Saturday, January 16, 2010
Why Are We Anxious? (Part 6/6)
Unfortunately, a good deal of intrauterine trauma is registered in the right brain. It then becomes a vain task to use the later developing left frontal brain to gain access to it. They are two universes apart, and, as I explained earlier, they speak two different languages.
At the start of therapy the patient rarely retrieves memories of high life-and-death valence. The laws of evolution often will not permit it; that is, repression does the job for which it was intended. It allows only manageable fear at first. We have found a way to access the depths of the unconscious in an orderly, methodical fashion so that the patient is not overwhelmed by pain. Man is a microcosm of the universe; therefore what man is, is a clue to the universe. And we certainly learn about the evolution of the brain by observing patients in our therapy.
A study of 3-day-old baby rabbits, deprived of oxygen, found radically lower precursors (building blocks) to serotonin (5-HT). And they did not recover from this deficit. If we found these rabbits later on and offered them Prozac (serotonin enhancer) I am sure they would literally jump at the chance (pun intended). There are many animal studies that show how oxygen deprivation at birth lowers the set-points of serotonin. The research is now endless, almost always with the same conclusions: early trauma, including pre-birth trauma, alters serotonin and other neurotransmitter levels in the brain.
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. 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. It 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, no longer communicating together. 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.
Are we actually born with not enough serotonin in our systems? Yes, but it is not genetic; we are born with it but not born with it. Think of it this way: We take drugs that boost serotonin (Prozac, Zoloft, etc.), levels to help repress anxiety and pain. Does that mean that anxiety is due to low levels of serotonin? Isn’t that like asking if headaches occur due to low levels of aspirin? Not really. Because serotonin is a natural product, something we produce internally; and it can be low. We are indeed born with low serotonin levels due to epigenetics where a mother’s anxiety and low serotonin levels herself cannot help the fetus out with donating any supplies. So the fetus is in pain. Because basic need was not fulfilled, for example, the need for safety, e.g., to feel safe and untroubled. A child who lives with a rageful parent never feels that kind of safety and can never really relax. The world becomes a dangerous place for him, and when the pain is compounded by a stark, sterile, unloving home there could be the development of delusions, “They are after me and want to hurt me.” This all comes from a feeling that there is no safety anywhere, no one to turn to for help and soothing. Danger lurks, not just from the outside but also from the inside; it is a danger that is hard to escape.
We professionals are never going to convince this person that there is no danger. There is, but the doctor cannot see it; only the patient can feel it and know what it is. What is troubling is that the person is convinced that the danger is outside.
I explained in other works how one of my patients during gestation was involved in an auto accident during her eighth month. Her mother was pinned against the steering wheel and had the fright of her life as the car turned over twice. A chronically anxious mother can produce the same effect. The child seemed anxious, nervous and distracted and remained so throughout her life. She suffered a continuous low level of anxiety throughout her life making her unable to deal with the simplest task. She could not handle any additional pressure. One obvious reason was that the mother remained anxious all through her pregnancy, downloading it into the baby. The baby then had a substrate of anxiety herself. When father was menacing with a strong, loud voice she tended to overreact and be especially fearful (hence, obedient). Overreacting means reacting to different epochs of early life, to different kinds of trauma and lack of love, or to layers of the same feeling compounded over time.
So she is not just reacting to the current situation but she is reacting also to the past trauma, as well. It is how parents take our “no” away. We dare not disobey because we are so fearful from the start. So a healthy baby would shake her head and say to her parents “I don’t want to eat this,” whereas the child who spent his life in an anxiety-filled womb wouldn’t dare say “no;” the dreaded consequences, triggering off the birth and gestational traumas would be overwhelming. Without a theory that takes into account gestational life we will be at a loss to help patients. The kind of person I am describing is someone who cannot refuse an invitation or who cannot discipline a child. She cannot say “no,” in the same way that the parent could not, as a child, say no to her father.
If we have normal levels of serotonin we could repress on our own and there would be no anxiety or panic attacks. Low serotonin means inadequate repression. Thus, those riddled with impulses, homicidal and suicidal, are typically low in this neuro-chemical. It means loss of control. Anxiety starts its life as pure terror barely held back by the gating system. It gets transformed later on to phobias or to free-floating fear. We are able to dampen it with a variety of defenses but it is never less forceful than originally. Let me state that again. Pure primal terror never changes; it is defended against, filtered and softened but it never changes its internal effects. It is biologic. It is kept in place for reasons of survival. But it uses up supplies of inhibitory neurotransmitters. And the suffering may be exacerbated.
The problem seems to be that from just after conception to adulthood some of us utilize more serotonin than we manufacture. Animals, who were shocked while rendered helpless had far lower serotonin levels. What is diabolic is that traumas during womb-life not only cause us to use huge supplies of serotonin but they can compromise the inhibitory/repressive system so that we cannot make enough. The set-point is then very low. Don’t forget that it takes almost half of our womb-life before we can make our own serotonin.
Consciousness is the end of anxiety. Consciousness means connection to what is driving us. Disconnected feelings are what drive us constantly to keep busy. Their energy is found in the form of ulcers or irritable bowel, in phobias and the inability to focus and concentrate. They are the ubiquitous danger, shaping a parallel self—a personality of defenses and the avoidance of pain; a self stuck in history forever. In effect, there is a parallel self, the unreal front; and the real self, the one that feels and hurts. Thus, there are parallel universes that make up the human condition; one that feels and suffers, the other that puts on a good front. The latter, the front, is what most psychotherapy deals with: the psychology of appearances versus essences; the psychology of phenotypes instead of genotypes. It is navigating in the wrong universe. I propose that we navigate in the right epoch with the right tools and the right brain?
I have come to believe that a general theory, made of many hypotheses is essential for guiding patients to their pain. It should contain some philosophy, some neurology, some psychology, and, above all, a strong sense of humanity. Suppose we were like the very early explorers (and current professionals) who did not know there was a down under? Their explorations were random, without maps, a hit-or-miss proposition. We need to know that there is a proper destination, and we need to know how to get there; to be cartographers of all the elements of mind, not just the thinking mind. If physicians and therapists don’t know about “down under,” they will not solve panic and anxiety attacks, depression, suicidal tendencies, high blood pressure, sex problems, nightmares, and hormone deficiencies, to say nothing of heart attacks and other catastrophic diseases. To continue the metaphor, when we stay in the verbal neighborhood, we are never going to learn a foreign language--the language of sensations and feelings—the language of no words. Even though these lower levels talk to us continuously, we have never learned to talk to them. We haven’t learned their language because their language is ancient, developing long before the newer verbal language we have today. We are trying to get one level of the brain to do the work of another level, and it simply cannot. We use words to control anxiety when it has nothing to do with words. With each unblocking of feeling in our therapy there is an incremental increase in consciousness, and one is less driven by unknown, unconscious forces. Our goal is to widen and expand consciousness and narrow the gap.
Each month of our personal fetal evolution and our infancy (ontogeny) seems to represent millions of years of human development (phylogeny). In this sense, in our therapeutic sessions, ontogeny recapitulates phylogeny. What we can do now is go back to our beginnings, and through reliving we can find what happened during our birth. Further, we can discover how that event affected our lives. We can get to the beginning of our survival strategies, and each step means getting back more of ourselves. Think of it: we can discover how and when our neurosis began, if indeed, there was a significant trauma early on. (Remember the auto accident by the carrying mother?) Otherwise, there is the slow accretion of pain week after week, year after year, until one day we wake up and discover that we are miserable. We fight assiduously against the liberation of the unconscious when that alone spells emotional freedom. We need to get “emotional.”
We have the power to make an atavistic leap into our past and unlock the unconscious. We can peer down into millions of years of evolution by traveling back in our personal development. We can see how when feelings are too strong, how ideas and beliefs jump into the fray. We can see the origin of anxiety in our system as we feel the primordial terror. Anxiety is not a normal feeling. There are those who claim it is necessary to drive us and get things done. That is true if we are neurotic. We are not normally born anxious.
What most of medicine and psychotherapy involves today is the treatment of fragments of a human being, pieces of an original memory that has lost its connection to the whole. So we have coughing spells, frequent colds, anxiety and phobias, seizures, migraines, all pieces of an original imprint. We then treat the varied offshoots from a central imprint rather than the imprint itself; treatment then becomes interminable. What we get is a fragment of progress—a change in aspects of an early experience. We treat the phobias, the high blood pressure and the palpitations, sometimes all with the same drug. Because it is all of a piece, aspects of the same early experience. We have several different doctors really treating the same problem. Inadvertently, we are treating the central experience even though we may not be aware of it. What we want to avoid is a false or deceptive sense of health in our patients. We will have that false sense when we do not have good access to our inner life and to our feelings.
Feeling isn’t just another psychological approach. It is a sine qua non for mental health.
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.