Saturday, February 9, 2013
Where Do Anxiety and Panic Attacks Come From?
For years I have been discussing limbic fear versus brainstem terror; that is, as we go deeper in the brain the responses become more exaggerated; mild hopelessness becomes suicidal hopelessness, fear becomes terror, anger becomes rage, and on. The responses become more primitive as they emanate from a brain that is more primitive; older and pre-human. Those deep responses go way back in time to when they were the reigning animal reactions extant. That brain is still alive inside of us and it provides all of the responses that existed millions of years ago. In some respects we are still that alligator or shark with no pity or remorse, just instinct. Those primitive animals are pre-emotion before caring and concern existed; they do allow us to murder. They also permit panic attacks. And where do those attacks come from? Ah.....They seem to come from a brain where panic is life-saving. Where rapid and ferocious responses meant survival. And where someone overwhelmed by his brainstem can react exactly like the alligator does....and kill. He is acting out of his brainstem.
The panic victim feels threatened but he doesn't know what he is afraid of. Or, believe it or not, that he is even afraid; it sometimes doesn't feel like fear; it is some unknown feeling that seems so alien. I know what he is afraid of..... Whatever lies in his brainstem. Oh my, what might that be? That is the rub as my friend old Willie (Shakespeare) noted. When I was in graduate school I learned about antecedent-consequent reactions. All it meant was that if there is a response something caused it. Well in rage and terror something causes it; and it is not ordinary reactions; they are primitive in the full meaning of the term. So far we have not known what that meant. Stay with me now as it starts to get interesting.
What is clear in my writing is that there are three brains in our head, (The Triune Brain), but we have ignored the first one, that I call "first-line." In the first line lies all of those primitive reactions; when there is trauma at birth or during gestation, long before we have an an intact emotional brain, our reactions are coded and stored down on the first line, the brainstem and the ancient parts of the limbic system. When we suffer great trauma during those early times the gating system weakens and we have "leaky gates". The trauma causes us to use up major supplies of repressive chemicals, such as serotonin, that impairs the proper functioning of the repressive gates.....our defense system. Not only does trauma use up serotonin; it damages parts of the brain that produce it, as well as dopamine and epinephrine. This is especially true of smoking mothers, in my experience.
We are less defended, so when we arrive at age thirty with a panic attack it is such a mystery. No longer, we can now understand its provenance. It comes out of a remote nervous system, so remote as to be constantly ignored, yet it is responsible for so much of our aberrant behavior. Who would dream that inside us lies all those primitive instincts that can surge forth when our defenses weaken? And up comes terror from a carrying mother who smoked and drank and who was effectively killing or damaging the baby from diminished oxygen. That and many other configurations conspire to inculcate terror in the baby that is imprinted and sealed in as a (Primal) memory. When there is a panic attack or rage attack we must look to that brain for understanding and cure. It is only with that brain that we can find causes and answers. And the cure involves reliving, as I have explained at length in my books and blog articles. If you all are interested I will go over it again but I think 2 blog articles ago I discussed in How to Make a Cure. Now comes the fascinating part:
Some recent research by Justin Feinstein at the University of Iowa City (Nature Neuroscience 2013), did a study with those who had a damaged amygdala, the hub of the emotional system. They did not have normal fear responses. But if oxygen supplies were lowered and carbon dioxide supplies were increased, mimicking suffocation (increasing acidity of the blood) there were panic attacks. Where in the world did those attacks come from? Certainly not from the usual emotional structures. They believe it includes the brainstem! Because the lowering of oxygen supplies and adding carbon dioxide provoked the lower structures to sense the danger and reacted appropriately. Very much like what happens to a fetus when the mother smokes during pregnancy and produces those same effects. What all this means is what I have been writing about for decades; fear and terror are two different reactions involving different brain structures emanating from structures million of years apart in evolution. However the emotional reactions have some similarities which allows resonance; that is, enough fear can travel down in the brain and trigger off those primitive panic/terror responses that I call first-line. It is not ordinary fear; it means a life-endangering cause and that come from our time in the womb and at birth. In the experimental patients, it meant and means terror of dying; that is what it feels like to the sufferer because that is exactly what it is. In the memory he is dying and the fear it evokes has a reason; a reason that is knowable. and therefore explains the reaction....and once known can lead to understanding about first-line and a cure. If all this is ignored there will never be a cure, no matter what the technique use to treat it.
It is interesting that suffocation has such a great terror reaction associated with it. And not so oddly in the panic attack there is often a feeling of suffocation, cannot catch one's breath, the heart beating so fast that it is about to jump out of the chest. And these breathing problems are again brainstem originated (included the medulla of the brainstem). It is all an ensemble of reactions originating deep down that later on set the stage for many kinds of pulmonary problems, asthma, shallow breathing and other malfunctions. One other part of this reaction is that there may be a certain vulnerability for the suffocation feeling during birth; that is, if a mother smoked during pregnancy there is already a groundwork for the suffocation feeling at birth. It becomes compounded, the anesthesia at birth in the mother and the background of a smoking mother. We must keep in mind that this is all an imprint from the beginning of life that will affect so many parts of us including constant nightmares........again where one cannot catch one's breath; a nightmare of being in a dark room with no air or someone putting a pillow on our head. It is fine to treat the nightmare, even to drug or medicate it but we cannot medicate an imprint; that remains to go on causing damage. So nightmares, panic attacks, breathing problems pulmonary dysfunction are all part of an ensemble, a gestalt, if you will that must be considered as one problem, not many many problems. Yes, there are many, many symptoms each must be treated until.....until we go to the generating source where it is all treated at once and permanently. What we must understand is that the physiology memory comes up intact with the whole panoply of feelings. There is often too much terror to feel it all at once and integrate it. That is why it needs to be revisited time and again. So how does the patient know where it comes from? Often not at first but after many relivings it becomes comprehensible. Clearly it is so remote an experience that it can be experienced but not immediately understood for what it is. It is the same when reliving a gestational trauma. We can experience it long before we understand it, and experiencing it is crucial for integration. Non-verbal experiences can be relived and experienced on their own terms and in their own way; they can be integrated, nevertheless. Let me explain further:
There are times when a patient can remember when his dog died, being hit by a car. What needed to be experienced and expressed was the repressed emotional aspect of the experience. The pain needs to be unleashed and finally felt. It is the same with preverbal pains. They need to be unleashed from their biologic constraints and fully experienced. They then are integrated and become part of us. That is the essence of a Primal. We don’t have to know exactly where it comes from because the fetus did not. But he experienced it and repressed the pain. It needs liberating. It is what we do.
To reiterate: because it is now established that lowered oxygen levels in the fetus creates panic in him, it should be clear that a carrying mother who smokes is damaging the baby severely. Can he really feel terror? I recommend to you the work of K. Anand. He did an amniocentesis on fetuses and found as the probe invaded fetal space all of his stress hormones rose; he also grimaced and show signs of distress. He felt pain and terror.
We have successfully treated panic attacks (they are anxiety attacks, and they are terror attacks) and rage because we address the first line. It is not a mystery; it just belongs to an ancient brain system that we have ignored for too long. If we want to help those in danger of acting out in rage and to help those who suffer panic we must travel to millions of years of phylogenetic history, deep in the brain to find our answers.
I want to ask something...
I think Primal Therapy lengthens life considerably. We would like to support our clinical observations by a series of research regarding the long-term effects of Primal Therapy on our patients. We need funding to undergo this research.
I would like to ask you, my readers, if you would be willing to contribute a small amount every month for one year to help out with this project. Only those where that amount of money would not do a hardship would be asked. No matter how good your heart is, do not contribute if you cannot afford it.
All money will go into research; no money will go into clerical work or our therapy work. We need about 2500-3000 dollars per month for one year.
I am not asking for anything right now, we just want to know who might contribute and if it is feasible. Please understand that our research is ultimately for the good of mankind and to show how important a feeling therapy is.
If you are interested and think that you can contribute, please send an email to firstname.lastname@example.org and specify the amount you can contribute per month.
Here are, in random order, a few of my ideas:
1. Measure telomeres to see if we do indeed lengthen life and avoid serious
illness, as pain foretells shortening of telomeres and of possible
early serious disease.
2. To see if the brain is more harmonized after our therapy, bottom
to top and right to left.
3. Measure vital functions core body temp; blood pressure heart rate etc.
4. Measure cortisol and natural killer cells and immune functions.
5. Measure methylation to see if we do indeed take the pain out of the
system permanently and reverse methylation. This means changing the
tumor combating chemicals, whose names escape me right now.
6. Measure cortisol levels to see how much we lower stress levels
and to see how it correlates with changes in telomeres; they work in
see-saw fashion with each other
7. Measure imipramine binding to see how much we produce serotonin and
the basic level of it we have.
8. Oxygen levels before and after therapy
9. Measure birth trauma and gestation trauma as it relates to
Alzheimer’s, heart disease and cancer.
10. Mapping resonance so we see how the brain works 1-2-3 and then 3=2=1
Arthur Janov Suggests that Stress During Pregnancy Leaves a Distinct Cellular Imprint that Predicts Mental Illness and Serious Disease
In his new book, 'Life Before Birth' (NTI Upstream, Nov. 2011), Arthur Janov makes the case that events during pregnancy and the first years of life leave a distinct cellular imprint that predicts mental illness and serious disease.
Read the full story:
* Readers: Our legacy program "The Art and Science of Primal Therapy" will be available next year. It is a series of videos exploring in detail how Primal Therapy is done and the theory behind it. It is 4 years in the making.
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.
Become a Primal Therapist.
Please contact the Primal Center for information.
Our therapy is constantly evolving. If a therapist has not had additional training in the past 3-5 years she is not up to date. The basic principles are the same but the actual therapy has taken a radical turn. It is much more precise, predictable and mathematical in practice. We have tried to tighten up what we do in keeping with current neurology and physiology. It is a constant learning experience. It is finally for the well-being of the patient who now has a much better chance of doing well. Yes, it was good before, but there is less time wasted now because the techniques are honed and the theory takes on more and more precision. We see patients from some thirty countries in the world, each with different cultures. It is up to us to continue the refining process so that the patient has the best chance of improving.
The clear understanding and application of the theoretical and clinical aspects of Primal Therapy are essential in order to provide effective therapy. Citing the most current findings from the field of neurology, trainees will learn the role that the physiology of the brain plays in the shaping of mental illness. The training will thoroughly examine the scientific basis for Primal Therapy and discuss the unique clinical approaches employed in the treatment of various emotional and personality disorders.
For our first year students, the training will entail extensive work in the understanding of the basis for Primal Therapy. On the theoretical level, there will be an examination of issues that range from the nature of the unconscious to the nature of traumatic imprints and their lifelong effects on physical and mental health. On the clinical level, trainees will have the opportunity to learn proper diagnostic and therapeutic procedures as they relate to Primal Therapy.
Furthermore, first year students will be mentored by our third year students in order to ensure that the key concepts in Primal Therapy are clearly understood. There will be an extensive library of training notes and taped lectures from the past two years available as well.
For our second year students, the training will provide a unique and varied opportunity to gain more clinical experience. Through closely supervised clinical sessions, trainees will gain a deeper understanding of the various applied therapeutic methods and hone their skills as future therapists. In addition, second year trainees will have the opportunity to work with first year students thru discussion groups, tape reviews, and clinical sessions.
Our third year students will continue to hone their clinical skills through a rigorous series of didactic clinical sessions. These sessions will be video taped and will be reviewed by Dr. France Janov and our senior therapists.
Dr. Janov’s books have been translated in some 26 languages, have been bestsellers in many countries, and his theory is taught at many universities. He has combined decades of clinical practice with the latest in research. It is the therapy of the future.
To apply, please visit our website at http://www.primaltherapy.com/primal-center-application.php and select the ‘trainee’ option when filling out the questionnaire. For further information, please feel free to call us us at (310) 392-2003 or email us at
We look forward to another exiting year of training. We hope you will join us.
Dr. Arthur Janov
Founder & Director
Notice to Primal People
I think it advisable for those serious parasympaths, those mired in hopelessness and helplessness, to have a test of your dopamine, serotonin (imipramine binding) and cortisol levels. It may be that we can help normalize some of those functions while and even before doing Primal Therapy. I have found that, for example, provigil can somehow boost alerting functions and help those very down come up a bit. What we would do, in effect, is take the depressives out of the trough that I have written about in several of my books (see The Janov Solution). It helps advance the imprint a bit so that the person is no longer wallowing in pain but is given a helping medical hand to move forward. This is not in lieu of therapy but as an adjunct to it. It is certain that certain imprints are manifest not only in terms of personality but also in biochemistry. We need to pay attention to the biochemistry, as well.