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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Friday, October 29, 2010
I have written about the prototype before. It is that traumatic event that impacts the fetal system and changes its evolutionary trajectory. It helps set up who we become later on and warps our personality. It also directs how we react to the trauma at birth, (if there was one).A carrying mother smoking a half-pack a day, and then suffering from lack of oxygen at birth. A lack of oxygen would compound the prenatal asphyxiation and warp the development of personality. The memory is then stamped-in so that it governs all future behavior in the event of stress.
It is the limbic system, most particularly the hippocampus, with a bit of help from the amygdala and striatum, which scans history and automatically finds the prototype, the imprint that originally fixed the survival mode for the organism. This survival reaction becomes fixed and directs us for a lifetime. Of course it can be compounded by later events in childhood.
Let us keep in mind the prototype when trying to understand sex. To reiterate: high excitation in sex can be taken as a danger by the system because the original high level of excitation was a danger. The system cannot distinguish between the two since they have an equal force or valence. In this way sexual stimulation can trigger off the original trauma and our reaction to it. The brainwave patterns of past and present become indistinguishable so that sex and trauma fuse and run off identically together. It is the hijack. They are old friends. Sex climbs aboard the trauma vehicle and goes along for the ride; but it goes where the trauma takes it and no place else. It leads the way because it involves survival. That is what is reawakened during sexual activation. That is why we can examine sex life and look back to the kind of birth and pre-birth that the person underwent. In this way when there is an excess of stimulation there is an immediate shutdown or shut-off; the very same reaction as originally. Sex stops abruptly when a certain level of excitation is achieved.
We can look at birth and predict the kinds of sex problems there may be in the future. This is in general terms; there are many other factors that play into this equation but in an overall sense it holds true. I am focusing for now on what has been left out of the equation. Conversely, we can look at sexual behavior and post-dict (look back) on the kind of prenatal and birth-life one has undergone.
Because pain insinuates itself into sexual behavior with the identical imprinted force, it seems clear that once pain is felt for what it is there will be radical changes in sexual conduct. Sex will no longer be a conduit for something else but will be what it is. Pain will no longer be rerouted into sexual rituals by the limbic system because pain will no longer be a factor.
During the reliving, the whole physiologic system joins in the fray. It must be; otherwise it is not a valid, complete memory, and not curative. The same blood pressure, heart rate and vascular processes are there. We can measure the trauma and its force in this way. We can estimate the effects certain events have on sex, as well as other behaviors. Ordinarily, the voyage to our depths is not a difficult trip when we consider that current feelings are an elaboration of early sensations.
If we take care to allow the brain to follow its own evolution and do not talk too much or exert too much control in therapy the therapy is usually successful. If we abstain from intellectual control and third line discussion we will find the patient going back in time in ordered fashion. This will happen if we have no preconceived ideas or anti-evolutionary theories about what the patient has to do. We need to trust the process and above all, trust feelings. These feelings lie in a different universe of discourse from conventional therapy. Follow the brain. Follow evolution because evolution follows us. That is the key to successful therapy of sex problems.
One final word: Yes, it does help to deal directly with sex problems just as one would give shots or pills to the migraine sufferer. Palliatives are sometimes very necessary. No one should suffer until final cure is achieved.
Tuesday, October 26, 2010
I have been thinking about evolution in regard to psychotherapy. Last night there was a program on evolution; scientists from several countries convened to discuss the possible evolution of dinosaurs. There were many explanations, none satisfying. One, however, seemed credible. The question was which came first dinosaurs or birds?, since fossils were found of dinosaurs with feathers. They studied birds found near the site that had similar appendages as dinosaurs and filmed them. They found that these birds were born knowing only how to run; as their personal evolution continued they began to fly. This seemingly added evidence to the notion that birds came second, not first; that birds evolved out of dinosaurs, not the reverse. It is still a moot question but it led me to think about our own therapy; observing a primal session explained so much about evolution. Specifically, about the primacy of thoughts over feelings.
In a reliving, feelings come before thoughts, as they did in evolution; and indeed, as feelings become preponderant they nudge thoughts and beliefs into action. Those thoughts evolve out the feelings—being suffocated during birth—leading to, “he suffocates me.” “There is no space for me,” etc. What resolves this is not a change in attitude or thoughts but feelings; the imprint, the generating source needs to be addressed and relived because it was not fully relived originally. It was at best partially experienced when it happened and then shut off due to its load of pain. It needs to be fully lived, connected and resolved.
When we look at the session we are exploring evolution; observing both phylogeny and ontogeny. It is my position that unless the system is allowed to follow evolution exactly there will only be abreaction and not a connected, resolved feeling; that is the reason to pay attention to evolution. During a reliving of birth where we find skyrocketing vital signs there can be no crying like a two year old, no radical movements of the legs and arms and no words whatsoever. All these come later in personal evolution (ontogeny). To do all this now is to defy evolution, which violates biology and how it progresses.
We cannot get ahead of ourselves in therapy. Evolution is not to be fooled with. If we do not believe in it then all is lost and therapy is a useless exercise.
The minute a patient who is reliving something in early childhood uses words like entertaining, satisfaction, disappointed, we know she is not in the feeling brain and it is not a real experience. A five year does not normally use those words. In other words, evolution is a check on the reality of what the patient is undergoing. If we don’t know how the brain develops, at least minimally, then we might err in therapy; worse, we might push the patient beyond her tolerance level, beyond where evolution allows her to go for the moment. We might push her back into her history where massive pain lies; and all that will accomplish is overload and then symbolic acting out or acting in. Example: a patient was coming close to a feeling of a sexual seduction by her father. The therapist was pushing for her to get there. She reached the lip of the feeling and then sat up and said, “I’ve been saved! Saved by the Lord.” She was saved by the thought of the lord as the feeling nudged the thinking/believing centers into action to protect against feelings. Here evolution rushed in to save the situation and it did so in orderly fashion.
So when we observe progress during a session we are seeing how the brain works; what functions it uses to protect us, how it recruits thoughts to make us safe and neurotic, at the same time. We see how neurosis can take place. Most of all, we learn how to do the therapy; what biologic laws not to violate. What we also learn is how impossible it is to fulfill needs that are long past their due-date.
When we look at the evolution of babies we learn the laws of fetal and infancy evolution; what are the key needs and, above all, when they can be fulfilled. That critical window of need cannot be violated. After the window is closed there is no fulfillment possible, only amelioration. We cannot love neurosis away. Pain is stronger than that.
Once we begin to understand all this we know that we cannot use a later-developing mechanism, thoughts, to bring about change in neurosis. Thoughts then become a cover for feelings, not a resolving process. One reason this is not Primal Scream Therapy is that screams come after grunts in evolution. On the way out of the womb but not as yet out, there seem to be no screams. If we force screams we are wrong. If we try to make something dramatic happen to prove how smart and effective we are the patient will suffer. If we are patient and trust evolution we are on the right tract.
Sunday, October 10, 2010
I am convinced that whatever a carrying mother puts into her body the results on the fetus/baby will be deleterious. There is a study reported in Ethical Human Psychology (Vol 10, Number 1, 2008) that when a pregnant mother takes ordinary tranquilizers such as Prozac so Paxil she could be harming her baby. The investigators looked at mothers who took the serotonin-enhancing tranquilizers and found that the offspring had serious brain and body changes. It was linked to several afflictions, not the least of which were changes in the structure of the brain. When depressed mothers took those pills the offspring suffered from pulmonary hypertension, meaning that the baby had a hard time catching her breath. She could not get enough oxygen in her lungs. (The critical period was in the first trimester).
Serotonin is very important in brain development, and what these pills do is interfere with that development, culminating in possible withdrawal symptoms in the new-born:. Pure muscle tone, poor sleep patterns, respiratory distress and other factors. This is to say nothing of later effects on depression and suicidal ideation. So it is not benign to take a seemingly banal drug while carrying. What is important here is that it sets the stage for later addiction to drugs. The gap between uterine life and later behavioral effects can be decades, which is why it is so hard to detect. So a mother taking drugs to alleviate depression could be setting up depression and the need for uppers in the offspring. The baby can be born depressed; that is, she is low on alerting chemicals such as dopamine. Her whole system has been in suppress mode since entering planet earth.
Science Writer, Bruce Wilson, adds a quote from an article on the subject by Peter Breggin:
“Not only is the unborn baby trying to deal with a flood of maternal stress hormones transmitted to it through the placenta, but it also must deal with a drug that is affecting the very development of its stress response system and its brain.”
SSRIs (the tranquilizer acts to keep serotonin at the ready in the synapse), “actually work on the whole stress response system, which includes a host of neurochemicals and hormones. So on top of the onslaught of maternal stress, the fetus has its defense system knocked out before it has a fighting chance. A fetus whose mother took antidepressants is more likely to be born with ADHD.”
The baby can’t win. It is depleted of what it needs to respond properly to stress and then goes to school and is blamed because he is hyperactive and cannot concentrate—ADD. And here is what is worse. Later to he goes to a shrink to find out what is wrong with him and they give him drugs again. Ay ay ay. And he needs drugs because nowhere in the shrink’s armamentarium is there room for a theory of gestational life, which would allow for a treatment without drugs. With the knowledge that is out there about this it is almost criminal to not acknowledge this crucial time in our lives. It deprives patients at any shot at health and stability; any chance of good relationships, any chance that their heart will go on working into his nineties. There is too much evidence now that drugs given to the pregnant mother produce later heart disease (See. Robert Whitaker. The Anatomy of an Epidemic. Robert Whitaker.org)
Saturday, October 2, 2010
The problems with breathing, the shortness of breath and panic in the face of suffocation are rampant among my patients. Most of it stems from real suffocation at birth where for many reasons there wasn’t enough oxygen for the newborn. The most frequent reason was the massive anesthesia given to the mother or heavy doses of painkillers which effectively shut down the neonate’s breathing. Even epidurals can cause the shutdown. The baby cannot catch its breath. And because of that there is a panic state as death approaches. It is the same panic that adults suffer from time to time; a state that seems to come out of nowhere. Anything that is suffocating, even a biology class or a crowded noisy restaurant can set it off. The breathing problems are part of the reaction syndrome to lack of air early on. It would seem that it all comes out of the blue but in reality it is a reaction. Nearly always a reaction since panic is not a natural state in us humans. The question is “a reaction to what?”. If only we therapists could get use to asking “to what?”. Instead, we often stop there and begin our regime of suppression with pills. We are suppressing memory, and access to ourselves and our feelings.
There is research into this subject that claims it happens when a trigger is set off erroneously. It is not erroneous. It is precise, albeit symbolic. The feeling is the same whether in a room with lowered oxygen or in a crowded noisy restaurant. What is most likely to trigger off panic is the feeling of being trapped, stuck and unable to escape. Being in a situation that evokes all that; being trapped at the DMV in an interminable line and when you get to the counter they tell you that you need to fill the papers better. Or worse, being trapped in a home with rules and discipline and no love. Or being trapped in a job that has no future and no “room to expand.” That is the compounding factor. There are many ramifications that ultimately trigger off the earlier imprints. Being in a car with windows closed can do it, or in a room that is very stuffy. All roads lead to Rome. Sometimes just a passing thought can trigger the panic and the person is not even aware of what that thought was.
There is real suffocation and often the compulsive sighing that goes along with it. I call it the “Jewish mother-in-law syndrome.” But what seems to happen is fluctuations in what is known as the PC02 and lactate. PC02 is an index of the partial pressure of carbon dioxide and tells us how much carbon dioxide is in the blood. When they are high there is also a higher level of lactate and the result is the physiology of panic.
And what is this trigger? Remember there are higher levels than the pure physiologic one. And each higher level represents the basic brainstem reaction in its own way. Each higher level of the brain adds a different quality to an experience. So the second-line feeling system adds emotional tone and images, while the neocortex puts it all to words. And it works in reverse. A certain emotional situation or certain words addressed to the person, a demand or an insult, can run down the chain and trigger off the original panic. The origin is so deep down and so remote as to make the reaction a mystery. With deep personal access it no longer is a mystery.
Thus, the imprint of suffocation changes the physiology toward panic. Deep breathing diminishes panic for the moment. As does primal because a session that includes heavy breathing and crying lowers the levels. Later on, it will be painkillers (opioides) that will suppress panic; yet it is the deregulated painkilling chemicals associated with the early suffocation at birth that are partly to blame.
I have discussed the compounding process elsewhere; a lack of love, an oppressive household, an overprotective, suffocating mother can all add to the symptom. A mother’s real love and affection early on can also diminish the force of panic attacks by raising the inhibitory/repressive chemicals in the brain. There is an important difference between a suffocating, over-protective mother and one that offers true love. I had a mother like that; she had a terror of her kids getting sick and her having to take care of them. So she watched over them all of the time, never giving them freedom to make a mistake, i.e., suffocation.
There was, and is, a window of healing. To achieve that now means traveling down the chain of pain to origins and opening the window again. Otherwise, we are only left with pushing down the panic which can go on for a lifetime. What makes it all worse is when the mother is distant and unloving with her baby. It is why some children go into panic as soon as they cannot see their mother. It triggers off, perhaps, the anoxia again. A lifetime of disordered breathing can be set off during this critical window. This may be due to affects on some brainstem structures such as the medulla. In short, breathing difficulties can be first line symptoms, which can only be treated by descending down the levels of consciousness to the first line.
Let’s not make the mistake of considering the panic syndrome a maladaptive response. It is perfectly adaptive and commensurate with the asphyxiation that went on at birth or before. It would be abnormal if there were no “abnormal response.” When someone shuts off our air we all get panicky. That means we have triggered off our alarm system; cortisol pours into the system as we get ready to flee. And what we are fleeing from? Our memory.
Don’t be mislead about taking pills or shots to push down the panic. Pushing it back is not the same as erasing it. It stays and gnaws away until other organs, not the least of which is the heart, cease to function properly.
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.