To my bloggers:
My article on Epigenetics and Primal Therapy will appear in the Activitas Nervosa Superior (ANS), a journal for neurocognitive research of the World Psychiatric Association (http://www.activitas.org/index.php/nervosa). I will also publish it on my blog as a series over a month or two, as it is 80 pages long. It is the most important article I have ever written and I hope it will change the science of psychotherapy; this is, begin to turn it into a real science.
Saturday, May 12, 2012
Erasing Bad Memories; Is It Possible?
Well here we go again. I keep swearing I would concentrate only on the positive and what really helps people and yet I see new articles every day that really need a response. This one is touted as exciting; it has to do with erasing bad memories and allows people to get rid of bad memories and get on with their lives. Sounds good, yes? And it has the imprimatur of well known and respected scientists. So what’s wrong? Just about every conclusion they come to. (It is about The Forgetting Pill by Jonah Lehrer, Feb 2012, Wired Magazine).
It all starts in the experience of a firefighter, called Jeff Mitchell. He witnessed a terrible auto accident and couldn’t shake the memory. He discussed it with his brother. It worked. He felt better. Jeff began to research it and finally wrote a piece on it in the Journal of Emergency Medical Services. He called it Critical Incident Stress Debriefing (CISD). He thought he stumbled on an amazing new kind of therapy. Here is what he said: “People who survive a painful event should express their feelings soon after so that the memory isn’t ‘sealed over.” He means before the memory gets repressed; once that is done we are vulnerable to post-traumatic stress disorder. In other words, suppressing the memory allows it to remain in the brain and physical system for a long time, may be a lifetime.
The article continues: it isn’t the trauma; it is that the trauma cannot be forgotten. The memory does not seem to fade over time. This is a slight turn on the old EST notion that it isn’t what happens to you; it is how we react to it. This is pure solipsism, reality is not what counts; it is all in your head. Too often this slides off into cognitive behavior therapy, where all we need to do is to change your ideas and beliefs. Think positive thoughts. So researchers decided that the therapist needs to ask penetrating questions. And, they go on, that the best way to ease traumatic memory is to express it…get the sufferer to talk about it in depth.
But, ayayay. They quickly add that they have done studies and found it makes people worse. Soon we arrive at the dilemma that statistics can point in several directions. But the net result was that debriefing did “not hasten recovery.” In brief, you can’t talk your way to health. So the scientists argued against using the method. They believe that the CISGers mistakenly think the way to get rid of trauma is to talk it out. But they emphasize that memory is not like an inert packet of data that is unchanging; that there is no indelible memory of our past. That the very act of remembering changes the memory; it is malleable, and therefore not reliable. Mitchell now claims that it does not help traumatic memories. So what’s wrong? Is it just a faulty idea that has no merit? Do people really get worse in recounting old traumatic memories?
The scientists say that trying to remember changes the entire memory itself, making it “the biggest lie of all.” But do they understand, really, what’s wrong? Is it going over the past? Does that in itself make us worse? Is “let sleeping dogs lie” the best remedy? And when anyone then quotes Dr. Elizabeth Loftus to bolster his case, it soon becomes a faux piste, a disaster, in my patois. For many years they have trotted her out to bolster the case against recovered memory, and she happily accommodates to their request. I have made many claims about all this but she clearly isn’t interested. She says that most if not all recovered memories are manufactured and not reliable. I have seen the opposite; reliving old traumatic memories are nearly always reliable and exact. Patients who relive a specific trauma continue to show the same vital sign alterations each session; something that cannot be faked, nor can their brainwave patterns be faked. Patients who relive incest find that their hands assume the position during the session with wrists bound together, held in place by the criminal/father.
What all this leads to is the America of the 1940’s, where due to Psychoanalysis the patient can never be believed; it is all a fantasy in the doctor’s mind. And this compounds a terrible crime against the patient who has to bury the memory all the deeper, and suffer more. Worse, the father often threatens the daughter if she says anything, and the mother castigates: “if you didn’t dress so seductively it would never happen.” So the poor girl is not only not believed but made to feel that she is guilty one. Loftus is aiding and abetting a crime. When did patients lose the right to be believed? When did we take on the role of judge?
Of course, if you go the cognitive route then it may be faked, but if the patient is in deep feeling during the session it won’t be. I have never seen it.
Sorry to get off the track. But of course, talking should not be the end goal; feelings should be. And that is why those doctors don’t believe in it. They are doing it wrong, and they have no guiding scientific frame of reference to help lead them to an understanding. Point by point research leads to facts and more facts; rarely to a broad understanding. That kind of broad understanding lies in the domain of the right brain, usually absent in all this kind of research. Point by point studies are often the province of the left brain.
About memory: down below the cognitive level it is exact, precise and never ever changes; what makes it change is the involvement of the neo-cortex whose job it is to warp memory, especially when the memory is very painful. The cortex, in this sense, is an anesthetic. It bolsters gating as it was meant to do. There is a whale of a difference between cerebral recall and neurophysiologic memory. And of course those scientists are confined to recall not memory. But the problem is that they designate recall as memory.
Yes memories are built out of consolidating proteins; and if you block the production of certain proteins you can block memories. But why? If you cut out the nerve tracks leading in and out of the amygdala you can block traumatic and fearful memory. But do we want to do that? Why do we want to inject chemicals that block key proteins from consolidating into bad memories? We already have a way to eliminate terrible debilitating memories; it is called Primal. But do we want to rearrange our history? To eliminate history? There are memories that need to be retained. The death of a sister should not be forgotten because it is painful; it should be cherished because it is both painful and endearing. I think it is a bad idea to start messing with the brain, its chemicals and nerve tracks, because there is nearly always a payback. We are interfering with a natural process. We need to mourn, and if we go to a therapist who is going to “cut out” our history, we had better be sure of what we are doing. Do I need to remind everyone about the prefrontal lobotomy so prevalent in the forties and fifties? They cut out a piece of the brain which relayed memories to the top cortical level; and they made vegetables of those patients. You see, eventually, we are going to find the brain structures that deal with fear, rage etc. But it is not the structures that are the problem; it is the person housing all those structures.
Here is what the famous brain research Joseph LeDoux has to say: “When therapy heals it is because of reducing the impact of negative memories. Therapy allows people to rewrite their own memories while in a safe space.” You see, it is a matter of rewriting memories. Sorry, doctor; it is the opposite. We don’t want to rewrite memory. We don’t want to change our history. We want to experience that memory fully and so get it out of the system so it cannot hurt us anymore. The memory is real and is to be believed; not in recall but in memory—the exact way it was set down in the brain. We remember with all of us, not just the top of the brain. Why do you suppose we have the ability to remember and to cry? Evolution provided our means for healing; it is already there and ready. Why do we think it can’t be trusted? Or it is unreliable? Here is what my scientific associate and science writer Bruce Wilson, has to say:
“There is a very important reason why "expressing their feelings soon after so that the memory isn’t ‘sealed over’” doesn't work. It's the same mistake made by the old analysts and the new analysts. The feeling/memory never has a chance to fully unfold as it was laid down and get connected to the cortex.
Without the understanding of how feelings actually work, without knowing them from the inside, one is led into a desert of ideas about feeling, some of which are quite bizarre. This inevitably leads to talking about feelings, which is useless, or to abreaction, which is not only nontherapeutic, but dangerous. This is undoubtedly why most psychologists reject deep feeling approaches on the grounds that they are re-traumatizing. Dredging up feelings without a clear understanding of what’s going on is a recipe for disaster.
Elizabeth Loftus, Joseph Ledoux, the CISGers, and most so-called "experts” don't really know what memory and feelings are. They don't do it right because they've never been there in the middle of it—not in a full, connected way. They think they know but they don't and they're all the more dangerous for it. They're like grocers doing brain surgery as you once wrote. And amid this muddle of non-healing, the psychosurgeons enter with their molecular scalpels. What you don't understand, you ablate. And then later, you witness the iatrogenic effects.”
Yes we can take out certain brain structures or chemicals in rats but will they lead a good life afterward? We did give electroshock therapy to thousands of patients during those same years, and all we managed to do was to separate a person’s feelings from his consciousness; separate his memories from conscious/awareness. To make him emotionless and ahistoric. Is that what we want?
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.