Saturday, June 21, 2014

Suffering, Pain, What is the Difference? It All Hurts.


No, No, my friends, there is a big difference.  In my scheme most of us suffer but few feel pain.  Why is that?  It is a bit of a tale but pray let me clarify.  First of all they come from a difference play in the brain and play a very different role; and you better hope for pain cause it will take you out of your suffering.

If I kick you in the cojones you suffer but it can go away. If your father kicks you there you feel pain and you suffer because it has multi-determined meaning; as Freud said, it is over-determined.  How could my father do that?  Does he not love me? I feel hurt, wounded and unloved: I suffer.”  That suffering has implications that hurt and make us suffer.  A broken heart is suffering. A faulty heart valve is pain. Pain can be fixed; suffering is another matter.

There is a structure called the ACC  (anterior cingulate cortex).  When we are babies and mother disappears we send out a distress call; a specific call that demands, “Whaa, Come back now.  I need protection and care.”  We need love and protection at all times when we are young; we don’t often get it: stop crying and stop acting like a baby.  And so we do and we begin to lose that alarm signal that makes help and comfort rush to us.  The pure pain areas overlap with the emotional suffering part. When research subjects were make to feel isolated and rejected the ACC got busy but the higher ventral prefrontal cortex did not.  And from the research we begin to know why it hurts so much to lose a family member.  But the distress can be lessened with painkillers, as we all know.  What they were showing was the difference between emotional and physical pain. They were not identical and involved different areas of the brain.

For my purposes it is the over-determination, the meaning of the pain that is repressed and remains unconscious so that we then walk around and not feel the suffering we are in.  “They don’t like me and there is nothing I can do.”  It happened to one of my patients who was born in error; neither parent wanted him and they made him pay throughout his life just for being alive.  The parents made up reasons for disliking him; but it was clear. He had “ruined” their life.  In suffering the ACC can mount while the pain centers remain aloof.  And what is our job? To make suffering into pain.  Why on earth would we do that? Because all of that suffering means unrelenting hurt.  That suffering must be made conscious, which means conscious/awareness/pain.  Then it can be dealt with, resolved and put and end to it.  So long as it hurts we cannot shake it.  In other words, according to the research we need to bring the limbic lower level suffering up the cortex.    It needs to be made consciously/aware.

Too often the patient demands help with her suffering so she is given tranqs and painkillers and the suffering is subdued for a time. But it will always return because it has not been made into pain.    And the suffering that is most troublesome and that cause serious addiction, is that from the brainstem. It is often horrendous and remains suffering because it is so deep and remote and inaccessible.  When we make that into pain we are on our way.  Pain is resolvable and suffering is not; it can only be suppressed.  Suffering is diffuse, amorphous, without shape, time or place.  It is an imprint often without words, but it endures for a lifetime.  Pain is a conscious, connected event which takes suffering makes it specific and we are done with it.  Pain, like the kick in the cojones, stops the vagueness; it is over and done.

It has been disconnected from its source, time and place and therefore remains a mystery.  When it becomes, “Oh my God. They hated me and blamed me for it.  And I thought it was my fault and that I was bad and unlovable. “  Or it can come from a traumatic birth and or a carrying mother drinking alcohol or smoking.  Many ways to suffer; only one way to feel pain.  Pain is connected and specific; you cannot be driven there by a therapist but you can be led there when the time is right.

So now we know that specific pain is held down by the gating system.  It was meant to be hidden so as not to be too disruptive.  But it continues to spray its agony all of the system, and we get high blood pressure, headaches, even epilepsy.
It is a mystery to everyone.  No one can see a carrying mother chain/smoking decades later but there it is and that is when it all began.  So what we need to do is wait till the patient is far along in her therapy and can safely descend
To lower levels;  we then using primal techniques to help dredge up those early pains from remote times, bring them up with the help of the right orbitofrontal cortex make them concrete and resolving.  That is  a different matter from suppressing pain. One is time consuming and evolutionary, and the other is always an emergency measure.  We should never do one without the other. We can kill pain with drugs while we are traveling to the lower depths.  But let us never fool ourselves; temporary measures, pain killing is not cure no longer how long it lasts.

13 comments:

  1. Possibly prayer for some people suffering helps and might even cure. Try to get some "spirit"; even though you, yourself, knows it may be false. Just go through the motions....have people believe you are content; not suffering....who knows really? Everybody is different....especially in dealing with suffering. I honestly believe that some parents cause suffering for their kids, because they don't want them to get "to close" to them; when the parent dies, the child will feel such loss.

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  2. For some, the choking feeling, the feeling of getting all "choked up" at times such as when a family member passed away, one just has to do something so as not to have that feeling and then become so weak. One cannot go through life with this habitual feeling of "being choked up"
    and going to cry a lot. Sure some people do go through life like this, but for me, it's not good. Primal therapy, I do believe , might definitely help this feeling, but if one can't get it right away, they must work on themselves to make them stronger, and it isn't through painkillers or alcohol....they don't make that feeling of : "getting all choked up" go away. One cannot constantly go through life with that feeling.....it will get them no where. The drugs and alcohol aren't a permanent , healthy solution. For some with this feeling, one must do hobbies, sports, activities, or do something to get a sense of strength; to help them along if they cannot get the primal therapy right away. They have to listen to their bodies, in order for them to help others. If one cannot help themselves, they cannot help others. For other people, they don't "get choked up".

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  3. Sorry for my ignorance Dr Janov, I discovered the search box on your site and read your thoughts on psychopathy, which all make perfect sense, especially in the context of the gestation, birth and development of my ex husband.

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  4. My Epilepsy A Blessing In Disguise.

    Evolution makes us suffer in order not to feel the pain when for example mother misbehaves or disappears more than we can stand. “The pure pain areas are overlapped with the emotional suffering part.” The message of the pain is repressed and remains unconscious. The pain caused is held down by the gating system and, within certain limits, it is hidden. But it leaks its agony all over us, and we develop high blood pressure, ulcers, strokes and epilepsy. These “laws of nature” are mysteries to everyone and no one can understand where and when it all began.

    Art’s latest reflection: “Suffering, Pain, What is the Difference? It All Hurts.”
    could be a brilliant and telling summary of how my friend Eva and I have experienced pain and suffering for almost 74 years. My friend was during years emotionally mutilated and threatened by a bipolar mother, and she turned off the connections between the limbic lower level and the cortex. The lower level suffering was never made consciously/aware. An efficient gating system supported by workaholism, intellectualism and cigarettes kept the pain at bay, and my friend got her reward in a lustrous academic career. The deep and remote suffering took its toll and towards the end of her career, high blood pressure, diabetes were facts before a burn out / stroke put an end to her career after a lifetime of suffering.

    My religiously confused, however loving; mother subjected me to a horrific birth trauma. Epilepsy became the symptom that represented my pain, and it was kept in check by chemical lobotomy / Tegretol (Carbamazepine). The hidden pain, though, continued to “spray its agony” and propelled a neurotic overactivity, which drove me out on a long, intense and restless career as a change consultant. Fortunately, 36 years ago, I met Art Janov and could slowly and determined embark on a new journey to resolve my pain and watch my suppressed suffering disappear.

    For decades, I considered myself to have been unlucky in that I developed epilepsy as a consequence of my birth trauma. In retrospect, after a successful guidance, over 4 decades, by Art Janov, through the Primal Principle, I realize my blessing in disguise. The pain, which triggered my epilepsy, constantly leaked and it became the gateway to my suffering. The job of Primal Therapy is to make suffering into pain! When my seizures, eventually, turned into pain, which I could feel and re-live, I finally got the key to being cured and free. Meanwhile, I got a general understanding of the difference between pain and suffering.

    No matter how intelligent, sympathetic and intellectually well-lit my friend is, it is impossible for her to understand the following statements in Art’s Reflections: “Pain is resolvable and suffering not.” “Suffering is diffuse, amorphous, without shape, time or place. It is an imprint often without words, but it endures for a lifetime.”

    Perhaps it’s no coincidence that my friend, for years, has been a significant personality (pedagogical award winner) in the world of academic research and education that provide Big Pharma scientists.

    Jan Johnsson

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  5. Cognitive phenomenon... what is there to know?

    I lose breath and becomes paralyzed at the slightest clue of tears... the air goes out of me and I help to hold it back. A similar vacuum takes shape... a stifled condition... my brain ceases to function... I am in a state of chock to not let my self feel... to feel how much it hurts.

    It seems as if the air has to trickle back so I can start breathing again... breath in the air of what?

    A recovery from a paralyzed state... but now without the breathtaking reaction. My physical "medical" process has run its course which saved my life... but is taking it now!

    My cognitive state has for a while put emotions rebuke from life-threatening experiences! If I don't learn to do this right I will die from it... sufferings into the last thing I do!

    I can only help myself but I have to dare me to the right questions... be smart as you say Art.

    Frank

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  6. OH MY GOD... HUMANS ARE FISH!

    In the early stages of development, human and fish embryos are made essentially of the same stuff and they look almost exactly the same... in fact they both have gill slits in the sides of their heads! But later, as they develop, the fish's gill slits turn into gills, and the human's gill slits turn into inner ears.

    Do humans really begin with gill slits or is this early structural similarity just a coincidence?
    Nope - it's not a coincidence at all. We were fish.

    Scientists compared the genes in a human arm with the genes in the fin of a particular fish. Despite the immense amount of information bundled into a single gene, scientists were able to use super-computers to analyze the DNA, and discovered that the gene that was responsible for building the upper arm bone in the human was the exact same gene that built the main upper bone in the fish fin. And a different type of gene; one that built the two lower arm bones in the human, was the exact same gene that built the lower bones in the fish fin. And a third type of gene that built the human finger bones was the same gene that built the tip bones in the fin.
    The shocking truth:
    different species share many of the SAME genes.

    How can this be? We look different!

    WHAT ARE GENES??!!
    Genes are pieces of software designed to create building materials. Those building materials can be used to create fish flesh and bones.... or human flesh and bones etc. Genes are not fussy -- they will do whatever they are told to do, but the instructions must comply with the type of material the gene is designed to manufacture. Theoretically, a chimpanzee's eye gene can be told to create a chimpanzee's eye, or Art Janov's eye. The differences in the final appearance are determined not by differences in the genes (there are none) but by the way the genes are CONTROLLED.

    REGULATORY DNA controls the genes, and the final outcome.
    The regulatory DNA in a fish controls the gill slit genes. It controls when and where the genes express themselves, and for how long.

    So, in many cases, the building material develops a structure which has the texture and taste of fish, but the structure is still made from the same building material used in humans.

    The regulatory DNA in humans prevents the gill slit genes from turning into fish gills. It ensures that the slits turn into inner ears instead of fish gills (in most cases).

    We all started from the same foundation. Humans were fish. If you don't believe me, study animal embryos.

    And now scientists are discovering many things that affect the regulatory DNA. We have discovered that the environment can affect the body's chemicals which activate gene switches in regulatory DNA. The genes switches affect the genes. This means the environment can tell the genes how to build an animal.

    How much of this process is random? How much of it is a programmed reaction to the environment? How can we interfere with this process? This is what scientists are studying now.

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    1. "98% of our DNA is junk -- it is the useless remnants of abandoned genetic code."

      The above conclusion, published in many scientific journals, and accepted by scientists of the highest caliber, came from a simple intellectual golden rule:

      ~~ If it doesn't make sense, it is junk ~~


      When scientists discovered that 98% of our DNA is not junk (it is regulatory DNA) a new door opened, and now we are seeing extraordinarily rapid progress in genetic engineering for the production of lab-grown meat and milk (no more animal cruelty), and medical treatments such as the reconstruction of body parts (want to live forever?), and hundreds of new pest-resistant vegetables (no absorbed pesticide sprays), and many other revolutionary applications.

      Psychologists will match this astounding rate of progress when they abolish their intellectual rules and walk through the door to the other side.

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  7. I have to add a postcript. The psychotherapist says, that behind anger/rage there is helplessness, and from there we come to pain or even the shock, in whick severe psychotrauma resulted.
    What do you think about that explanation for every rage?
    And would you say, that expressing anger is always a kind of acting out and that we are always loosing time, when we are expressing it in psychotherapy, because it bewares us from reliving the helplessness?

    This is a very pointed way of explaining her thoughts. Surely she would not push me to relive my trauma quickly. But as you say one can waste years by suffering and not feeling pain, and i guess she thinks similarely. Still i have my questions which i explained in my former post. Would be very nice and help me taking my decision, if you tell your thoughts about these questions.

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    1. Beware of charlatans in white coats. art

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  8. An email comment Part 1:
    During a few weeks, I have read Louis Cozolino’s books; “The Making Of A Therapist” and “The Neuroscience Of Psychotherapy.” Both have given in-depth insights into what I have experienced and learned during my almost 40 years in connection with Art Janov and his innovation The Primal Principle. I have experienced Cozolino’s message as a softer version of psychotherapy than Janov’s, but at the same time more instructive, informative and social in its pursuit. Immediate personal reactions in connection with my most intimate contacts have not been lacking, and I have experienced an improvement in my social interactions. As usual, my dreams have not been slow to act around my brain circuits and last night I had an extensive, pleasant dream of freeing character.

    In the dream, I participated in a conference in a big city. Participants were people from different positions that I had met during my career as well as a few close friends from way back in time. The conference aimed to improve our general social skills, be honest and dissolve inhibiting repressions. I enjoyed not having to keep track of either time, belongings or documentation. I noticed that my keys disappeard, but it did not worry me (it turned out later that I had them inside my shirt), and my usual concern that travel documents would disappear was gone.

    A young man who looked to be suffering from stress and anxiety came up to me, and I held him until he had re-lived a difficult repressed pain trauma. Afterwards, he looked relaxed and healthy, and I told him he did not need any therapy treatment because the feeling had cured him. A woman, to whom I had previously been married came up and expressed her admiration, in an emotional way, over my treatment of a young man.

    After friendly but undramatic saying goodbye to a number of conference participants, I left without my previous fear of not finding my way home. I lay down on a giant skateboard deck and rolled, feet first, through a large city (probably L.A.) at breakneck speed and slid smoothly through many narrow passages without striking neither guardrails nor signs. Suddenly I rolled out of town and came to the countryside. The paved road turned into a dirt road and suddenly I had three horses with riders in front of me. I slowed down, and one of the riders stepped down from his horse. I immediately identified the rider as Sigmund Freud, and he took off his hat when I passed him. The two riders in Freud’s companion remained anonymous. My ability to roll forward on the gravelly horse road was limited and with this realization, I woke up and felt glad to have made Louis Cozolino’s literary, psychotherapeutic acquaintance.

    Cozolino’s books make my experience and knowledge from Art Janov and Alice Miller complete. The three represents, for me, a complete psychotherapeutic ensemble, but whose individual perspectives I had not fully understood my birth trauma, my neuroses and my confused social relationships. Additionally, Art Janov gave me the courage and the will to penetrate the pain behind my trauma that eventually developed into epilepsy. However, despite all the words in their books, it is the wordless re-experience of the pain that makes the journey.


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  9. An email comment Part 2:
    Art Janov has, for decades, harshly, criticized the tendency of cognitive therapists to repress the pain of their patients due to the fear of their own repressed pain. Instead of asking “WHY symptoms?”, they treat, these symptoms, by repressing, cognitively, the pain further down, over and again. Louis Cozolino realizes this danger and to develop the psycho-therapists’ ability, to in social interaction with patients and supervisors, cure themselves from the mental problems, that originally drove him, her to become a therapist / “caretaker.” “The brain is a social organ of adaptation built through interactions with others. There are no single human brains – brains only exist within networks of other brains.”

    My delight in Cozolino’s therapy training model works until my own stigma of epilepsy. I have a feeling that Louis Cozolino has set a severity / category boundary in his professional therapy ambitions. Fortunately, Janov, without being careless, has not drawn any limits, at least not any that stopped me. My own successful development reflected certainly my experiences of dramatic pain from my epileptic seizures.

    Why does not Cozolino with a word mention Janov & The Primal Therapy? That is a question that demands an answer. He mentions Alice Miller, who I believe, is the one of the three who in a personal way, most empathy richly, describes the experience of pain from childhood traumas. She is unyielding in her demands to the patient’s liberation / removal from certain inhibitory family relationships, which have caused a trauma due to lack of care / love before, during and after birth. Her reference to the repressive role of religion (4th commandment) is a cultural and psychotherapeutic eye-opener.

    Louis Cozolino is probably looking for a wider audience than Arthur Janov. He will probably choose, according to Peter G. Prontzo’s review of his book in The Primal Mind, and according to Daniel Kahneman, to follow the model to avoiding (physical and mental) pain is a stronger motivation than the attraction of pleasure. “Based on the way our brains operate, evolution appears to have been far more interested in keeping us alive than making us happy.” Is it an “anti-evolutionary” attitude that keeps Art Janov / The Primal Principle outside neuroscience (research and education), health care and psychotherapeutic literature?

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    1. ( I agree that we normally avoid pain.) Even though the motto: No pain; no gain has applied to athletics, it now can have another home: the brain (in experiencing old pains bits at a time.) Sheri

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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