Wednesday, June 6, 2012

On Painkillers and Pregnancy

The more painkillers a woman takes during labor the more likely her child will be to abuse drugs or alcohol later on. Karin Nyberg of the University of Gothenburg, Sweden, looked at medication given to the mothers of 69 adult drug users and 33 of their siblings who did not take drugs (Nyberg, et al., 2000). Twenty-three percent of the drug abusers were exposed to multiple doses of barbiturates or opiates in the hours just before birth. Only three percent of their siblings were exposed to the same levels of drugs in utero. If the mother received three or more doses of drugs, her child was five times more likely to abuse drugs later on in life. Enough animal studies have been done to confirm the finding—exposure to drugs in the womb changes the individual's propensity for drugs later on.

There is some evidence that a mother taking downers during pregnancy will have an offspring who later will be addicted to amphetamines, known as “uppers” (speed) (Jacobson, et al., 1988); while a mother taking uppers during pregnancy—coffee, cocaine, caffeinated colas, may produce an offspring later addicted to downers—Quaaludes, for example. And the reason that the person can take inordinate doses, such as drinking two cups of coffee before bedtime and still be able to sleep easily, is that there exists a major deficiency of stimulating hormones—the catecholamines. In short, the original set points for activation or repression have been altered during womb-life and persist for a lifetime.

I have treated patients who have taken enormous doses of speed and yet have shown very little mania as a result. While other patients of mine have taken lethal doses of painkillers in previous suicide attempts, enough to kill anyone else, and yet still lie awake hours later, only feeling slightly drugged. The severe brain activation by imprinted pain resists any attempts to quell the system.


Jacobson, B., Nyberg, K., Eklund, G., Bygdeman, M., Rydberg, U. (1988) Obstetric pain medication and eventual adult amphetamine addiction in offspring. Acta Obstet Gynecol Scand 67:677-682.

Nyberg, K., Buka, S.L., and Lipsitt, L. (2000). Perinatal Medication as a Potential Risk Factor for Adult Drug Abuse in a North American Cohort. Epidemiology 11(6):715-716.

7 comments:

  1. Hi Dr Janov

    I totally get this. It's amazing research especially with someone trying to counter something that happened to them decades before. I have a friend who drinks gallons of coffee a day. If he ever comes to stay my wife and I always tease him that he needs a nuclear amount of coffee to get him going in the morning. he's so dopy as to almost fall over. He's 50 now, so whatever his Mother was taking in the 1950's in the UK must have had an effect. I wonder what it was?

    However I still think the other 77 percent is also interesting. Why do those other drug addicts still become addicted?

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    1. Obviously the addiction is due to unmet need. The pain of not getting one's needs met from early childhood. I gather that the orbitofrontal cortex is one of the parts of the brain that is damaged if a child is left to cry out at night for example. Thus the need for being held and comforted by a Parent at night when tiny gets burned into the brain as pain. Totally get that.

      I know I bang on about my family a lot but I find their interactions fascinating and it helped me learn a lot about me. I was the listener so everyone talked to me so I picked up a lot but until recently was not able to assemble it into some kind whole.

      One group in the family all smoke like chimney's and another one drinks like fishes. Both addictions. Mine was alcohol. My Mother neither smokes or drinks. Her addiction is control. Total and utter totalitarian control. So much so my Father probably suffocated to death. Everything is controlled. The plants in the garden can't relax and get established because they get moved. Everything is in continual flux and she blames everything outside her mind and body. She can't sleep so blames some food she ate. The best things to blame are other people because they are not who she expects them to be. My sister is "A selfish little Madam", I am an "Ungrateful little Sod" and all men are wimps and "Everyday is Mother's Day". She invented an invisible friend as a child and was probably when we were little and still is occasionally physcotic now. She lives in a dream world of her own and now that my Father is dead will go slowly barmy and why? So little love in childhood. Everything in her life is about coercing people around her to love her. I felt the pain of the total lack of love in my early life last night. So sad.

      I just worry that how can one judge whether one scientific study is undertaken by someone who understands all this like your mate Bruce or by someone cut off from their feelings and thus looking in the wrong direction as Bruce suggests in "It's not about the Brain".

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  2. The "knowledge" does not know anything about the psychological issues because it is more related to a physiological process than to be a psychological issue. It is physiologically feel see and hear and it is psychologically to INTERPRET what we feel… see and hear. We interpret the symptom... symptom that is "far" from what caused it. It is indispensable to feel before we can understand... feel what actually is happening. If what I know... I know to not put the question right till why I know what I know... that is the question.

    Frank

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  3. What we do and what is right or wrong is the question concerning the content of the defense evolution refurbished us with... a brain that thinks... plan to alleviate suffering of life-threatening intensity… life-threatening when it was impossible to manage our own sufferings with consequence that blocking substances was produced... a physiological process for survival beyond our ability to influence… at the time "consciously" influence was impossible.
    If it is so… then the thinking brain is a product of the evolutionary process for survival... survival more than to be an asset for life in its true "meaning." Then we are victims of what we can understand in a process of healing. What a revolutionary thought… and so right it is! WHAT ARE WE WAITING FOR?

    Frank

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  4. Hi Frank,

    -"I know to not put the question right till why I know what I know... that is the question"-.

    I totally get this now. This is completely resonant with the 3rd line insights I am having.

    As we re-gain contact with true feelings the entire organism begins to make small changes from 'less than optimum' set points gradually to 'optimum' set points (in titrated episodes). Consequently the entire function and emotional responsiveness also change. The 3rd line (being the slowest of the three) eventually 'catches up' with all these changes and uses words to try to self reflect on (and to share with others in the group), we call that "Insight". It is inevitable that the literal words of perception alone therefore can not be relied on to actually 'describe & depict' what's going on.
    If you are still totally trapped in a cognitive framework (probably by your 1st & 2nd line pain pressing up from below) then you might be unable to break out of a combative way of thinking that assumes words and descriptions of feelings are the enemy.

    This is I feel the problem with neurosis on the social scale. If I can extrapolate: Neurotic people trapped in cognitivism can mistake words and totems for the real value in life, consequently interchanging so called 'meaning' for direct feelings AS a combative defence. This would explain why anthropologists may conjecture (from the evolutionary view) that the 3rd line is just a defence mechanism, an outgrowth, such few words but with so many profound implications. I can see why Jack keeps on about this but also why Art says there is more to the 3rd line than just that. . .

    Because I am occupied regularly in timber construction, both procurement, design and fabrication with hand tools I know for sure that there is more to the 3rd line. So Jack, please engage in this if you will: I have conversations with other fabricators and a common theme is that we fear for the following generations who may never experience the way the 3rd line can be trained to perform with precision for EVOLUTIONARY purposes. I am not putting my craft / trade on a pedestal but I am saying that if you dedicate your life to something constructive like that, the 're-posturing' that your 3rd (& 2nd) line has to do to thoroughly learn the trade and to get the projects done, to stay in business and to attract new customers becomes a lifestyle that can keep you open to the possibility of true feelings. Many of us constructors therefore wonder how much more repressed young people become in the absence of any really tangible constructive activities.

    Ok this is my particular ‘hobby horse’ but nevertheless as we become more computerised and more remote from the means of production and the means of survival we run the risk of increasing neurosis. . . Don't we?

    Basically the 3rd line is really not all it's cracked up to be but on the other hand it serves a constructive purpose that reflects the ability to contact true feelings. Which is why (when we are really repressed), what ideas we have in the 3rd line can seem so important, so significant and 'solid'. Until true feelings surface and take the pressure out of that ideation we will inevitably return to 3rd line beliefs.

    I am sure of what I am saying because it comes out of my own personal experiences over the last month or so. I have had a less developed insight into this before and I predict that when I eventually contact 1st line stuff in me properly, I will cease to behave like the bloody know all that even I don't like much. Me telling you all this in my emphatic style is (I suspect) 1st line pressure distortion in my 2nd line affecting my 3rd line "convictions".

    I'll probably still have the same convictions but without the "emphasis", without the pressure.

    Paul G.

    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.”
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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.
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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,
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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