Tuesday, November 28, 2017

Womblife and Serotonin. The Origins of Mental Illness

(Originally published July 9, 2008)

Let’s begin with the poor lonely mouse. Regarding its womb-life: it is only after several months of gestation that the fetus produces adequate amounts of inhibitory/repressive chemicals such as serotonin. A mouse fetus does not make its own serotonin until close to the third trimester. It seems like the mother supplies what is needed until the baby can take over. But when the mother is low on supplies, she cannot fulfill what the developing baby lacks. Now if we extrapolate a bit to human mothers. But first a caveat: it seems to me that the principles or laws of biology apply pretty much across many species so that what is true in the physiologic evolution of mice might also be true in our own biologic evolution, as well, and as the following discussion indicates, it is true; the lag between the ability to experience pain and the ability to repress it can be considerable. 

Whereas the beginnings of serotonin production in mice are sometime in the third trimester, in humans it seems to begin slightly earlier. Research on a fetus seems to indicate that it can experience pain after thirteen weeks from conception but that it really fully experiences pain after 20-24 weeks of gestation--bout five months of life in utero. It is fully sensitive to adverse events at this time. (see Paul Ranalli, “The Emerging Reality of Fetal Pain in Late Abortion.” www.nrlc.org) My guess is that it begins even earlier. What is critical here is there is a time during gestation when the fetus can not produce repressive/ inhibitory chemicals and must “ask” for help physiologically from his mother. When the fetus does begin manufacturing is own neuro- chemicals it sends some of it to the mother. It says, “I can soothe myself now. Thanks for the help.” Above all, serotonin is a soother. 

Allthough the pain-killing aspects of serotonin are well known, less is known about its role in affecting appetite, gastric symptoms and heart function. In short, it has a role in normal development and evolution. In particular, new evidence points to its role in actually shaping some brain structures early in fetal life. (see Cote. F. et al. “Maternal Serotonin is Crucial for Murine Embryonic Development.” 2006 National Academy of Science.) Traumas very early on, before the secretion of serotonin is evident in the fetus, impact later serotonin output and can change who and what we are significantly. One reason we see serious mental illness arising during adolescence is that the hormonal turmoil going on and the weakening of defenses permits some of the fetal pain to rise and affect thought processes. Hence delusions and hallucinations. 

Interestingly, in its early secretory life serotonin functions to control and shape anatomic structure. Later on, it carries on as a pain controller. It too evolves and changes. Thus, we as humans may have a significant delay in secreting serotonin during gestation. And we rely on our mother to pitch in before we start making our own. She needs to have an adequate supply for both herself and her baby. If she is chronically depressed she is apt to have low levels of serotonin, used up in the fight against her pain. In this way the mother cannot fulfill the fetal needs for a way to blunt the impact of adverse events; i.e,. of pain. Thus, the fetus has developed a residue of unblocked, free floating pain and terror early in his gestation. This makes him much more vulnerable to trauma at birth and in infancy. He is defective in coping mechanisms. Any later trauma can have double the impact on the relatively undefended system. 

The low serotonin output is an imprint that remains pretty much the same throughout our life, making us not up the task of everyday living. That is why we so desperately need serotonin enhancing medication later in life. (Prozac. Zoloft) The medication is blocking pain that happened before we set foot on this planet. 

We know from current research that an imprint during gestation remains pristine pure for all of our lives, whereas an imprint from after birth can produce compensating secretions that blunt the impact of trauma during infancy. My very notion of the imprint means events that they create irreversible dislocations of function in the neurobiologic sysems. The only way it can change is if we return to the origin of the dislocation and right the ship. It needs a push from below not a cry from above. 

It seems to be another biologic law that whatever happens during gestation can alter basic physiologic set points, which is rarely the case after birth where there can be compensatory mechanisms to make up for the dislocation of function associated with the original trauma. 

So we have a developing fetus who has no effective repressive mechanisms trying to borrow some of mother’s serotonin to help out, but to no avail. A completely naïve physical system has no frame of reference that tells it that basic physiologic processes are deviated. During gestation the system deviates and then considers that deviation as normal. So the baby is born with inadequate serotonin/gating capacity, and that deficiency follows him throughout life. But it is an already wounded organism, a wound that almost no one can see or even imagine. He will grow up chronically anxious, unable to concentrate or focus. He may well be ADD and be unable to sit still because the activation goes on incessantly. It shows itself in the panic attacks that happens when the system is vulnerable and gating weak; the imprint from gestation rises to the top and shouts out its message which almost no one can decipher. It is such a mystery because its origins are so arcane. 

An example: a girl is born in wartime to a mother who is chronically anxious because her husband has been sent to war and left her all alone. The anxious mother transmits some of that to her baby who is then considerably weakened. He cannot fully repress to hold down pain. By the time infancy happens there is already a weak, vulnerable baby who is chronically agitated. This may be the beginnings of serious mental illness. It is not obvious to the human eye but the damage is done. 

Too often this is ascribed to heredity because no one can imagine what has already happened in the womb. It is kind of a free- floating anxiety that seems to have no specific time of origin. Remember, this is a purely physiologic reaction originated at a time when there was no higher brain centers to process the event. To recapture it we must retreat to that primitive brain. 

What we may see many decades later are panic and anxiety attacks, and then much later a cerebral stroke. This imprint would militate against cancer because for cancer to develop we often need massive repression; and for that we need massive secretions of neurojuices such as serotonin. What would exacerbate the risk of cancer is events later in infancy and childhood with unloving, stern parents. The result is a person who never had outlets for his pain. What further shuts down the person is growing up with a violent father or mother, a strict religious household, and no one to turn to. The force of the imprint may well affect the brain when the person is in his sixties. How on earth can we access such remote experiences, a time when there were no ideas to help out? 

We do know that each high level of brain function can incorporate the previous lower level. That is, early memories become elaborated on higher levels of brain function and are incorporated into those levels. So when we relive a non-verbal pain or trauma in infancy we are at the same time reliving the residue from earlier in womb-life. The events are united under a resonance factor that makes a higher level of brain function trigger off a deeper and more remote feeling. To put it differently, each early preverbal imprint is ramified on higher levels so that feeling fully on the higher level automatically has us feeling the earlier aspects of the feeling. Because of this we can over-react to events in adult life. As we see in our therapy, it may be one cause of erectile dysfunction—the feeling of being overwhelmed because of even slight pressure to function in the present. Or the inability to get going at work. 

So to summarize: there seems to be a time in gestation when pain or noxious stimuli impinge, but we are not yet able to produce our own gating chemicals, such as serotonin and endorphin, resulting in un- gated pain. When I refer to gating, I refer to electrochemical process that blocks the transmission of the pain message across the synapse. This residue will continue and may lead to bouts of anxiety later on in life. It becomes free-floating, unbound fear or terror. It can then be focused on elevators and a phobia is born. This is not due to heredity but rather to experience in the womb. Part of our in-utero life, therefore, takes on hurt at a time when the system can do nothing about it; nevertheless, it affects all later development. At 30, we may suffer from panic attacks that began its life in the very early months of our mother’s pregnancy. It is pristine, ready to spring forth whenever we are vulnerable. No talk therapy can make a dent in it because it involves a vegetative primitive nervous system which was adequate to register pain and terror during womb-life. This is a nervous system impervious to words; it doesn’t understand them and does not respond to them. So insights leave it absolutely indifferent. The womb experience leaves us fragile for a lifetime so that any insult or lack of love in infancy and childhood weakens us all the more. That is why we need drugs that work on lower brain centers below the intellectual in order to suppress these imprints for a time.

So much severe mental illness has its causes so early in our lives; and then nature later provides us with useless intellectual tools to address them. When all we have to do is let the primitive nervous system take charge and lead the way. It knows the path to liberation.

Tuesday, November 21, 2017

Thank you...

I would like to thank each and every one of you for your kind words that touched me deeply. It is comforting to see Art was able to touch so many lives.

He was indeed an extraordinary man and his development of Primal Therapy is one of the most important discovery in psychology as it is the only treatment that addresses pain from all stages of life, starting at birth, helping and allowing the patients to feel that pain, freeing them forever from its lifelong consequences.

Some of you have expressed curiosity as to what will happen to the blog. Unfortunately it will not go on as Art was the only one to write articles, but it will remain online so that people can go back to the old posts. You may not be aware that Dr. Janov started the blog in 2008 and you may not have read all the posts! We will be bringing older articles back up in the current blog.

 My best, 

Dr. France Janov

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.