Friday, April 15, 2011
On EMDR (Part 3/4)
Kolk states that If you are stuck in old memories you can't have new behavior. True, but new behavior is not something one superimposes onto a patient. New behavior emerges dialectically out of the reliving of the past, for one simple reason: the agony portion of the past imprint has not yet been lived. It has led an underground life manufacturing ulcers, migraines and high blood pressure. When I say agony, I believe that until one sees it or feels it there is no concept of the depth of that pain; something that can elevate brainwave amplitude by hundreds of percent. (Hoffman, Eric. Long-term Effects of Psychotherapy on the EEG of Neurotic Patients. Res. Comm. Psychol. Psychiat. Behavior. Vol. 8, 1983 pages 171-185. See also, “Hoffman, E., Goldstein, L. “Hemispheric Quatitative EEG Changes Following Emotional Reactions in Neurotic Patients. Acta Psych. Scand. Vol 63. 1981 pages 153-164)
Reliving anoxia or hypoxia at birth, the patient turns red and struggles for breath as if it were a life-and-death matter, which it was and is. An imaginary ending would be to feed the patient oxygen at a critical moment, which would inter alia, abort the memory and stop the healing process. The patient is beginning a dying sequence, as dramatic as that may sound, and needs to complete it; she did not die originally, and she will not die in the reliving. But with a thermister, an electronic thermometer, attached rectally we see the temperature drop by many degrees as the patient approaches “ground zero”. Why is this necessary? Because the trauma and the ensemble of physiologic reactions form a template for survival—a prototype which guides future behavior. To change the prototype one must descend to its origins. Out of the original trauma evolve numerous ramifications, directing diverse behavior and diverse symptoms, from colitis to heart problems such as frequent palpitations. Until the prototype is relived the best we can do is treat deep problems symptomatically. Generally, the deeper in the body the symptom the earlier the trauma, not always, but often.
Feeling the terror in the birth canal reduces and eventually eliminates phobias of elevators, for example. No one has to take the hand of the patient and help her enter an elevator. That is Behavior Therapy and makes the mistake of taking the ostensible problem as the real one; taking the symptom and making “it” well instead of the person. The deeper one feels and integrates the terror the less there is to deal with.
Retrieval of early memory activates the right hemisphere more than the left. When our patients are deep into reliving early trauma the limbic system is fully activated, and we believe the information is then transferred to the left hemisphere for final integration. In our brain research there is a shift of power from right to left hemisphere. Kolk: “Traumatic memories are often stored in the limbic system, which is responsible for attention, arousal, and attachment, but are usually stored as somatic (body sensations) memories. Traditional therapy does not even begin to approach the limbic system to resolve the trauma, so a therapy that accesses body memories (like attachment therapy does) is much more effective. EMDR is useful for resolving many traumatic memories, although it is not at all clear why it works.” Dr. Van der Kolk suspects that it works because doing the eye movements distracts the person from the traumatic memories and allows the brain to be changed.
There is a basic contradiction here. If eye movement therapy distracts the person from memory it defeats the ability to fully access that memory; it then cannot be integrated. He is right. Eye movement is a distraction that aids in the process of repression, which is exactly why the person feels better. Prayer can do it, “om” can do, thinking other thoughts can do it, directive daydreaming can do it by offering other images instead of the real one, etc. The fastest way is a good dose of Paxil.
Let us discuss what integration means. First let us see what disintegration means. Feelings stored on lower brain level, and this is where pre-birth,` birth and post-birth traumas reside, due to their valence of pain cannot rise to the prefrontal cortex for connection and integration. They are inhibited by various neurotransmitters and kept below the level of conscious-awareness. This is disintegration; the higher levels do not know what is going on in the various lower levels even while they are being driven by it. Paranoid ideation can help be quelled by tranquilizers that work on deeper brain levels, indicating the provenance of the higher level ideas. The person is not aware of the deep-level imprint but is driven to develop strange ideas by it. He does not need to feel a little bit of it, say being abandoned in infancy, or living in an institution for the first year of life, and then told to change his ideas or his behavior. He needs to relive the early traumas bit by bit over many, many months or years until the ideas driven by them evaporate. And they do. Solutions provided by a therapist are his solutions, not the patients’; therefore not real. Reality lies in the reality, as banal as that may seem. Reality lies in the truth of the memory and only there; certainly not in someone else’s brain.
We can only heal where we are wounded. The seeds of cure lie in the problem. We do not teach people how to live or how to manage in the future. Once free of their past they can figure it out themselves.
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.