Tuesday, January 17, 2017
Can Psychosis Be Treated with Primal Therapy?
In our Primal view, all mental illness arises from trauma and pain at different stages of development, starting in the womb. But since there are different degrees of pain in people, we also see different degrees in the severity of mental illness. In the broadest terms, insanity falls on a scale from bad to worse, from common neurosis to full-blown psychosis.
Which begs the question: Can Primal Therapy help with the most extreme cases of mental disturbance? Do we even treat psychosis? Is that so different from treating neurosis? The answer is more complicated and nuanced than the question suggests. Please allow me to explain.
Psychosis, is the result of massive first-line pain compounded by later devastating pain. For example, gestation events such as a smoking and drinking mother – which from the start overloads the baby’s ability to integrate the input – compounded by continuous trauma over the early months and years in the form of neglect, lack of touch, harsh parents who eventually divorce. In short, a life immersed in the complete absence of love. That is a prescription for psychosis.
I treated two women who were psychotic, and both had experienced incest in childhood. One was the result of incest at the age of seven; the other was the daughter of a Nazi officer who also underwent incest. I find from clinical observation that the earlier the incest the more likely the psychosis. Obviously, incest is devastating, as the protector becomes the predator.
The point is that one rarely gets over incest or a terrible birth. The imprint has a great force and it endures. Then when it is compounded by so many adverse events early in life, it becomes deeply embedded and endures as a lifelong force. Along the way at various stages, the system has a number of options for dealing with the trauma. If the traumas are early enough, the effects lie deep in the brain with major impact on the brainstem. Since the verbal system is not yet developed, we can expect the possibility of cancer or major biologic disease. The memory is deep in the brain as are its ramifications. Vascular problems, heart and kidney ailments, breathing impairment, are all part of the effects of the imprints. What happens is a serious crack in the defense system, leaving the person much more vulnerable to later trauma.
There may be hallucinations and delusions that become possible, the latter as the verbal/cognitive system becomes functional. Hallucinations signal a very early, preverbal brain system at work, meaning the result of more primitive traumatic imprints. In the case of delusions, a later system is working to provide some sort of meaning to the experience. In one case, I was walking down the street with my patient who suddenly ducked, yelling that the ice cream vendor wanted to kill him. Notice here the content: death is approaching. Terror is involved. Someone wants to kill him. Yes, there is an imprint of impending death from early on, but the person has no idea that it comes from inside. He projects that terror and the related threat onto the ice cream vendor. Death from an imprinted memory is near, but he has no choice; he projects it outside. And now he can hide from the threat. He is no longer helpless.
One of my patients, a boxer with many blows to the head, sealed up all his doors and windows to keep the “enemy” away.He still could concoct reasons and rationales for his terror, but it was totally irrational. Yet, his cognitive brain had to produce reasons for what was going on inside of him. This means that cognition was still in force, somewhat. When deep pain surges forward we see, “They are after me. They want to kill or poison me.” I saw one patient who, as a child, had the misfortune of witnessing his father shoot himself before his very eyes. The poor boy soon became delusional about the police, who he was sure wanted to kill him.
So what is the central difference between neurosis and psychosis? Defenses. Neurotics can incorporate some of the input and hold the major force of the imprint below the gating system. Psychotics have a different defense structure with the inability to reconstitute a normal reaction. In their minds, there is now a permanent threat. That is why when there is a deep imprint there is a constant menace of the return of symptoms. With a small adversity we again may see psychotic ideation. Or later, the return of a catastrophic physical illness.
So here is the problem for us lonely shrinks. In psychosis, we need to rebuild a dangerously damaged defense system. Patients need tranquilizers for many months or years. These drugs make up for a chemical system that was impaired early on in life. Those natural chemicals are part of the defense system which have been depleted due to the early trauma, a carrying mother who takes pain killers daily and smothers the baby’s ability to integrate. What is overcome and devastated is this ability to integrate input and make it part of the biological system. The neuro-biologic system can only take so much before it becomes a new kind of system: psychotic. In depressive psychosis there is a serious descent of blood pressure as depression grows deeper.Psychotic ideation is the last stand against the imprint of pain. The system seems to reach high up for help from the newly active ideational brain, which responds with concepts and rationales. That higher brain jumps in with weird ideas but to no avail. Because when I write “pain,” I mean a terrible pain that exists in force on lower brain levels. It is beyond description. Not like a broken arm. This is pure agony. And it informs us that a force exists in us that is truly ineffable.The reason that the verbal/cognitive system resides far above this kind of imprint is that the level of pain is far below and beyond verbal description. Patients often tell me about their deep pain: “It is something I do not even know how to describe. There are no words for it.” It has to be approached in therapy slowly and methodically, often with the added help of strong tranquilizers so that even a small part can be experienced. Once we see and observe that kind of pain, then psychosis is no longer a mystery.
Let me add a warning about the danger of hallucinogens. These psychotropic agents can make matters much worse, because they open the gates even more to relieve the pressure of repression/ depression. It affects the person systemically, making them vulnerable to the heavy input of subsequent repressed pain that will be too much for him. This is particularly dangerous once it is set loose by the drugs. In the case of someone who uses pot and hash, we have a system enfeebled and more likely to have subtle paranoid ideas. It is not as irrational or abrupt as with hallucinogens, but still dangerous. In either case, the lesson is there: a fragile system can go psychotic when we open the gates abruptly. Or, over time, if we add so-called benign drugs to the mix until the system implodes. It is very hard to reconstitute a broken system that was overwhelmed by deleterious input and then later aggravated by drugs that weaken the gates. Why are we fooling with one drug after the other? Because we do not understand what is going on in the neuro-biologic system. We are fiddling around with what seems obvious, but OH, it is not. If I told you that the average neurotic carries around an ineffable pain deep inside him all of the time, some may scoff. Alas, it is the ineluctable truth. We produce painkillers to meet terrible pain; even that is not often strong enough so we go to our personal pharmacy and take drugs that add to the mix. We do not buy them; we order them from our cerebral system. And still we may need more; then we buy what we need, and when that pain is agonizing and enduring we keep on buying until we are known as addicted. Then we are treated for addiction: with what? Pain killers.
So can psychosis be treated? In some ways, but that always requires a full knowledge of Primal Pain and Primal Therapy, which elicits traumas engraved deep in the brain. The doctor must be awareof the lurking menace that can spring forth and crash the system without warning. I have seen that force for decades. It is not guesswork. And it is certainly not banal. It is ineffable.
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.