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.