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

25 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

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  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

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  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

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  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

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  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

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  6. 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

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  7. 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

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  8. emanuel: Try training and you will see. Art Janov.

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  9. 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.

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  10. 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?

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  11. 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.

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  12. 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

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

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  14. 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

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  15. 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

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  16. 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

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  17. 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

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  18. 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?

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

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  20. 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

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  21. 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

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  22. 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

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  23. 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)?

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  24. 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.

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  25. 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

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Bailey Endowed Chair of Animal Well Being Science
Washington State University

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Editor