Why do I insist that there is a hierarchy of needs? It is an important distinction. As I have written that the most powerful needs and pain lie deep down into the brainstem. Howling screams emanating from this area are chilling, something I hear every day. But it can also be a quiet terror of near death with choking and coughing. Rage also lives there, and in a Primal we see it as well. It is how we know what level of brain function the patient is on. And patients confirm it when they come out of it. It is the source of severe migraines and addictions because here is where the pain is great and so are the drugs needed to quell them. We do not have to guess about when pain occurred; the patient in his feelings informs us. If there are no words during the session, just grunts and screams, we know it is preverbal and we would never encourage the patient to speak or say any words. If there are migraines, then we know the pain is deeply embedded; the flow of oxygen impeded in its ability to nourish various parts of the brain with oxygen. The vessels, in order to conserve energy, constrict and diminish oxygen delivery: hence migraine. One good therapy for it? Oxygen. Any stress can set it off as it is now part of the stress response. The brain thinks it is under attack and shuts down.
One of the reason it has taken fifty years to understand it all is that it took many patients reliving different kinds of pain on different brain levels to begin to compare and distinguish. It took years to find the different reasons and different levels of consciousness for distinguishing muscle headaches from migraines. Now we know that muscle headaches are less involved with oxygen supply and have more to do with wrenching the head and neck at birth, either by the cramped canal or by a rough doctor who was not gentle, thinking, as so many did, that the baby is a blob with no capacity for feeling.
As for addiction, there are different levels. But those who relive birth trauma (never re-birthing) often show signs of oxygen deprivation. Terrible addiction to drugs like heroin can signal the brainstem at work. They are the less prolix of patients. It is a triune, three part brain at work and different traumas and experience reside on different levels.
Those who easily get into fights or shoving matches are often riddled by first-line (brainstem imprints). Road rage is a perfect example. Recently two women on a freeway got into a shouting match because the other one cut her off and blocked her movement. Not being able to move set off first line rage, and when they both stopped to argue the one blocked pulled out a gun and shot the other woman. She was out of control, under the control of deep imprints that the neocortex was helpless against. I taught my wife and kids that there is so much hate out there, they should never argue with any stranger. I have not done formal research on this except clinical research, which informs me that deep pain can be the source of serious deep disease in the body. It is so hard to treat because rarely do doctors find the source and address it. The pain is so well hidden as to remain recalcitrant and a mystery.
We see in therapy that some patients lose clear articulation as they descend down the chain of pain to low levels of brain function. When they get into pre-verbal life, they lose all articulation. And the pain level rises exponentially. Patients need warmth and kindness when they get into deep pain. When appropriate I will hold their hand to make it a softer ride. Not early in the feeling but when it rises sharply. We need to bring down the level of suffering into feelable levels. That is always the goal; not suffering but feeling which spells the end of suffering.