Sunday, November 27, 2011

How to Measure Progress in Psychotherapy



Look, we all agree; we have a triune brain--3 brains in one, each with different functions. So one brain can be sick and the other two not so. Or two brains can be sick as a result of compounded early trauma. So isn't it silly to measure progress in therapy and leave out half or two/thirds of the brain? This is what is going on in psychotherapy today. We do followup studies with paper and pencil tests of mood, attitudes, comprehension and other intellectual/cognitive tests. And what do we get? A one third appraisal. So the mind works but the body is a wreck. The engineer functions very well at work while his body is preparing itself for cancer. Or the mind does not work, as in attention deficit disorder, but the body still gets migraine; or the ......you get the idea. Part of us can be more damaged then the rest of us. But all three parts need to work well and in harmony for us not to get seriously ill.

Can you imagine an MRI specialist studying only the cells in the kidney but not the mind? Not a good idea because the sickness starts up there. And we need to cross-reference all parts to see how they interact. We need to get out of the fragmented approach, taking the head and muscle cells to understand migraine, when all we will understand as a result is how those cells work, not how the system works together with other systems., and how that interaction produces symptoms. Again, I am pleading for a unified field theory of illness; illness of all kinds. Yes we need specialists who know more and more about less and less, know how the muscles in the neck work, how they contract and what happens to the blood vessels, but not anything about headaches, their cause and sudden appearance. Yes, they say the vessels contract and this or that happens to them but never why; never the ultimate cause, and certainly never the demise of the symptom and how we can achieve it.

So we treat a drug addict and we measure him afterward. And she feels great; all those great meals, massages and lectures. They work to drown the fish. But we measure the biology and there is a raging cauldron down below; the cortisol level is chronically high and can be life threatening. So much for self-awareness. Or vice versa: we are strict medical scientists and we measure cortisol and the person seems OK but he still feels terrible.You see what I mean? There are parts of us that need to be examined. It may take a combined crew but it will be more accurate. We have been fragmenting the patient, dissecting her because it is easier to study than the whole system as an ensemble. And we get a full blood panel, and we read the numbers and they tell us whether the patient is sick or not. Not much interpreting going on. We become bean counters, so much of this, too little of that and voila, you got diabetes. And of course it is worse in psychology because we do not have enough precise measurements to give us a precise diagnosis. So we ape medicine and imagine we do. We don't.
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18 comments:

  1. S. W. AlexanderNovember 27, 2011 at 3:38 PM

    Dr. Janov,

    This is exactly my experience.
    One doctor sees only one symptom; then you are sent to another who finds another symptom... Where are the doctors/therapists ect. who see the whole person and his/her history?

    The question is, what can we do? There are only treatments for symptoms. No one is interested in “what causes the problem”.
    Sieglinde

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  2. Jan Åke JohnssonNovember 27, 2011 at 4:13 PM

    I hope that the future epilepsy treatment will develop an approach in which visions,
    goals and a team of responsible can raise the quality of treatment as well as the lives of
    the sick. The explosion of knowledge in the brain research and the dynamic therapies in
    combination with modern patient treatment give me the courage to be positive. Future
    neurological clinics will naturally evolve from today's technology-oriented center, with the
    hunting for symptoms with drug recipes as the main weapon, to a more holistic treatment
    center. Teams will analyze and cross-reference the causes which will be treated with therapies, diet, exercise, medication and surgery when all else fails.

    Within a few years, our neurologists have gained a much better knowledge to determine from which type of epilepsy we suffer. There will obviously always be different reasons for
    developing epilepsy and the guidance of a neurologist is mandatory. Medications are from both a short and long-term perspective a necessary need for those who cannot or will not use, for example, Primal Therapy or other alternative solutions. For those who are able to go to therapy a flexible administration of medicine may act as a balancing aid. This flexibility will depend on teamwork between the patient, the therapist and the neurologist.

    The current knowledge explosion is likely to make it less scaring to be an epileptic in the future when the fragmented approach finally has been revealed as inadequate.

    It is sad to live in a time when it is easier to split an atom than to blow up a prejudice.

    Albert Einstein

    Jan Johnsson

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  3. JacquieNovember 28, 2011 at 4:31 AM

    I was talking to a CBT Psych about Primal last night. He was interested, to his credit, tho ultimately said he would "like to go deeper, but (what he does) works". But at what cost??? And does it really work? It is a bandaid, with a cost.
    Time and again I see how people, even professionals in the field, cannot-will not necessarily understand Primal, as they are not perceiving from a unified field theory.
    When I first discovered Primal I had a strong Science background, passion and aptitude. Perhaps all Primal literature should come w/a basic intro on the triune brain etc.
    I write this as I try to starve off my up-tenth migraine. Keeping codeine down with Maxolon, hyperventilating without dizziness windows open, the heater on for low blood pressure and writing in the dark. When I tell ppl how I came to suffer this hell I even point out the markedly smaller right nostril and deviated septum. They just look at me as if *I* am deviated..

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  4. Richard AtkinNovember 28, 2011 at 1:31 PM

    well said jan

    ReplyDelete
  5. Leonard GibbsNovember 28, 2011 at 3:40 PM

    Art,

    with regards to your blog about creativity & whether artists tend to die from heart disease rather than cancer. I chose 23 prominent Australian artists to see what they died from, but could only find the causes of death with 14. Of these, 7 died from some form of cardiovascular disease either directly or indirectly. So that's 50% ! In general about 33% of Australians die from heart disease. There may be something in your theory , though 14 artists is a pretty small sample. Of the 23 only 3 made it into their 90's - Lloyd Rees, died aged 94; James Gleeson, 92; & Hans Heysen 90 - maybe they died of natural causes?

    Anyway here is the list- (artists name, age at death, cause of death).

    1. Tom Roberts, 75, cancer.
    2. Frederick McCubbin,62,asthma & heart failure.
    3. William Dobell,71,hypersensitive heart disease.
    4. Ian Fairweather,83,heart attack.
    5. Russell Drysdale,69,cancer,but a stroke a year before he died.
    6. Fred Williams,55,lung cancer.
    7. Clifton Pugh,65,heart attack.
    8. Donald Friend,74, emphysema & mild stroke.
    9. Brett Whiteley, 53, heroin overdose.
    10.Arthur Boyd,78,a minor & major stroke 2 months before dying.
    11.John Percival,77, stroke.
    12.Albert Tucker,84, heart failure.
    13.Clement Meadmore, 65, Parkinsons disease.
    14.Howard Arkley,48, heroin overdose.

    You can check out these great Aussie artists on the internet, Also Willem De Kooning lived into his 90's but had alzheimers in the end - when does one die from natural causes or something else ? Or do a lot of us die from old age AND the subconscious forces ?

    Best wishes, Len Gibbs.

    ReplyDelete
  6. PaulNovember 29, 2011 at 12:52 AM

    Hi,

    How well I know now that I am sick in my feelings.

    I can one moment 'seem' to be ok. . . in my head I think to myself: "well, you're ok now Paul eh"? Then almost as if by magic I'm suddenly aware of something else in me boiling up, welling up and bang there are my true feelings and I'm on the floor screaming.

    It is as if there is a switch in there and it is either thrown or not. Unless you've had this experience repeatedly you really would not know how true Arts' words above really are.

    Most people are utterly unaware of the difference between thoughts, feelings and sensations.

    Least of all the 3rd line types.

    Paul G.

    ReplyDelete
  7. FrankNovember 29, 2011 at 4:25 AM

    What is there more to add? If we do not understand what you write… it means only one thing… and that is… our “understanding” serves other purposes… simple and very clear.

    Frank

    ReplyDelete
  8. Arthur JanovNovember 29, 2011 at 5:31 AM

    A facebook comment:"Hi, what is your thoughts about falling in love?Is this aspect just biology or is it predicted from our emotional history or.... I just can figure it out. I would be very happy if you could give me some vievs on this. Thanks. from a former patient."

    ReplyDelete
  9. Arthur JanovNovember 29, 2011 at 5:32 AM

    And my answer: Please read my Primal Healing for a discussion of love. Also my book on sex (Sex and the Subconscious: buy it at smash box) has a chapter on it. art

    ReplyDelete
  10. Arthur JanovNovember 29, 2011 at 5:33 AM

    Len: Hey you can't win them all. Thanks for your efforts by the way. Art.

    ReplyDelete
  11. JacquieNovember 29, 2011 at 6:07 AM

    Len, are you Australian? I am an Australian artist (yikes!), I often put my hand on my heart to go to sleep :)
    My migraine advanced last night b-t-w, hideous.. I reached a point where I simply couldn't breathe. Only vomiting released it. So f-g painful and terrifying. I cannot wait to be rid of them.

    ReplyDelete
  12. JacquieNovember 29, 2011 at 9:20 PM

    Hey, just wanted to add report today the Australian (Federal) Gov't is going to spend $5 BILLION over the nx few yrs "prioritising" mental health care.
    Imagine if the that could be spent on Primal????
    I AM SERIOUS

    ReplyDelete
  13. Arthur JanovNovember 30, 2011 at 4:44 AM

    Jacquie: Should I remind you all that I do not go on forever. art

    ReplyDelete
  14. Arthur JanovNovember 30, 2011 at 4:50 AM

    Jacquie: If you are serious then you must do something about it. art

    ReplyDelete
  15. Len GibbsNovember 30, 2011 at 3:29 PM

    Art,

    with regards to the little survey I did on Australian artists dying from heart disease or cancer, I must emphazise that 7 died from heart disease and only 3 died from cancer - so this does seem to give weight to your theory - even if it is only a small sample. I have just discovered that 1 in 2 in Australia will be diagnosed with cancer by the age of 85. Cancer is the leading cause of death here !!

    Jacquie,

    Yes, but originally a migrant.

    Len Gibbs.

    ReplyDelete
  16. Arthur JanovDecember 1, 2011 at 5:42 AM

    Len thanks for the input. interesting yes? art

    ReplyDelete
  17. JacquieDecember 2, 2011 at 2:45 AM

    Len, where are you? I am in Perth.
    Have you had Primal?

    ReplyDelete
  18. raindogDecember 7, 2011 at 2:21 AM

    Hey Len don't forget 75% of us get Melanomas by old age (most fixable), maybe that skews your figures?

    ReplyDelete

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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.
Editor