Thursday, January 7, 2010
Why Are We Anxious? (Part 5/6)
Living with hypercritical parents can be the soil for this feeling, and of course, the sense of catastrophe also emanates from from the early non-verbal event at birth, perhaps, where the baby sensed that to make a mistake could be fatal. There is lingering feeling that, “I cannot be wrong or make a mistake.” And the inability to be wrong is present in so many of us. This kind of person does not know how to react in crises. It is not a reasoned response that is required but a physiologic/feeling one. Defending against the possibility of a mistake begins with that very early feeling/sensation where doing the wrong thing, being wrong, could have been fatal. Defenses sealed in the feeling which then lingers and can make the person a “know it all.” Someone who cannot be wrong.
When a fetus develops normally the inhibitory/serotonin cells also develop in orderly fashion. But trauma to the carrying mother (a husband leaves the home) interferes with that process. Later on when the baby, now adult, suffers panic and anxiety attacks that appear out of the blue we can perhaps understand the origins. We see it in newborns whose bodies express it in restlessness and afflictions such as colic. They are often non-cuddly babies.
One reason for the evolution of the left frontal cortex was to produce a brain system that could distance itself from the other areas of the nervous system where painful feelings lie—a way of not being overwhelmed by what lay below so that we can get on with life and deal with daily problems. The prefrontal area is a brain system that can uncouple itself from massive, damaging input. It is the human part of us that can do it; it can disengage from that lizard in our head with our brain above water. It is a system that can bolster defenses and keep us out of inordinate pain. Another important reason for the evolution of the left hemisphere is that the left frontal cortex evolved with the use of tools. It is the left frontal area that is involved in precise tool use, as for example, hammering a nail. Precision has become the domain of the left frontal area. If we are looking for a good surgeon we should find one that is left-brain dominant. We can be assured that she will be precise. If we want a therapist who can feel and sense things we may want a right-brain dominant individual; but of course, someone with a balanced brain is always the ne plus ultra.
The anxious patient is giving us her early generating source on a platter. The key feeling is right behind the anxiety, which is a sort of an avatar ushering in some catastrophic feeling. The fore-runner of doom. How do we know that? Because when a patient begins the session with feelings of gloom and doom, and is miserable, we often know what feeling is coming. And from what level. If we listen carefully we will know where to go in the patient’s past. The feeling is there. We need to understand its significance. We can begin serious therapy while the patient is suffering because she is very close to the feeling and its origin. Acute anxiety means in itself that the generating source of it is very close to consciousness. And as I note elsewhere, the closer the person is to her feelings the more anxious she becomes; it is telling in almost mathematical precision how close to conscious/awareness the feeling is.
We see the defense at work in studying the brains of our patients. As feelings surge forth there are higher vital signs and a mounting amplitude of the brainwaves (how many neurons are recruited to defend against feelings). As connection is made the amplitude drops precipitously. It would seem that one aspect of brainwave amplitude is in the construction of defenses. At a certain point when defenses are lower the connection is being made and the brain can relax. No, we do not use too much of our brains; we use too much of our nerve cells when we must defend against feeling.
Since to be conscious is to be free of anxiety we are already half-way there. There is not much difference between an anxious patient and one who develops anxiety during the session. In both cases the feeling is approaching. With the patient, she only gets anxious as she gets near the feeling. Then we can see a full-blown anxiety attack; just before fully experiencing the feeling the patient whispers, “I am going to die!” Generally, the anxious patient has chronically leaky gates so that part of the feeling is seeping through at all times. Both are propitious for the therapy so long as the anxiety is not terribly overwhelming; meaning that the patient needs to be brought into the primal/feeling zone. It is not helpful in conventional therapy because they attempt to suppress, not express. Quite different processes and goals. If feelings are erupting it is clearly better to let them out in some methodical way than to continuously push them back. It hasn’t been done because since Freud’s admonition that the unconscious is a dangerous place. It is the flip side of the old religious tenet that says we are inhabited by dark demons and must hold them down. Those demons to the layman were evil spirits. To the psychologist they may be negative feelings. The same thing; some mysterious force at work. The mental health professional often cannot accept what it really is because in his theory there is no room for deep-lying memories that constantly direct our lives. And he has not the techniques to travel deeply to the antipodes of the mind.
The more we learn about personal evolution the more we understand about evolution of our internal universe. As I noted, inside the human brain we can find remnants of our fish and reptilian ancestors. What this means is that what we are is built on the most successful adaptations of what we were. When our patients go back to the most primitive brains in their reliving, we see those ancient brains at work. And,I might add, there are never any words in those first-line relivings (Primals). There cannot be because it would mean not a true reliving (there were no words when it happened). No real reliving and therefore no getting better.
The power of anxiety explains much about the power of the imprint. And we note that anxious individuals are forced to keep busy so that they are never left still long enough to fully feel the anxiety. It is absorbed in the constant phone calls, moving here and there. Phone calls are telling because the original anxiety may have been just after birth when there was no one to hold and caress the baby, no real contact. The feeling behind the anxiety may be feelings of total isolation and alienation. Also a feeling of abandonment. Phone calls reconnects the person constantly. The act-out is, “I need contact to show that I am not alone.” And above all, he doesn’t have to feel that abandoned feeling he suffered just after birth or in the first months of infancy. He stays on the phone for a long time because he is staving off the feeling of no contact. He cannot judge that he may be on the phone too long with someone because he is acting-out old feelings that drive him to talk; he has found an outlet for his feelings.
On my desk is a scientific paper on how early life affects adulthood (Max Planck Institute, Germany, 8 November, 2009. Published online in Nature Neuroscience, by Chris Murgatroyed and nine other authors). What they have shown rather conclusively is that very life events can induce long-lasting changes in the brain, physiology and behavior. Early life stress can cause over-secretion of the stress hormone, cortisol, which effects changes in memory and coping mechanisms. (For those scientifically bent, there is a detailed explanation of methylation in the article, explaining long-duration effects). In their study of mice they found that periodic infant-mother separation just after birth was a major cause of anxiety. And in humans the earlier the separation the more lethal.
I have discussed anxiety and the levels of the unconscious in several of my previous works (see Primal Healing or The Biology of Love). A first- line imprint requires a first line response, that is, reactions that heavily involved the brainstem and limbic system. The brainstem is involved in high blood pressure, palpitations, and shortness of breath—the silent killers. It houses many of our instincts, our terror and furor, and our basic, primitive needs. It is and always will be, wordless, unless we think that salamanders can speak. It contains the secrets of our birth and of our lives before birth in the womb. If we want to know what kind of birth we had, it will tell us in its own way. It will be precise and unmistakable. Its wonderful quality is that it cannot and will not lie. If we claim not to be afraid, but down deep there is unabated terror, there is no argument.
A chronic symptom of palpitations is testimony to the possibility of an old imprint lying deep in the nervous system. It is a fragment of a central memory where a rapid heart beat was called for; one aspect of an anxiety state. So one goes to a specialist for heart problems; another for high blood pressure; another for migraine, when they are all part of a single imprint, which, when relived normalizes all reactions. There is a reason for high blood pressure. Too often the reason is so arcane as to be disbelieved. But it is there. Either genetic or more likely an imprint while we lived our womb-life (epigenetic). The specialist, a necessity, offers medication to lower the blood pressure without asking once where it comes from. She has a task to complete, a task to help the patient not suffer. That cause is so mysterious that the question is rarely asked by the treating physician. And, as I often point out, we are not used to delving deep into the brain and its levels of unconscious. We don’t delve because we often do not have the tools. We do now. But still, it takes such a level of abstraction to tie palpitations in the now to an event during our womb-life. Luckily, we don’t have to make that intellectual leap; the patient will do it for us. And when we give the patient the possibility of deep penetration of herself, giving her total freedom of expression we will discover things we never knew existed. And we will learn from the patient and change our theory and therapy accordingly. We will learn from experience instead of creating the same old circumstances and explanations that reinforces our prejudices. And for the patient, too, she will learn from experience, not ideas; not the beliefs of the therapist; i.e., that there is an id or shadow forces that drive us. Rather, there are concrete events in our lives to account for a heart attack or out of control behavior.
Once a patient has access she may relive oxygen deprivation (a smoking mother) during her time in the womb. The patient may have a transient palpitation attack, or the pain of angina which she can now connect to the original threat (perhaps too low oxygen supply). One patient, as I discuss elsewhere, re-experienced being polluted in the womb as her mother smoked constantly. She learned why bars or smog drove her crazy. She could not stand any kind of pollution; it resonated with its original source. She never knew it as pollution originally. It was just a disagreeable sensation. She called it pollution after she grew up. But that early experience of smoke, over and over each day, laid down a permanent stratum of misery that kept her unhappy. And of course until she had access she never knew why. She finally connected.
The feeling makes the connection. Anxiety is a refractory symptom because it is basic to our survival. It should not disappear easily.
Because the brainstem continues to develop for several months after birth, what happens to us emotionally during the few months of life on earth can affect our heart function, most of our survival mechanisms, and our brain development. It is the first organized response to threat among most animals. It involves breathing difficulties and heart problems. My dog gets anxious when there are fireworks in the neighborhood. She begins to pace and breathe heavily and her heart beat is forceful and pounding, which won’t stop until an hour or more after the fireworks. In humans there is often a very rapid beating of the heart (makes me feel like wanting to “jump out of my skin.”) Unable to uncouple from a runaway sympathetic nervous system, one remains powerless. That’s one good definition of powerlessness; the linchpin of why most efforts for control fail.
Painkillers plus reassuring ideas from a therapist can control anxiety for a limited time. But it is never eradicated. And if we want to see if this hypothesis is true we have only to measure key biological processes during therapy, not the least of which is cortisol. As the patient approaches a first-line feeling the vital signs begin their rapid rise, much higher than we see when a second-line feeling is at hand. This is one way we know about the force and danger of the feeling. It is how we know what feelings to ignore for the moment. We do not want to push the patient into a feeling he is not ready for. If we listen carefully we won’t make that mistake. When we feel that we know best, the patient will suffer.
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.