As time goes on and I learn more about the human condition, I have decided to share some of my thoughts on what we are all about. I will publish my reflections on this blog, hopefully to enlarge our understanding of what makes us human. Art Janov
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Wednesday, September 22, 2010
I often talk about our internal pharmacy. When pain enters the arena our brains go to that pharmacy and order what it needs; say, more serotonin for the synapses to help with repression. What the commercial pharmacies do is produce the precise molecules that we manufacture inside our brains; and they do it because we cannot manufacture enough ourselves. I am convinced that most of us manufacture what we need in the ordinary course of life. But we know that just as the brain is developing in the womb there are traumas that beset us that cause lower serotonin set-points; that is, we cannot secrete what we need because pain (noxious elements such as a mother very anxious or who smokes), has caused the brain to use up its reserves in the battle to stave off being overwhelmed. And this sets up a permanent deficit. And then what happens is that the offspring/now adult, is also chronically anxious because her gating mechanisms are faulty; and so the cycle goes on.
There is a debate going on now about the advisability of using tranquilizers in the womb to normalize the mother’s system. There are minuses in both directions. If there is no medication given to the mother than she is anxious or depressed, and will pass it on to the baby. If we do give tranquilizers while the fetus is still in his womb-life, then that can be transmitted into the baby, as well. We are overloading the fetus’ serotonin levels with medication. There is no great solution except one: normalize the system before getting pregnant. That can be done, and we have shown in any number of studies that we tend to normalize the brain system after one year of primal therapy. This is preferable to messing with our inner manufacturing plant.
Frederich van der Veen presented his findings on serotonin to the Forum of European Neuroscience (July 2010). They gave one dose of a serotonin enhancer to subjects. They then watched sad films. Those on medication cried much less. It effectively brought down the levels of pain and opened some access to tears and the sad feelings. We are not normally low in serotonin except for trauma; and those traumas that occur the earliest in our lives are the most powerful, dealing as they do with life-and-death matters. Crying less doesn’t just mean less flowing tears; it also means less access to ourselves and our feelings. The purpose of serotonin enhancers is to numb out some of our feelings and reactions to them.
Taking shots or pills does not eliminate the pain or the churning of the system; it hides it all, making us more unconscious. But that unconsciousness can kill; what you don’t know can hurt you. Taking medication needs to be seen as a stop-gap method and not a cure.
Thursday, September 16, 2010
How does a cross word by a father become a chemical in the child's brain? The angry words portend possible danger and rejection. There are clues in the tone of voice, the look, and the words themselves. What is going on inside the child is that the hypothalamic-frontal cortex axis is engaged to send messages to all other systems to be on the alert. This message is sent by chemical courier. It is the meaning implicit in the message that begins the chemical transformation in the child's brain. The hypo-thalamus then triggers the endocrine system to release catecholamines, making the heart speed up and the blood flow. Generally the process goes from the perceiving frontal cortex and other aspects of the cortex (hearing, sight, etc.) to the hypothalamus to the pituitary and then to sympathetic nervous system neurons which organize the flight or fight response to danger.
How does a loving look by the mother at her baby change the baby’s brain? It is responsible for the increased serotonin output that keeps him comfortable. When the traumas are severe and early enough the brain and particularly the brainstem, cannot manufacture enough. The setpoints may be altered. The child then overreacts because it cannot dilute or vitiate feelings. This child may become terrified of a slightly angry father, while another loved child would not. A deviated personality is on route.
Terror of the father now becomes permanent increases in stress hormone levels. The frontal area, now signaling extreme danger, interacts with the medulla in the brainstem to affect heart and lung function. In turn, the brainstem maintains the tone and vigor of the frontal cortex, constantly adjusting it to react to stimuli. When the brainstem is in a hyper state due to early trauma or lack of love, there is chronic, dramatic overreaction. "Hysteria" is the label we attach to this. "What are you getting so excited about?" "Dunno." Now we know. The brainstem has been primed and too ready for action.
When warmth is expressed in the actions of a parent toward a baby, the baby's brain is suffused with opiates, resulting in a feeling of well-being in her. I have heard many of my patients cry out, "Show me that you want me, Mama!" In animal research, the loving handling of specimens just after birth increases the anti anxiety chemicals such as serotonin. This level endures so that later in life there is still an adequate mechanism to handle adversity or stress.
When a father never touches his infant, is impatient and angry, and demands obedience from a two-year-old, the frontal cortical neurons are going to be impaired, perhaps for a lifetime. Hugs and kisses during these critical periods make those neurons grow and connect properly with other neurons. You can kiss a brain into maturity.
A father who never shows happiness to see his baby, never responds with kindness to her cries is forming a new brain in her. Every action of the parent may exude unhappiness with the child who did nothing more than get born and interfere in his life. The stage is already set for later unhappiness and depression. She is now on a lifelong struggle to make the father happy to be with her—a fruitless effort. The baby can feel unwanted long before it understands the concept. And what can the baby do about it? Nothing. Her brain goes on the alert, and stays that way until later on she finds a downer or painkiller and suddenly finds what she needed all of her life — comfort and relaxation. Who can live with such a feeling when you are totally dependent on people who don't like you? And in the child’s brain that feeling remains intact and present. Drugs are calming the child, the child who feels unwanted and unliked. Drugs do exactly what would have happened if the child were adopted out to a loving, kind, warm family. Drugs become the family, and now if the adult is in a 12-step program he has another family of addicts beside him. That support bolsters the second-line limbic function and calms pain on that level. Thus the agglomeration of pain on all brain strata has been reduced on one of those levels making the search for drugs that much less importuning.
Saturday, September 11, 2010
I have two advanced degrees in the field of mental health. Despite about 12 years of university I learned almost nothing about how to do therapy. It was always hit and miss, never a science. It was “do what you feel comfortable with,” which is a license to do terrible stuff. Since neurotics are comfortable with neurotic goals and neurotic techniques; witness cognitive therapy, intellectuality raised to the level of a principle. Head lucubrations converted to a theory. The training was useless and meaningless and could help no one. Why? Because it was not and never was a science with testable hypotheses that one could suss out and discover things that would enhance our techniques.
I was also trained, a residency, at the Freudian clinic of the west, a sort of Meningers on the west coast. Also useless. I never learned a single scientific principle, nor how to put the therapy to the scientific test. The reason was there was no science and still is not: except, primal therapy. When I do training all of my advance therapists know the minute a mistake is made; it is that precise. And we do training in science as well so that we are all aware of the scientific method. Our training never stops. It goes on for years because there is so much to learn. We have done several double blind studies in Europe on our patients; and what did I discover? No one cares. It is the syndrome, “I won’t believe it even if you prove it.”
Is this sour grapes? Maybe, but when trying for research funds we are always turned away as unscientific.
Our patients are always our scientific subjects. We do vital signs before and after each session. I have written earlier on my blog about their importance. We have studied the immune system, the brain function, the inhibitory/serotonin system, and on and on (see Primal Healing for a discussion of all this). But for those shrinks who are left brain the greatest voyage they are ever going to make is to the right brain, and alas, they cannot do it. No one can do it voluntarily. We need to open the gates between the hemispheres and that takes time and serious scientific therapy.
We try to make sure that our therapy coincides with current physiology and neurology; you will see that I write a lot about that. Because we cannot concoct a psychotherapy that flies in the face of how the brain works; for example, believing that ideas change feelings, when it is just the opposite that is true. We have spent something like one million dollars in scientific pursuits, often using outsiders who have no idea what we do. But I am convinced that you cannot “prove” our therapy but these facts alone. It has to hit you in the gut. And who does it hit there? Those who suffer. Those who are close to feelings. Those who cannot make it, who are constantly depressed and anxious. They understand my theory right away and come from 26 countries for the therapy. I am not sure I would read a book by a curly haired shrink and travel 10,000 miles for help. But they do and they get help. They do not care about statistics. They care about their feelings and their misery. We are the therapy of last resort, a therapy of misery where patients can finally let their misery out. Almost every single therapy extant works to push back feelings. Isn’t that strange? Feelings need to be expressed and they push them down. The result is more depression and anxiety, more not getting along with others, more dysfunction and later, more serious disease. And worse, they have the statistics to prove their case because it is all in the definition of what is success. And if they say better social adjustment and self-described feeling better, then you cannot beat that. Because nothing is as infinite as self-deception.
Wednesday, September 8, 2010
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.
Saturday, September 4, 2010
The depressive is, by and large, a parasympath — someone whose whole system is skewed to that part of the nervous system (the parasympathetic). This subsection of the nervous system is controlled by the hypothalamus. It is a system of rest, relaxation and repair, a system that usually produces undersecretions. It is the system that has evolved out of the "freeze" response in animals, which evolved over time to inhibit the ability to make an immediate and aggressive response to danger. There are times when the best defense is to do nothing or at least think and reflect a moment before reacting. One key marker for this is body temperature that is almost always universally low in these patients and is controlled by the parasympathetic nervous system. It speaks of a birth or pre-birth trauma that skewed the system into passivity, despair, defeat and an inability to react. It thereafter controls our behavior and our symptoms. Migraine, for example, is often part of this system’s response: a shutting down of (constricting) the vascular-blood circulation, followed by massive dilation.
If one ignores deep feelings, encased and remote imprints, then it is easy to overlook them in treating depression. One, then, has no choice but to offer prescriptions. One can only then attempt to push back the surging forces of pain, as repression of early pain leads to no other alternative. "Looking on the bright side" is a religious idea transported into the realm of psychotherapy. The "power of positive thinking" is best left to the church because, as much as we want to look on the bright side, our internal system is "looking" on the dark side. Why? Because the imprinted memory is dark and painful. However, it can be reached and extirpated. I have taken my patients as deep and as remote into their past as possible and I have never found a demon or dark, evil force. All I have ever seen is sequestered pain. All that is there is a pure need left over from infancy when those needs should have been fulfilled.
Friday, September 3, 2010
David Laplante and Michael Meaney of McGill University, Canada write the following: "We suspect that high levels of prenatal stress exposure, particularly in early in pregnancy, may negatively affect the brain development of the fetus." ("Stress During Pregnancy Affects General Intellectual and Language Functioning in Human Toddlers." David Laplante, Michael Meaney, et al, Pediatric Research, Vol. 56, No. 3, 2004.) They studied pregnant women during a severe ice storm in Canada in 1998. In this study they note: "Imprinting at birth may predispose individuals to certain patterns of behavior that remain masked throughout most of adult life." K.J.S. Anand and associates state that in a number of suicides by violent means "the significant risk factors were those perinatal events that were likely to cause pain in the newborn." (Page 70.) They also point out the pregnant women who smoked heavily had babies more prone to criminality later on. And mothers, who took drugs while pregnant, had children far more prone to drug use, both serious opiates (morphine) and speed (amphetamine). There are literally hundreds of studies now to bolster the hypothesis about early imprints, how they last, and alter our systems.
This is new material. Some 20 years ago, most of this research had not been thought of. Most clinical studies confirm what we have been saying for almost 40 years. Proof of that is now not in question among scientists. What is in question is the necessity of reliving it all. There is scarcely a psychotherapist among us who believes in the absolute necessity of reliving old events and altering their imprints, yet it is that very process that is curative. Might I say that the only process that is curative is one that deals with history and memory?
When I state that the patient "remembers" his time in the womb, we must keep in mind that memory can be something beyond verbal recall. The body remembers in its lack of oxygen, its lack of freedom to move, both in a physical and anatomical sense, its being strangled on the cord or its sense of being overwhelmed and shut down by anesthesia. Clearly, at the outset there is no intellectual recall but there is a lower brain system that has recorded the experience.
Imprints are usually not in the therapist’s lexicon; if nine months of fetal life is ignored, then there is no choice: rules and more rules, 10 or 12 steps to nirvana, etc. Feelings are the opposite of rules. Rules are one causative factor in depression. The depressive too often grew up with rules and regulations instead of warmth, kindness and caresses. They too often go to a therapy that has rules — known as behavior or cognitive therapy, an attempt to change behavior — that involves rules of conduct. The approach is basically, "Do me." It is unfortunate that in most conventional therapies the patient is "done to." It is what parents did now writ large. The person is the recipient of a variety of manipulations. When we ignore feelings, we need to be "done to." This is what happened to many of us growing up — being ordered around without regard to how we feel. It can be as subtle as never asking a child what she wants for dinner. She learns, however subtly, that her needs and feelings don’t count. We certainly do not want to compound the error.
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.