More and more evidence indicates that the thalamus plays a key role in human awareness. The thalamus has a relay function to the cortex, but it also serves as a switching station which handles most sensory input and delivers it to the cortex. When it is overwhelmed it cannot do that; the message gets blocked and rerouted. Those in a coma often have damage to the thalamus; what happens is that messages never arrive to consciousness. It would seem that in hypnosis, as in coma, there is a functional "lobotomy" between cortex and thalamus, so that the higher level (cortex), doesn't know what the lower level (thalamus) does or feels.
I often call a Primal a "conscious coma" because the patient is (re)living on a lower level of consciousness during the session but "knows" what is going on as well. That is, the patient has retrieved a memory stored on a lower level and is feeling it on that level while bringing it to consciousness. Whereas hypnosis depends on the split and guards it, in Primal Therapy we mend it. That is why you cannot get cured with hypnosis. The split is the source of the problem, not the solution.
Pain Control and the Neurotic Split in Consciousness
Let's take another look at the statements made by Hilgard's subjects (HS) in the hidden observer experiments, followed by rephrasing of what the subject is describing from a Primal viewpoint (PV):
HS: It's as though two things were happening simultaneously. I have two separate memories as if two things could have happened to two different people.
PV: In neurosis the adult recalls the Pain of the child as if he and that child were two separate people. He can talk about it in a detached way, dissociated from its suffering component. This is precisely the neurotic split in consciousness: the Pain is merely repressed and concealed, not eliminated.
HS: Both parts (of me) were concentrating on what you said – not to feel pain. The water bothered the hidden part a little because it felt a little but the hypnotized part was not thinking of my arm at all.
PV: In neurosis the child is told "not to feel pain" in some direct and many indirect ways. "Why such a sad face today?" "What have you got to feel bad about?" "Stop whining and sniveling or I'll give you something to cry about." "It can't hurt that much." etc. As a consequence, he grows into an adult who is well able to not think of the Pain he is in. It may "bother the hidden part a little," but the "hypnotized part" – the part that is neurotically split off – does not think of the Pain at all. It thinks of telephone calls, things to do, places to go, projects....all to keep from feeling the emptiness and solitude inside.
HS: The hidden part knew that my hand was in the water and it hurt just as much as it did the other day (in the waking control session). The hypnotized part would vaguely be aware of feeling pain – that's why I would have to concentrate really hard.
PV: The hidden part of the neurotic feels how much Pain he is in so that he also has "to concentrate really hard" to ignore it: "I can take it like a man."
HS: The hidden part knows the pain is there but can't feel it. The hypnotized part doesn't feel it but may know it's there.
PV: It is possible to observe this process of dissociation taking place in the hypnotic subject. If we could photograph a neurotic with time-lapse photography over years, we could probably see a similar (neurotic) process taking place. The main difference is that neurosis is a long-term, lifetime event. The important similarity in hypnosis and neurosis is that while a false reality is imposed upon the system via ideas and suggestions, the ideas and suggestions cannot remove the pain actually experienced in childhood.
In both hypnotic pain control and childhood trauma, the lower levels of consciousness continue to register the pain. Recall the hypnotic subject's description that "the hypnotized part really makes an effort." Why does it have to make such an effort? Because the truth of reality is just beneath the surface. In hypnosis the hypnotist simply repeats the suggestions whenever the person starts to feel pain – when the "effort" of the hypnotized part begins to lag. In neurosis the lower levels of consciousness produce manic activity, for example, a constant effort to distract oneself from the Pain. In either case, we see the reality of pain pushing toward the surface, necessitating efforts to push it back down. One can either take a cigarette (in neurosis) or take a suggestion (in hypnosis) to push it down.
Pain of any kind is an affront to the system and, as one of Hilgard's experiments suggests, denial of that pain may constitute a kind of double-barrelled assault. Attempting to differentiate between pain and anxiety in hypnotic analgesia, Hilgard found that hypnotic pain reduction techniques may actually increase the amount of anxiety felt by the person while he is in the process of supposedly reducing his pain. Hilgard wrote:
Maintaining hypnotic analgesia requires some effort by the subject, even though he knows he is going to be successful in reducing pain. This effort is accompanied by physiological signs of anticipatory excitement when the subject knows he must soon fight off painful stimulation. These signs may be interpreted as a form of anxiety, perhaps deriving from a latent fear that this time control may be lacking. In any case...both heart rate and blood pressure increase more when pain is to be reduced by hypnotic analgesia than when it is to be felt normally at full value. [Italics added]
In neurosis, of course, it is typical to see both blood pressure and high heart rate chronically high. Hilgard's description illustrates the conflict between Pain and repression continually waged in every neurotic, a conflict which often results in anxiety. Anxiety is the global symptom which arises when Primal Pain threatens to overwhelm inhibition and make itself fully conscious. Every pre-Primal state, where patients are about to enter into an old feeling, can be considered an anxiety state.
There is no anxiety without repression; anxiety is a sign of faltering repression. Without repression, one simply gets terror in context. When my patients feel their terror in the ancient context there is no more anxiety. Thus it is both a symptom and a signal.
Anxiety indicates that the defenses are under maximum strain and signals for the extra production of repressive chemistry. The system revs up to quell the Pain before control is completely lost. Anxiety is taxing enough but its suppression even more so, and the anxious person usually uses self-hypnotic techniques in order to control himself (though he may never identify them as such): "It'll be alright," "Don't worry, it'll turn out fine," "Take it easy," "Calm down," "Think positive." These are all hypnotic style suggestions. Very often they have to be repeated over and over to produce any effect, which gives us some idea of the energy needed to suppress and contain the anxiety.
Hilgard's discovery regarding the link between pain and anxiety parallels what we have learned about the effort involved in maintaining dissociation: feeling the Pain in its entirety is "easier" on the system than going through the labor of dissociating from it. In fact, it is not Pain alone that produces symptoms, but Pain together with its counteracting repression. Repression is responsible for the pressure the system is under leading to symptoms. It takes great physiological effort to keep Pain out of awareness, an ongoing internal struggle which is measurable through one's vital signs. Indeed, heart rate and blood pressure tend to decrease permanently after a period of releasing Primal Pain.
The fact that emotional pain registers as a physical entity, one which is imprinted throughout the system (indicated by the physiologic changes which occur as a result of its removal), is vital to our understanding of neurosis and hypnosis. This knowledge wrests neurosis from the abstract and even metaphysical realm created for it by its definition as a mental illness, from the realm of mechanics created for it by the behaviorist viewpoint, and at last, places it where it belongs in the very real and physical organismic processes.
Pain is not often thought of as anything other than the localized sensations caused by physical injury. When it is viewed on another level it is seen as an idea: as something that can be thought away, forgotten, or in some way mentally altered by psychological gymnastics (hypnosis, biofeedback, directive daydreaming). More recently we have coined the term "problem" to describe the affliction of neurosis. It then becomes a matter of unbalanced equations, malfunctioning machinery, and unsorted puzzles. Mental solutions are sought for mental problems and behavioral solutions are sought for behavioral problems.
Pain creates problems for those who suffer from it, but to become caught up in the treatment of each problem is to lose sight of the central issue: that only by dealing with the physical reality of repressed Pain does the nature and depth of the organismic disease known as neurosis become fully treatable.
As mentioned earlier, psychological mechanisms by which hypnotic states are induced are based on the innate defensive capabilities of the brain. Even more importantly, they are based on a pre-existing pattern of behavior that has been in constant and active use throughout the subject's life. Neurosis is the ongoing post-hypnotic state which is already operating when the hypnotist goes to work. The neurotic lives in a state of permanent dissociation from his pain. Hypnotic techniques take advantage of this situation without it being recognized. The already existing defense of dissociation gets an added boost from hypnosis. When translated back into neurological terms, this means that extra endorphins pour into the system. In other words, hypnosis helps the system function even more neurotically than usual.
"Pain," writes hypnotherapist Yapko, "is a warning sign that something is wrong. The various hypnotic approaches are essentially 'band-aids,' for while they may assist the client in being more comfortable, their healing abilities remain uncertain."
See Science News, July 2, 1994, pp. 10-11.
Hilgard, Hypnosis in the Relief of Pain, p. 78.
Yapko, Trancework, p. 276.