Tuesday, January 5, 2016

The Complexity of Primal Therapy


To some it seems that Primal Therapy is simple and all you need to do is help people scream; about as far away from the truth as possible.   It is quite complex because there are elements, not only of neurology and biochemistry, but of the dynamics of psychology.   We need to know how those elements are interwoven and how they evolve in the human system.

The therapy’s complexity matches that of the human species, in general.  We need to know about how evolution developed over the millennia and how that affects how we understand the unraveling of the various levels of consciousness.    We need to know about this evolutionary process so that when certain psychologic or physical signs show themselves we know what it means.  We know at what level of consciousness the imprint lies.  We must know the steps in the brain’s evolution so that we don’t force patients to trespass too deep in the brain during the first stages of therapy.  We cannot do therapy apart from evolution; rather, we need to follow its dictates precisely.  It is when that does not happen that we can harm the patient who may be face with imprinted pain that he cannot integrate.  We grew up following evolution; we did not have a thinking brain until some time after birth.  Nor could we walk at 6 months.  Evolution leads the way and we remain its obedient servants.  This is no less true of our emotional development.

I will offer one small example to embellish my point.   I saw a patient recently who had been in therapy for quite a while.  She was feeling how her parents ruined all their children due to their unyielding ideas about they should grow and learn.  It was tempting to sympathize with her and to say “Yes, I understand your feelings.”  That was it, and there we see a major mistake.  We can empathize with a patient but not when we sense that she is descending down the levels of consciousness to deeper and more arcane pains. She may be traveling down the neuronal paths to the antipodes of the brain and we must not put her into the present, talking to the therapist when she needs to go deeply into herself to retrieve part of her history. And why is that a mistake?  Because even a word of understanding and empathy ,“I get it,” takes her out of her descent and blocks the therapy. She cannot go where she needs to go because there is an outside input she must deal with, when she needs to lose most of her conscious-awareness of the   outside world and let herself be engulfed by her early pains, roiling the deepest level of brain function. So when a neophyte therapist wants to show kindness to the patient, he is hurting her; and this comes from an incomplete understanding of evolution and neurology.  And of course, a lack of key feelings about where the patient is at any time in the session.  We need to master the patient’s history, a first prerequisite of Primal therapy. And in some cognitive behavior therapies it is the last to be considered, as a-historic approaches seem to be the mode.  As if behavior had no historic anchoring points and simply sprung out of the ether. And the very nature of current focus-therapy militates against searching or finding deep-lying forces.   And the serious imprints are found on deep brain levels; by ignoring them the patient is being robbed of key transmuting experiences.

For example, there are key pathognomonic (sure) signs  when the patient approaches first –line brainstem levels.  We need to know what they are and whether the patient is ready to feel such deep-lying imprints.  If she is not and we encourage her to descend we will get overload and a lack of integration.  It sometimes is flattering for the therapist to see the patient reacting so vociferously but it may well be premature.

On the contrary, there are times when a patient gets lost and wavers from his evolutionary trajectory, and needs help to keep him on track.  The body is pulling the patient toward the pain while the defenses step in to block the experience. The therapist must know when that happens and what to do.  Here help is critical, but…but.  The therapist must suss out,  and sense, when to make a move and when not to.  The therapist must know the key signs of readiness for a feeling and then help guide him. So two different ploys depending on the biologic system of the patient and what level he may be ready for.  Janov Law means we do not  talk to the patient who just had a feeling until she talks to you. Because Primals begin to engender a host of notions, insights and elucidations that go on for some time.  They must not be interrupted because the therapist needs to act smart and offer insights.  Insights follow evolution: feelings first and later ideas and insights; not the reverse. The insights help  explain the feelings which were experienced; and because of how the brain evolved, cannot precede them.

So many mock Primal Therapists urge the patient into anger. It seems like primal but it is not. Do we know whether anger precedes tears?  Does crying come naturally after anger?  We need to know that before we do helter-skelter therapy on unsuspecting patients. There is an order to feelings; some come later than others; each feeling in its time. In therapy when we guide the patient into feelings that should come later there will be no integration nor resolution. Fully experiencing means resolution, allowing the imprint to become organic-an integral part of us.  To borrow from Freud; it needs to become ego-syntonic. That is what being oneself means.

When to touch the patient?  Of course she needs love and holding but first she must feel the old, deep unloved. “I am not loved and never will be.”  Only that will open the channels of feeling and maintain an openness in the patient so that later she can feel loved. In short feeling unloved is a feeling too. We were unloved long before we were loved; we must take the feelings in sequence. If we “love” our patients they will never get there.  After a feeling when the Primal imprint has been experienced we can hold and hug the patient but never when we replace the needed “unloved” with being cuddled. Again, patients do not need love; they need unloved first. Evolution first.

When to touch, when to hug, when to talk to a patient, when to show empathy, all have a specific place in therapy and there has to be the neurologic sequence that the therapist understands to guide the therapist.  I am often tempted to provide an insight for the patient; it is so obvious but not to her. When we help out with insights we rob the patient of her insights and critical discoveries that are often so liberating. But it must come on the evolutionary timetable:  feelings always come before the higher understanding/insight of the neo-cortex at work. The insight now tells us what the Primal feelings meant and how they affected behavior.

Let us not rob the patient of his sadness, his need to cry and scream, his need to show fury; let us not rob him of his key discoveries about himself.  We therapists, purveyors of wise insights, too often are not smart enough to stop acting smart.  Professionals are used to knowing so much; yet acting stupid sometimes is a very smart thing to do.

22 comments:

  1. Top notch explanation! 5 stars!

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  2. Dear Arthur
    You should get Nobel prize.

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    1. From your voice to God's ears. Alas, he no listen. art

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  3. It is not just the love we miss... we also need to express the hatred and experience the fear the need caused... so all is about need!

    "The complexity of primal therapy" is that understanding is only intended neocortex as neocortex is tasked to protect us from the disastrous experiences in the limbic system! To ask about love... need is the complex task because the need for love is isolerat i det limbiska systemet and are in a catastrophic process. It became and are so painful that symptoms of anxiety and depression was and is a way out for survival... survival against the pain that we had and still has to defend ourselves against... and so we are stuck in a way of thinking neocortex causes complexities.

    Franka

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  4. Another thought of the complexity around primal therapy!

    We are all hopeless cases to survive ourselves... but we are not hopeless to think otherwise!

    Frank

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  5. Have you heard of deepak chopra...and his insights into consciousness.....

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  6. Express my condolences 40th anniversary of the death of your daughter, Ellen

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    1. Thanks, there are things you never get over and I know that so well. art

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    2. Art, I never wanted to raise the issue, but now it's come up I am so sorry for you to have been through this. First 'not knowing' and then suffering the remorse of finding out why.

      - I've heard that this kind of thing makes for 'Self Remembering'. Who but the most feeling would want to forget?

      most sincerely Paul.

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  7. Dear Art, Glad you called it what it is, "Robbing" the patient 'of key discoveries'. Here are some thoughts from the Supplement to A Course In Miracles, Psychotherapy, Purpose,Process and Practice, " The therapist has a tremendous responsibility. While truth is simple it must still be taught to those who have already lost their way in endless mazes of complexity. Truth needs no defense and sanity is safe. It cannot be too strongly emphasised that the insane believe that sanity is a threat.The therapist must meet defences without defense. It is his task to demonstrate that defense is not necessary, and that defenselessness is strength." .....I went off track a bit, however I was a Primal Patient in Australia for some time, and also been a student of A Course In Miracles, believe it or not.....OMG that's enough to do anyone's head in. I still wish to come over and take care of unfinished business, at the Janov Centre sometime. Making the decision to take the necessary steps is of course, birth triggering in itself. But I have learned that nothing else is worth living for if your not really living.....so it's just a matter of timing, and time. Having said that , I can't wait to get over there, and meet my long lost self. The feeling right now is" I miss you!" .
    Brilliant article Art! .... Hope it gets laminated and pinned up in the tea room, or into the folder of protocols. Katherine

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    1. Katherina: Too much procrastination may not be a good idea. Remember my age? art

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  8. Art: Even in 1970, in the infancy of Primal Therapy, in The Primal Scream, you wrote that a training group had been set up several months previously yet neither you nor your therapists felt able to practice primal therapy because of its complexity. And yet ever since then you have made regular claims that the therapy is light years ahead of what it was even a year ago. If that is the case, it must be a hell of an achievement for ANYONE to practice, especially if you still believe that any practitioner must also have spent years primalling.
    As the current training at your center is 5 years, and you cease to recommend anyone you have trained working outside your center after 5 years (?), which I understand is because their training will be out of date, (but also burnout and the stress of practising PT without proper support), none of this bodes well for the future of PT. I´m not sure I would spend 5 years training for 5 years work.Gary

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  9. It is good to know about the quality of care in Primal Therapy. We are so interrupted in our regular lives all the time, sometimes,I find it a wonder that I get anything done at all. Of course I don't mind interruption from family, but on job, how one spends their break, just a little bit of "quiet" reading time during a break is welcomed, or just "gather" ones' thoughts is a good thing during a break (that is one's own time). So in Primal Therapy, it is good to know about interruptions, what goes on in Primal Therapy. We all know why many times people interrupt many people, and these people could care less about the person being interrupted (family of course , I exclude.). So it is important to know that in Primal Therapy, even if one is interrupted (whatever) , there, still one would feel safe.

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  10. An email comment:
    "The first few paragraphs reminded me of my basic principle: Do not distract the client from what they experiencing. Misplaced reassurance does that. Great point!"

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  11. You really love your patients. That nobody can deny. It shows, both from your forceful reasoning and also by your commitment to unveiling the truth throughout all these decades. Your words have disclosed what so many still refuse to admit. You were already ahead of your time back then when John Lennon proclaimed you were the answer to his dispair. And you still are 45 yrs after. We all will leave THIS world some day, our bodies physically decay I mean. But the courage to push through the thick layers of denial and addiction to despair will have been worth it. I only trust your perspective will be kept alive and kicking by your staff. Meanwhile let's attach to the only expression deserving to tie a knot for:beauty. Allow me to quote Albert Camus:"The artist translates both suffering and joy into a language we all understand. How remarkably weird to witness Creativity can still be expressed freely" (Conférence. 14/121957). All the best. Lars

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  12. An email comment:
    "Awesome, just awesome, it all makes sense. How I wish I could have had this wonderful therapy as it has evolved to be: a precise and meaningful way to probe the depths of feeling without false and misleading entanglements. Hit and miss is slow and dangerous and I think only done by people too unreal to feel genuinely themselves or for the patients.

    As always you are lights to the world.

    Keep shining. :)
    "

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    1. "As always you are lights to the world." - How the world needs this; yes !!

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  13. Art, what if a trainee therapist disagrees with your approach. Would the therapist graduate at your Centre or fail. For example, if they believe that a therapist should not touch a patient, because if the patient has a bad experience for whatever reason - and likes to seek revenge through litigation - such touching could become part of a legal battle to sue the therapist.

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    1. Gordon, ayayayay more fantasies. What if.......I do not speculate on matters like this. I am not a dictator but I have been in practice for 63 years so I have learned a bit. Anyone can add to our knowledge and I accept it if it is within the bounds of science. There is no booga booga here.I allow disagreement at all times but do not give into neurotic whims of someone trying to act smart. If I were not open minded there would be no primal therapy. It took me 50 years to learn it and make it precise and effective.
      art

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    2. Gordon: Therapy is never going to be perfect IMO, but sometimes tough decisions must be made. A few years ago Real Beaulieu was dismissed from Arts traning program for unethical practices. Personally I´m sure that Art was right cos i believe in his judgement, as I do re Michael Holden. In Primal therapy extremely strong feelings can cause a lot of damage of the sort you refer to eg litigation if they are not FELT IN CONTEXT. This is true for therapists with unresolved pains as well as patients.
      Deep Feeling Therapist Paul Verehack had his medical licence revoked years ao for allowing a patient to er....something sexual. However his defence was extremely compelling; honest,authentic, intelligent. Also the manoeuvre had got his patient to an early feeling.
      Sometimes even what seems blatantly obvious is a misperception/tranferred feeling. Gary
      It´s not all black & white

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  14. An email comment:
    "The first few paragraphs reminded me of my basic principle: Do not distract the client from what they experiencing. Misplaced reassurance does that. Great point!"

    ReplyDelete

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