Wednesday, April 25, 2012
Primal Therapy Research Proposal
What you find below is the outline of a proposal for research. We have neither the funds nor personnel to carry it out. We seek help from all of you. I do believe we lengthen lifespan, and I want to confirm it. I also believe that gestational trauma is behind so much later dementia and other disease. art janov
Research Question: Can Primal Therapy reverse biological markers caused by early life stress and slow the rate of aging? Epigenetics, telomere length, and Alzheimer’s Disease
Primal Therapy is an affect-based psychotherapy created and developed by Arthur Janov, PhD, of Los Angeles, Calif. First popularized in 1970 after the publication of The Primal Scream, Primal Therapy has undergone continuous development under Janov’s direction, both in theory and practice. Now in his 80s, Janov and his wife, France Janov, PysD, continue to practice and train therapists at the Primal Center in Santa Monica, Calif.
The fundamental tenet of Primal Therapy is that the cause of most psychological disorders (and many physical disorders) is early life trauma. From the moment of conception, humans have needs, and when those needs go unmet, the result is trauma. A vast body of research conducted in recent years demonstrates that trauma begins in utero when the fetus is subjected to environmental stressors, including maternal stress hormones, malnutrition, tobacco, alcohol, drugs, chemical toxins, and a host of other stressors. The result is a biological imprint—or wound—that lasts a lifetime. Later events, such as birth complications, poor maternal attachment, parental neglect or abuse, bullying, failure in school, etc. add to the earlier trauma and reinforce the imprint. Janov has made the hypothesis that a neural resonance exists within the brain that “links” earlier and later trauma. For example, when an adult is rejected by a love interest or frustrated at not being able to find a job, the feelings of rejection or futility may trigger implicit memories of neglect in childhood or maternal separation in infancy. This in turn may resonate with implicit, physical memories of a life-and-death struggle at birth or toxic stress in utero. Although controversial, the idea that fetal memories and learning can influence later life is supported with recent research (Wintour, et al., 2006; Entringera, et al.,2004). The end result may be an overwhelming feeling of despair leading to suicidal depression. In other words, a psychobiological response is evoked that involves the entire body and mind. Janov calls this the Primal Imprint. This imprint endures and affects nearly all systems during our evolution. It is the key motivational entity.
Rationale for the Study
It is established that early life stress leaves a permanent imprint on the physiology, predisposing the individual to a wide range of diseases, including coronary heart disease, hypertension, metabolic syndrome, diabetes, obesity, autism, depression, anxiety, schizophrenia, learning disabilities, accelerated aging, cancer, etc. This is known as the Early Life Origins of Health and Disease paradigm (Wintour, et al., 2006). One of the main mechanisms by which this imprint is encoded is through epigenetic changes. Meaney and colleagues have shown that parental neglect leads to changes in genetic expression via DNA methylation and histone acetylation. (Meaney, 2001; Weaver, et al., 2004; Weaver, et al., 2006; Weaver, 2007; Diorio and Meaney, 2007; McGowan, et al., 2008) In another study by the same group, suicide victims who had been abused in childhood showed methylation of the glucocorticoid receptor (GR) gene promoter in their hippocampal tissues, indicating lower GR expression. GR is a key component of the hypothalamic-pituitary-adrenal (HPA) axis and necessary for downregulating the stress response (McGowan, et al., 2009).
Long-term clinical observation has shown that many patients undergoing Primal Therapy become both physically and psychologically healthier, suggesting that the therapy ameliorates the biological imprints caused by early life trauma. Over the decades, Janov and his therapists have routinely monitored clinical signs such as blood pressure, heart rate, body temperature, serum cortisol levels, EEG patterns and others. As the therapy proceeds, these parameters tend to settle toward healthier set-points signifying lower levels of chronic stress. Emotional regulation, resilience, and stress tolerance also increases for many patients, suggesting that Primal Therapy effects a fundamental change in the underlying neurohormonal mechanisms regulating the stress response. In other words, Primal Therapy appears to normalize the physiology of many patients.
For some time now we have been preparing to do a research project about telomeres, which cap the chromosomes and keep the DNA of the cell stable. Telomere length is known to be associated with aging: when the telomeres are longer, we live longer, and when they are shorter we know life gets shorter. It turns out that telomeres do get shorter with stress (Epel, et al., 2004) and shortened telomeres are associated with depression and high levels of the stress hormone cortisol (Wikgren, et al., 2012). Our thought was that since cortisol levels come down in our patients, it should be reflected in longer telomeres. Further at Brown University (Carpenter, et al., 2009), they studied those adults who had been abused as children. Their telomeres shortened more rapidly. One of that study’s authors, Audrey Tyrka, stated “It gives us a hint that early developmental experiences may have profound effects on biology that can influence cellular mechanisms at a very basic level.” More recently, researchers have found telomere shortening with deprivation in early childhood (Drury, et al., 2011) and, importantly, that intrauterine stress led to shortened telomeres in young adults (Entringer, et al., 2011); the authors of that study state: “To the best of our knowledge, this study provides the first evidence in humans of an association between prenatal stress exposure and subsequent shorter telomere length. This observation may help shed light on an important biological pathway underlying the developmental origins of adult health and
disease risk.” Again, the kind of abuse we know about and write about is even more profound, more remote in time and deeper in the brain than the obvious kind of abuse that is ascribed in the literature.
The purpose of the first leg of our research project is to examine whether or not Primal Therapy has an effect on: (1) the rate of telomere shortening, an indicator of aging; (2) DNA methylation and histone acetylation caused by early life stress; and, (3) whether Alzheimer’s Disease is related to fetal or early life stress in infancy. Epigenetic factors (environmental effects that result in functional modifications in the genome without changing the underlying DNA sequence) are crucial, since we may have a way of measuring how the imprint is laid down and how the imprint changes with reliving of imprints in Primal Therapy.
Study #1: Measurement of Telomere Length in Patients Undergoing Primal Therapy
Purpose: To correlate the rate of telomere shortening (a correlate of aging) with progress in primal therapy. The hypothesis is that Primal Therapy will correlate with reduced rate of telomere shortening, indicating a reduction in the rate of aging.
Patients: All incoming patients at the Janov Primal Center will be eligible for the study.
· Age range: ??
· Clinical assessment: any diagnostic criteria?
· Access to primal feelings (therapist assessment)
· Subgroup: Access to first-line feelings (therapist assessment)
· Unable or unwilling to commit to at least one year of therapy (may need longer period of time)
· Unable or unwilling to commit to regular follow-up (e.g. interviews, taking tissue samples, etc.)
· Others? (e.g. psychosis, substance abuse, smoking, HIV-positive, etc.)
Study Design: A prospective, non-randomized, non-controlled, case series study of one year duration or longer (whatever is needed to observe significant changes).
Methods: Baseline assessments will be made on the following:
· General physical health, medical history
· Psychological diagnosis: levels of the imprint; what level the patient presents at the start of therapy
· Psychological scores: life quality, anxiety levels, depression, etc. Many scales for this. We should do this to make it more objective.
· Vital sign measures: blood pressure, heart rate, serum cortisol, deep body temperature, other?
At regular intervals over one year blood samples will be drawn and stored. These samples will be used to analyze leukocyte telomere length (telomeres can be measured in several ways: see Aubert, et al, 2012).
Physical and psychological measures of stress
All baseline measurements will be repeated at the same intervals (physical health, psychological assessment, vital signs, cortisol, etc.)
Statistical analysis: To be determined. Factor analysis will examine interaction between telomere length and other outcomes.
· Leukocyte telomere length
· General health
· Vital signs
· Serum cortisol
· Psychological outcomes: anxiety, depression, etc. (Patient and therapist assessment using recognized scales.)
· Success at Primal Therapy (therapist assessment)
· This is important for we hope to show that Primal therapy can help lengthen life and make it healthier; not a negligible effect. In other words, if we normalize function, if we normalize the rerouting of the neurobiology due to primal pain and right the dislocation of function the normal system would have a chance of a longer life.
Study #2: Measurement of Epigenetic Changes in Patients Undergoing Primal Therapy
Purpose: To examine the effect of Primal Therapy on epigenetic imprints.
Study design: Design will be similar to study #1, however, DNA methylation and histone acetylation in certain tissues will be examined. The implications are the same as the above.
Study #3: Correlating Alzheimer’s Disease with Early Life Trauma
Purpose: To correlate the incidence of Alzheimer’s Disease (AD) with scores on an Early Life Stress survey. The purpose of this study is to determine whether or not there is a link between early life stress and later Alzheimer’s, according to the LEARn (Latent Early-life Associated Regulation) model of AD (Lahiri & Malony, 2010). The hypothesis is that gestational stress (as well as infancy trauma) may be a prime factor in the development of later Alzheimer’s.
Methods: The ELS survey will be given to all patients or caregivers of patients diagnosed with AD.
Statistical Analysis: To be determined.
1. Can you describe your birth? Was your mother given any drugs or anesthesia? Was your birth natural, breech or cesarean? Did you have a pre-term or late birth? Home or hospital birth? Were there any complications associated with your birth? Were you breastfed or bottle-fed? If breastfed, how long? Did your mother have adequate milk?
2. Can you describe your gestation period? Was your mother and the household calm and not under stress? Was there marital discord of any kind? Was the father in the home through your being carried? Was there any talk of separation or divorce? Was there a recognized marriage before your birth?
3. Was the external environment benevolent? Were there environmental stressors, such as poverty, war, strikes, or natural disasters?
4. Were one or both parents under stress? For what reasons?
5. Did your mother regularly take medication, tranquilizers or pain killers?
6. What did your mother eat during your gestation. By today’s standards, was her diet considered healthy or not?
7. Would you describe the family as loving or unloving?
8. Was your mother chronically anxious or depressed? For how long? Was she exceptionally tense?
9. Was your conception planned or accidental? Were you born long after your next oldest sibling?
10. Were you held immediately after birth? Were you sickly as a newborn? Describe.
These are the factors to be scored to determine how much trauma there was and the valence of the trauma.
All the above is preliminary, possible hypotheses to be fleshed out over time. It points to what we want to try to accomplish both in our therapy and our research on that therapy. We already have many studies (see Primal Healing for discussion), but now we want to refine our investigations.
Aubert, G., Hills, M., Lansdorp, P.M. (2012) Telomere length measurement-Caveats and a critical assessment of the available technologies and tools. Mutat Res. 730(1-2):59-67.
Carpenter, L.L., Tyrka, A.R., Ross, N.A., Khoury, L., Anderson, G.M., Price, L.H. (2009) Effect of childhood emotional abuse and age on cortisol responsivity in adulthood. Biological Psychiatry, 66(1), 69-75.
Diorio, J. and Meaney, M.J. Maternal programming of defensive responses through sustained effects on gene expression. (2007) J Psychiatry Neurosci. 32(4):275–284.
Drury, S.S., Theall, K.P., Gleason, M.M., Smyke, A.T., Devivo, I., Wong, J.Y.Y., Fox, N.A., Zeanah, C.H. and Nelson, C.A. (2011, epub). Telomere length and early severe social deprivation: Linking early adversity and cellular aging. Molecular Psychiatry, 1-9.
Entringer, S., Epel, E.S., Kumsta, R., Lin, J., Hellhammer, D.H., Blackburn, E.H., Wüst, S., and Wadhwa, P.D., et al. (2011) Stress exposure in intrauterine life is associated with shorter telomere length in young adulthood. Proc Natl Acad Sci USA, 108:33, E513-E518.
Epel, E.S., Blackburn, E.H., Lin, J., Dhabhar, F.S., Adler, N.E., Morrow, J.D.
and Cawthon, R.M. (2004) Accelerated telomere shortening in response
to life stress. Proc Natl Acad Sci USA, 101(49):17312–17315.
Lahiri, D.K. and Maloney, B. (2010) The “LEARn” (Latent Early–life Associated Regulation) model integrates environmental risk factors and the developmental basis of Alzheimer’s disease, and proposes remedial steps. Exp. Gerontology 45(4):291-6.
McGowan, P., Sasaki, A., Huang, T.C.T., Unterberger, A., Suderman, M., Ernst, C., Meaney, M.J., Turecki, G. and Szyf, M. (2008) Promoter-Wide Hypermethylation of the Ribosomal RNA Gene Promoter in the Suicide Brain. PLoS ONE. 3(5):e2085.
McGowan, P., Sasaki, A., D'Alessio, A.C., Dymov, S., Labonté, B., Szyf, M., Turecki, G. and Meaney, M.J. (2009) Epigenetic regulation of the glucocorticoid receptor in human brain associates with childhood abuse. Nature Neuroscience, 12:342-348.
Meaney, M.J. (2001) Maternal care, gene expression, and the transmission of individual differences in stress reactivity across generations. Annual Review of Neuroscience, 24:1161-1192.
Weaver, I.C.G., Cervoni, N., Champagne, F.A., D’Alessio, A.C., Sharma, S., Seckl, J.R., Dymov, S., Szyf, M. and Meaney, M.J. (2004) Epigenetic programming by maternal behavior. Nature Neuroscience 7:847−854.
Weaver, I.C.G., Meaney, M.J. and Szyf, M. (2006) Maternal care effects on the hippocampal transcriptome and anxiety-mediated behaviors in the offspring that are reversible in adulthood. Proc Natl Acad Sci USA, 103(9):3480–3485.
Weaver, I.C.G., (2007) Review: Epigenetic Programming by Maternal Behavior and Pharmacological Intervention. Epigenetics,2:1, 22-28.
Wikgren, M., Maripuu, M., Karlsson, T., Nordfjäll, K., Bergdahl, J., Hultdin, J., Del-Favero, J., Roos, G., Nilsson, L., Adolfsson, R., Norrback, K. (2012) Short Telomeres in Depression and the General Population Are Associated with a Hypocortisolemic State.Biological Psychiatry, 71:4, 294-300.
Wintour, E. and Owens, J.A. (Eds) (2006) Early Life Origins of Health and Disease (Advances in Experimental Medicine and Biology, Vol 573). Springer.
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.