Friday, August 7, 2009

On Connection (Part 1/6)

Someone wrote to me asking about the difference between abreaction and a Primal: the key difference, of course, is connection, which takes place in a Primal but never in abreaction. Why is that? Several reasons, not the least of which is that it takes great skill to produce a connected feeling and no skill to permit abreaction.

The two most important factors are: 1. that the patient arrives at a feeling/pain/need untrammeled by other feelings, (often compounded by a history of unrelenting pain from childhood trauma) and neglect. That is, the therapist must be acutely aware of the leitmotif in the session; which feelings are critical and which are peripheral. It takes years and much experience to know how to do it. If the wrong feeling is addressed we get abreaction, which is the discharge of the energy of a feeling on a different level. Secondly, We need to know on what line or level the patient is operating on so that we confine her and us to a single level and not a mélange of levels. The idea is to remain in the feeling zone, the only zone where connection can take place. If the pulse is too high or the heart rate too fast we will be over or under the feeling zone (I call the Primal Zone); no integration can take place.


Once abreaction takes place the vital signs go up and down in sporadic fashion. In connection they rise and fall together. Generally those on the high end of vital signs stay there and then have to keep feeling and feeling because nothing gets resolved.

Now why is the wrong feeling addressed? Because when a therapist has unresolved feelings of her own she will tend to drive the patient where she needs to go. Or worse, she will avoid feelings of the patient that she is not ready for. As for example, anger. If the therapist is terrified of hostility he will shut it down in the patient. He won’t let the patient go near it, and the feeling will remain unresolved. If the therapist cannot be criticized she will dodge any blame and try to make any error the patient’s fault instead of hers. This is the most widespread of problems with therapists.
What we are after is to hook up the feeling/instinct brain with higher levels so that there is a proper lock-in. This means that the historical need/feeling/pain has been fully addressed and experienced (with all of ourselves); experience means that it is not confined to a neocortical level where intellect lives. It would seem that there may be a chemical affinity between higher and lower sites so that feelings recognize each other through their chemistry. But in any case when the vital signs do not reflect integration you can bet that connection never took place.

To put it differently, we can often tell how much of a feeling has been resolved by the amount of change in cortisol levels, all vital signs or other biochemistries. I must emphasize that abreaction is a non-feeling event. It looks like feeling, often to both the patient and therapist but there is a qualitative difference. It produces awareness without consciousness. And of course the most important is that with feeling we get well. Abreaction is destructive to any feeling therapy. To a well-trained therapist there is a hollow ring to abreaction. It doesn’t “smell” right. A therapist who is not feeling cannot pick out the difference. A patient may use abreaction as a defense against feeling, slipping into crying the minute she lies down. Or simulating a birth primal. If the patient doesn’t have her feet and arms in a specific position we know it is abreaction. Each level of consciousness is an entity onto itself. If someone is reliving something emotional and then begins birth movements it means to us that there is intrusion from another level; it may be that it is a defense against too strong emotions. If she says one word or tears up during a session of reliving birth we know it is abreaction. Defenses are tricky and we need a long training to pick them up correctly. In Primal Therapy we make it safe not to block pain, because feelings are preserved with their early scenes intact. Because each higher brain level elaborates the same sensation/feeling/need differently, we can ride the top level down and it will eventually take us to the bottom—to origins. Once down there, the system on its own will move upward toward connection automatically, following the paths of evolution for connection. We then move again up toward the right OBFC and then to the left prefrontal cortex for final connection. How do we verify this? We note that in almost every reliving there is a mounting of vital signs to inordinate levels; these levels drop with connection to normal, healthy measures. In a feeling without context, which is an abreaction, there is never this kind of organized, coordinated vital function movement. A random discharge of the energy of the feeling/pain will find its reflection in the disorganization of vital signs movements. There is no harmony to the system. And our brain research found that after one year of our therapy there were systematic changes in brain function toward a more harmonized cerebral system

27 comments:

  1. Hi again Dr Janov,

    Quote: "In a feeling without context, which is an abreaction"

    So that is the/a key difference, for a primaler to recognise an abreaction? That is, there is a feeling that is experienced but the feeling is detached from the *specific* event-context? ...so, as I would imagine in an abreaction, the abreactor feels primarily like they are reacting to the feeling itself, rather than reacting to the original traumatic event? Or in an abreaction the context is artifically (creatively) manufactured such as in a dream? (which is still detachment of course)

    Is that how you would define an abreaction from the subjective position? Can you clarify?

    I notice that when people speak of being 'emotionally confused' what they effectively mean is that they feel a certain way, but can't really clarify what the reality is that is generating that feeling (I do a lot of that!). Essentially that sounds like the same psychological situation as an abreaction, if I got it right. And indeed, from my own experience, until everyday feelings that we do not understand are linked to their real causes, they don't change or go away!

    It seems to me that in essence the *raw realites* must be the focus to address, not the feelings as such. Feelings are primarily just the emotional reaction to realites, so it is the realities that we must get to for our feelings to go through real changes*. If that is right, then PT is just a far more profound version of a process that we can observe in everday life: Just dealing with what is real.

    *(though I understand that realities must be experienced, not just intellectually known, so feelings can only be absolutely on-board with respect to a REAL experience. Psycholanalysis is obviously not experience. It is an academic personal history lesson.)

    I'm not 100% sure how right all that is. Can you add?

    Andy

    ReplyDelete
  2. Dear Art,

    You might rightly say that I have a compensatory desire (and of course also a defensive style) to for explanations that are all of 'encompassing/precise/true'.

    However, because that is how I became/am, when I read what you have written I tend to find myself wishing that you had formulated yourself differently.

    [I know I was throwing stones in my own glass-house by what I just wrote, but that does not mean that I always lack a logical/science-aligned leg to stand on. ;)]

    One small example: You wrote in this essay, "It would seem that there may be _a chemical affinity between higher and lower sites so that the feelings recognize each other through their chemistry."

    I would rather have seen that you had put this more plausibly, by words such as: "... a to each specific feeling corresponding chain - the entire length of which also traverses our different levels of our capacity to experience (be conscious) - of synaptically linked excitatory neurons....".

    Sometimes one has to use not so simple "semantics" [though of course not necessarily my partly decEPTively SEPTIC-humored "sem_antics" %>] in order to with Enough Precision Tell the (most likely and most sense-making) truth.

    Sincerly, and with plenty of appreciative regards (nevertheless),

    Peter

    ReplyDelete
  3. Andy: wait wait wait! there is more explanation to follow. It doesn't take six years to begin to learn this process, for nothing. My therapists would attest to its complex nature. So far you got it mostly right. art janov

    ReplyDelete
  4. Andy where did you get your smarts? After you read all of the piece (in two parts or more) write what questions you have left. There is a grey area where feelings are enough in and of themselves but that is for therapists to understand, not the lay public. art janov

    ReplyDelete
  5. Alright Peter, fess up. What do you do? A professional? and of course your right about how to phrase it all. I am doing my feeble best. art janov

    ReplyDelete
  6. Hi Art,

    I'm definitely looking forward to reading the next 5 blogs. I was "sold" on the theories behind primal therapy long ago, and don't need to read anymore in that area. What I do want to learn, is how to gain right brain access. I've been trying on my own, and in support groups, and it just doesn't come naturally. For me, a few seconds access, on rare occasions, mostly abreaction. I just don't hit the mark. You said it is a complex process, and takes a skilled therapist. Does it also take a special patient? I have excellent, maybe even total recall, of hundreds of childhood scenes, and almost zero connection to the feelings. Seems like the split is very severe. Are there patients whose brains are damaged, and can't be helped, or can your techniques work on most everyone who puts in the effort?

    ReplyDelete
  7. I don't think we specialize in any one kind of patient. We see a whole gamut of conditions. Clearly not everyone gets well, but a sufficient number do that makes me think our therapy is the first real science of psychotherapy. art janov

    ReplyDelete
  8. Hi Dr.Janov, this is Emanuel ...I wonder in reading about the complexities of this therapy why it is so ..! In nature all "good things" run easily and smoothly if her laws are fulfilled and in case of disease humans and animals are gratified with a ordinarily quick recovery i f !!! they return to fulfillment of this laws (fasting for example,biological correct nutrition etc.. Only in case of "mental illness" there is the need of highly trained personell to regain one`s b i o l o g i c a l ability to feel (correclty..?) Yours emanuel

    ReplyDelete
  9. emanuel: Try training and you will see. Art Janov.

    ReplyDelete
  10. Ok Dr Janov, I'll try not to be such a sympath and wait until you've finished the parts (smile).

    I don't know what you mean by 'my smarts' exactly, but most of my outlook on psychology has evolved from my own reflective thinking from over the years (and casually reading various books). I have a strong drive to understand things as solidly as I can, which is my focus (actually I think I have some neurotic need in that). With respect to neurosis, I am trying to see the full "system" as clearly as I can - hopefully more understanding of the 'why happens', and not just the 'what happens'.

    I find primal theory to be by far the most comprehensive theory relating to mental sickness: your theory I consider to be essentially validated from own general observations.

    ReplyDelete
  11. I hate the idea of someone trying to read my body language in a simple academic way. That would be impossible and I would never trust my therapist. I would want my therapist to be empathetic and intuitive. I imagine the time taken for a therapist to deal with his/her own neurosis, the time taken to become more intuitive and to build up experience with patients....this must count for a large portion of the training. I'd expect the academic stuff to be a small part of it.

    I'm curious as to whether there have been any other primal therapists (currently working at the Arthur Janov Primal Center) who have spoken in this blog?

    ReplyDelete
  12. In one of your videos i remember that Frances Janov say that if you have a sympathetic tendency is more probably that you succeed selfprimaling.In the other hand you say that after a time of primal therapy you can do it yourself. So the problem maybe to realises when somebody is prepare to work alone.

    ReplyDelete
  13. Hi Art,

    "Clearly not everyone gets well..."
    I wonder what kind of patients don't make it in PT? What is your experience telling you?

    Marjan

    ReplyDelete
  14. Marjan I will write in the future about who does not make it and why. art janov

    ReplyDelete
  15. Richard: I am afraid all the therapists are overloaded with work and do not have the time to blog. There are few of them, sadly. Righ about the emotional development. Far more important than the academic. art janov

    ReplyDelete
  16. Garevalo: It's like pornography....you know it when you see it. It is organic. when you're ready you will know it and no one has to tell you. How could they know more than what you feel inside? art janov

    ReplyDelete
  17. Hello Arthur,

    I would like to know what do you request in order to come to Sweden and do the presentation of Primal therapy so we at least can hope that someway somehow there will be a possibility that primal therapy can be introduced to the Swedish people in a way that could be accepted for a start… I know that you have been here before… but sometime must be the right time… so we can’t give it up!
    I know that there are many of us that should be “happy” to se primal therapy introduced In Sweden… I know by my own researches that there are very… very difficult because of the suspected minds that control what is right and wrong in psychology… how should this be done?
    Sincerely
    Frank Larsson

    ReplyDelete
  18. Regarding the abreaction: do you gently stop the patient the moment he starts abreacting (risking to stop a real primal) or you let him finish it and then later talk to him about that?
    It's my impression that some experiences might be a mixture of both primal and abreaction, which makes it more difficult for the therapist to act.

    Marjan

    ReplyDelete
  19. Hi Art,

    It was cool making contact with someone I've idolized over the years. (See prior post above). But it was also unsettling. I guess the point of the post, was to get some type of grand reassurance. I didn't get it. Of course, it's not relly someting you can provide. It busted the illusion of well being I felt, after recently reading a couple of your newer books. Anyway, I don't really have any doubts that the process can work, just a lot of doubts that it will work for me. Uncharacteristically, I've decided to take action, and just emailed an application. I look forward to the interview, and getting started as soon as possible.

    Losangelee

    ReplyDelete
  20. Art,
    In your experience, how would a patient's life be different after, say, 30 years of therapy? and compare that with a patient in any mainstream therapy. if such a notable difference takes place after 1 year, one would expect to arrive at some sort of plateau after so and so years of feeling one's feelings, whould they not?
    If not, what advantages does the therapy offer in comparison with abreaction, if, in the long run, both patients (in PT and another type) still wallow in their pain whenever met with difficulty?

    ReplyDelete
  21. Marjan: Abreaction "smells" phony and we stop it before it becomes a "grooved" response. art janov

    ReplyDelete
  22. Dear Frank. I can no longer speak due to a severe throat surgery problem. My wife, Dr. France, who is clinical director of the Primal Center, can, along with members of my staff. You need to invite us, have the means to bring us there and also rent a place for the speech and film. art janov

    ReplyDelete
  23. losangelee: Hi. I am not sure what your name is but we will try to make sure that you will not be disappointed in the therapy. Very few are these days. art janov

    ReplyDelete
  24. Delphi: Hi. I think that what happens is that after a year or two of formal therapy, feeling becomes a way of life rather than a treatment mode. You feel when necessary; not on any timetable. We have done so much research (see Primal Healing) that shows profound changes down to the molecular level that there is no question that our therapy endures in terms of its lifelong effects. I am 85 next week. If you want therapy I suggest you do it. No No!!! there is no wallowing in pain in our therapy; that is what happens in abreaction, a never ending cycle of release (not relief) and pain again. IN our therapy when one feels bad one knows that there is something that can be done about it. Our aim is not pain; it is only means to an end.....feeling good. art janov

    ReplyDelete
  25. Art,
    I understand what you say, and have read the book. But beyond the internal changes one can't see, can you compare one on one the life of a person who has been a patient of yours, and one who has done another therapy - is there more to be gained than recognizing that a feeling needs to be felt? does one's life ever "get better"? or maybe there is no way of measuring this, in the case, perhaps, of there being such small changes accumulating over time, that after a while they are no longer noticed. what would one have to look forward to, if he has the alternative of fulfilling a false need for as long as he wants (for example having a therapist who makes him feel cared for)?

    ReplyDelete
  26. oh no, your throat surgery sounds bad Dr. janov. I hope you get well soon.


    "IN our therapy when one feels bad one knows that there is something that can be done about it. Our aim is not pain; it is only means to an end.....feeling good."


    this reminds me of a quote from the Primal Scream, I always seem to remember it because its so powerful:


    For the suffering neurotic who thinks primal therapy is too overwhelming or too difficult to go through, I would only say that the herculean task is to be what you're not. The easiest thing to be.. is yourself.

    ReplyDelete
  27. Delphi: Most therapists make you feel important and cared for, while your internal reality (I am no one and uncared for) is tearing your system apart. Is that what you want? art janov

    ReplyDelete

Review of "Beyond Belief"

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

Quotes for "Life Before Birth"

“Life Before Birth is a thrilling journey of discovery, a real joy to read. Janov writes like no one else on the human mind—engaging, brilliant, passionate, and honest.
He is the best writer today on what makes us human—he shows us how the mind works, how it goes wrong, and how to put it right . . . He presents a brand-new approach to dealing with depression, emotional pain, anxiety, and addiction.”
Paul Thompson, PhD, Professor of Neurology, UCLA School of Medicine

Art Janov, one of the pioneers of fetal and early infant experiences and future mental health issues, offers a robust vision of how the earliest traumas of life can percolate through the brains, minds and lives of individuals. He focuses on both the shifting tides of brain emotional systems and the life-long consequences that can result, as well as the novel interventions, and clinical understanding, that need to be implemented in order to bring about the brain-mind changes that can restore affective equanimity. The transitions from feelings of persistent affective turmoil to psychological wholeness, requires both an understanding of the brain changes and a therapist that can work with the affective mind at primary-process levels. Life Before Birth, is a manifesto that provides a robust argument for increasing attention to the neuro-mental lives of fetuses and infants, and the widespread ramifications on mental health if we do not. Without an accurate developmental history of troubled minds, coordinated with a recognition of the primal emotional powers of the lowest ancestral regions of the human brain, therapists will be lost in their attempt to restore psychological balance.
Jaak Panksepp, Ph.D.
Bailey Endowed Chair of Animal Well Being Science
Washington State University

Dr. Janov’s essential insight—that our earliest experiences strongly influence later well being—is no longer in doubt. Thanks to advances in neuroscience, immunology, and epigenetics, we can now see some of the mechanisms of action at the heart of these developmental processes. His long-held belief that the brain, human development, and psychological well being need to studied in the context of evolution—from the brainstem up—now lies at the heart of the integration of neuroscience and psychotherapy.
Grounded in these two principles, Dr. Janov continues to explore the lifelong impact of prenatal, birth, and early experiences on our brains and minds. Simultaneously “old school” and revolutionary, he synthesizes traditional psychodynamic theories with cutting-edge science while consistently highlighting the limitations of a strict, “top-down” talking cure. Whether or not you agree with his philosophical assumptions, therapeutic practices, or theoretical conclusions, I promise you an interesting and thought-provoking journey.
Lou Cozolino, PsyD, Professor of Psychology, Pepperdine University


In Life Before Birth Dr. Arthur Janov illuminates the sources of much that happens during life after birth. Lucidly, the pioneer of primal therapy provides the scientific rationale for treatments that take us through our original, non-verbal memories—to essential depths of experience that the superficial cognitive-behavioral modalities currently in fashion cannot possibly touch, let alone transform.
Gabor Maté MD, author of In The Realm of Hungry Ghosts: Close Encounters With Addiction

An expansive analysis! This book attempts to explain the impact of critical developmental windows in the past, implores us to improve the lives of pregnant women in the present, and has implications for understanding our children, ourselves, and our collective future. I’m not sure whether primal therapy works or not, but it certainly deserves systematic testing in well-designed, assessor-blinded, randomized controlled clinical trials.
K.J.S. Anand, MBBS, D. Phil, FAACP, FCCM, FRCPCH, Professor of Pediatrics, Anesthesiology, Anatomy & Neurobiology, Senior Scholar, Center for Excellence in Faith and Health, Methodist Le Bonheur Healthcare System


A baby's brain grows more while in the womb than at any time in a child's life. Life Before Birth: The Hidden Script That Rules Our Lives is a valuable guide to creating healthier babies and offers insight into healing our early primal wounds. Dr. Janov integrates the most recent scientific research about prenatal development with the psychobiological reality that these early experiences do cast a long shadow over our entire lifespan. With a wealth of experience and a history of successful psychotherapeutic treatment, Dr. Janov is well positioned to speak with clarity and precision on a topic that remains critically important.
Paula Thomson, PsyD, Associate Professor, California State University, Northridge & Professor Emeritus, York University

"I am enthralled.
Dr. Janov has crafted a compelling and prophetic opus that could rightly dictate
PhD thesis topics for decades to come. Devoid of any "New Age" pseudoscience,
this work never strays from scientific orthodoxy and yet is perfectly accessible and
downright fascinating to any lay person interested in the mysteries of the human psyche."
Dr. Bernard Park, MD, MPH

His new book “Life Before Birth: The Hidden Script that Rules Our Lives” shows that primal therapy, the lower-brain therapeutic method popularized in the 1970’s international bestseller “Primal Scream” and his early work with John Lennon, may help alleviate depression and anxiety disorders, normalize blood pressure and serotonin levels, and improve the functioning of the immune system.
One of the book’s most intriguing theories is that fetal imprinting, an evolutionary strategy to prepare children to cope with life, establishes a permanent set-point in a child's physiology. Baby's born to mothers highly anxious during pregnancy, whether from war, natural disasters, failed marriages, or other stressful life conditions, may thus be prone to mental illness and brain dysfunction later in life. Early traumatic events such as low oxygen at birth, painkillers and antidepressants administered to the mother during pregnancy, poor maternal nutrition, and a lack of parental affection in the first years of life may compound the effect.
In making the case for a brand-new, unified field theory of psychotherapy, Dr. Janov weaves together the evolutionary theories of Jean Baptiste Larmarck, the fetal development studies of Vivette Glover and K.J.S. Anand, and fascinating new research by the psychiatrist Elissa Epel suggesting that telomeres—a region of repetitive DNA critical in predicting life expectancy—may be significantly altered during pregnancy.
After explaining how hormonal and neurologic processes in the womb provide a blueprint for later mental illness and disease, Dr. Janov charts a revolutionary new course for psychotherapy. He provides a sharp critique of cognitive behavioral therapy, psychoanalysis, and other popular “talk therapy” models for treating addiction and mental illness, which he argues do not reach the limbic system and brainstem, where the effects of early trauma are registered in the nervous system.
“Life Before Birth: The Hidden Script that Rules Our Lives” is scheduled to be published by NTI Upstream in October 2011, and has tremendous implications for the future of modern psychology, pediatrics, pregnancy, and women’s health.
Editor