Our "will" remains on the top cortical level and cannot reach down to tell the penis what it should do, so it cannot stop it from ejaculating too quickly, for example. Very early trauma has compromised the development of the controlling orbitofrontal cortex, which could slow ejaculation.
Being disconnected means losing a bond with many of the processes that are mediated by lower levels. Thus, we have no way to control heart palpitations or lower our blood pressure, or will an orgasm. No willpower on our part can make a difference. We are trying to harness forces with which we have lost contact years ago. They are sending out orders in their peculiar silent language, shifting resources from one place to another and trying to warn us of danger. To illustrate, the level of the stress hormone, cortisol, may be raised to a high level, but all we will feel is the vague sense of impending doom, and we do not know from what. "Doom" was in the offing during perhaps a birth experience with too little oxygen. Or worse, we do not feel anything at all. This is a problem, and the essence of which I call the “Janovian Gap.” The wider the distance or disconnection between a deep imprint and the conscious/awareness of it, the more susceptible we will become to illness. The space between feeling/sensation and the cortical, "thinking" acknowledgment of it, is a precise measure, and in my opinion, a gauge of our longevity. One can say, "Yes, but the man developed lung cancer because he smoked 2 packs a day." I would say that the man smoked because of the gap between what he was experiencing physiologically and his conscious awareness of it; that gap that compromised his system, and his health.
Friday, August 15, 2008
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.
The research in blood gases with these patients was carried out in association with UCLA director Dr. Donald Tashkin and his associates, pulmonary scientists Dr. Eric Kleerup and M. B. Dauphinee. They were wired for, among other things, oxygen and carbon dioxide levels. They were then taken through a simulated Primal, or reliving, of an early trauma. During the simulation, both patients became dizzy and had "clawed hands," within three minutes, typical of hyperventilation syndrome. This research has great significance for understanding the human psyche, for understanding access to deep brain levels and for how psychotherapy must be practiced.
We took frequent blood samples with an in-dwelling catheter during the subjects' reliving episodes (every two to three minutes for one and a half hours) and during voluntary hyperventilation. We measured blood oxygen and carbon dioxide levels, as well as core body temperature, heart rate, and blood pressure. The simulation and the reliving were quite similar in terms of strenuous physical activity and deep, rapid breathing.
During the simulation, the blood carbon dioxide and oxygen levels were what one might expect. There were clear signs of the hyperventilation syndrome after a little over two to three minutes of deep breathing, including dizziness, tingling hands, rigidity of the extremities, bluish lips, loss of energy such that the subject could barely exert himself, and great fatigue.
In the reliving of oxygen deprivation at birth, however, there was no hyperventilation syndrome. Despite 20-30 minutes of deep, rapid, locomotive breathing (it is raspy and sounds like a locomotive), there was no dizziness, puckered lips, or tingly hands. The UCLA researchers found that lactic acid in their blood compensated for the low carbonic acid level caused by their locomotive breathing, preventing the hyperventilation syndrome. In other words, their muscular exertions during the reliving were so great that their oxygen requirement exceeded the supply. Their muscles were forced into anaerobic respiration, like a sprinter in a 100-yard dash: glucose is broken down to lactic acid in the absence of oxygen. No amount of voluntary exertion during a simulated primal could equal that effort. The factor that makes the difference is imprinted memory. The musculature under the control of the imprinted brain memory is working as hard in the session as in the original trauma to try to survive. In the reliving, the brain was signaling its history; a lack of oxygen and the necessity to breathe deeply.
In the UCLA study, we had accessed, almost directly, brainstem structures, something unheard of in the psychological literature, and witnessed their awesome power. It is perhaps the Holy Grail of psychological science. The import for psychotherapy is that only total reliving and frontal cortex connection makes profound change, for it is only in a reliving that vital signs change radically.
Oxytocin is a neuro-hormone that is a key hormone of love. When the level of oxytocin is low there is less emotional attachment, less interest in social engagement, less caring and bonding, and less touch ... in short, less love. "Less love" has a physical base. Less love early in our lives can be found in an imprint, which affects many systems. These effects are measurable. In some respects, love is a measurable entity. The imprint affects sexuality, particularly how key brain structures such as the amygdala and hippocampus translate pain into sexual behavior.
Oxytocin is found only in mammals. When it is high, one experiences a sense of relaxation, rest, and growth, repair and healing, loving behavior and emotional-attachment. Love and nurturing early in our lives are necessary for optimum health, and healthy brain development cannot take place without it. It isn’t just that low oxytocin levels are an indicator of early neglect and lack of touching, it also indicates a dysfunction of the entire system, and serves as a prognosticator of our later mental and physical health. Its presence says, "I was loved and could develop normally,” its lack says, “I was unloved and my system is skewed.” It is one of the key indices of how much love we received in infancy and around birth.
In the same way that we may increase sexual drive in males with testosterone injections, it may well be that we can "inject love" into people, or at least inject a hormone that encourages it – give people a shot of love, so to speak. This shot may help us attach to others and bond with partners, allows us to feel close to someone else, to feel and empathize with their feelings and pain. Bonding is a strong emotional attachment that helps us want to be with one another, to help and protect one another, and to touch and become sexual with one another. High levels of oxytocin encourage and strengthen bonding. Because early trauma and lack of love affect the output of this hormone, the ability to relate and have good sex later is determined even before birth and just after.
Someone can swear she is full of love, only to find herself very low in the essential hormone of love – oxytocin. It is actually good news that "less love" has a physical base, for there may be something we can do chemically to alter that state, and there is certainly something we can do psychologically to change it, as well. At sometime in the future we may be able to determine what proper love from a parent to a child is through the measurements of various hormones, not the least of which is oxytocin, which, as I state, has been in wide use to help birth along, affecting contractions in the mother. (Pitocin).
Early parental love is a permanent painkiller. Rats who were able to self-administer painkillers by pressing a lever did not do so when given oxytocin. Oxytocin (OT) inhibits the development of a tolerance to drugs such as morphine, and also decreases the painful withdrawal symptoms that occur when one is taken off these drugs. The degree of addiction can be measured by the severity of one’s withdrawal, yet oxytocin reduces the severity of these symptoms. Love will do the same thing; early love calibrates the system for life. A current shot of love, such as someone hugging and kissing us, may well change the levels temporarily. If we rub the belly of an animal the oxytocin levels will rise immediately, but once the initial critical period of the system’s development has passed, every change we can effect will be transient. Once we arrive at adulthood, oxytocin levels are fairly set. One can be given a shot of it, but it will not have a permanent effect, for once low levels of oxytocin or high levels of stress hormones are registered early in life, it is difficult to re-establish normal set points. After the critical period to receive love is over, the only way to normalize the system is to neuro-chemically relive the early events that dislocated the set points. The “critical period” is the time when a need must be fulfilled. It can never be recaptured. After that period all we can do is play catch-up.
If we are to ever have any chance at normalization we must feel again "unloved." That enables us to go back to the point of deviation or dislocation and rewrite the scenario and return the body to its correct set-points. . In that way only can we right the ship and return to the original biologic settings. It is that agony with all its concomitant biochemical components, that, when fully experienced, helps normalize the system. And when I mention “normal,” it seems to me that one of the key indices of normality is the ability to give and receive love. This is what patients should expect out of a psychotherapy.
We do know that in our measurements of the salivary cortisol (the stress hormone) there was a return to normal levels after one year of Primal Therapy. (see Primal Healing for a full discussion). In various other avenues we find the same phenomenon. True of heart rate and blood pressure. We assume it will be true with oxytocin levels. We make that assumption because our patients state over and again how they finally could relate to a partner and feel comfortable in an emotional relationship after the therapy.
There are many kinds of hormones that play into love and sex; I am extracting these for discussion and to show how early experience affects adult behavior. Many years ago we studied testosterone in our male patients. We also classified those who were low on testosterone as parasympaths – those dominated by the passive, reflective, healing nervous system. Those, who were high in testosterone, tended to be sympaths, meaning they were more aggressive, goal seeking, optimistic and ambitious (looking ahead, an analogue of the birth process). After one year of Primal Therapy, those who were low on testosterone tended to rise, while those who were very high tended to come down a bit; in brief, their systems would normalize.
When it comes to love, however, oxytocin is by far the most important hormone. The question we now face is what came first: lowered oxytocin and then the inability to love and to bond, or the lack of early love, which lowered the set points of oxytocin? I would choose the latter. Because hormones are so sensitive to early trauma, we must take care not to blame high or low levels to genetic factors. We must never forget the critical nine months of life in the womb.
Bonding is the most positive aspect of human relationships. We learn how to bond emotionally in adulthood through early bonding in childhood, as simplistic as that sounds. It cannot be taught! And it certainly cannot be taught in later life. Attachment is pretty well set in our childhood. It is not something we learn; it is something we feel. It is also something biochemical. Those who did not bond very early on with their parents may well be condemned to a lifetime of broken, fragile, tenuous relationships. It may be in large part due to deficits in the hormonal wherewithal such as oxytocin. Oxytocin researcher Thomas Insel has remarked that, "Many of the affectional ties to the mother observed post-natally (after birth) could be laid down by pre-natal experience." Life in the womb may determine life outside the womb for decades to come. If the early relationship with one’s parents was distant, alienated and glacial, it may be a harbinger of the love relationships we have or don't have later in life. The earlier the alienation from one's parents, the more trouble there may be in relationships later on. I have seen it in hundreds of my patients. It approaches a biologic law – if my sampling of our patients is any index.
In certain mountain rodents such as the mountain vole, a species that lives an isolated life (as differentiated from the prairie vole, which is more social), a shot of oxytocin proved to encourage bonding and pairing between voles. After repeated injections there was a long-acting anti-stress effect, which calmed overall behavior and gave rise to a strong tendency to bond. This again indicates that early love supports calmness and serenity. Those humans who are able to bond with others have high levels of oxytocin. Love seems to be the ultimate painkiller and a permanent one. It prepares us for the challenges of life and is the ultimate survival tool.
Need a good sex life? Be loved early on by your parents. That means, inter alia, right after birth and for the few months afterward. By that I mean plenty of hugging and kisses. Touch is ne plus ultra. Suffer from perversion? It may be because early in life, you were twisted by your parents in the quest for love. Parents whose personalities made implicit demands on the child to be someone else—non-coomplaining, passive, listening never speaking.
There is enough evidence to show that a newborn's heart rate, body temperature, and respiration rate are governed by the mother; when she is loving and nurturing towards the baby she carries, there is a positive affect on the baby and the set points of heart rate and blood pressure become normal. Any neglect she inflicts changes the biochemistry of the baby, perhaps permanently. Her anxiety and depression during pregnancy may very well alter the offspring's sex hormone levels. We know, for example, that anxiety in the mother can and does alter the sex hormone level of the fetus and can feminize infant males. So what we see is that once a male is feminized he is vulnerable, more vulnerable to a lack of love during infancy and childhood. He may become homosexual as a result of a cold, distant father, while the one who is not vulnerable will remain heterosexual. We need to understand that at certain levels of vulnerability, stress, trauma or pain can produce an overload and channel them into a symptom. In this sense, homosexuality could be considered a symptom, in the sense that there is a latent tendency, a feminizing, which only becomes overt homosexual behavior due to trauma; i.e., the lack of a father’s love. If the father’s love is there, it remains a latent tendency.
The female prairie vole, when treated soon after birth with steroid/stress hormones, showed an increase in masculine behavior, such as mounting. Most of us don't have to be injected with stress hormones; stress in the womb and just after birth accomplish the same thing, and may indeed masculinize females.
Although we may think that an injection is something special, the same chemical process takes place naturally. We can inject oxytocin, or we can massage the animal, and increase oxytocin levels that way. We can create stress for a pregnant woman, or inject her with steroids – the psychological effect is precisely the same as from a needle. A mother can be kind and loving and raise the serotonin levels in her offspring so that he can better handle adversity or a doctor can inject serotonin into the offspring and produce a temporary calming effect that is no different than that created by a loving look from the mother. A mother can "inject" oxytocin into her baby through her milk, which contains high levels of the hormone. Love, or what looks like it, can be injected. When "injected" naturally and at the proper time it will produce a loving human being.
Oxytocin means "quick birth." A synthetic oxytocin known as Pitocin, is given to mothers who need stimulation for contractions. I surmise that some mothers who need oxytocin to expedite the birth process may have had a history of pain that lowered their levels so as to make giving birth difficult. Statistics indicate those mothers who give birth by cesarean have lower levels of oxytocin. Additionally, when oxytocin is given to mothers to facilitate the birth process, it also enhances the love they feel for their child; they nurse better and are more relaxed with the baby. Conversely, a chronically anxious mother may leave her offspring with low oxytocin levels, which will contribute to the child having trouble later in life with bonding and forming attachments, as well as harboring a latent tendency to addiction. Thus, lack of early love translates into inadequate chemicals with which to bond, creating a vicious cycle of misery – unhappy relationships, poor sexual function, and failed marriages with suffering, abandoned children who bear the brunt of something that had its root causes in the infancy of the mother.
Loving feelings are transmitted to the fetus through the biochemistry and oxytocin levels of the pregnant woman, and then later through physical contact, which again raises oxytocin levels. If we were not loved early on, looked at, touched, listened to, nuzzled and adored, those biological changes, subtle though they may be, follow us throughout our lives. Yet a mother who takes good care of herself, is not depressed or anxious, does not take drugs, and eats properly, will produce a loving child.
If the traumas of birth, pre-birth and early childhood are inundating the system there will be an eventual overload and breakdown of the neuro-inhibiting, suppressing systems – serotonin, as well as oxytocin. There are many chemicals that live in the gaps between nerve cells, neurons; some push back and while others facilitate the message of pain. They are either information blockers or enhancers. Supplies of neuro-inhibitors will be used up over time in the fight to keep pain down. These supplies are not inexhaustible. It is the very earliest pains that have the highest valence and require the greatest amount of inhibition. These biochemicals will be used in the battle against emotional deprivation. The system will eventually be less sexual as the hormones of love become transmuted into the job of holding down pain.
A therapist can ask us, "Were you loved?," and we may insist, "Absolutely," yet we are betrayed by our oxytocin levels, which are far too low, and by our stress hormone levels, which are far too high, and also by our hormone levels which may be quite deviated. They speak too. The body and its physiology do not lie. Indeed, we may have been loved after birth, but suffered severe traumas in the womb of which we remain completely unaware. Our physiology will tell us the truth.
Many of us come close to death at birth or before. The massive anesthesia given to a 130 pound mother is overwhelming for a 6 pound newborn. All of his systems are shut down and death lurks. Even though the baby cannot articulate it the system does in its own way. And later when we are capable of articulation we are still obsessed but now we give it a name and an idea. The death experience is ever present and does not go away because it is an imprint that cannot be erased. In infancy and childhood that imprint can move the child constantly in hyperactivity; then later in attention deficit problems, then still later a preoccupation with death. Enter religion. Its first task is to take care of death. It provides an ideology and a belief that diminishes the threat; it takes the place of the obsession. Now there is a new obsession--God. That idea suffocates the death fear for a time—until the next prayer. The belief has to be strong and persistant to keep the real fear at bay.
Those who obsess about it have in general weak gating systems; that is, the amount of early pain is so high that the gates have always been faulty. Death lurks constantly in the background and foreground. It is immediate and the person thinks he is going to die NOW! That means the memory is up on top just close to conscious/ awareness. Pills that suppress the pain do help and lower the belief system. Alcohol the same. But the appointment in Summara won’t go away. You know the story. The man hears that death is coming to his village and so he escapes to Sumarra only to learn that death has changed his itinerary and will come to Sumarra. There is no escape— because we cannot escape the imprint. It is real and that is what makes imminent death real.
Arthur Janov Suggests that Stress During Pregnancy Leaves a Distinct Cellular Imprint that Predicts Mental Illness and Serious Disease
In his new book, 'Life Before Birth' (NTI Upstream, Nov. 2011), Arthur Janov makes the case that events during pregnancy and the first years of life leave a distinct cellular imprint that predicts mental illness and serious disease.
* Readers: Our legacy program "The Art and Science of Primal Therapy" will be available next year. It is a series of videos exploring in detail how Primal Therapy is done and the theory behind it. It is 4 years in the making.
Quotes for "Life Before Birth"
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Our therapy is constantly evolving. If a therapist has not had additional training in the past 3-5 years she is not up to date. The basic principles are the same but the actual therapy has taken a radical turn. It is much more precise, predictable and mathematical in practice. We have tried to tighten up what we do in keeping with current neurology and physiology. It is a constant learning experience. It is finally for the well-being of the patient who now has a much better chance of doing well. Yes, it was good before, but there is less time wasted now because the techniques are honed and the theory takes on more and more precision. We see patients from some thirty countries in the world, each with different cultures. It is up to us to continue the refining process so that the patient has the best chance of improving.
The clear understanding and application of the theoretical and clinical aspects of Primal Therapy are essential in order to provide effective therapy. Citing the most current findings from the field of neurology, trainees will learn the role that the physiology of the brain plays in the shaping of mental illness. The training will thoroughly examine the scientific basis for Primal Therapy and discuss the unique clinical approaches employed in the treatment of various emotional and personality disorders.
For our first year students, the training will entail extensive work in the understanding of the basis for Primal Therapy. On the theoretical level, there will be an examination of issues that range from the nature of the unconscious to the nature of traumatic imprints and their lifelong effects on physical and mental health. On the clinical level, trainees will have the opportunity to learn proper diagnostic and therapeutic procedures as they relate to Primal Therapy.
Furthermore, first year students will be mentored by our third year students in order to ensure that the key concepts in Primal Therapy are clearly understood. There will be an extensive library of training notes and taped lectures from the past two years available as well.
For our second year students, the training will provide a unique and varied opportunity to gain more clinical experience. Through closely supervised clinical sessions, trainees will gain a deeper understanding of the various applied therapeutic methods and hone their skills as future therapists. In addition, second year trainees will have the opportunity to work with first year students thru discussion groups, tape reviews, and clinical sessions.
Our third year students will continue to hone their clinical skills through a rigorous series of didactic clinical sessions. These sessions will be video taped and will be reviewed by Dr. France Janov and our senior therapists.
Dr. Janov’s books have been translated in some 26 languages, have been bestsellers in many countries, and his theory is taught at many universities. He has combined decades of clinical practice with the latest in research. It is the therapy of the future.
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We look forward to another exiting year of training. We hope you will join us.
Dr. Arthur Janov
Founder & Director
Notice to Primal People
I think it advisable for those serious parasympaths, those mired in hopelessness and helplessness, to have a test of your dopamine, serotonin (imipramine binding) and cortisol levels. It may be that we can help normalize some of those functions while and even before doing Primal Therapy. I have found that, for example, provigil can somehow boost alerting functions and help those very down come up a bit. What we would do, in effect, is take the depressives out of the trough that I have written about in several of my books (see The Janov Solution). It helps advance the imprint a bit so that the person is no longer wallowing in pain but is given a helping medical hand to move forward. This is not in lieu of therapy but as an adjunct to it. It is certain that certain imprints are manifest not only in terms of personality but also in biochemistry. We need to pay attention to the biochemistry, as well.