Saturday, June 23, 2012

On the Diagnostic Manual in Psychiatry (Part 1/3)


Hello my children, and nearly every one of you is young enough to be my child; otherwise if you are too old you are not interested in what I have to say.  And I think of you all as my kids who want to learn; I take it as a sacred trust to fulfill that need.  I am also sure that many of you have an expertise where I could learn. We are all smart in different ways.  Anyway, I print the above from Time Magazine (March 2012) about the new DSM manual, now as thick as the Manhattan Telephone  Book,  to explain why this is nonsense and the  field of  psychiatry/psychology is bankrupt.  It has left science behind; well, not exactly.  It has addressed science through the new machines such as the MRI, but it is cloistered away from the actual practice of therapy.  And never the  twain shall meet.  MRI results never tell us how to do psychotherapy; they tell us what drugs to give or not give.  They tell us more about our neurons in the brain but not what causes them to act the way they do.  We take their actions as a given and go from there, very much like Freud’s Id.  We need to know why cortical neurons are sometimes hyperactive, not just how do we slow them down.  There is a whole system encapsulating behavior, not just something that stands alone without any background information, nor any interrelationship to other parts of us.  We are just “behaving” and the cognitivists/behaviorists say our task is only to change it.  Such a mechanical view of complex human beings.

Look at the above Time description and then multiply it by hundreds of pages to understand the garden variety of neuroses.  It is literally mind boggling.  What it does, as you see, is list behaviors; and the field  is captivated by the behaviorists who never see underlying motivations, who  count this or that behavior as a disease.  Eat too much?  Bulimia.  Eat not enough? Anorexia.  How to define this?  By behavior.  The behaviorists hold sway in the field today.  What you see is what you get; you look for the problem, you see behavior.  You look for the answer and you see behavior.  You look for progress, you look at behavior, and never, never look deeper.  So in their scheme of treatment a certain number of weeks of feeling down puts you in the pathological category called depression.   And, the insurance will pay for this therapy category, for a very brief time only.    I imagine if you were required to to be depressed for 25 weeks before we could diagnose you as depressed you would get grief from the insurance companies.  It all has to be brief; and therefore we are obliged to shorten our therapy accordingly.

Giving fancy names to psychiatric disorders does not make it scientific; it just makes it complicated. And when you rely on lists of names instead of feelings you see how complicated it gets.

All this has to be complicated because when you leave the arena of feelings and travel to the disconnected neocortex you have ever-widening verbiage with less and less sense.  You arrive at an intellectual never-never land.  I guess the whole idea is to make it so complicated; that no layman can understand it, therefore it has the patina of something really “scientific.”   Look, I have two advanced degrees, have been in practice for 60 years and I cannot understand it.   It is just mystifying.  What compels all these names, diagnoses and lists is the behaviorist belief that behavior alone accounts for afflictions.  And since behavior is as broad as the entire human condition, imagine the difficulty in diagnosis. They have built themselves a trap: they define in terms of behavior and then have to list almost all behaviors in terms of neurosis or not.  Whew!!  Let’s see, now I have to count how many months someone has been hypomanic to see if she qualifies for my concocted diagnosis. More important, to see if she qualifies for money.  The diagnosis has to fit, not science, but finance.

So in the category, Expansive Irritable Mood, it needs to go on for days to earn the diagnosis.  Now who decided that?  What about 3 days or six days?  What they conflate is average with normal.  The average  period  is about 4 days; ergo, the diagnosis is for those who suffer for four days.  Below or above can be normal.  If I don’t eat hardly at  all for six days you are anorexic,  but if only 3 days you are normal.  You see the trap in  counting the days.  How about the forces that drive all that?  Examine the fear of elevators.  I have treated dozens of these cases, and the generating source is most often a post-birth trauma of being enclosed in an incubator just after birth.   `The terror of being enclosed all alone with no kind and warm human contact is imprinted at the  time and remains embedded in the system.  Anything later that can trigger the memory (resonance) can set off the original terror and the phobia.  So why dance around the behavior instead of going to the source?  Because  the source is never recognized, particularly with cognitive/behavior therapists who have no place for generating  sources in their psychiatric schemata.   Their theory does not allow it.  “Stay on the surface” is their motto, and they do.   Can anything be more spurious?    We have a whole history of experiences that could help us understand who we are now  and it  is all ignored.  They only want to correct behavior,  which is the modus operandi of the Behaviorists. Only correct what we can see.  What we cannot see is forgotten.

You see the patient has to recount to the doctor whether something is mildly annoying or really terribly debilitating so she can note the depth of the probelm.  I have an article before me written by a patient who was anxious for years and never knew it. Why would they do in this case with our diagnosis?   She was only mildly aware. So is she severely neurotic?   Look at the obsessive-compulsive disorder.  I have treated many who suffer from it. Often there is imprinted terror down deep in the brain that underlies it.  It surfaces as, “If  I try the doorknob twenty times I will be safe.”  It has little to do with a doorknob and more to do with underlying terror that drives the search for trying to feel safe.   If you ignore the underlying force you need to make a list, many lists, because one key feeling can drive multiple behaviors.  


Are you compelled to try the door five times a day or twenty?  If twenty  you are obsessive.  If five???    If even once you are still compelled to try the doorknob to feel safe and that is the underlying motivation, and if you have to do it everyday, I offer you my diagnosis—compulsive.    If the generating source is ignored you have to spin a diagnosis that is off in intellectual never-never land.  Let’ s see, I go to my office, see a patient, and then I have to count her number of episodes.  And then I have to take her word if it is annoying or not.  Yes, I refer her first for an MRI, magnetic resonance, and it comes back "agitation in the amygdala," now what?  Is there  someone who will connect the two (the MRI and the patient’s complaint) from a comprehensive diagnostic point of view?  Will it dictate the therapy we do?    Doubtful.  Each specialist is off on their own.  I have an MRI that shows what happens in the brain when I am compulsive but who notes that there is underlying terror and why?  And above all, what to do about it? For that we need an overarching theory that encompasses theory and therapy so that one informs the other.

The behaviorists are caught in a trap.They have to decide on a diagnosis based only what they can see.  So four days of one behavior makes it a disease but three days does not.  And you need to be depressed for at least one week to qualify; and for what?  To get paid by the insurance companies for a disease called depression.  And it is now called a disease, not because of scientific input, but because of money to be paid.  Here the insurance companies and the psychiatric profession are imbricated and merge into a financial arrangement that suits both well. Behaviorism pays and it helps the insurance companies lower their payouts: brilliant!  Everyone should be happy—except the patient.  Doctors will correct your behavior and your ideas until  you reach what they decide is normal, and voila!, success.   We have become willing tools of the insurance companies whose key role is to keep costs  down; and too, of the psychiatric establishment who has a financial incentive to find quick ways to treat, with diagnoses that lend themselves to quick fixes. And what are the costs?  Us.    The quicker the cure, by  their definition, the quicker the end of therapy. This obviates feeling therapies that do not lend themselves to quick fixes.  The problems are more long-standing, deeper and more remote.   So we accommodate to the companies through specious diagnoses and rearrange our treatment modes.   And then we really believe that we are dealing with real biologic states.  We are  really dealing with financial states with a veneer of psychiatric lingo.  Did I say that the 
APA  brings in millions of dollars through the world-wide sales of the manual?  This is really where finance, politics and psychiatry meld into one. The APA hired a Pentagon spokesman to defend their work,  as if it were a matter of promotion and influence,  not science.  Maybe it really is indefensible.  And maybe it has to be promoted just because it is scientifically indefensible.   And maybe scientists were not engaged to explain it because it cannot be explained within the realm of science. If it were clear and solid science it would not have to be "promoted."

45 comments:

  1. So we observe a group of manifestations, slap a label on it ("diagnosis"), and call it psychology. But of course that isn't psychology at all. It's just organised observation and note-taking of human behaviour.

    Maybe primal theory isn't just the first science of psychotherapy, but the first PSYCHOLOGY, period! Behaviorism is what you do when you don't know what you're doing.

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  2. Art: There is another way to start to fix it. I gather in the old days you were into this way also, but then this is as elusive as trying to get your profession to see it your way in-spite of you using their methodology.

    Just abolish money (and don't replace it with another exchange system) and slowly (I'm not sure how slowly) we'll come round to realizing it's ALL feelings. Once money is gone then law and government will just evaporate and we'll know the only real reason to bring children into the world is by and through loving.

    Fixing this generation is a long and expensive process and I'm not sure this generation will buy into it (pun very much intended).

    Jack

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  3. Hi,

    I've noticed the closer an individual is to 'procurement' of their 'goals' the more likely they are to use 'resources' that do not belong to them; to 'acquire' (win) the goal.

    So, the insurance quantifiers 'borrow' the label of science to procure the advantage for their employers.

    Long has it been said that money is the root of all evil. . . what is meant is that people driven by 'cost lead decisions' is the root of all evil.

    The 'bottom line' is not necessarily the way to take a pulse and taking a pulse is not the first thing to do if the patient is bleeding profusely is it? Stem the f*****g flow, isn't it?

    We have allowed our cultures to become excessively departmentalised, overspecialised and then these different areas of research and concern become 'competitors' for funding for diminishing returns. . .

    So, in the interests of saving money it is costing more. That is the problem that results when the various departments are not joined up and co-operating as a whole entity.

    But should we be surprised? NO! Because this 'behaviour' (of the Behaviourists) is a reflection of the old adage of control:

    "Divide & Rule". . . It is the assumption that if you take a clock apart and analyse the individual parts you will understand the whole mechanism. It is reductionism gone mad and making a self fulfilling prophesy of the human race.

    I see this manifestation regularly in the construction industry. So often the client / agent / architect just assumes that somehow when the tradesmen supply their individual services that somehow these separate things will all come together as if by magic.

    Where's the Project Manager? Where is the will to co-ordinate efforts to really understand the Human Condition and once and for all allow Nature to Evolve without continually trying to control the outcome, to channel the chemistry or to 'define' the parameters?

    The resultant mess costs more. . . that is the terrifying truth.

    It is all a manifestation of the Human Neo Cortex cut off from feelings, cut off from the body. Cut off from need.

    Paul G.

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  4. The simple beauty of experiencing a "primal" is the last step that should be recommended at the end of the new DSM manual or maybe at the beginning? I remember somebody I knew in therapy many years ago telling me. "You know, it actually feels good to go deep into a feeling." There's a release and relief that has to be experienced to be believed and understood. The patient has all the answers inside themselves not the eggheads still chasing their own tails.

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  5. Hello Art!

    You are at my desire for what could have been... an loving dad for my need and understanding so that nothing should have gone wrong.
    Now I can let go... go of what there was... was at the time as saved my life (my cognitive "ability" to imagine love). Love till all that was possible... something that has followed me all the way here... so I now... through primal therapy can experience what Dad should have meant to me.

    Love and thanks to you Art.

    Yours Frank

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  6. Wow, when you put it like this; this diagram; it really is something isn't it?! (Lol) It's like an attempt to understand behaviour, by breaking it down, or to contain it. Instead of going to the source, as you say. But I addressed this w/the Clin Dir of the hospital I trained at, he said they leave that (causes) to scientists; that was his outlook.
    And they certainly miss individualism. Depressed w/loss of interest for 2wks w/associated symptoms=Major Depressive Episode for eg, hell I've had that description w/o in my mind qualifying for that diagnosis.
    Another factor overlooked here is insight. If patients' demonstrate insight (into their state, behaviour) in Mental State Examination that too dramatically alters diagnosis, and therefore treatment. So what does that mean? If I'm *aware* I'm acting a bit loopy I'm manic but not schizophrenic? People's awareness differs and is not necessarily congruent w/psychiatric problems.
    I was pretty blown away in my recent Primal intake interview, how deeply personal it was, so great. *Such* a different approach to the 'norm'. Such attention was given even to my childhood horse, Duschia. When I was at the same hospital, if I even mentioned the patient may have had past trauma I was looked at suspiciously, one Consultant even quipped back "there's no record of that in the clinical history". Clinical history? Being privy to patients' files, I was constantly dismayed families were hardly mentioned, let alone explored.
    Jacquie

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  7. Excellent article. The question that's interesting for me is why is it that humans prefer quick fixes? Why do humans not favour more resource-intensive therapies that offer long-lasting, longer-term results? (There could be parallels with diet and exercise here). Why does the typical human seemingly not care about curing himself of his neuroses for a longer-term benefit? Perhaps there is an evolutionary perspective here. Are we not wired to do just enough to survive long enough to reproduce and, (with a potential gender-bias), raise offspring to sexual maturity? Perhaps if the typical human judges that he has a good chance of achieving these outcomes despite his neuroses, then quick fixes are good enough. Is engaging in Primal Therapy going against the grain of being human?

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    1. Maybe because of a near death imprint - I'm not going to make it - so why bother. There is no future.

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    2. Well, for me it is right now; I am deliberately holding back on gaining a partner and having a child I so desperately want. Also, am not living 'in the flow'; this is also difficult for me but I don't want to be distracted from achieving my single greatest dream: becoming a Primal Therapist. It is worth it, and hopefully everything will come together.
      On a broader level, I think also yes, if we were truly human; had the right access to our feelings and were (mostly) neurosis free; we wouldn't need PT in the first place. And then for the neurotic this also holds true, as most neurotics make their neurosis work for them. They don't generally seek to heal, at least not w/the therapy of feeling Primal is. Jacquie

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    3. Emma: you are not helpless before the imprint; you can try to combat it. art

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    4. Hi Emma, I feel like I'm going to die (from pain) when I have migraine and remind myself at the time that it didn't kill me in the first place, so it's not going to kill me now (altho I've passed out with vomit in my mouth & throat which concerns me). Not to take you out of your imprint, but can you connect w/altho you touched on death you *didn't* die, you made it? x Jacquie

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    5. Hi,

      I was thinking this a lot recently. Why not just push the feelings down and get on with life?

      To do this (amongst many other 'postures' and chicanery I would be forced to try to wriggle around in) I would have to adopt hate of many people for past events in my life. I have realised that 'hating' is like taking poison and expecting the other person to keel over. . . (forgiveness is like opening an imaginary present). Furthermore I would have to 'identify' new goals and aims and 'hazards' and invent a new 'map of my territory' to 'contain all that pain'.

      Some people can do this and I have found I can not. Art is not the first person to say emotional and physical repression makes us terminally ill. It was an old holistic idea before Art discovered Primal and I agree; my repression will cut my life short and keep me repeating the same old mistakes. No thanks.

      Paul G.

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    6. Is it to do with the majority of humans being sympaths - running off their imprints, not wanting to sit with anything too long - run, run, run (away from the pain)?

      Also, perhaps, the adoption of the 'state' as parents and in an effort to be 'good' citizens ('cause they were never good enough children), trying to take what's on offer (accepted norms) so as not to be black sheep/unloved/rejected, to avoid resonating the pain of original unmet needs?

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    7. People prefer not quick fixes... people have no choice they have to take what is offered. People are not aware of any long-term solutions. No one knows that there are more resource-intensive treatments of help that produce a different result.
      People cannot get involved in something they do not know about... such as long-term solutions would be good for them.

      The evolutionary process does not think of which solutions are better or worse… but it contains the science of how... the evolutionary process contains only consequence... that we can breathe in between is also a consequence... we just don't know yet.

      About people's "good chances"... there is a solution in the consequence.
      Richard you're talking out of a thought construction... a thought of defense for meaning to not feel. It's all about consistency... it is no more complicated than that.

      Primal Therapy brings us to the causal effect and consequence of the evolutionary process... what an incredible luck we have.

      Frank

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    8. Anonymous, Art: I would think parasymp's are the majority, especially w/birth interventions dramatically on the rise (incl c-section). Love to hear your feedback on this Art
      also, Art: I'd rather you post the response to Emma I gave and correct me if I'm wrong (outside Primal thinking), I very much want to learn
      Thanks.. Jacquie

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    9. Jacquie wrote:

      > "I am deliberately holding back on gaining a partner and having a child I so desperately want."

      Wow. It's like you're holding your breath, not feeling.

      > "my single greatest dream: becoming a Primal Therapist. It is worth it, and hopefully everything will come together."

      Your honesty is sorta "breath-taking." I don't know quite what to say. You seem to be willing to "give all" to Primal, thinking it the "end all"... delivering more happiness than being "married with kids" ever code. You seem not to seek happiness so much as the "state" of therapist/guru.

      Does it work that way?

      Too many shrinks choose a career that lets them use proxies to feel their own unfelt pains.

      What you say enthralls while scaring me. It's like Catholicism's rule for priests: one can only be "there" for others if one is celibate...and so, not happy/loved the way "others" are. Masochism, really. But appealing to those who weren't loved enough as kids.

      Why can't you have a mate and child and seek the Holy Grail of primal, too? Art married AND divorced.

      And is your not seeking a husband/child a form of cerebral-control/pain-moderation?

      I ask because I tend to go through periods of what I call "emotional anorexia" when I half-live, not loving anyone. I only "feel" the loss when I'm again in a relationship and then-- and only then-- wonder where the hell I "was" before.

      It's probably a replay of my childhood: bipolar mother and aloof father. Daily feeling the pain of their non-love was too much to bear. So I developed "episodic involvement" to survive. I'd try to get close to them, feel "dead" inside (there being little reciprocity), and then retreat into books-writing-thinking. Anything to avoid feeling the absence of their love and support.

      I remember intentionally staying out in the fall/early winter until I felt "chills" up my spine. The subsequent contrast with the physical warmth of home was yummy. Until I thawed out and felt the absence of love again...and numbed out.

      I read somewhere that "self-denial" is the worst delusion. It gives a false sense of "enlightenment." You think you're "advancing" (by giving up something key) when, in fact, you're just stalling growth. That is, just staving off pain.

      Simon & Garfunkel nailed it, thus:

      "Hiding in my room, safe within my womb.
      I touch no one and no one touches me.
      I am a rock,
      I am an island.

      And a rock feels no pain;
      And an island never cries"

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    10. Trevor: That song, and those lines in particular... man. I love it. For a long time I was only familiar with the Hollies version, though, but the original is great too.

      Those lines capture my childhood, at least from age six onwards, so well. That's what it was, hiding in my room. If I wasn't at school I was in my room. I didn't make friends that I would play with outside school. Listening to music was a good escape. When I heard "I am a rock" (the Hollies version) for the first time, I was eleven, I think. I immediately identified with it, especially the "Hiding in my room" part, and also the lines "I I have no need of friendship; friendship causes pain/It's laughter and it's loving I disdain".

      At the same time yearning for friendship and loving inside, of course.

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    11. Hi Trevor,

      So f*****g true.

      I have discovered too many times as a service user (like a spy in the house of love) that the caring institutions offer only a symbolic channel for un-met need in the operatives that populate their halls (of fame or infamy).

      Having sculpted their psyches with the cognitive operations needed to earn their professional crust for so long; having 'acquired' the financial freedom to 'break free' from the constraints of those aforementioned institutions to pursue 'personal goals', operatives often face a new dilemma: Not enough time left (nor the depth of consciousness) for the personal choice required to actually decide, though the accumulated reward could pay for it all.

      Long has it been said that Time = Money; but you can't buy back the time. . . meanwhile history keeps on repeating.


      Paul G.

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    12. Trevor: I don't believe I am seeking the "state"(?) of therapist/guru over happiness; Primal therapy is what I want to do. And I am certainly not seeking to be a guru
      I also don't think Primal Therapists are like priests at all; celibate etc; I imagine, like all post-Primal patients, they very much live their lives
      For *me*, *right now*, I don't feel I can seek Primal, in the way I want to, and have a mate/child at the same time, as I don't want to become distracted, as I said. I also can't offer a partner everything as I don't even know which country I'll be living in next year. I give myself completely to rel'ships..
      This is extremely hard for me; I'm not being emotionally anorexic. Our natural state is to pair bond and procreate. I have lovely rel'ships w/family and friends, but obviously this is not enough

      In my defence. Jacquie

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    13. "I would have to adopt hate of many people for past events in my life. I have realised that 'hating' is like taking poison and expecting the other person to keel over"

      Hi Paul

      I totally understand that you feel that hating is not something you wish to do. However how can you possibly get in touch with your feelings if you push down hate that you may need to feel. How can you love if you don't hate. My understanding is that hate is a feeling that is there to break down a bond between the person feeling it and the people who have hurt, abused that person. I felt hate for my sister, Mother and Father because they all treated me really badly. Before I felt that hate I was far more obsessive and had far more migraines. I found it very liberating. I eventually went though it and felt sadness and pain and remembered events and also realised how dreadfully I had been treated. I don't think I would have felt those particular feelings or remembered those events if I had not embraced hate and seen it as part of being human. I think it is one of the great taboo's to actually acknowledge it. I think society instills in us a sense that to feel hate will eat us up and burn us from the inside out. Perhaps it does release caustic cortisol and so perhaps does eat us up in some ways.

      A person will keel over in some ways because they are no longer part of our lives. I do feel that the pressure to forgive is so prevalent in society and is so tied up with honouring Parents no matter what they may do that we are surrounded by people who expect us to forgive. In essence all of those people are programmed to forgive their own Parents so they will pressure us to fit in with them. It's a lonely business getting in touch with ourselves.

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    14. richard, you are asking about what is and isn't natural. primal therapy is extremely unnatural. naturally, we don't allow a child to get really hot and squirm like a salamander. but the primal is totally natural.
      when we were cavemen, the LOVED children spontaneously primalled, but this natural healing process was risky due to the parents' lack of primal knowledge. but in those challenging prehistoric times, feelings were crucial to survival. so nature took a risk. some children primalled successfully, while others suffered from their parent's non-therapeutic actions. primal was clumsy but crucial. the successful children survived and raised healthy children of their own. the unsuccessful primallers did not have enough intuitive intelligence to survive. they were eaten by lions for many years until fire and spears were developed.
      in these modern times, few children feel safe enough to spontaneously primal. most are doomed to become unsuccessful in life. but instead of dying in the jaws of a lion, we are protected by a high-tech society and grow up to become highly neurotic adults. in this developed stage of neurosis, our minds cannot heal naturally. that is why we need therapy.
      primal therapy is an unnatural, therapeutic love. it enables us to unnaturally slip through our defenses, and resolve the underlying pain, diminishing the need for defenses so that eventually, perhaps after a year or two, primals will come naturally (spontaneously).
      but unlike those clumsy cavemen, we have the knowledge to ensure our primals are proper. we don't need to take risks any more. we can help the mock therapists to discover the modern world.

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    15. Hi Jacquie,

      I'm horrified that migraine can do that to you. I just spent the last three days in an almost total anxiety attack making it almost impossible to get anything done. This always happens after returning my daughter. Breaking down and wailing every 20 mins. Mostly all ab-reaction and uncontrollable. . . then 1st line intrusion without connection. Blah.

      Mondays, shoot the whole day down. . . (Tuesday, and most of Wednesday too).

      I completely understand your sentiment about the conflict between parenting and doing your ambition. I was once a single parent at a time when I really wanted to get on with my profession and I couldn't. This conflict spoiled my parenting ability. I eventually ended up where I am now. . . and I'm still in conflict about it.

      Nearly all parents are in this conflict, mostly due to the crisis of money.

      The conflict has become competitive between men and women in a diminishing job market. There aint enough jobs to go round.

      After you get your Primal therapy my guess is that your conflicts will evolve into insights that lead you toward an unknown destiny. . . .

      Currently I am developing my little carpentry enterprise with website redesign and new marketing exercises. . . For all I know. . . . after Primal I might chuck in the whole carpentry thing and take up writing, or even selling Elephant Dung. . . But I'm not going to discard anything till I'm at the clinic.

      -"Keep tight hold of nurse for fear of something worse"-.

      Paul G.

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    16. Hi planespotter,

      I'm not saying hate is wrong.

      Yes, I hate and I feel it too but I have found that I can continually dwell (with thoughts) on the injustice of my history and make it into an obstacle in the path of the way to my deeper feelings, my 'need'. I suppose we are misunderstanding each others words. More specifically I even told my Dad what I thought of him to his face and he has banned me from his flat (in the interests of a quiet life he said).

      When I break down, sometimes I get to the need to know why he sent me away. I get to begging Mum to take me home. I have many more repetitions of this to go yet.

      The hate I talk about is hateful thoughts. For me hate is the thought part of rage at injustice. Rage is the feeling, hate is the thought. For me that is. My hate is my rage directed at someone. In the confines of the clinic I expect I'll get down to a lot of that.

      When I rage at the injustice of my father and cry for the need to be met my hate vanishes. Maybe this is just semantics but I know what it's like to be stuck with hateful thoughts that eat me up inside my brain. Once I get to the feelings this shifts to deeper un-met needs. For me that is my experience. I hate to be stuck with hate, this has driven me to horrendously painful act outs.

      This has utterly nothing to do with forgiveness, at all.

      Paul G.

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    17. This is really beautiful, thanks so much Paul
      I'm very sorry you have that anxiety-- the awful state of *suffering* when you aren't feeling (the most likely fear) 'behind' it. I hope for you you can get to the Center too
      And yes, I agree and suspect PT may lead me to an unknown destiny, possibly realising music. I'm reserving a space for this. I want to be a PTherapist but know that in the process of the therapy things can change. I may do both, and parent!
      Stay well

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    18. Hi Paul

      Have you very thought that your hateful thoughts may have the germ of an insight in them. Recently I got very depressed and started to obsess about killing myself. When ever I think like this, my prefered method is hanging myself with a thick knotted rope. Then I suddenly thought "My God that is the umbilical cord". I was breech birth and I am convinced the cord got wrapped round my neck at some point. Death is an end to the pain. Might be wrong but it feels right. I also have very violent fantasies about beating my Mother up when in actual fact that was what she did to me and so in my head I am getting my revenge.It is part of a recognisable set of obsessive thoughts that replay my childhood experience in a disguised form. The other part is my Father being disdainful of my protests. Many of my fantasies are about dealing with being totally obedient and oppressed.

      What do you think your thoughts might hide?

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    19. What is quite amazing and fantastic is that having worked out about a month ago that perhaps my obsessions with hanging myself with a rope was perhaps to do with being strangled by the umbilical cord I then get to one of the last chapters in The Janov Solution and there are other people who had thoughts about killing themselves with methods directly associated with their own birth trauma. Drowning themselves because they were perhaps drowning as babies in amniotic fluid or taking loads of sleeping pills due to their Mother being doped up during birth etc etc. It's so brilliant to have something like this confirmed.

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    20. Hi, yes, I have suicidal thoughts and impulses.

      I seem to have a 'constellation' of related feelings/sensations/fantasy thoughts/act outs/projections including hanging myself.

      Mostly the feeling behind all this is anxiety and loss , betrayal.
      The rage I feel is triggered mostly by feelings of betrayal.
      I find it hard to trust people if they betray my loyalty etc.

      But I tell you recently I have begun not wanting to speculate like this because it is all too much like 'insight self therapy'.

      What seems central and unique to Primal is need. You gotta, we gotta get to our need. If raging unblocks the path to need then rage. I need to do that at the clinic. The few times I have become the vehicle for my rage it has sadly been directed at other people. Fortunately the worst I did was frighten them a bit for a while but the reality is that rage is such an all consuming emotion any of us could be well advised to seek really experienced help in channelling and 'containing' it. (Padded cell thank you very much).

      I do have a few battered pillows but an experienced therapist is essential to guide and support. Once the rage is brought up so too comes yet new unmet needs, more frightening and complex to access. More repressed.

      Paul G.

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  8. I noticed starting a few years back that there seemed to be disorders sprouting up to fit (ever so conveniently) the drugs that supposedly treated them, in that temporal order, but the system you describe is more insane than I ever imagined.

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  9. Dr. Janov,
    If you take away the DSM and ICD 10 from psychiatry and psychology how would they function...
    How can it help to know where my neurons are showing reaction in my brain? Would it help me getting rid of my trauma?
    The other side is that every 'violent' court case depends on diagnosis. Nobody is interested in healing the trauma. Look at the Sandusky trial. Sandusky is now in Jail. The media reports: “The Sandusky case that rocked the Penn State community teaches important lessons about how power and prestige can blind people to abuse.” Not one sentence about the victims how must find a way to cope or about what made this man abuse so many.

    On June 12, there was a hearing of the victims of institutional abuse in the Bavaria (Germany) Landtag (Senate) where victims spoke up about their brutal experience.
    The senators were shocked about sooo much violence and injustice, but criticized at the same time how the victims behaved. As one senator mentioned: “ they are repeating, very aggressively, the same story over and over again”. The media, ignorant of the effect of trauma, however, found a lucrative “bleed to lead” headline.
    I was not invited to speak. However, I wrote a 6 page statement, pointing out the denial and that insurance pays millions for ineffective psychological treatments, how society and politicians keep on damaging the already damaged - and how a society is weakened (socially and economically) by having 30 percent of their postwar citizens traumatized.
    We are experience the same in the USA.
    Nursing the wounded:
    Millions of dollars are spent on treating soldiers with PTSD, only treating the symptoms. First they spend billions to start a war, then they spend millions to (proclaim) healing the wounded.
    A scientific study is now conducted to find the effectiveness of “mantra repetition” for PTSD.
    Earlier it was said, the longer someone is repressing the symptoms the longer it takes to deal with it, and the more PTSD will manifest itself. “Mantra” is repressing the uprising pain!!!! – is delaying, further repressing the trauma. No one is making connections to the initial injury, earlier trauma. I believe most of the soldiers who have PTSD may also suffer childhood and/or birth trauma.
    Seeing this report the question arises – what in the hell they are doing?
    Looks like snake oil remedies to me...
    http://www.pbs.org/wnet/need-to-know/video/video-nursing-the-wounded/14125/
    I cannot see how psychology and psychiatry can possibly change their locked-in approach. Just think for a moment what is involved: Insurance pays good money to see a psychiatrist for 10 minutes and a diagnosis cost $200. We don’t have to mention the 50 Minute CT-therapy cost. Then there are the many MRI’s with a pricetag of $3500. Researchers will not give up their expensive toys and research money that is paid for what helps repressing the trauma; and the billion-dollar, antidepressant pharm-industry would be bankrupted if Primal Therapy would lead. Think about all the universities who have to throw away their books when all the psychology professors come interns at the primal center.
    Why is nobody interested in addressing the trauma and its origin? “GUILT on every level”.
    Think about the moment a psychologist and mother must face the reality that her reaction toward her own child, not breastfeeding and out-sourcing her child 14 days after birth to a babysitter?
    Or a judge who just had to condemn an abuser who is an abuser himself- he will not order Primal Therapy for the victim.
    Or a politician who abused his own children facing a vote for erasing the statute of limitations. It is a conspiracy on every level driven by denial, money, self-righteousness, emotional rigidity. Hierarchical thinking triumphs and makes “repression” and treating only the symptoms possible.

    Diagnoses über alles - and what comes after? - mantra, prayers, SSRIs and pain management"!!!!

    Sieglinde

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    1. Hi Sieglinde,

      -"It is a conspiracy on every level driven by denial, money, self-righteousness, emotional rigidity"-.

      It may be a cognitive approach I have adopted to face this particular adversity (what you describe) but I don't believe in conspiracies any more. I have concluded that repression makes anybody very blind and very much like a robot. I was once like that, still am a bit. "Automatons under the influence of external stimuli" is an expression that comes to mind.

      Some of us don't want to be like that. I don't. You obviously don't.

      I don't forgive the robots; often I rant and rave at their foolish 'behaviour'; automatons. . . but the day the robots work out a way to conspire to prevent PT will be the day we could mount a PT D-day and I would be the first to suggest an integrated plan of 'resistance'. . . (I'm good at that sort of thing).

      Unconsciousness seems like a conspiracy because of the absence of something. This absence is so widespread it feels like nearly everyone is hiding something, they are, true feelings! That feels like a conspiracy but really it is an absence of feelings and that is truly alienating.

      If we can actually get PT we will be better prepared for a PT D-day if it's needed. After PT we'll probably find enough genuinely feeling people to befriend and subsequently not feel alienated any more.

      That's my theory any way.

      Hope you make it to the clinic. I'm getting closer, day by day.

      Paul G.

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    2. Paul: How close are you? Can we help? art.

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    3. This is a fantastic documentary made about the development of the DSVM and the direct manipulation of mental health by the big drug companies.

      http://topdocumentaryfilms.com/marketing-of-madness-are-we-all-insane/

      Quite obviously the Lunatic's have taken over the Asylum.

      Delete
  10. There is a growing movement within psychiatry towards Darwinian psychiatry (e.g google Dr R. Nesse or look at http://www-personal.umich.edu/~nesse/) . This small movement within the psychiatric profession recognises that DSM V has no scientific theory underpinning it but is, as Art says, a descriptive and phenomenological classification system which very often fails to match up with presenting symptoms of real patients.
    Darwinian psychiatry aims at categorising disorders in 4 or 5 basic ways:
    1. domain mismatch abnormality = where the modern environment no longer suits the a human nervous system that evolved under hunter-gathering conditions e.g. fear of snakes/spiders is adaptive under the old conditions but not the new.
    2. displacement abnormality = where an environment consistently thwarts a normally adaptive behaviour or leads to two conflicting impulses being activated so that a third seemingly unrelated behaviour emerges. e.g. hair pulling disorder
    3.frequency dependent abnormality - these relate to strategies promoting growth and reproduction that also have anti-social consequences because their success is based on adopting strategies that only work if not pursued by the majority. For example, psychopathy can be viewed as a strategy by which a person avoids real attachments and seeks to exploit relationships for personal gain.
    4. ontogenetic abnormality - a disorder that can attributed to developmental problems e.g. autism
    5. distributed abnormality - states of mind or behaviours that are under or over amplifications of normal adaptive states e.g. anxiety

    There is a slow but growing recognition that without an evolutionary approach to disorders no unifying theory within psychiatry/psychology is possible. Such a recognition requires that no diagnosis or label is applied to a patient without an informed understanding of the situation (or environment) in which the behaviour has manifested itself.
    For those interested also in Darwinian medicine check out:
    http://www.youtube.com/watch?v=pcnCJqDa1us

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    Replies
    1. Will: Sounds terribly complicated. It does not have to be so. art.

      Delete
    2. I think this is the point:

      "Here the insurance companies and the psychiatric profession are imbricated and merge into a financial arrangement that suits both well. Behaviorism pays and it helps the insurance companies lower their payouts: brilliant! Everyone should be happy—except the patient."

      I often think this way:
      What I read in scientific papers, no matter the subject, it may be true but most probably it isn't.

      Delete
    3. Hi Jan,

      -"imbricated and merge". . . If only it was a deliberate conspiracy we could combat it outside of ourselves and achieve some improvements in the Health Services.

      Arts' efforts over nearly half a century show that not only does virtually none of the 'professionals' have the 'receiving apparatus' to appeal to, but also there is no counter attack on him. Art is not besieged by law suits to stop him practising. He hasn't been thrown in jail.

      PT is not outlawed.

      This to my mind is compelling proof that Primal Theory about Human Consciousness is correct, or very nearly correct.

      Nearly everything us humans need we discard first and then later mourn the lost opportunity of. Like angry toddlers with old toys, or teddys.

      I bloody hope I don't end up in that 'category' regarding my Primal Therapy. As for other hurting people, well, I am overwhelmed by the mere thought. I hope somehow, one day the truth about evolution and human consciousness will spread far and wide.

      Paul G.

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  11. KISS = keep it short and simple!!! Feeling = healing (period).

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  12. I just lost my brother two days ago so I have the sensitivity to surface. I really liked that you called us children, I hope you do well in Paris a beautiful city perhaps too rationalistic.

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  13. Chyron: Sorry about your loss. Keep feeling.

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  14. An email comment: "My own experience is that the medical corporations and the psychiatrists that work for them are the ones that set the criteria for what is defined as mental illness and treatment. The DSM is just a book of billing codes. It's not about helping people at all but about the money. They have long since decided that they don't want to pay for talk therapy, because it's not profitable for them. So patients are encouraged to get on medications and discouraged, in many ways, when they seek talk therapy.

    The DSM is important to those that bill insurance companies for payment, because it provides a list of what those medical corporations will pay for. All it really provides is the Axis I diagnosis, that needs to be on the claim form. Axis 2 is almost never diagnosed, at this point it's only an after thought. It there is no Axis 1 diagnosis, there will be no payment. But since most of those medical corporations no longer require pre authorization for any form of output treatment, they simply allow those on their provider panel to submit claims. And since they don't require pre authorization, they no longer scrutinize, treatment modalities. So panel therapists can use any treatment modality they want to, from CBT, to EMDR. It doesn't matter as long as they submit a 90806 with an Axis 1 diagnosis, they can use any form of therapy they want. But if someone were to call those companies and ask for an authorization for Primal Therapy, it would be denied, because Primal Therapy is still considered experimental.

    If we consider the cost of seeing a therapist runs about $100 per session nationally , with 52 weeks in a year, or about $5200 dollars a year. Typically medication management costs them about $250 a session with 4, or sometimes 1 session a year, rarely once a month usually in cases of BI-Polar. You can understand that it's a decision by the medical corporations based on their profit. Lower utilization of services, means that medical corporations keep more premium dollars, that they are free to invest in the stock markets. Or in Derivatives. Their derivative exposures, are not currently public information.

    Unfortunately, the system of care managed and run by the medical corporations has created a catastrophe here in the United States for millions needing help. Medical corporations, encouraged the closures of County Mental Health Systems, so that their patients could be put on drugs, they drove many talk therapists out of business by keeping panels small, and reimbursement rates low for non panel providers. They have also increased the severity of Mental Illness in this country by putting people on medications that cause brain damage and increase the severity of their symptoms. With the result being, as well documented by WHO, that we have worse treatment outcomes in the United States than the country of Nigeria. Nigeria does not rely on medication as the background of its treatment for Mental Illness.

    Many patients prescribed Neuroleptics, consider them a form of torture. Indeed, the were used just for that in the former Soviet Union. "

    ReplyDelete

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