Wednesday, November 13, 2013
The Mystery Known as Depression, Part 3/12
3. THE THREE LEVELS OF CONSCIOUSNESS
To understand how it is possible to trace the causes of a lifelong illness – and its cure – to the very beginning of a person’s life, I must explain my view of the three levels of consciousness.
We basically have three brains in one as MacLean (1985, 1990) already proposed in 1960s: the brainstem, the limbic system, and the neocortex, each representing different stages of evolution, from shark, chimp to human brain, respectively. These neurologic stages of brain growth correspond to three distinct levels of consciousness: the earliest, pre-verbal stage of infancy, followed by childhood and finally present-day awareness. At each level of brain development, we have specific needs that must be fulfilled uniquely. The earlier the needs the more lasting the consequences when they are not fulfilled, and the more grave the imprint. In infancy, we have a need to be touched and nurtured tenderly. On the second line, we seek fulfillment of emotional needs: to be listened to, to feel secure and supported, to get an empathetic response to our hurts and fears. And the third level involves intellectual stimulation, communication and understanding by the parents. Fulfillment on this level can lead to clear and logical thinking; to an accuracy of perceptions.
3.1. First Line – The Brainstem
The first level, the brainstem, is a primitive or reptilian brain, which is our oldest brain system (MacLean, 1990). The brainstem was the first to evolve, and the first part of the central nervous system to develop in human evolution. It seems that we never lost that part. We just added new brain tissue on top of it. The brainstem deals with instincts, basic needs, survival functions, sleep, and basic processes that keep us alive such as body temperature, blood pressure, heart rate and very deep breathing. At this level, we can store a carrying mother’s depression, anxiety, stress, drug-taking, smoking, or drinking. Mother can also communicate, through her changing hormones, her unconscious rejection of her coming baby, which then becomes stored in the baby’s brainstem. Such experience is not stored as ideas, obviously, since we don’t yet have a neocortex, the thinking, intellectual, comprehending mind. But what is important is that the imprints in this storehouse will later motivate certain thoughts and aberrations of thinking. The brainstem imprints the deepest levels of pain because it is developed during gestation and handles life-and-death matters before we see the light of day.
3.2. Second Line: The Limbic/Feeling System
The second level of consciousness is basically the limbic system of the brain (and its affiliates), which is responsible for feelings and their memory (MacLean, 1990). It provides images and artistic output, processes certain aspects of sexuality, and is partly responsible for anger and fear. The limbic system possesses some key structures which affect brain function. They are the hypothalamus and thalamus; the hippocampus, which is the guardian of emotional memory; and the amygdala.
The hippocampus contains the archives of early experience, particularly trauma, and also puts a damper on amygdala activation so that our reactions themselves do not become a danger; after all, continually high blood pressure and heart rate will threaten our existence. The hippocampus has a high density of stress hormone receptors and is therefore quite sensitive to stress. The context of a feeling is predominantly organized by the hippocampus. It gives us an anchor for our feelings—a time and place—and allows us to connect to our feelings.
The amygdala is one of the most ancient structures of the brain and the oldest structure of the limbic system. It is the hub of the emotional system; the gateway to feelings. It gives us the sensation behind feeling, while the later developing hippocampus registers those feelings as facts. Early traumatic memory is consolidated by the amygdala. Luckily, when the going gets rough, it can help manufacture its own opium to hold back pain. In this way it helps us remain unconscious. It is truly a wonder that this small brain structure “knows” when to stop pain and can release a poppy derivative to help. More, it tells other brain structures about how much to release and when to stop.
The hypothalamus works with the lower structure, the pituitary, to govern the release of key hormones, not the least of which are the stress hormones. When we have strong emotions, it is the hypothalamus that organizes our response. (Within the hypothalamus lie two different kinds of nervous systems, the sympathetic and parasympathetic, which are key to understanding depression and are discussed in detail below.)
The thalamus is the central switchboard of the brain, relaying certain aspects of feeling to the frontal cortex. It can decide a feeling is too powerful to be felt and orders that the message not be relayed, and thus kept from awareness. The thalamus talks straight neurochemical talk, a language that expresses itself wordlessly. Yet it can translate painful messages into something understandable by the frontal cortex. If the pain is too much, the message that arrives is garbled. If it is acceptable, the gates open and the message is clearly understood – we know what we feel.
3.3. The Third Line: The Neocortex
The third line is the neocortex, the part of our brain that was the last to evolve and the one responsible for intellectual functioning, generating ideas and thinking (MacLean, 1990). The left pre-frontal area deals with the external world, helps us repress and, when able, to integrate feelings. It comes online at about the third year of life. The frontal cortex is part of the feeling system to the degree that it gives meaning and understanding to our physiologic- emotional reactions. The neocortex serves as a portal for entry into the suffering component of memory, a portal that cannot operate by itself. It’s the first door we walk through toward retracing our history and understanding our pain.
We can be fulfilled or deprived on any of these levels; when deprivation occurs so does pain, as the lack of fulfillment means that the integrity of the system is threatened. And pain is most often accompanied by its counterpart, repression. Fulfillment is more serious and urgent as we descend down the neuraxis on what I call the chain-of-pain. Indeed our biology dictates that deep pain elicits strong repression, to keep the pain at manageable levels. Heavy repression on the first line can mean a deadness of affect, a lack of good interconnection to bodily function so that sex is problematic and appetite is dulled; there is a lack of energy and passion. Symptoms on the first line include ulcers, colitis, and breathing problems. Symptoms on higher levels have different manifestations; the inability to make a decision, to be independent and forthright and to be aggressive.
This is simply a brief overview of the three levels in order to better understand the origins of depression and its therapy. If we consider that those ancient brains are still active in our head, the nature of the problem becomes clearer. All three brains should work in harmony throughout our lives. How they all get along is paramount. We need clear channels among the levels; otherwise there is distortion. Early trauma, however, creates a lifelong disharmony and disconnection among brain levels, resulting in many forms of mental illness. Essentially, neurosis is driven by lower brain centers that are trying to communicate to higher ones but are unable because a disconnection has occurred, a disconnection caused by the imprint of an early lack of love that spells hopelessness and helplessness. The goal of therapy is to restore that harmony, neurologically and psychologically, because consciousness (not to be confused with awareness) means all three levels working fluidly.
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.