Wednesday, September 8, 2010
More on Psychosis
How do you know when someone is crazy? Not easy because we can all go crazy in different ways. If that is so then how can we possibly define it. And, as I often say, someone can go crazy to keep from being insane. This is not just a joke but a truism. Let me explain. What psychosis is about generally is when the first line (in my lingo) moves into the third line. When deep pain and remote trauma occupy the thinking, present day frontal cortex. When the inhibitory gates are so leaky that traumas in the womb, at birth and in the first year cannot remain repressed but instead move higher in the brain and interfere with present-day functioning. Those events are so shattering that sometimes they cause aberrant ideation, paranoia, and bizarre beliefs. But those ideas and beliefs are relating to the traumas; that is, they arise out of them, so that these beliefs have been formed out of the sequestered pains, however remote.
Psychosis and neurosis are not different diseases, psychosis is the more heavily loaded pain affliction causing exaggerated beliefs and reactions: pounding a door shut with nails to keep the devil’s rays from penetrating the brain. What happens is that the heavy-valence early traumas are the kind of events we cannot see yet are the predominant factor in later psychosis. It is the result of preverbal events that provide a shaky couche upon which later events are compounded. They are so severe, near-death experiences that the gating system is weakened; and by that I mean that among other things, they put such a drain on the inhibitory chemicals in the brain that we are chronically deficient in them; hence leaky gates. It doesn’t take much neglect or loss of love later on to overwhelm the gating system completely leading to psychosis . And when a stressor such as adolescence occur there is apt to be a frank outbreak of psychosis because the body, already in turmoil due to hormones, is weakened again by raging hormones.
Because the early imprints are most often of near-death experiences when they provoke paranoid ideation it is nearly always to do with death; someone is after me and is trying to kill me. Or they are shooting rays into my head. Or they are poisoning my coffee. There is an immediate threat which forces the person to wear aluminum foil on his head to ward off rays from the helicopter above. Logic is out the door as the cortex strives mightily to concoct a rationale for the upcoming pain. In the person’s mind that rationale makes sense since the feeling he is dealing with seems very real to him. “They are trying to hurt me,” is the leitmotif from perhaps a birth experience so terribly painful and hurtful that thinking someone wants to hurt us makes sense. It is the first terrible experience occurring to the baby who has been comfortable in the womb. He is suddenly plunged into a pain that is excruciating but for which he has no scenes or explanation since he had no words nor capacity to produce scenes at the time. So of course it is bizarre since it is an event that never had words nor understanding.
So the paranoid has to compile a complex reason for what he is undergoing. Sounds crazy and it is. He is going crazy to keep from being insane. That is, he is keeping much of his cortex intact with a set of compartmentalized, cohesive ideas but so he can function. If the early pain is catastrophic it might completely overwhelm the neo-cortex and we get a babbling idiot who cannot function at all. In this sense psychosis is a defensive measure against complete mental collapse; meaning the kind of person who enters a school house and kills fourteen people. His past became his present. There was nothing left in his brain to inform him of the different between past and present.
In a sense, neurosis/psychosis is the difference between a dream and a nightmare. Dreams weave acceptable stories that are ego-syntonic. Psychosis produces stories that are ego-dystonic. Still they both attempt to ease, filter and defend against the pain. The source of the pain and its force may be the critical difference.
So how do we know that this is true? When those who had horrific birth, gestational and infantile life approach those imprints in my therapy they can undergo transient psychotic episodes. When they approach not-so-devastating events they do not go crazy. But we have to be careful because putting a fragile person into very early horrific imprints can be dangerous; and it can be lasting if the therapist does not know what she is doing.
A paranoid belief is at least a structure that keeps the psyche from fragmenting into pieces so that a person can function and repair bicycles during the day. I had one patient who was a knife sharpener; completely delusional, and yet housewives would let him in their living rooms and kitchens to sharpen knives.
The stuff of psychosis is the same material from which our brains make nightmares. They are the intrusion of very early womb/life events into the top level brain that produces ideas and some scenes to go with them. One classic one: I am in a washing machine whirling around and drowning and I am going under and cannot stop myself or the machine. His primal was of being the womb, thrashed about, drowning and feeling powerless against it.
We all go crazy or become neurotic in different ways. It depends on so many factors: where we grew up, in institutions or foster care, during war time or not, how anxious or depressed was the carrying mother, etc. These are all influences but the amount of pain and how early it started largely determines psychosis or neurosis. There is in my opinion nothing more psychotic-making than incest. I have rarely seen an incest victim who was not pre-psychotic. It depends on how early it started but when the person who is supposed to protect you becomes the danger it is crazy-making.
So what does the anti-psychotic medication do? It is largely a first-line blocker. It holds down the pain of those very early traumatic imprints. And when effective there is much less paranoia and bizarre behavior. All this means is that someone with heavy early pain needs massive painkillers to keep it all in check because those same imprints depleted the inhibitory, repressed chemicals that we produce ourselves. The levels were permanently suppressed. When early pains occur they affect the production of serotonin (think Prozac). Later that is exactly what needs to be added to the mix to keep the pain down. Ideas do help produce those chemicals, as well; so in a way, delusions are pressed into service to help secrete pain killing chemicals. The system is always trying to right itself; to normalize. Most of what we do and what our bodies do is a constant attempt to achieve normalcy. That is, to function, protect ourselves and our loved ones. Normal means survival in every way. Our physiology when normal lets us live a longer life. We do not fall so easily into disease. And in my books I have quoted study after study that shows how early trauma leads to later cancer and heart disease.
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.