Sunday, August 16, 2015
On the Difference between Abreaction and Feeling (Part 7/9)
How Good Primal Therapy Should Work
Now, let us look at how a Primal Therapy session is supposed to work.
A patient comes in for his session feeling anxious and not knowing why. “What does it feel like?” we ask. He doesn’t know. It is all agitated and “jumpy” and cannot sit still. And here we do not make any effort to get him into a feeling. We spend a lot of time just on understanding the feeling: when it is worse, how it affects work and sleep, etc. What it feels like. He cries a bit and we let it happen; he is overwrought. We embed the current feelings solidly before we travel back in time and deeper in the brain. The present becomes the platform from which we work. We want to establish as much as we can in the present and embed the feeling in the present. No going back right away unless the patient leads us there. But we want to take easy steps with the feeling going back to childhood later on, and in each stage settle the feeling deeper. The patient begins to feel more deeply; this can go on for many months and then, after a year or more the feelings will take him down to first line if there is a traumatic first line, and if the feelings are very disturbing. It is not always necessary. Then the patient may alternate first- and second-line events for reliving which get deeper and more powerful over time. We keep the pace even and not too overwhelming; otherwise we get abreaction due to overload. It is an ordered process as much as that is possible. We help keep him on track when he diverts from the beginning feeling so he doesn’t get grooved into a new channel of feeling. That is our skill, knowing when and how to keep patients on track. We follow evolution in reverse at all times.
Remember, each level of consciousness is an entity unto itself. If someone is reliving something emotional and then begins birth movements, it means to us that there is intrusion from another level; it may be that it is a defense against too strong emotions. And of course, if any words leak out we know it is not a preverbal imprint we are working with, another sign of abreaction. Similarly, if the patient doesn’t have her feet and arms in a specific position during a first-line Primal, we know it is abreaction. Defenses are tricky and we need a long training to pick them up correctly. In Primal Therapy we make it safe not to block pain. Since each higher brain level elaborates the same sensation/feeling/need differently, we can ride the top level down and it will eventually take us to the bottom—to origins. Once down there, the system on its own will move upward toward connection automatically, following the paths of evolution for connection. That is, we then move back up toward the right orbitofrontal cortex, around the orbits of the eyes, and then to the left prefrontal cortex for final connection.
How do we go back in time? Good question and the answer is simple. We don’t deliberately decide to go back and visit our early lives; that is a recipe for abreaction. We cannot engage the higher-level cortex; we must disengage from it. Cede to feelings. And that is our scientific mission: to provide access to feelings and let the whole organism proceed in an ordered, slow descent into the deep unconscious. As odd as that seems, feelings are the vehicle that take us where we need to go. Deep feeling has little restraint and flows effortlessly. There is no such thing as trying to have a deep feeling; it flows and pours like the well-known salt.
Again, it is not for the therapist to determine what the patient should feel. Our system has a biologic sensor that knows not only where we have to go in the past, but also how far, and above all, when. During therapy, when the body temp reaches a low of 96 degrees it often means that there is a first-line component. The patient has touched on the brainstem part of the feeling and therefore it drops inordinately. So the patient feels depressed and his vital signs indicate that he is close to the original imprint. Otherwise, we would not get such low readings early in therapy. This physiological reaction gives us a clue about the beginnings of depression. Some life-and-death threat during womb-life forced the system to a last-ditch defense to conserve energy. All systems slowed down and went into energy conservation mode. Worse, that mode gets stamped in. Then we spend a lifetime depressed and have no idea why. To end depression – notice, I did not say “to treat” depression – we must address those origins fully. It means going back a long way. In our therapy, we have patients reliving remote deep pains, those with no words nor tears, and we see it over decades.
In Primal Therapy, we seek access to those deep recesses of the brain, where ultimate healing lies. First-line is always more powerful than later imprints; so the insights that flow from first-line feelings are widely encompassing because they are the basis for so much later behavior. There are fewer words in these insights to match the preverbal pains that give rise to the insights. But they have weight and importance. Reliving on the brainstem level means complete connection as the driving force of impulses are experienced at last. We connect, in short, on the level of the trauma and in that context only. Here we are dealing with the shark brain: no shouts, no words and no tears. Evolution has taken over. It means the patient has gone back in time and is living again what went on decades before. Then it was too overwhelming for a naïve and fragile brain to integrate. Now, perhaps, he is ready for it. This is the true meaning of facing yourself and accepting yourself; not in the booga-booga, new-age sense but in the biologic evolutionary meaning of it where the feeling is now integrated into the physical system. It is ego syntonic. (Excuse my use of old Dr. Freud for this contribution he made which expresses exactly what I mean to say.) As the reliving goes on, the feeling is fully integrated and there is a continued drop in vital signs, arriving below baseline. The body temperature lowers to real normal, rather than “average” normal. In this sense, “integration” is a new biologic state where the whole system can re-regulate itself. Blood pressure drops and heart rate slows.
But a word of warning: vital signs are a symptom, not the problem. Treating the symptom alone is a mistake, one that can make matters worse. So when doctors see someone with very low vital signs, they look around for a good diagnosis. They work on his blood pressure, for example, in a medical effort to “normalize” it without understanding that the patient is already in his normal, life-saving mode. In Primal Therapy, we do nothing to address vital signs directly. We work to change the whole neurobiological system by addressing the repressed pain which vital signs only reflect. The difference is between a temporary effort, which has to be repeated into infinity, versus a basic biologic change which lasts.
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.