Monday, July 27, 2015

On the Difference Between Abreaction and Feeling (Part 2/9)


 Taking the Wrong Track into Abreaction

 To understand more about how abreaction works, let’s see what happens when a session goes off track.
 As we now know, there is a critical window during a session when the patient brings in a certain feeling, say, helplessness. If the therapist does not act to help the person delve into the feeling it very well may be too late, later on in the session. When the therapist does not strike at the critical moment, the specific feeling/frequency the patient came in with is now gone. What the patient will be left with is abreaction, the discharge of a secondary feeling, not the key one she brought in. That means no resolution and integration of feeling because the feeling has not been felt. When we measure vital functions after the session, the signs move in sporadic fashion. They do not move in coordinated ways but as though each function moves at a different pace. They seem to have lost their cohesion, which tells us that no primal has occurred.


 What I think may happen, and this is only hypothesis, is that when the feeling and its frequency are left unaddressed the patient slips into a secondary feeling with a different brain pattern and frequency. Even though she may look like she connected and resolved the feeling there is a good chance that it is abreaction. It is simply the discharge of the energy of the feeling without connection.


 Let me make this clear because so many so-called primal therapists make this fundamental error. There is a time in the session when that feeling is very near conscious-awareness. Without professional help the feeling slides away and the patient, now floundering, manages to get into a different feeling, one that may belong to the therapist’s agenda, not the patient’s. That is because the therapist did not pick up on the entering feeling and then projects his own needs and feelings onto the patient. The patient then goes where the therapist decides, which has nothing to do with attacking the basic need and resolving it. Too often, the patient goes where the therapist tacitly is interested. The patient senses that and becomes a “good girl.’ The unconscious of the therapist implicitly directs the patient.


 The pain of lack of fulfillment is always an adjunct to a specific need. To address the wrong need is to forego proper connection and resolution; it is feeling the wrong pain at the wrong time. A depressed patient comes in feeling hopeless and helpless. The therapist may perceive latent anger and urges the patient to hit the wall. The release does offer some relief and they both may think there was resolution. But it was only temporary. The real feeling will return again and again only to be waylaid. Or the therapist may say, “Tell your mother!” But it may have nothing to do with mother, at least not the patient’s. What is coming up is the pain of the doctor; he needs to scream at his mother. Indeed, the patient’s core feeling may date back to a time before words. So expressing the feeling verbally is a false route. It is tricky business. A sound knowledge of the evolution of consciousness will help here.


 Doctors are used to being active during therapy sessions so it is difficult for them to see how little there is to do. I speak on average about 50 words a session. My patient feels and then the insights follow. I do not need the majesty of bestowing insights on patients. It is wonderful that they make their own discoveries. And what discoveries they are, up-surging feelings accompanied with their notes from the underground. Telling the doctor what the feelings mean.


 On the other hand, therapists have a lot to do when we sense abreaction entering in. At that point, the therapist must be vigilant and hyperactive to keep the patient on track. He must make sure not to reinforce the tributary feeling while steering the patient back to the main feeling. And how, you ask, does the therapist know the difference? By instinct and experience. The therapist has to sense that his patient has taken a detour and he has to know what the real feeling is. That skill you can only acquire by primal intuition. There is no law.

15 comments:

  1. Now my mother is dead!

    What is a feeling? The need! How does it look like? It is full of tears... holding my thumb with the other hand and "desperately" calling out for mom... it in my living room as loneliness is approaching! Then it just happens... the feeling of when mom leaves me as five year old in the hospital... alone without any idea when she'll be back. That is a feeling as long as it exists.
    Back in the room... and I know a lot more about feelings than I have ever done!

    Frank

    ReplyDelete
  2. Dear Art
    Maybe some day I will be able to relive all my pain and connect it corectly.

    ReplyDelete
  3. It really can't be stressed enough, being able to zero in on the primary feeling pretty much determines your success with the therapy. I wasted countless sessions trying to feel what was most recently "triggered", when the biggest thing going on, in the back of my mind, was that I was afraid of male authority figures, which the therapist symbolized. I had to deal with that feeling first, before anything else.

    ReplyDelete
  4. Now that is what I call getting to the core and spellig out how therapists have to be fully "tuned" to their client, knowing exactly the moment to speak or not. I have been observing for some years now seeing exactly as you describe.

    ReplyDelete
  5. Why we can become so vulnerable during the Primal therapeutic process!

    To imagine the child in us... when we as adults are embarrassed to meet someone we like... it's a matter of life and death! If it sounds ridiculous... or we become afraid... or causes any other reaction as we by any means trying to avoid... it's life of death that remind us!

    I do not think there are many psychiatrists who experienced the drama of standing in front of a train with assertiveness to jump... to be in longing and hopelessness for something absolutely necessary... something he/she experiencing will never happen. The intensity of death in itself! Death we senses the intensity of... death of being ashamed to meet someone for something he/she absolutely have to get... but in time long ago... can we imagine that?
    We need other than psychiatrists and psychologists!

    Frank

    ReplyDelete
  6. Dear Art,
    I understand how abreaction can be triggered by an unexperienced therapist. But what is the mechanism of abreaction in the case of self-primaling? When the patient is alone with noone to interfere is there a danger of abreaction? Or only a danger of not going deep enough into the feeling?
    Thanks
    Anna

    ReplyDelete
    Replies
    1. Hello Anna!

      "But what is the mechanism of abreaction in the case of self-primaling"?Your neocortex!
      "When the patient is alone with noone to interfere is there a danger of abreaction"? Yes! Your questions tells of uncertainty where no one will suggest you to undergo primal therapy on your own! Head to Janovs center if you have the money ... it is betted where you get paid for every penny you spend.

      your Frank

      Delete
  7. I feel like the problem of abreaction would be most critical early in the therapy process when
    the patient is still learning.
    In an individual session I usually am clear on what I want to talk
    about and the feelings, as I have been doing this a long time. I don't find my therapist ever
    really redirecting, he mostly stays quiet and is just a really good listener, which isn't at all easy to do.
    In therapy groups, which I rarely get the chance to take of advantage of, it's more spontaneous and I have a harder time. It seems like anything could happen with other people reacting and
    the group amplifying the feelings.
    Phil

    ReplyDelete
    Replies
    1. A reply to Phil by email:
      "Art

      I was unable to post this comment (a response to Phil) on your abreaction part 2 piece, so am sending to you direct:

      "Phil: I disagree; even long term primallers can slip into abreaction, especially when the pain awaiting them feels too much
      Also, I know that, as you say, many therapists are not directive or controlling, but that doesn´t mean they are proper primal therapists either. Gary"

      Also, I didn´t receive your latest (abreaction part 3) essay. Am I still subscribed?"

      Delete
    2. Gary, I checked and your subscription is active. art

      Delete
  8. Art: The following is an extract from an article titled "Natural Vs. Directive Primal therapy" by Harley Ristad, written in 1975, whilst a patient at the then Denver Primal Center. It illustrates perfectly what you are talking about. Gary

    "During my fourth month of therapy, a mistake was made whereby I was subjected to some directive therapy which brought up some pain out of its natural sequence. I was a willing and cooperative participant who believed that good therapy had been done. It was two months later when it suddenly became clear to me why my therapy had stagnated. I believe this mistake set my therapy back more than a month. Because of this mistake, I have learned how very good natural primal therapy has been for me.

    It happened on a Friday; I had been deep into my feelings for six hours, and came out of a two hour primal in, the middle of post group. (Patients are in separate rooms during group, and meet in one large room for post group.) It was then that another patient, who was a stranger to me, dumped a lot of anger on me. I was very together, felt his charges were nonsense, and chose not to dignify his diatribe with a defensive reply. Instead, I tried to share with the group that I had just primalled being left all night alone in a hospital when I was about one year old with my arms strapped to my sides like a slab of beef and insects biting my face. When I was in most need of support for my feelings, the therapists joined the goup with their need to see gladiators in action. They urged me into a different response, and I replied with anger.

    At my next session, the following Monday, my therapist chose to talk about the Friday anger dump. I was told that, as an adult, I can see that the anger is crazy, but when I was a little boy I couldn't. In post group the same patient dumped his anger on me again. This time, I followed my therapist's suggestion and went with the feeling of being small and not being able to figure out the craziness. I went down on the floor, and went real deep, My therapist greatly intensified the pain when she put her hand on my shoulder.

    Being pushed to where I wasn't ready to go was so unnecessary. The anger dumps were locked in my memory. At some later session, when my body was ready, I could have gone into feelings about them. Natural primal therapy assumes that there is a natural sequence for a patient to feel his buried pain which is unique for each patient and can never be known by the therapist"

    ReplyDelete
  9. You're damned right: what blocks the patient's brainstem from freeing its accounted terror is the therapist's own fear to witness his own being triggered by that. Oh my God. "Tell (shout at) your mother!": certainly a detouring neglect (subsequent laryngeal irritation avoidable?) Do you mean no patient needs to be told, even suggested, to tell her mother -let alone on a face to face basis?. I'd say That precise vomiting happens naturally when it comes to freeing the cognitive Brain, and that belongs to the realm of first line discharges from daily uploads, doesn't it?. I was once told there comes one time (and only one) to tell your mother and father a few home truths. Do you feel that is pointless and helps relief in no way?.
    Accurate as ever. Thank You. Lars

    ReplyDelete
    Replies
    1. Lars: Not pointless but when it is right, decided always by the patient. We never know what feeling needs expressing until it arrives. No therapist is smarter than the patient. That is what mock therapists do in their arrogance and innocence. Art

      Delete

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