Tuesday, August 4, 2015
On the Difference Between Abreaction and Feeling (Part 4/9)
The Dangers of Mock Therapy
In our four decades of experience, we have seen many ways the therapy can go wrong. A skilled therapist can take an upcoming feeling and channel it where it must not go. In the case of deep depression, it is an early death fore-told. But an ill-prepared therapist may take a near-death metric – such as very high heart rate – and refocus it into some other feeling that is not related to the cause but is decided on by the doctor. Whether aware or not, he is meddling with biology. The result is counter-productive because the patient begins to form a groove so that each time a deep feeling comes up with all of its power, it is rechanneled into a byway of unrelated feeling. And that is also an aspect of abreaction: taking a beginning, inchoate feeling and turning it into something else. The doctor thinks he understands the process and takes control, instead of the feeling controlling the session. The patient’s feelings, far from ready, are taken up prematurely, and the patient deals with an offshoot instead of the next feeling available. Those feelings seem to be in a queue, each waiting its turn, and each bringing relief when its turn comes. Primal sessions normally start with agonies up top of the brain; unhappy events in the present that can trigger more painful early associated memories. “My wife just suffocates me,” eventually connects to the basic imprint: “I am suffocating.” This is not thought out; it happens automatically through resonance where one pain high up can set off deeper lying pain, in a chain of events when the patient is ready to feel it. It seems like each feeling is classified as to its content and nature into separate compartments; one kind of feeling here and another kind of feeling there. Resonance in brain function connects the evolutionary links to each other to encompass most of our lives. Our biology decides, not a doctor or therapist, which feeling is on the rise and can be experienced. But when the unconscious of the doctor intercedes into this still untrammeled, pristine sequence of feelings, the result is an emotional detour – abreaction.
We do harm in therapy when we think we know where it all comes from, and we don’t. It is our guess against the reality inside the patient. So we have an internal battle: the patient’s system struggles to maintain his neurotic equilibrium, which is the body’s natural adaptation to early trauma and pain, while the misguided therapist struggles to change the neurotic’s life-saving ploy by tinkering with his thoughts and attitudes. The cognitive therapist, in particular, wants to change neurotic normal into abnormal by turning depression into a more positive, optimistic outlook. They don’t understand that depression is normal for the patient because his life experience drove him there and his biology is doing its best to maintain the equilibrium – the neurotic normal – established when trauma disrupted and rerouted his system’s natural state. The primal therapist also seeks to dismantle the neurotic normal but by resolving its origins, not by futilely trying to manipulate its present-day manifestations. Neurotic normal is what patients have to do to adapt to serious imprints, while abnormal is an attempt to enter into this equilibrium and alter its careful balance.
This is a state where the vitals betray the patient. It literally can be a death foretold because constant abreaction weakens the system and can lead to premature death due to the load of unresolved feelings weighing in, stealthily adding pressure on the biologic system. We don’t see the pressure that repression is exerting constantly on the heart, liver, lungs and other organs. We don’t see what chronically high heart rate does to the whole cardiovascular system.
In short, what is killing us is exactly what we don’t see. And why don’t we see it? It is just too much to face and experience all at once, because it is life endangering in and of itself.
We can watch the descent into lower depths of the brain as the patient sometimes will touch on the first line, brainstem part (the base and/or lower part of the limbic system) during a higher-level Primal. At that point, he may show vital signs down into unimaginable depths – body temp at 96.0 and heart rate down into the fifties. We know what part of the brain is activated as the brain systems unveil and indicate unmistakably what level of the brain is at work; defending against what trauma and at what period of ontogeny. When there is suddenly a breakthrough – an abrupt trespass – we see intrusion at work; the ripping away momentarily of the defense system, giving way briefly to deeper feelings.
This tells us that deep material is now just below the surface and may be ready to be addressed and relived, or Primalled. It is not guess work as the body signals its readiness. If we do not recognize intrusion we may wait too long to allow deep imprints to mount; the body is ready but the doctor is not. Again, the feeling may be changed into something else by the doctor because personal evolution of the patient, his ontogeny, has been ignored. The therapist has led the feeling elsewhere. A neophyte therapist, anxious to show his skill and dramatic effects, will force the patient far too deep too soon. As a result, the patient develops far-out ideation as the top-level brain is doing its best to handle the doctor-induced overload. It is the same effect we see with the ingestion of LSD.
I remember during the LSD craze of the sixties when some doctors experimented with hallucinogens for patients. Many went into transient psychosis as out-of-sequence pains were thrown up and could not be integrated. The result: overload of the neo-cortex and delusions. In our early research, we saw the residue of all this: aside from universal sleep problems, the neo-cortex was in a constant flooded state and the brainwave amplitude came way down, which meant to us, after many of the same readings among other LSD patients, that the repressive defenses were faltering and crashing. When patients are pushed too fast in therapy we often get the same kind of profile.
One clear example of dangerous feeling therapy is rebirthing – driving patients way too deep way too soon. Reliving birth in the first weeks of therapy is defying evolution and leads to disaster. It is arriving at deep levels of consciousness prematurely, skipping evolutionary steps and going through the motions of feelings without feeling. It overwhelms the integrating capacity of the brain and there is flooding with far-out ideas and bizarre notions. We have seen pre-psychotics who come to us and slide immediately down to some kind of birth trauma, way off a proper evolutionary voyage. They are often deeply disturbed and start therapy with a severely damaged gating system. They usually need help in gating so we may recommend medication for a time to control the upsurge of brainstem imprints. The medication temporarily enhances gating so that a proper descent is now possible. Without that there is no integration and therefore no getting well. Even worse, when the doctor buys into the ideas and beliefs the patient is in danger. Suddenly, he “merged with the Almighty.” And in booga-booga land, the doctor may nod agreement. It is now a folie a deux. If the therapist is mystical he may not find all this so strange, because those into mysticism never think that their beliefs are odd.
The problem with rebirthing is that it defies the fundamental evolutionary law. Never challenge evolution; respect and follow it. It will unerringly take you where you need to go, and only when you need to go. I have seen the psychosis that this mistake engenders; and we see the inherent danger in rebirthing because feelings are directed by someone else, the therapist, on his timetable and they are reached prematurely violating history’s careful steps. Don’t fool with history. No one is smarter than that and no one has any idea what lies in the unconscious; only the patient knows. And it takes time for him to know. His body knows but he needs a higher brain to inform him. His body is screaming the message through its asthma and migraine and high blood pressure but it is a silent scream that only his system can feel. It says, “I hurt” and he says “I hurt” but he does not know from what. The decorticate message has gotten through but it lacks key information that cannot be imparted when we are too young and fragile to understand and accept it.
When the whole brain is forced into a state for which it is not ready, it galvanizes itself and moves up the evolutionary scale abruptly searching for a handle, some way to deal with the pressure. When the ineffable feeling reaches the top-level neocortex, it concocts ideas and beliefs that are basically psychotic – “at one with the cosmos.” And this is the precise mechanism in a true psychosis (rather than induced) where the gating system has been trashed by the continuous onslaught of compounded pain over the years until it collapses. Notice that the pressure of the feeling moves up the evolutionary scale searching for some way to turn off the pain. It is a biologic rule for all therapists to understand. Crazy ideas are not single entities; they are the result of a long evolutionary voyage that ultimately results in a belief. When a therapist meddles with an idea, she is interfering with this evolutionary process. And I include behavior in all this and the anti-evolutionary behavior therapy. How simplistic to strip behavior of its roots and then to keep on manipulating the effluvia.
This is exactly what happens with mock primal therapy. The correct roots have been evaded while driving the patient into false byways. The result? Abreaction. A false root can mean leading the patient into first line, brainstem level where highly charged imprints await. So what does the doctor see as the first line intrudes? Gagging, shortness of breath, squirming, coughing. And what does he do? He encourages the patient to go into it when he is not nearly ready for such a deep experience. What does he get? Abreaction – temporary release plus a residue of feelings that could not be experienced, which push against defenses to make the patient feel bad. More often such great reactions produce fear in the therapist and he avoids dealing with it at all. It is left hanging and unresolved.
But beware: there is also danger when the therapist is too passive. Those who do not recognize first line on the rise will keep the feeling down and only let it come up for experience when it is far too late. It is too late due to the lack of experience of the therapist who has no idea how to handle pretty strenuous feelings on the rise. So what happens? Abreaction again: feeling different memories from the ones at hand. Again a groove is formed and instead of deep resolving feelings, there are little by-ways that are not resolving. For this timid and reluctant therapist, Freud’s dictum about the unconscious still holds true: don’t go too deep. Freud decided almost one hundred years ago that digging deep into the unconscious was dangerous for the patient and would disturb his equilibrium irrevocably. We have seen the unconscious at work and it is simply not true.
We therapists need to abjure being omniscient. We don’t know enough, and I cannot even guess how it happened that we became experts in the human condition. Whenever a therapist tells the patient what to feel we know he is already on the wrong path. We must sense feelings and follow the patient, not lead him. We take him by the hand and follow where he leads, not vice versa. We doctors must avoid the temptation to act smart. We spent years in college learning to be smart, and now we must elude it. How ironic! Yet the history of psychotherapy was intellectual and provided a therapy of the intellect, exactly what we don’t need. We don’t let the patient act “smart;” we allow her to act intelligent, to recognize her feelings and how they drive her and cause her to act out. When she tries to act smart we help her get to the feeling; of how to please momma or father. Finally it is a great relief just to be yourself and not have to act this way or that to get love.
It seems banal and harmless that a therapist supplies insights for the patient, but it is far from that because the patient is given a guess about his feeling from the professional which may be accurate but most often is not because it does not emanate from the patient’s feelings, but from someone else’s. It is a subtle way of channeling the patient into a groove because the therapist is insecure and wants to make sure that the patient is really feeling. And a facile groove is what most people suffer from in abreaction; they find a release to direct their feeling and it becomes comfortable to stay in it. It becomes embedded until they cannot get out of it and they don’t even know they are in it. The force of the feeling, the actual content, finds its groove, and it takes months of proper therapy to help patients out of it. Abreaction has compounded the neurosis rather than eliminating it. Worse, the person is convinced he is better, and he is not. Much worse, the doctor is convinced that all is right, yet nothing is right. The whole process has become a charade; a delusion of wellness. It feels good for the patient because he can release the pressure of the upcoming feeling and that feels like progress: ergo he is getting better.
When we try to insert ourselves into the feeling process we get a reflection of ourselves, not the patient. And that reflection relies on a host of theories concocted by doctors to explain that which needs no explanation. The mistakes in theory are as myriad as the unconscious of the doctor. He may see a need for power or of meaning or of sex and on and on. He often sees what is not there and refuses to see what is right there. His vision is limited by his openness. And that depends on how much he has felt and experienced of his own pain. You cannot be more open than your repression. That blocks so much: vision, insight, empathy compassion and understanding. If you live in your head you will never consider plunging to the depths of feeling; it is then all about explaining feelings, discussing them or writing about them. There is a form of therapy today where patients believe they can get well by keeping a journal about their feelings. Again, it is too obvious for comment but it is the top level that is embraced when we need to push far below it. The same is true for mindfulness therapy, which enhances attention and asks the patient to concentrate on details such as rate of breathing. This keeps that top level super-attentive when it should lie quietly. In these therapeutic schemes, there is no way to go deeper when every move that is made in therapy militates against feeling. They cannot go deeper because they are locked into kind of abreaction themselves. There is no larger, encompassing frame of reference that can guide them. They are as diverted from feelings as the patient who abreacts.
These cognitive theories are based on a basic distrust of feelings in favor of intellect; the opposite of one needs to produce a feeling cure. When a doctor defines his therapy as cognitive, he has already lost. It means he will deal with half the brain to the neglect of the other parts; above all the feeling parts; those parts that are healing.
Feeling is healing. No feeling, no healing.
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.