Thursday, May 16, 2013

What's Wrong With Psychiatry?


 Believe it or not there is a statement from the director of the National Institute of Mental Health (Thomas Insel) (see for ex: http://www.nimh.nih.gov/about/director/index.shtml) who seems to think that everything is wrong with psychiatry. He thinks there is no science of psychotherapy and little validity to the new DSM, diagnostic manual which he says, is not a bible of psychiatry but a dictionary; listing symptoms and not getting below them. He’s right. I wrote him a letter about our work and its validity but I doubt if I will get an answer. At least I wrote to the previous directors and never had the courtesy of a reply. So we’ll see. He is right about what’s wrong but I am not sure he knows what to do about it. I think he wants to get into brain function and genetics; and those will never get him there. As I said in my last article, the brain cannot feel pain but the mind does. If we go on reducing it all to brain function we will never succeed. If we delve into the works of the mind and its relationship to the brain, then we will succeed. The mind has to relate to how the brain functions so we don’t erect theories that fly in the face of brain science.

 It cannot be either or; when it is you get theories of therapy by brain scientists, and I could mention several well known neurologists, who miss the mark completely.They have never done a day of psychotherapy and they extrapolate from the brain about how therapy should be practiced. I have written to them with no answer and that includes Antonio Damasio. They are too busy lecturing to see how therapy can work. You know what an expert is? Someone from out of town. I would change that to someone out in space because they are not grounded and do not see daily, anxious and depressed patients. It is not that something is wrong with their brains; they grew up neglected, abandoned and unloved. We won’t find that in the brain………ever. We will find it in their history. Neurons contain history but we cannot see it, and they won’t give up their secrets freely. I have an idea. How about talking to the patient? How about not drugging him but delving into his or her past? How about listening? That is hard to do when you take 8 patients a day. We don’t.

Insel admits that there is no science here and no proper theory to guide therapy for addiction, for example. Rates of mental illness are mounting rapidly. Let us hope they hear but why am I so pessimistic? Because I have sent at least 50 letters to the powers that be without response. It seems that many scientists are putting their hopes into president Obama’s new initiative, pouring millions into mapping the brain. Yes that is wonderful but it won’t solve the problem of mental illness; unless we think it really lies in brain dysfunction or in genetics. And now there is so much focus on the brain that we have missed out on the mind which speaks for the brain.

Let me tell you a story. When I was young and naïve I asked the NIMH to come investigate and see our work. Three men in ties came and watched a session. The patient, a woman, was screaming in agony; her ass was in the air. One of the men turned to me and without commenting on her pain said,” Why is her ass in the air? Is she being provocative?” Right then I knew the jig was up. There was no chance. Here was a horny guy who saw no pain. He had no empathic reaction. My heart sank.

27 comments:

  1. Hi Art! As insightful and as smart as you are your are to freqently putting the cart in front of the horse. Very few people will be in a position ideal enough to take their primal therapy as far as you and your closest collaborators have been able to; and most will never get going with it or even get to know about this your most systematic, focused, efficient and profoundly potent method of facilitating or tapping the psychophysiological aspect of people's individually differing self-regulatory potential.
    I can only wish that you and we all put more and better effort into promoting practically and politiccally possible reforms of a somewhat more realizable prophylactic kind.

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    1. Pbef: Nice letter but can you go further and tell me what you have in mind. I have in contact with the National Institute of Mental Health and they seem open. My neuroscientist colleague and I will submit a proposal. art

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  2. "The mind must be related to how the brain works."

    The mind which by their defensive task repress what the limbic system carries on... therefore is the limbic system cemented in hatred and the need of mom in a mess without any ability to get out of it. It is leaking now but explained as symptoms by anxiety and depression and will do so until the day the mind is connected to what it is defending.

    In my anxiety now... I stand beneath the stairs... my father has just thrown me out from our home... OUR HOME. I'm five years... with tears rolling down my cheeks... in need of love... in despair and anger mixed with fear in an attempt to suppress the terrible loneliness that awaits me.

    My anxiety now... for what I do and must do has its source at age five and was cemented in my brain by my mind to defense for survival.

    "Something" tells me... by help from the center to say "dad I am here" and I am there and the "atmosphere" can not be mistaken... my memory repeats it self just as it once was.

    Frank

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  3. An email comment:
    "Art thanks again for writing, on one of my favorite subjects.

    There are numerous works, available detailing the problems of modern psychiatry. Two of my favorites are Anatomy of An Epidemic, and Mad in America, both by Robert Whitaker.

    In Anatomy of An Epidemic, Mr. Whitaker focuses on why, rates of mental Illness are increasing. He asks the question if medication is effective in treating psychiatric illness, one would expect there to be a downward trend. But that is not the case, actually rates are going up, and going up dramatically. Mr. Whitaker writes:

    " There is a story that psychiatry doesn't dare tell, which shows that our societal delusions about the benefits of psychiatric drugs isn't entirely an innocent one. In order to sell our society on the soundness of this form of care, psychiatry has had to grossly exaggerate the value of its new drugs, silence critics, and keep the story of poor long term outcomes hidden. This is a willful conscious process, and the very fact that psychiatry has had to employ such story telling methods reveals a great deal about the merits of of this paradigm of care, much more than a single study ever could. "

    More from Anatomy of An Epidemic.

    " This book tells a history of science that leads readers to a socially awkward place. Our society believes that psychiatric medications have led to a "revolutionary" advance in the treatment of mental disorders, and yet these pages tell of a drug induced epidemic of disabling mental illness."

    Basically it boils down to a system of exploitation of people for profit. Large insurance companies don't like therapy, because therapy, is less profitable for them than giving people pills. Seeing a psychiatrist twice a year for some pills is more profitable for them, than paying for therapy once a week, for several years.

    These medications cause the very symptoms they were supposed to have cured, they create a dependency, that in time can result in profound brain dysfunction. For many people the brain must eventually be placed on a bizarre cocktail of medications, and adjunctive medications. Once they stop working, there is always ECT. Then Maintenance ECT, once a week for the rest of your life.. Believe me I have seen it happen time and time again. They think nothing of giving multiple convulsions to people well into their 80's. Think about it.... Each one of theses session is profitable in the thousands of dollars and some psychiatrists do 30 to 40 a day. ( The FDA, doesn't require calibration of ECT devices, so they vary widely.)"

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  4. Dr. Janov,

    Among professionals, there is always this last bit that leaves me not understood and my pain not recognized, even though they try very hard to understand.

    Where does this "limitation” come from? Is it lack of empathy? Is the brain of the psychiatrist limited to their own need/pain? – the reason why they are restricted and concocting ideas such as - ” Why is her ass in the air? Is she being provocative?”

    After the Cleveland kidnapping, Frank Ochberg made a statement (I’m paraphrasing) - many victims who experience severe trauma in childhood must live for the rest of their lives, undetected, with PTSD.

    I was very grateful that finally someone from the academic circle defended on TV what I been saying since 1992, that was disputed by psychiatrist and therapists that childhood abuse also causes PTSD.

    However, Ochberg is not including birth-trauma and continues to struggle to find the origin of PTSD -why some soldiers have it and others not.

    The Ochberg interview”
    http://www.psychotherapy.net/interview/ochberg-interview

    Sieglinde

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    1. Hi Seiglinde,

      " -why some soldiers have it and others not".

      Those of us who 'have it' feel like 'it has us'. . . and it continues that way until we can find the time and space to relive the feeling pushing the symptom. Then we can have it, back again, not split off.
      It feels like a theft, we've been robbed of ourselves insidiously by our hidden past. I want myself back again.

      Paul G.

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    2. as you know Paul There is one way to get it back.....go back to where you lost it. art

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  5. HI Art!.
    A new fashionnable "therapy"(sic) is now arriving in France,after raging your country,this mock therapy is called"The somatic experience".

    Have you already wrote something about it or are you going to wrote something?

    It would a sound and necessary article.

    Thanks in advance.

    Jean-Pierre an old french primal patient

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    Replies
    1. Jean Pierre: Don't know about somatic experience but there is always nonsense every day coming up. art

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  6. In response to the last email comment I wish to add that I once had a very dear friend, a man in his 70's (I was 20)who was a highly sensitive, intelligent, lovable man, with so much understanding of me and he also was hugely interested in primal therapy and reading Dr Janov's books who also suffered from depression. He got married at his age and I think his wife may have suggested ECT to help his depression. I lost him! He had too much of it when finally it gave him a fatal heart attack and he died.

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  7. Dr. Janov,
    did you read: "Psychiatry’s Guide Is Out of Touch With Science, Experts Say"
    http://www.nytimes.com/2013/05/07/health/psychiatrys-new-guide-falls-short-experts-say.html?src=recg&_r=0
    Sieglinde

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    1. Sieglinde: Yes I saw it. I am in touch with Dr. Insel. art

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    2. I just read your blog on EMDR.
      You say that EMDR asks you to imagine a different outcome of the original trauma.
      Where in the 8 step EMDR model do you find this?

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    3. Art, nerds feel good when they receive love from cool people. Think of Richie Cunningham and Fonzie. Nerds compete aggressively with their own kind, but they are easily influenced by cool people. You should think about that when you write to mental health professionals.

      If Richie Cunningham was to read one of your letters, this is what he would see:

      Dear Mr. Cunningham,

      All of your accomplishments are non-accomplishments, and you are unintelligent because you are unfeeling. You need Primal Therapy. Hope this helps.

      Yours sincerely,
      Arthur Janov




      I think this is what Richie Cunningham wants to see:

      Hey Richie,

      I think you're very brave. I'm working on some cool stuff, maybe you can help me to make it even cooler?

      Art

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    4. Tarjei: In phase III, Assessment. art

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  8. Hi Art,
    some 35 years ago I had contact with one of those white clothed guys who think themselves to be therapists.
    For the first time in my life I had opened to someone (professional) concerning my life theme..(my exceptionally thin body in "conjunction" with 2m.(Ido know that nowadays..! and esp.in Your country.. it sounds ludicrous
    to suffer!!! of one`s height BUT no! then for me.

    This psychiatrist only had one remark for my longing!! for a 2better" body
    (not Arnold`by the way, " As long You are dependent on that(outer appearances) You ..." -I forgot that gem of therapeutic wisdom...-
    and for my crippling sleeplesness he offered me HALCION...

    And my suicided pal often internalized in "their "institutions spilled
    saliva from his mouth (aftermath of HALOPERIDOL

    As You might understand I only feel CONTEMPT for those inhuman therapists.
    Yours emanuel

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  9. Sorry Dr. Janov, nowhere in phase 3 nor in the EMDR protocol does it say this.( imagine a better outcome)
    You need to reread the protocol, this is too sloppy.
    You also misrepresent Van der Kolk when you claim that he says that in EMDR the important effect of eye movements is to distract from the feeling.
    Why these misrepresentations?

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    1. Tarjei it's important that you don't get lost in semantics. In phase 3 of the EMDR protocol it says "The client then picks a positive self-statement that he would rather believe." The protocol uses the word "focus" instead of "imagine" but the result is the same.

      The patient screams inside his head, "I AM SAFE!! I AM SAFE!!" His loud thoughts drown out the dreadful sound of the alarm bells, but his internal organs continue to burn in cortisol.

      When you run from the fire, you can become very unfeeling -- unable to feel the further damage you inflict on your body, and unable to sense the need to vent (albeit a neurotic vent). The Janovian gap widens and you die even earlier.

      The miserable Jim Morrison once said:
      "Come on baby light my fire."

      Conversely, when you shatter your defenses, you can become psychotic, and this can strain your body in a different way.

      The exuberant David Bowie once said:
      "Putting out the fire with gasoline."

      But you can do some healthy things to help reduce the rate of decay, such as choosing a healthy diet etc. You might add some years to your shitty life, but still, you will die too soon.

      The thoughtful Andrew Atkin once said:
      "Neurosis is like a hot electric element that is always turned on. You can throw water on it to keep the temperature down, but you have to do it forever if you don't get to the off switch. PT is getting to the off-switch."

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    2. Tarjei -- respectfully -- I just re-read the EMDR Protocol, and I came to the same conclusion as Dr. Janov.

      The clinician identifies the aspects of the target to be processed. The
      first step is for the person to select a specific picture or scene from
      the target event (which was identified during Phase One) that best
      represents the memory. Then he chooses a statement that expresses a
      negative self-belief associated with the event. ... The client then picks
      a positive self-statement that he would rather believe.

      (Source: http://www.emdrnetwork.org/description.html "Phase 3: Assessment")

      To repeat the last sentence in the quote: "The client then picks a positive self-statement that he would rather believe." This is not an isolated use of outcome switching used in EMDR. If you disagree that it's what Dr. Janov described it as, you should explain -- but misrepresentation it ain't.

      --DavidT

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    3. "A positive belief you would rather believe about yourself. This positive belief should reflect what is appropriate in the present".www.anapsys.co.uk/emdr.pdf‎

      how can something constructed from motivation to be a positive countermeasure to something negative be called "appropriate"?
      do not forget Tarjei that this belief will affect every appropriate negative reaction.
      what is real?
      EMDR help us feel better. i don't think it help us be appropriate.

      feel better therapies are sloppy by definition because they do not know what they are dealing with.
      this is my sloppy opinion.

      Delete
    4. Richard: Andrew was so right. art

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  10. ” Why is her ass in the air? Is she being provocative?”

    The academic "condition" can also be a symptom like any other symtom whatsoever for psychological disorders. What that tells us... it is a tragedy... unfortunately... there is room for neurotic conditions high up in the hierarchy of controlling devices.

    For us to have patience for this... is no room. To use moral admonitions to stop it... will not do... they will persistent deny it... they will not change their perception.

    If we think about the implications for them... then it is not difficult to understand why. We know ourselves how much it means in trying to feel "loved"... even through sick circumstances... we can go over the corpse in an attempt to achieve it!

    What is there to do? We could try a legal processes that can prove what primal therapy will do. ART let us for the sake of "god" give it a chance. Look in to what is needed... what the cause... effect and consequence for a legal process possible can and will do TO SAVE LIVES!

    We're talking about saving lives against a full ongoing insanity... murdering people (murdering considering what primal therapy can do). They kill people in a forever ongoing process and we don't "bend a grass" through the legal power to stop it.

    To us it seems like we do not really understand what it is about. shall we let apparent serious circumstances be in our arguments AGAINST a lawsuit... we wonder how much we really understand?

    Yes... yes... yes we understand that it by science should be possible to kominusera but... but... but what is proven intill to day? "The academic "condition" can also be a symptom like any other symtom whatsoever for psychological disorders".

    Frank

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  11. Art, are you in Sweden?

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    1. Vuko: No I am in Los Angeles. Where are you?

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  12. Love and care that was missing!

    What am I if just the idea works? It is "not for nothing" the world of computers conquered such a large "space"... the reason is more obvious than our ability to understand why. It's hard to care about their anxiety in belief that something good will come out of it!?

    If we're stupid as academics... it is at least not supposed to be so... THAT is very difficult understand as understanding is used for other things!

    Frank

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  13. Hello all !

    let's be annoying ! ok the sentence "imagine a better outcome" is not written but as far as I can read and understand english there is "elicit the image, current negative belief" right : so if I am scared of falling from the roof of a building even when I am confortably lying in my living room, let's say that the EMDR therapist will try to induce something different in me instead of digging in the why's and how's I feel that way (current negative feeling) to turn it into a positive one...and what can a therapist of that kind offer but a symbolic and different outcome to this feeling/scene of me falling from a building?...

    http://books.google.fr/books?id=cPYHeEAdkIQC&pg=PA41&lpg=PA41&dq=phase+3+emdr+protocole&source=bl&ots=ILvTWQ3CdQ&sig=Qj_a-Er6P02bOqrt_3rOVlzAD5E&hl=fr&sa=X&ei=S5yfUcvcJIil0wWGyYCwDg&ved=0CGAQ6AEwCA#v=onepage&q=phase%203%20emdr%20protocole&f=false

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  14. A fascinating piece. Not so long ago a programme on Radio 4 in the UK ran a piece on how mapping the Brain will solve all mental health issues. What was heartening was the number of experts who attacked this position with a number saying that as usual the trauma faced by the person early in their life probably had a great deal to do with it. Not saying they even thought about womb life but it was great to hear.

    With regard to your patient and the two men in suits as usual they were blind to the woman's suffering and while asking an interesting question of you the therapist "Why is her Arse in the air" they did not think of asking the women why her Arse was in the air once she had come out of her Primal. if the body never lies and offers up many clues to early trauma then why was her Arse in the air?

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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