Isaac Newton, one of the most celebrated scientists of all time, once remarked that he could see far because he was, “standing on the shoulders of giants.” In the same way, Arthur Janov’s ground-breaking approach to psychotherapy, Primal Therapy, combines some of the most important elements of his predecessors while providing a deeper and more complete theory of the healing process.
This became clear to me as I was reading the second edition of Louis Cozolino’s invaluable book, The Neuroscience of Psychotherapy.
For instance, Cozolino writes that Freud’s psychoanalysis and the psychodynamic forms of therapy that grew out of it, share theoretical assumptions such as the existence of the unconscious, the power of early childhood experiences, and the existence of defenses that distort reality in order to reduce anxiety and enhance coping.
Janov, who originally trained with Freudians, practiced conventional psychotherapy until his work led him to discover what he termed “Primal Pain”. In general, this refers to traumas experienced by babies and children which are so painful that the hurt must be dissociated from consciousness. In the more than three decades that followed, he has refined Primal Therapy as a way to allow patients to connect with these feelings in order for healing to occur.
However, in contrast to Freud’s psychoanalysis and some modern psychodynamic methods, Primal Therapists do not interpret or explain to a patient what they think he or she is “really” feeling.
They don’t offer “insights” or speculate about the source of the trauma, nor would they ask a client to do something artificial, such as exaggerated breathing or play-acting.
Instead of such arbitrary practices, Janov maintains that patients must discover their own unique truths for themselves, with the therapist acting as a skilled and empathetic “witness”. This “client-centered therapy” was pioneered by Carl Rogers in the 1960s. As Cozolino explains: “Rogers emphasized creating a relationship that maximized the individual’s opportunity for self-discovery.”
In the same vein, a Primal Therapist does not end a session after 50 minutes or some other artificial time limit. The patient has as much time as needed, and a session often lasts two hours or more.
A session usually begins by encouraging the patient to get in touch with whatever they are feeling at the moment. That is the real “royal road to the unconscious”. It may be an emotion, a memory, a dream, a song in one’s head, or perhaps a physical sensation. This bodily focus was first used by Wilhelm Reich, who had studied with Freud and who, as Cozolino notes, understood “that memory is stored not just in the brain but throughout the entire body.”
In short, trusting the client to find their own way (with appropriate suggestions from the therapist) is not only the most reliable approach to access deep feelings, but, not surprisingly, is vital to build trust between the client and therapist – an element that is essential for a healing relationship to develop. While Janov does not agree with the belief that, “the curative element is the therapeutic relationship itself”, he stresses that the patient must feel that they are in a safe, supportive, and understanding relationship.
This empathetic situation is the opposite of that which existed when the damage was done, and it allows the client to safely re-live the trauma - this time in small doses to avoid re-traumatization.
When all of these elements are in place, the patient has the maximum opportunity to make the healing connection between the conscious self and the repressed pain. When the old pain is felt, there may be crying, fist-pounding, trembling – even curling up in a fetal position when re-living a traumatic birth. (After observing Janov’s tape of a patient experiencing a birth Primal, affective neuroscientist Jaak Panksepp observed that such behavior “could not be faked.”)
Janov’s position is that - most of the time - a therapist must allow the patient to go as deeply as he or she needs to in order to make a full connection (and he believes that too many therapies do not let a patient fully descend into their pain). After a deep connection, patients will have insights into why they felt a certain way or acted out neurotically. It takes many sessions before enough of the pain is released so that one is no longer driven by the old feeling.
Like Cozolino, Janov holds that the, “primary focus of psychotherapy appears to be the integration of affect, in all its forms, with conscious awareness and cognition.” (Not surprisingly, Janov contends that cognitive behavior therapy only addresses symptoms – ideas – while ignoring the cause - buried emotions. Ideas are one of the most common defenses against feeling one’s pain).
Over time, this “integration of affect” leads to increased neural integration and information flow, as Daniel Siegel notes. The healing is not merely psychological - neuroplasticity means that there will be physical changes to the architecture of the brain itself.
Comments to Elements of Primal Theory
ReplyDeleteI like the image you borrow from Isaac Newton, when he said that the reason he could see far was because he “was standing on the shoulder of giants”. That is the same metaphor, I feel adequate when I am thinking of what Dr Janov has meant to me. This I don’t say just to support his Primal Principle about how pain can be relived and dissolved in the reverse evolution order. I have over 40 years on my own body, in my psyche and behavior experienced this revolution. I now feel that I can see much further than before.
Last night I brought home “The Neuroscience of Psychotherapy” by Cozolino from Kindle, and read it in order to see if I finally could find someone giving credit to Art and his invention. Of course I found nothing. However, you had in an elegant way bridged over this fact by referring to Carl Rogers and Wilhelm Reich, which both are quoted in Cozolino. (“Rogers emphasized the individual’s opportunity for self-discovery”).
(Regarding Reich, I cannot stop myself from quoting Ida Rolf when she in her book “Rolfing and Physical Reality” is saying: “Reich began to put a material body onto Freud’s theories, this kind of thinking and working that we are doing is forming the bridge between psychology and physiology. We too are standning at that point, that very vital point. We need to collect our clinical information together so that we can bring the psychologists down from the clouds and put their feet on the ground.” Said in the 70-ties...)
A couple of days ago NYT had a brilliant analyzes of the Deepwater Horizon’s final Hours in the Gulf of Mexico. http://www.nytimes.com/2010/12/26/us/26spill.html This is the story about what seemed to be an inevitable casualty of the blowout of the Macondo well. It was not. A top paid, handpicked crew of well educated, well trained and experienced, tough, strong and well coordinated people were frozen by the sheer complexity of the Horizon’s defenses and by the policies that explained when they were to be deployed. The chief counsel for the presidential commission that is looking into the Horizon disaster, said Tansocean’s handbook was “a safety expert dream” and yet after reading it cover to cover, he struggled to answer a basic question: “How do you know it is bad enough to act fast?”
When I read Cozolino’s invaluable book “The Neuroscience of Psychotherapy”, I struggle to find an answer to my problems. How to approach the pain behind my epilepsy and my feelings of not being counted, loved and behind my hurting nose and fingers, etc.. Why doesn’t Cozolino include Janov and the Primal Therapy? Is he so burdened by all the theoretical aristrocrazy in his reference lists that he against better knowledge chooses to exclude him? I like when he’s quoting Albert Einstein: “I never came to any of my discoveries through the process of rational thinking.”
1977 I had a different epileptic seizure. I didn’t cramp but climbed a high oak tree subconsciously driven by a memory how a boy (in a novel by Danish Nobel Prize winner Pontoppidan) had done the same after his father had assaulted him, very similar to what my father did to me when I was 9. The boy fell down and was killed. I was helped down by neighbors and paramedics and brought to a hospital where neurologists and psychologists gave me a treatment like that Jack Nicolson was given in One Flew over the Cuckoo’s Nest.
1984 I came to Bergen, Norway, after 750 miles / 15 hours drive from the south of Sweden to visit a Primal retreat held by Dr Janov. I went to the meeting and felt tense and scared. Inside the door in the group room I met Art and he only needed to see me, and he said: “It is a feeling” and I laid down and felt safe to follow my feeling into a deep birth primal, in stead of having an epileptic seizure. Art followed his intuition. He was not bogged down by no handbooks!
Thank you for your positive comments to Dr Janov and The Primal Therapy.
Jan Johnsson