Monday, March 19, 2018

On Drugs And Tranquilizers

(Originally published September 10, 2008)

The choice of tranquilizers or pain-killing drugs depends on very early life experience, even during womb-life. It is this fact that makes a cure so difficult to achieve; yet without delving down into the antipodes of the brain we cannot resolve the need for any kind of drugs, from cigarettes to alcohol to illicit drugs.

No one takes drugs chronically if there isn’t some lack in the physical system. An addiction, first of all, is not to alcohol or drugs; it is to need. (either trying to fulfill it or repressing it). We are addicted to fulfillment but because the critical period is past when need could have been fulfilled; we become addicted to substitutes. We are forced into seeking symbolic substitutes so long as the real need is heavily suppressed. And the urgency of the drug seeking is the same as that of the original need. The person is not only suppressing current pain but also the past pain which he or she may not be aware of. That is what makes addiction look like—addiction. The original need is sequestered and unreachable. 

Drug or alcohol taking is overt, something obvious, a behavior we can treat by redirecting behavior through, not so oddly, Behavior Therapy. It is something we can see and measure; so many months off booze and drugs equals a successful treatment, in their approach. The success is measured in terms of external behavior, not internal processes. Yet it is those internal processes that count the most in the use of drugs. Addiction most often results from very early painful imprints, even during womb-life. It is this fact that makes a cure so difficult to achieve; yet without delving down into the antipodes of the brain we cannot resolve the need for any kind of drugs, from cigarettes to alcohol to illicit drugs because, again, it is not the need for alcohol, it is THE NEED.

Since we needed love early on to stabilize the system, we must make up for its lack by taking something that does what early love would have done: with alcohol or drugs we feel warm, relaxed, untroubled and energetic. And, important, they are immediately available. All of these are temporary solutions; the only permanent solution is to have been loved very early on, or to feel the need and pain from that lack. That re-balances the system. Love in the present won’t do it, but feeling unloved in the past will. 

Our former speed (amphetamine) addicts cannot imagine taking speed when their systems are normal. Perhaps one may consider this a simplistic approach but behind these statements are many decades of experience and much new research that clarifies our position. For a bit more detailed explanation I am indebted to Myron Michael Goldenberg for his description of drug action.

("Pharmacology for the Psychotherapist."Accelerated Development Inc. 1990). 

We need to understand what addiction is and how it works. We need to know what we mean when we say that a drug binds to a receptor, which is how it may work to calm us.

For primal pain to be acknowledged it must arrive at conscious-awareness. If the message never arrives, if it is blocked by any one of the neuro-inhibitors we produce in our brains, we may feel a vague uneasiness, a tension or amorphous suffering, but we will not know what it is specifically. And we will go on suffering. The central aim of those inhibitors is to block too much information, too strong an emotional message from rising to conscious-awareness. When some of the message gets through there is active anxiety, symptoms and impulse-driven behavior. How does that happen? 

Receptors and Receptor Theory

Several theories exist on how drugs actually act in the brain and body. These are by (1) attaching to cells called receptors, (2) interacting with cellular enzyme systems, or (3) affecting the chemical properties of the outer cell membranes. (Goldenberg. Pages 36 & 37)

Many drugs are believed to combine with chemical groups within the cell or on the cell wall. These drugs combine with specific agents known as receptors. The theory is that these receptors actually attract the drug by having a molecular shape that fits with the drug. This is sometimes known as the "lock and key" theory. Think of the shape of a key that will only fit into a certain lock. When the correct shaped key and lock are matched up then the lock can be opened. The receptor theory is much the same. A certain shaped drug molecule is attracted by a receptor site on the cell wall. When the two shapes fit or line up together, the drug acts the same way as a natural body chemical does to set off a chain of events. The key here is that the drugs mimic what our body should have done if we were loved as infants or even before. What almost any drug does is somehow mimic what we should produce naturally. For example, the naturally occurring body chemical acetylcholine combines with receptors in the membranes of muscle and nerve cells that are chemically specialized to receive it. Certain synthetic drug agents can duplicate the action of acetylcholine by combining at the cell wall. These drugs are sometimes referred to as agonists. They boost the action of the cell. The antagonist, in this case atropine, competes for the receptor site which normally accepts acetylcholine. It says, “get out of the way. I will now take your place for the moment.” It will block or dislocate the normal physiological function. Why dislocate? Because the energy and its tendency still exist but must be diverted somewhere. It noses around finding another vulnerable place. The person acts out by overeating, is made calm by drugs, and then suffers from high blood pressure. Sometimes the attack site is not apparent until years later. 

There are drugs that can block the receptor site and interrupt its effect. If there is too much stimulation and we feel that we are about to jump out of our skin there are medications that can stop that stimulation. The pressure is so much from inside that we literally feel that we need to get out of our skin. It is the message lodged deep the nervous system that is doing it, mostly of not being loved or early trauma, a chronically depressed mother both while carrying and afterward, for example. Not being loved has always to do with not having needs fulfilled—from lack of oxygen at birth to lack of touch right after birth. There is a timetable of needs that form a critical window when they must be fulfilled. Once past that window needs can only be fulfilled symbolically. Feeling unloved cannot be eradicated in adulthood by more love. 

One way to rid of the feeling of being so anxious and agitated is to slow down or stop the transmission of messages between neurons (nerve cells) so that the message of pain (which stimulates) does not reach higher levels. We then feel calm even though a grand tumult is going on in lower brain centers. We never change the pain, only the appreciation of it. That is why we can take tranquilizers and pain-killers and feel good, but damage is still going on. No matter what we think or what we think we feel, it is an unreal state. In cognitive/insight therapy they change the way patients think they feel, not the way they really feel. To change the way they really feel means pain. If there is no pain there is no addiction or need for a drug that is calming.

The aim of therapy must be to establish fluid lines of communication among the levels of consciousness. This communication is a given when we have positive experiences from conception on. But when noxious stimuli--pain--intrudes, gating intercedes and blocks information between the levels. Communication is halted or misdirected, and one level doesn't know what's going on in the other levels. The true meaning of "holistic" is when all levels speak a common language and contribute their share to a single feeling. To make a patient whole is a desired goal so long as we know what that means in the brain. This is, grosso modo, the overall scheme, the goal of our efforts.

To be human means to be feeling. Inordinate, noxious input very early on provokes repression and blocks an aspect of feeling. Fully feeling beings are not blocked off from any aspect of themselves, that is, there is no massive gating that has sealed away major portions of brain function from access. Thus, each level of consciousness is able to contribute its share to an experience. This means being able to feel great joy as well as sadness. It means to sympathize and empathize. When a depressive tells us that he is not getting anything out of life, no interests, no joy, we know that he is carrying a load of repression and that repression is the underpinning of depression.

So what’s wrong with taking tranquilizers and pain-killers? Their primary job is to gate emotional pain. It keeps feelings unconscious. The result is that the cortex cannot signal emergency; thus keeping reactivity within bounds. The key here is that with pain-killers reactivity is blunted in order to save the system from massive over-reactivity (or occasionally, under-reacitivty). That reactivity, when enormous, can threaten one's life. This is what we see in our therapy when defenses are dismantled. Vital signs mounting to the danger area. Feelings are responding realistically to some unknown hidden force. If we do not acknowledge that force we are helpless before it. If we measure lower brain activity we will understand immediately; there is tumult going on below decks that we never dreamed existed. The ship is sinking; there is water below decks and we carry on as if nothing were happening. 

Quelling the deeper centers with drugs eases the so-called "thought" disorders. As our patients ease their defenses in a session, and great pain begins its march to prefrontal areas thinking centers, their cortex will ruminate about this danger or that until they actually lock into the feeling. In short, there is an anxiety attack as the system tries to stave off the approaching pain. Great terror pressing against cortical centers creates paroxysms of obsessive thoughts: "There's no space for me." "I am stuck and no one is helping." These often are birth statements. But because the actual feeling is so well buried, the person is left only with a vague anxiety. She will manufacture things to be afraid of but it is all a rationale. 

In the hierarchy of the nervous system the comparative force of imprints on the different levels diminishes as we move up the scale of evolution. Thus, something that happens at two months can alter the brain structure permanently, whereas if that same trauma, lack of touch, happens at age ten it will not produce serious brain impairment. There is clearly a timetable of imprints depending on the critical period; what characterizes the critical period is its irreversibility. Once the cortex is diminished it is not going to flower in adulthood. And the brainscans bear this out. There is less activity in the prefrontal area in certain impulse states. 

In our Attention Deficit Disorder research, hyperactive patients we have seen had elevated cortisol or stress hormone levels. (Our research in salivary cortisol, St. Bartholomew's Hospital, London) After reliving very early trauma, including the birth trauma, there is a normalization of cortisol levels. So dampening of pain is no longer necessary because the pain is gone—shorn of its original power it is now but a memory. 

Based on our own research, we can find no other explanation for chronically high cortisol levels other than the imprint. There is also a normalized brain system with a better balanced right and left hemispheres. 

We are all of one piece; part of an organic whole. Thus, we cannot isolate one factor, serotonin, or another factor, time off drugs, to make definitive statements about addiction. No can we attack only one aspect, lack of serotonin level, to achieve our goals. We need to attack the central organizing principle, and then the rest will take care of itself. The brain can no longer be considered an isolated organ encased in the cranium but must be considered part of an entire physiologic system. Thus, when the body is in distress, that distress can be found not only in the brain but in hormones and in the blood system.

It is our hypothesis that drug addiction is made up largely of early pain, i.e., lack of love, and that pain sets in motion its countervailing forces, namely repression. When repression is in place but faulty or failing, when the serotonin-endorphin systems are inadequate to the task, there is suffering and the need for outside help in the form of drugs to dampen that suffering.

Often the outside drugs utilized mimic the exact biochemicals we should produce internally, and that is what makes it so addicting; drugs are normalizing the system. We need them. We will go to any lengths to get them, even risking jail. The strength of internal imprinted pain can often be measured by its opposing forces--the repressive system. It is the dialectic again. Pain provokes its opposite and turns feelings into numbness. Then the person feels like she is in a bubble and cannot reach out of real life. It is all grey and dull. That is the price we pay for tranquilizers. Feeling no pain equals no life.

Monday, March 5, 2018

Turning Back Evolution

(Originally published September 4, 2008)
Primal Therapy is based on evolution. Further, it is also based on devolution. Are we nothing more than a time machine where we can visit our history in a precise way/ turning back the clock to a previously neutral non-neurotic state. Is that really possible? Scientists are now learning how to wind back the developmental clock—taking a skin cell, for example, and treating it so that it returns to a previously neutral uncommitted state. Once that is done it can be reprogrammed to become yet another kind of cell.

It is not such a big leap to apply that to humans, who after all, are but complex accumulation of microscopic cells. What may happen in our therapy is having patients go back and relive events that preceded and caused a neurotic deviation; going back to relive the great traumas, resulting in a return to a neutral state of internal harmony.Going back down the chain of pain to a physiologic memory of wellness and internal balance. It is evolution in reverse. We start out as a collection of uncommitted cells, finally resulting in a collection of different organs and brain neurons that have distinct and separate functions. In our therapy we go back and become our old shark/salamander selves (basic brainstem and limbic behavior). And then become our old Bonobo/chimp organism with its feeling brain, finally arriving at our late developing human selves. Those ancient brains still exist in all of us, performing different kinds of functions that finally add up to us humans. If we do not understand that we are made up historically of all those brains and focus only on the human thinking brain in psychotherapy, we can only get “well” in the thinking brain, excluding a vast treasure of lower brain experiences. In this way getting well on all levels of brain functioning is impossible. For example, we have found that high blood pressure and migraines often have pre-birth origins, imprints set down before we make our lives on this planet. If we do not address the brain that mediated life in the womb we cannot hope to make a profound change in these maladies.

If we want to eliminate ulcers and colitis we need to know where in the brain those responses are organized and return to that brain for cure. What we want to do is reprogram a neurotic brain system into a purer normal one. We want to lower brainwave amplitude and frequency to slower and lower levels, which we have done in our therapy. We cannot do that by making the thinking brain more active; the task is to make it less reactive while the feeling brain becomes more active. And now we know that the hyperactive prefrontal cortex can often be used to suppress the limbic/feeling output. So a busy intellectual brain can be seduced into thinking one is well, when all that has happened is self-delusion; a distanciation from feeling centers of the brain, and a flight to the thinking structures. In a psychotherapy based on language the most that can be expected is to run along superficial ideational tracks leading to other ideas, i.e., insights. The lower brains do indeed “speak” another language; and we must learn that language if we are to make deep, profound change. And obviously, we must not couch “cure” or “improvement’ simply in verbal language terms; we need to see what the body says about improvement. We need to measure the lower brain/physiological language, as well. It speaks in slower heart rate, in more natural killer immune cells and higher levels of serotonin. It speaks from experience; from experience mediated mainly by our non-human ancestors.

Not so oddly, new research is showing that as we search for an emotional memory our brains come to resemble the state it was originally. In other words, we go back to the brain originally involved in laying down the experience. We cannot do that so long as a therapist’s brain along with your brain is engaged in a badinage regarding present day events. We need a therapeutic setting that encourages reflection and introspection.

So what does devolution in therapy entail? It means, first and foremost, not to skip evolutionary steps. It means beginning in therapy with the most recent traumas and letting the vehicle of feeling carry us back in history to related earlier events. It means that in therapy we begin with the late brain neocortex and work back over time to preverbal life. It means not getting to infancy and pre-birth events until far into therapy. There are those who are re-birthers who help patients down into birth traumas long before the system can integrate them. The result is abreaction, going through the emotions of feeling without its full emotional content. It means descending down the chain of pain slowly and in ordered fashion, integrating feelings on each level. It means a basic understanding of neurophysiology so that therapists know what to expect on each level visited by the patient, and do not provoke a patient to verbally express a non-verbal feeling. It means knowing when a patient is ready for the experience of a deep early feeling, and when she is not ready. And above all, it means recognizing what a birth imprint looks like and what reliving it looks like. It means carefully titrating vital signs and seeing how they are affecting the whole organism.Finally it means not pushing patients to go somewhere when they are not ready.Reliving birth trauma and pre-birth trauma is not arrived at until late in therapy. For example, deeply depressed patients usually begin therapy in deep hopelessness and very low body temperature. We need to understand how to normalize that state and what kind of feelings the patient can accept. There is hopelessness on all levels commensurate with different brain systems. We may need to avoid deep level hopelessness until later in therapy.
When we finally arrive at birth events late in therapy we become more and more able to live in the present. That is what is meant by revisiting and reliving the past to insure the present. The deeper we go in history the less it has its grip on our current life—a pure dialectic. Therapies that focus on the present only insure that the past will remain entrenched. That is the meaning of freedom—to be liberated from our history.

Sunday, February 18, 2018

On Appearances and Essences

(Originally published September 4, 2008)

Another way of looking at the difference between awareness and consciousness is that of appearances versus essences—of phenotype (appearance) versus genotype (generating sources). An approach of appearances is always individual while that of essences is universal, generating universal laws. Essence is stable while appearances are transient. Essence is historic; appearances are ahistoric. Essences are few; appearances are multitudinous – meaning an endless therapeutic search down the most complex, labyrinthine behaviors. Essences lead to consciousness, the confluence of lower centers with frontal cortical structures. Appearances lead to awareness without consciousness. Essences necessarily mean the understanding of concrete contradictions between the forces of pain and those of repression because that is the essence of the problem of neurosis. Essences mean dealing with quantities of hurt leading to new qualities of being. It means dealing holistically and systemically. Appearances mean fragmentation of the patient, isolation of her symptom from herself; treating the apparent. Progress in psychotherapy is couched in terms of appearances instead of essences; and therein lies the rub.

The reason the Freudians and other insight theorists do not generate universal laws is because they focus on appearances and not essences, on fragments not systems. I should say that sometimes they do posit general hypotheses but invariably they cannot be tested and verified because they have no scientific base. It is very difficult to compose a universal psychologic law from individual, idiosyncratic behavior that applies to one person only, or from an id or dark forces that no one can see or verify. Cognitive approaches seem to superimpose psychologic laws on humans—on (their) nature. By contrast, we believe that through careful observation we can discover the laws of nature and apply them to humans; after all, they derive from humans. Biologic truths are of the essence.

In Primal Therapy, we make every attempt to meld our observations and our own research and current neuro-biologic research. We do this by not having too many preconceived ideas about the patient, and maintaining an empirical attitude. We do not treat each symptom as an isolated entity to be eradicated. Rather, we know that there is an ensemble of symptoms tied together by something that links them. That “something” is what we must get at in therapy; it is of the essence. Thus, we need to see the whole, not fragments of behavior. To see the whole we need to investigate history which is the context for its understanding. We need to look beyond a phobia of elevators and see historic events (put into an incubator at birth, perhaps) that gave rise to it. The minute we are bereft of history we are devoid of generating causes, and therefore essences. We remain in the dark.

The Freudians claim to have a deep dynamic therapy but they stop at plunging the patient into old, infantile brains where solutions lie. They too rely on the here-and-now, on current ideas about the past. Reliving the past and having an idea about the past are not the same thing. One is curative; the other is not. One involves awareness, the other, consciousness. Even tears in psychoanalysis are derivative. There is crying about in their therapy: the adult looking back on her life and crying. But it is not the baby crying as that baby, needing as that baby, something deep that is beyond description that can go on for an hour or more. In “crying about,” there is never the infant cries that we hear so often in our patients—a sign of a different brain at work, a different brain system solving its problems in its own way. The patient in the here-and-now, ego-oriented therapies is walking around in his history while the therapist is focusing on the present. He may be physically present but his emotions are in the past.

What we discover about the cognitive/insight therapists and especially the televangelist psychologists is that they embrace old homilies, morality, and religious ideals that are in the zeitgeist, mix them into some kind of psychological jargon, and deliver them with a folksy air of, “I know what you need.” Too often it all amounts to: Get Over It! And we all shout, Yeah! For we too think others should just get down to business and stop whining. That is the George S. Patton syndrome. Develop a positive attitude and you won’t feel like such a loser. But it’s hard to feel that you are capable and can succeed when you have spent a lifetime with parents who reminded of what a failure you are.

Every insight therapy has the implicit base that awareness causes improvement. It is founded on the notion that once we are aware, we can make necessary changes in our behavior. Awareness can make us aware, and that is a positive step. But it cannot change personality, which is organic, and it can never make us conscious. We can be aware that we are too critical of our spouse. Maybe with effort we can stop that behavior. But if we understand the concept of the imprint, then we know that anything that doesn’t directly attack the imprinted memory cannot make a permanent change. We can be aware that we are working too hard and neglecting our family, but when there is a motor inside driving us relentlessly, that awareness is useless. Ideas are never a match for the strength of the brainstem/limbic forces, which, I remind the reader, have everything to do with survival. There is always a rationale for our behavior: “I have to be gone and work hard to support my family properly.” We have applauded this kind of neurosis in our culture, which adores hard work, ambition, and relentless effort. Being driven is about the most widespread of neurotic forms. If only we knew how to finish the equation: being driven by . . . (Answer: need). Translation: I was not loved in my infancy and I am in pain, which drives me incessantly. And besides, I can’t stop because my imprint at birth was that to stop was to die. I have to keep going to keep from feeling helpless, that there is nothing I can do. Those are the truths we find when we feel our imprints—the truths that when felt will stop our drive and allow us finally to relax.

Why is cognitive therapy so widespread today? To a large extent because it is far easier and quicker (and cheaper) to change an idea than a feeling. Insight and cognitive approaches tend to appeal to those in their “head”; this applies to both patient and therapist. Neither the patient nor the therapist is likely to realize the amount of history we are carrying around and how that affects our thinking. How else could we possibly ignore the horrendous things that happen to our patients in their childhood? Nowhere in the cognitive literature have I seen a discussion of basic need as central to personality development, of why the person cannot put the brakes on impulsive behavior. As I have mentioned, the ascending fibers from down below, starting from the brainstem and the associated limbic networks, alert the cortex to danger; they are more numerous and stronger and faster acting than the descending inhibitory fibers, which as we know come later in evolution. Here in purely neurologic terms do we see how feelings are stronger than ideas.

An early lack of love means that there is an even further degradation of these descending inhibitory systems, not only because of cortical weakness, but also because the limbic-amygdala forces holding the imprint are enormously powerful and are importuning the cortex to accept the message. The engorged amygdala is figuratively bursting at the seams to unleash its load of feeling. The dominant direction it can go is determined by evolution—upward and outward, impacting the frontal cortex. There is only one direction that repression can travel—and that is downward, to hold those feelings back. Ideas can help in that job just as tranquilizers can. I suspect that therapists who practice therapies that deny history, and deny imprints and biology, are drawn to such therapies, ironically, as a function of their own history. So long as the connection is poor and access impaired, the therapist is open to any kind of ideas that appeal to him intellectually. And what appeals to him intellectually is what is dictated by his unconscious. And that means that he might choose a therapy that operates on denial, such as the cognitive, because he operates on denial. He makes therapeutic choices that obey this dictum.

If a therapist, unconsciously, has a need for power, he is apt to dictate to the patient; it may be directions for living, relationships, choices, and, above all, insights. He will impose his ideas, his interpretation of the patient’s behavior. What he says will become the most important in his therapy instead of what the patient feels.

If the therapist has the need to be helpful and get “love” from the patient, he can act this out in therapy. I remember feeling my need to become a therapist and be helpful, trying symbolically to help my mentally ill mother to get well and be a real mother. No one is exempt from symbolic behavior. And it is certainly more comfortable for a patient to act out his needs and get them fulfilled (symbolically) in therapy, and imagine he is getting somewhere, than to feel the pain of lack of fulfillment. It is understandable that the idea of lying on a matted floor crying and screaming doesn’t appeal to some. Pain is not always an enticing prospect. Thus, the cognitive/ insight therapist can be similarly deceived and entangled in the same delusion as his patient: both getting love for being smart. It is a mutually deceptive unconscious pact.

Any time we are not anchored in our feelings we are up for grabs; any idea will do. It is good that the left frontal cortex is malleable, but bad because it is too malleable. It is the difference between having an open mind, and a mind that is so open as to be a sieve. The difference is having a left frontal cortex open to the right brain versus a mind too open to others and their suggestions precisely because it is not open to its better half. That is why a scientist can understand a great deal about neurology but practice a therapy that has nothing to do with the brain, which I have seen time and again—the bifurcation of consciousness. What he or she knows scientifically does not translate to the other side of the head because of disconnection or dissociation. He/she may be utterly aware and utterly unconscious.

In appearances, the therapy remains pretty much the same no matter what is wrong. The Freudians have a certain take on development and pathology. They will follow that irrespective of what is wrong with the patient, and it all adds up to insights and more insights. Other therapies specialize in dream analysis. They go on doing that without any proof of its efficacy other than patient reports. There are no physiological measurements. They neglect the fact that experience is laid down neuro-physiologically, not just as an idea; they neglect essences.

Think of this as magic: Take a tranquilizer and we can sleep better, avoid sleep problems, hold down acting-out, stop feeling anxious, be less aggressive, less depressed, stop bedwetting and premature ejaculation, and stop using alcohol and taking drugs. One specific pain pill can accomplish this universal task. Why? Because the essence, pain, is behind all of those disparate symptoms.

Pain will always remain pain no matter what label we pin on it or how we choose to deny it. Whether we feel ignored or humiliated or unloved, the pain is the same and processed by the same structures. The frontal cortex gives it different labels and we act out differently, but the centers of hurt treat them the same. Isn’t it strange that we use the same tranquilizer to ameliorate depression and children’s bedwetting? Maybe it is all one disease with different manifestations, and when we attack the generating source with drugs, all of the manifestations disappear for a short time. We need to learn from Prozac the most obvious lesson: It blocks all manner of symptoms. Therefore, if we, too, in a feeling therapy attack orchestrating forces, we can block and eradicate all of those different symptoms. Notice also that it is a nonverbal medication that slows down ideational obsessions. It tells us about the relationship of lower centers where there are no ideas to higher level thought processes, which deal with ideas.

In an anti-dialectic approach, which is that of appearances, there is no central motivating force. There is no struggle of opposite forces that move and direct us. It all remains on the surface—static. And because the approach does not contemplate the deep conflicting forces motivating us, there is no reason to delve into the patient’s history. It is all non-dynamic. Treatment based on dialectic principles means that there can be no ego or mystical forces that arise out of the blue, containing a mechanical, hereditary “given.” When the dynamics are left out, the therapy has no alternative but to be mechanical.

Because of an unloving, traumatic early childhood, a person cannot put the brakes on the amygdala or brainstem structures because he hasn’t the neurologic equipment; there is an impaired prefrontal cortex that does that. The cognitivist adds his frontal cortical weight to the patient so that their ideas, welded together, help control underlying forces. “You are strong. You can succeed. I will help you try. You just think you’re a loser but you are not. You are really a good person, not the evil one you think you are.” We see this in an experiment reported in a 2002 journal of Nature where electronic stimulation of the prefrontal cortex prevented rats from freezing up after they had been conditioned to do so at the sound of a tone (the one was paired with an electric shock). (FOOTNOTE: Nature (Nov. 7, 2002) When the therapist and the patient combine their thoughts in an insight session, it is no different from an electronic stimulation of that area. In short, it blocks the experience of terror and pain.

How is that psychologic notion different from the religious? The difference is that psychologists do not use the word evil; they call them negative forces. Shrunk to size, they are the same thing. And of course, the mass of current television psychologists are really televangelists in psychological clothing. They have wide appeal because they combine current religious precepts with psychologese (think Wayne Dyer). It doesn’t challenge anyone; it only confirms their prejudices. It offers cachet to them.

Then there are the drug therapies. Patients are given a variety of drugs for almost any condition. Talking to the patient is secondary. Patients are anxious—one type of drug. They are depressed—another type of drug. And, often the drugs have the same effect on the brain: killing pain. And if the drugs we give to patients do not work, we raise the dose. And if that doesn’t work we change drugs. Meanwhile there is no attempt to find out and address why they are depressed. Though we are trying desperately to find genetic causes, depression is not a necessary part of the human condition. 

A recent newspaper article described a woman who is suing her psychiatrist because her husband was suicidal and his doctor kept changing his medication. She said that it made him worse. The doctors were relying on appearances, not essences, and were possibly misled. She claims that no one talked to him. Here is a case where even a little talking and some sympathy would have helped. There is a place for it. Maybe drugs weren’t the answer. This approach saves the bother of having to deal with the patient’s history and his early life. It saves the troublesome effort of talking to the patient and feeling for his anguish. Just that, feeling something for the patient, can convey empathy and can be therapeutic.

Treatment that primarily involves giving drugs considers the patient as a “case.” There is no personal interaction after a few cursory questions. “Tell me about your symptom but not about your life. Tell me about it, not about you.” I have been in that position as a patient, seeing doctors who treat me as a “case.” It is not comforting. But then there are the economics. Seeing many patients every hour makes it difficult to empathize or to even know much about the patient. After filling out a long questionnaire, we find the doctor entering the treatment room scanning the file, unable to really take in the essentials about us. History is another victim in current therapy, both medical and psychological. Today, psychiatry has become an arm of the pharmaceutical industry. They tell us what drugs work and we use them. The insurance companies won’t pay for us to delve into the patient’s history, to take our time to find out about her. They pay for immediate results. The conclusion: We develop new therapeutic theories to accommodate the idolatry of the here-and-now intellectual, drug approach. We have ceded our integrity for pay. We don’t do it consciously, but we don’t feed our families if we don’t accommodate to the new reality.

Of course, cognitive approaches are ideal. Tell the patient, in essence, “get over it” and “thank you for coming.” In the new zeitgeist, the aim of cognitive therapy is to get the patient over it, not to understand basic dynamics. What is basic in man is his reservoir of pain and how it drives him to behave. Once we neglect basic need, we are thrust into awareness because it is the beginning and end of consciousness. We cannot see the reservoir when we focus solely on awareness. Therefore we cannot see the reason so many people on are drugs, both legal and illegal. We try to stamp out the need with words, but we will lose that war because need is stronger than anyone or anything. It will not remain suppressed. No one is stronger or brighter than her need because need is inextricably intermeshed with survival, and survival reigns. If we want to stop the demand for drugs we must attend to basic childhood needs, starting with the way we perform childbirth.

Thursday, February 1, 2018

The Difference Between Awareness And Consciousness

(Originally published September 4, 2008)

The leitmotif of every intellectual therapy is that awareness helps us make progress. I’ll grant that awareness helps; but being conscious cures. Unless we are able to achieve consciousness in psychotherapy, the most we can do is tread water, having the illusion of progress without its essence.

When it comes to measuring progress in psychotherapy, it matters whether one measures the whole system or only aspects of brain function. Awareness fits the latter. It has a specific seat in the brain— Awareness and consciousness are two different animals. “Aware” and feelings lie on different levels. Awareness is what we often use to hide the unconscious; a defense. Awareness without feeling is the enemy of consciousness. What we are after is the awareness of consciousness and the consciousness of awareness. Not the awareness of awareness. When the patient is uncomfortable during a session, therapists typically take the position that “More insights is what we need. She is not aware enough.” But it is not the content of those insights that helps; it is the fact of the insight—a belief system that aids the defense mechanisms to do their job. Yet, what lies on low levels of brain function is immune to any idea. We can be anxious and aware but not anxious and conscious.

Psychotherapy has been in the business of awareness for too long. Since the days of Freud, we have apotheosized insights. We are so used to appealing to the almighty frontal cortex, the structure that has made us the advanced human beings that we are, that we forgot our precious ancestors, their instincts and feelings. We may emphasize how our neocortex is so different from other animal forms while we disregard our mutually shared feeling apparatus. We need a therapy of consciousness, not awareness. If we believe that we have an id stewing inside of us, there is no proper treatment because the cause is an apparition—a phantom that doesn’t exist. Or worse, it is a genetic force that is immutable and therefore cannot be treated. In any case, we are the losers.

There is no powerlessness like being unconscious; running around in a quandary about what to do about this or that, about sexual problems, high blood pressure, depression, and temper outbursts. It all seems like such a mystery. The aware person or he who seeks awareness has to be told everything. He listens, obeys—and suffers. Awareness doesn’t make us sensitive, empathic, or loving. It makes us aware of why we can’t be. It’s like being aware of a virus. It’s good to know what the problem is but nothing changes. The best awareness can do is create ideas that negate need and pain.

Awareness is not healing; consciousness is. True conscious-awareness means feelings, and therefore humanity. The conscious person does not have to be told about his secret motivations. He feels them and they are no longer secret. Consciousness means thinking what we feel and feeling what we think; the end of a split, hypocritical existence. Awareness cannot do that because awareness has to change each and every time there is a new situation. That is why conventional cognitive/insight therapy is so complex. It has to follow each turn in the road. It has to battle the need for drugs and then battle the inability to hold down a job and then try to understand why relationships are falling apart. This also explains why conventional therapy takes so long; each avenue must be traversed independently. Consciousness is global; it applies to all situations, encompasses all those problems at once. The true power of consciousness is to lead a conscious life with all that that means: not being subject to uncontrolled behavior, being able to concentrate and learn, able to sit still and relax, being able to make choices that are healthy ones, to choose partners that are the healthy ones, and above all, to be able to love.

By and large, “awareness” is left brain, but that does not necessarily mean language. Conscious-awareness is right-left brain working in harmony. Incidentally, a study out by two psychologists at UCLA, Eisenberger and Liberman, found that people who experienced less discomfort had more pre-frontal cortex activity. (FOOTNOTE: N.I. Eisenberger and Matthew D. Liberman, “Hurt Feelings,” Los Angeles Times, Oct. 11, 2002, page A16) Again, higher centers are able to suppress and calm the lower ones. They also found both physical pain and emotional pain use the same pathways in the brain. In brief, pain is pain no matter what the source—emotional pain is physical. It is not just in our minds; it is not just psychological and cannot be treated on the psychological level alone.

We know that when there is awareness without connection during a session—it is known as “abreaction.” The vital signs rise and fall in sporadic fashion, rarely below baseline. This is what often happens in the pseudo primal therapies where patients are told what and how to feel. Here the vital signs do not move at all. It is why we measure vital signs before and after each session. We measured a new patient who had mock primal therapy. He went through early feelings that looked real. His vital signs never changed, indicating an energy release but no connection. So long as there is no connection, nor a shift in brain processing from right to left, there will be no commensurate change in physiology.

This is not to be confused with appropriate emotions where a person is expressing anger over an injustice or grief due to the loss of a loved one. Those are appropriate feelings, not neurotic.

The right limbic brain/brainstem is responsible for a great part of our arousal, while the left-frontal brain is the calming agent. When there is hyper-arousal due to brainstem/ limbic unfulfilled needs and memories, the left orbito-frontal cortex can help dampen that arousal and produce a false sense of calm. This is one key element in cognitive therapy. Indeed, as I pointed out, one reason for the development of the left brain was to help in the repressive process; keeping enough pain at bay to allow us to function in everyday life.

It is my experience that the wider the gap between deep feeling and awareness, the greater the unreality of the belief system; the more remote the feeling, the more far-out the belief system, and the more tenacious its hold on us. We had one patient who was fixated on aliens coming from another planet to attack her. After many lesser-strength feelings, she finally felt what those aliens were—her alienated feelings; unknown terrors that she converted into attacking aliens. She needed to justify or rationalize her fears. Because they were so monumental, her beliefs soared into the bizarre area.

Consciousness is the end of anxiety. Consciousness means connection to what is driving us. Disconnected feelings are what drive us constantly to keep busy. Their energy is found in the form of ulcers or irritable bowel, in phobias and the inability to focus and concentrate. They are the ubiquitous danger, shaping a parallel self—a personality of defenses and the avoidance of pain; a self stuck in history forever. In effect, there is a parallel self, the unreal front; and the real self, the one that feels and hurts. Thus, there are parallel universes that make up the human condition; one that feels and suffers, the other that puts on a good front. The latter, the front, is what most psychotherapy deals with: the psychology of appearances versus essences. It is navigating in the wrong universe.

Awareness means dealing with only the last evolutionary neuronal development: the pre-frontal cortex. It is the difference between the top level versus the confluence of all three levels, which is consciousness. Once we are conscious, we have words to explain our feelings, but words do not eradicate them; they explain. We are deeply wounded long before words make their appearance in our brains. Words are neither the problem nor the solution. They are the last evolutionary step in processing the feeling or sensation. They are the companions of feelings.

There are types of awareness that are important for our survival. Being aware of a healthy diet is crucial even in the absence of consciousness. But a therapy of awareness versus one of consciousness has an important difference in terms of global impact. In science we are after the universal so that we can apply our knowledge to other patients. A therapy of needs can apply to many individuals (we all have similar needs); a therapy of ideas usually can only apply to a specific patient. When we try to convince the patient of different ideas (e.g., “People actually do like you”), we generate no universal laws. It is all idiosyncratic. But if we address the feelings underneath, we can generate propositions that apply generally: for instance, pain when unleashed can produce paranoid ideas or compulsions. Or, the frontal cortex can change simple needs and feelings into complex unrealities, changing them into their opposites.

One cannot be aware without an intact prefrontal cortex. By contrast, there is no seat of consciousness. As banal as it may seem, consciousness reflects our whole system—the whole brain as it interacts with the body.

Monday, January 22, 2018

Why We Over-React

(Originally published August 27, 2008)

It always seems like a mystery when we see ourselves or someone else react inordinately to some some event.. But it is not overreaction; it is that we are reacting to things we cannot see. Once we lay bare the feeling or event that caused the reaction it all makes sense; it is then reaction not overreaction.

Let me explain. When something happens in the present it triggers off related feelings or memories on lower levels of consciousness—in the unconscious. It is what I term “resonance.” (It may be that the nerve or neuronal circuits have the same frequency so that when one feels neglected or ignored it sets off memories of the parents neglecting us and we “overreact” to the slight in the present). It seems like an overreaction but it is not; what we are reacting to is just hidden from sight. That same feeling can resonate with being ignored in infancy; (no one comes when the baby is crying in the crib). What seems to be happening is that the synaptic weight of the memory is commensurate with the valence of the very early painful imprint. Each level of consciousness contributes its share to the total feeling that will coalesce to produce a unified, cohesive neuronal circuit, finally offering meaning and power to the event. It is that meaning/power that can drive one to kill when a girlfriend leaves her lover—“I feel abandoned (by mother). I can’t live without her.” Murder is clearly an overreaction but when placed in context we can at least understand it. Think of present-day trigger as a dredge that digs deeper and deeper widening access to the most powerful and remote memories. That dredge goes where the feeling leads it. It seeks out related events associated by feeling. 

Although the resonance/frequency connects all the top and lower level circuits the weights of the memory are not the same. The valence of some memories is greater than others and become more powerful as we descend down the chain of feeling to the level of birth memories or even to events in the womb. 

The deeper circuits provide the impulsive, importuning force for some of our uncontrollable behavior, forcing us to “overreact”. We will scream and yell or even punch someone. The point is that when we approach the lower levels of imprinted pain we are also approaching the shark brain with all of its possibility for murderous rage. In my experience it is very rare that events in childhood can trigger off anything more than terrible anger and tantrums. In other words, when we start off life with heavy trauma at or before birth our later criminal/psychotic tendencies are given a boost and are better understood. Since those memories are so remote and sequestered we usually have no access to them; thus our current reactions remain a mystery. So something in the present sets off a gathering of these weights on each level which ultimately merge under the rubric of a feeling. The deepest levels of brain organization engender the most heavily weighted memory; it has to be because on that deep-lying level lives our survival mechanisms. On that level lives life-and-death events that require life-and-death reactions, including rage. It is the level we can only arrive at after one has integrated smaller less life-endangering events. The need to be picked up just after birth is primordial. That thwarted—unfulfilled need can turn into rage. Or at least it can be the trampoline that adds volatile fuel to the mix later in life. We can judge from someone’s behavior how deep the memory/imprint is. If there is uncontrolled rageful, violent behavior we can be fairly certain that very early imprints, often during gestation and around birth, are behind it. In short, anger has levels. The most recent causes would not involve murderous behavior. But when coupled with traumas on even lower levels it can adumbrate into violent tendencies. It is when a current mild event sets off exaggerated reactions that we know how deep the imprinted painful memories go back. And when I discuss behavior it can also encompass symptoms—raging or violent headaches, for example. I had a patient who suffered from migraines. She took aspirins for it, and called these pills her little bullets. It is pretty clear symbolism.

In most current psychotherapies the focus of each session is the act-out of the feeling rather than on the feeling/need itself. This analysis of the by-ways of behavior is an interminal task, skimming the surface reactions. Focusing on the deep internal imprinted reality finally makes it all have sense. The problem is that we cannot approach that deep-lying force with words. We must speak the language encased in our most primitive nervous system. It is for this reason that psychotic rage cannot be treated with conventional psychotherapy. Thus a slight misunderstanding can provoke a massive outburst of behavior. In order to make a dent in our raging behavior we need to delve deep in the brain and its unconscious where the organization of rage gets its start. We can see why it is not a good idea to plunge people in remote and painful memories in psychotherapy because the system is not ready to integrate them. The patient will tumble into overload and the result is a scattered, dysfunctional human being. lost in symbolism. It is also not a good idea to keep all focus on the present when there are icebergs of feelings lying deep ready to disrupt our forward progress. In my patois,severe overreactions are when third line current events set off first-line, brainstem reactions. The feeling may be identical on all levels of brain function but their driving force is quite different. There is no way that a here-and-now behavioral approach is going to solve deep-lying historical tendencies.

Friday, January 12, 2018

Why Most of our Lives is a Rationale For The Imprint

(Originally published August 21, 2008)
We think we are rational beings driven by rational thoughts toward rational ends, but we are basically irrational beings driven toward a rationale, and that rationale is to justify the fact that we are being driven beyond our control.

Let’s start with the imprint. There are events very early in life, even while being carried in the womb that are engraved into the total system—blood, muscle, joints, brain and nerves. They happen when certain needs must be fulfilled and are not. How we react to that event becomes a prototype and determines our reactions, in part, thereafter. The prototype is an adaptive mechanism in the service of survival. It endures because it is the first major adaptation in life and helped us live. To do that there had to be compensatory behavior, dislocations of function that also endures. The dislocations endure as a necessity for the fact that the imprint is indelibly impressed into the whole system. So, for example, the serotonin inhibitory system may be compromised, and becomes deficient. Or the thyroid secretion may be diminished. There is always a compensation and dislocation, and that occurs in the most vulnerable areas, places where genetics may play a part. The imprint prevents the physiologic system from functioning normally, all because basic need is not fulfilled. When there is insufficient oxygen in the womb or at birth it is impressed. And when all that occurs before birth the dislocation of function will endure for a lifetime; the pre-birth system is not equipped to make up for lacks. The post-birth system is.

Now the imprint, by definition is early and remains in the deep unconscious. Yet it has the force of survival. A pretty hefty force. What it does is create behavior, external (act-out) and internal, (act-in) that still attempts fulfillment of those basic needs. That is why we are driven by it. And we need to make those behaviors rational; hence we develop rationales for what we do. Remember that I wrote about an experiment where in a split brain experiment the scientist input stimuli on the right side. The left brain had no idea what had happened yet to justify his behavior he needed to develop a rationale: “I am laughing because of your funny white coat.” That is the basic paradigm I am discussing. We have input from the right brain input (the emotional brain stores many of our imprints). Then due to repression and the inability to access our feelings we need to “explain” our beliefs and behavior. Once we get access to that brain we are no longer driven by the unconscious and are finally in control of ourselves.

Example: during the birth process there is no help. The baby is drugged by the anesthesia given to the mother and cannot help out to get born. It is “all too much”---the imprint. Even when there are no words to describe it is still imprinted. Much later when we have words and concepts we will put an explanation to it; but it will always be inadequate because until we arrive there we have no real idea what the feeling is that is driving us. Later, with parents who won’t help the child, who drive her to accomplish and do, the feeling is reinforce—there is no help. The feeling is also, “I have to do it all on my own.” It seems “right” to the person not to ask for help (and therefore not to get it). Not asking for help means “doing it all on my own.” And this is due to a feeling and need that is unconscious, deeply buried out of sight of conscious/awareness. Another example: a pregnant mother is depressed and drinks coffee constantly during pregnancy. She is low on many of her hormone levels. The baby is being over-stimulated. He cannot combat this input: “nothing I can do will make a difference.” At birth being drugged by painkillers given to the mother and again, “nothing I do will make a difference,” In college he drops out because it is too much and it seems like no matter what he does it is not enough. This has been compounded by parents who never praise, always criticized, and the child cannot please no matter what he does. He gives up easily because at birth the drug stopped all efforts; later he gave up because no one cared that he tried and did good, and now he is married to a hyper-critical wife who never lets up. She calls him a “loser.” He has no idea where the base of all this is; he just keeps giving up in the face of adversity, doesn’t even try for approval because inside he is sure it will never come. In a self- fulfilling prophecy he does become a loser. He is sexually impotent because the minute there is excitement he loses his drive and his will. Nothing he will do will turn out right. Total defeatism.

Another example: a child is born after a mad struggle to get out. He has learned aggression as a key mode of behavior. His passive parents give into him because he is so assertive. He takes on chores that are very heavy and he does not recognize real obstacles in his way. He does too much and does not know when to back off. To give up is to die, in his physiologic equation. He pursues a woman who really does not want him. He cannot see that because he has learned aggression as a survival technique. He thinks the woman just needs coaxing, but he does not know when to stop.

In these cases the left prefrontal area is just a large rationale-concocting apparatus to keep behavior ego-syntonic— comfortable to the self. It also keeps the feeling unconscious and unexamined.

A child with the same birth configuration as above is left feeling all alone—no one to help. His parents are emotionally distant and he learns to be alone. Right after birth there was a sick mother so that he was not cuddled right after birth. He grows feeling alienated, keeps himself removed from others and doesn’t notice his isolation. He is acting-out “all alone.” The force comes from birth and before, the emotional focus comes from how life experiences channels him. He is slightly reserved and not cuddly, so he gets less love. He can rationalize this how he wishes but he is still victim of his imprint.

The imprint endures for a lifetime. It is stuck in the need— unfulfilled mode. It can only be undone when it is no longer useful. What does that mean? It means that so long as the load of pain is inordinate and needs repression the imprint goes on. But when we feel the original need in context with all of its emotional force it no longer serves any purpose and is done with. To get there we need to take a slow, orderly descent down to origins; but not before we have felt the top level portion of it. We need, in short, to feel and integrate the least noxious part of the feeling first. Third-line (current) pains are rarely if ever life-threatening. As we descend down the brain we come to pains, such as a lack of oxygen at birth, that are life endangering. If we go below that top level part and plunge into the lower level pains it will all be too much to integrate. Suppose we have a level ten childhood/infancy pain lying below a level ten adult-level pain. The level twenty is too much to integrate. But if we have felt the top level pain first and then go lower the overall level will not be too overwhelming. Whenever we try to relive very early pains without seeing what lies on top we are bound to fail. Our gating system is masterful; it allows us to feel just enough and not so much as to be shattering.

Our act-out is just as unconscious as the feeling living inside of us. We are driven by the imprint until we are free from it. Then we are in the driver’s seat. It is the difference between being driven and driving. We will no longer be passengers on our worldly peregrinations.

Thursday, January 4, 2018

A New Paradigm for Psychology: Revolution in Psychotherapy

(Originally published August 15, 2008)
In over one hundred years of psychotherapy very little has changed, except cosmetically. It is still the fifty-minute hour, the sit-up face-to-face-talk with a plethora of insights swaddled in the gentle and dulcet tones of a concerned therapist. There is still the evasion of the unconscious as a place of ill-defined demons—something to be avoided at all costs. No one says it, but it is implied in the careful steering the patient into the present and away from the past. The Freudians now call it ego-psychology but it is still psychoanalysis with a slightly different focus; an habiliment—antique get-up with a modern facade. Sadly, in the name of progress they have moved away from the past into a more present approach. The same is true for all of the cognitive/behavior therapies. There is an apotheosis of the present, of the here-and-now, and a move away from the one thing that is curative--history. We are historic beings, imprinted neuro-physiologically with our past. Any proper treatment must address that history.
Thus far, we have been talking to the wrong brain! Unfortunately, that brain doesn’t talk, doesn’t understand English and, as a matter of fact, doesn’t understand words. The correct brain is one that contains our history, our pain; the lower brain that processes our deep feelings that can finally liberate us. It does understand feelings; we need to speak that language—one without words. No one can be cured until we understand the profound underpinnings of emotional and mental illness. Words are the province of the top-level neocortex, evolved much later than the feeling brain. There is a lifetime of experience buried below that top level that governs our behavior and the development of symptoms. Therein lies the rub. For it means flouting the warning about plunging patients into the deep unconscious, an unconscious, they implore, that will irrevocably disturb the psyche. And it is this caveat, among many equally wrong, that have kept the practice of psychotherapy in the dark ages, literally, believing there are dark forces that propel us here and there beyond our control.
Psychotherapists often bow to history but only as a token. Yet history, the patient’s past, is medicine, and it is the only medicine that is curative. The past is a duty for the therapist; without it we are again in the old psychotherapy of the early 1900’s. Can we imagine any other branch of medicine still in the grips of the science of 1920? Freud wrote his major, “Interpretation of Dreams,” at the beginning of the last century. Surely there is a bit of progress since then.
Once we have a firm grasp of history and its evolution we will know that addressing mental illness is not a matter of just understanding it but being immersed in it; submerged in our history, in its feelings, ceding to its power until words (our top-level brain) will no longer suffice; only feelings can. Words will simply not do it; in fact, words are the antithesis of cure, inimical to any therapeutic progress, as odd as that sounds, because they are too often used for a defense. As a matter of fact, in many situations the more the intellectual brain is active the more suppressed the feeling centers are.

I practiced Freudian-oriented psychotherapy for many years. One key reason was that there was relatively nothing else for the practice of dynamic psychotherapy. At least Freud posited an unconscious, and were he alive today I am sure he would not be a Freudian.
Let me start with my first important observation in therapy. A young man in conventional group therapy was recounting a visit he made in New York to see Raphael Ortiz in the theater of the absurd. He said that Ortiz was marching up and down the stage shouting mama! And inviting the audience to do the same. When they did many people in the audience began to cry and scream. I encouraged this young man to do the same. He refused but I insisted. Finally he began to scream mama!, fell off the chair and was writhing in pain on the floor. It went on for a half hour, something I had never seen before. When he came out of it he touched the carpet and said, “I can feel!” He felt different. I taped this session and for years afterward I listened to it to see what secrets this held. I also tried this again on other patients with very much the same result. I knew that I saw something that therapists practically never see but I did not know what it meant. I finally figured out what it meant only years later. I tried to see what these patients had in common. It was feelings—access to feelings that made the difference. It would take another twenty five years to figure out what was going on inside the person and her brain; but there was some basic truth I had uncovered. The result, I believe, is a new paradigm in psychotherapy; and it is not just a belief. 

Obviously, if we allow patients to go deeply into their past without any intellectual interference we can learn so much. There lies a sequestered reality undreamed of in our field. And there lies the cure. By “cure” I mean arriving at ultimate causes. If we see time after time that those with migraine often relive oxygen deprivation at birth we begin to realize that perhaps oxygen deprivation may be one “cause” of later migraine. Particularly when those migraine begin to disappear after many relivings. This without a fixed theoretical mind-set. The same is true of many symptoms. Until we see in therapy the relationship between high blood pressure and traumatic events around birth we cannot alter it significantly. “Cure” means addressing and reliving the ultimate cause of our behavior and physical problems. We cannot do that until we acknowledge that very early events, even before birth, are imprinted and endure for a lifetime; that in order to eradicate serious even life-threatening symptoms we need to go back and relive those suffering aspects of an imprint that could not be experienced originally due to their load of pain. In my book, Primal Healing, I document the many, many studies that confirm the enduring power of early imprints.
There is no Jungian unconscious or shadow forces to blind us to the patient’s reality, no id nor other mystical notions. We can observe and later, we may draw some conclusions. Those conclusions would follow our observations. The problem is the need to absorb current observations within some kind of pre-established theory in order to make sense out of it. Some of the past trauma makes no “sense” in the ordinary scheme of things. there are no words nor scenes to put to it. I saw birth reliving for months and told my patients this was absolute nonsense because a local university neurologic department said that it was not possible. But they continued on and I had to reorient my thinking. Not only is it possible but we have seen it now with hundreds of patients from many countries of the world including those individuals who never read about it in my books. It is a measurable event. And we have researched it at the UCLA Pulmonary Laboratory as well in several brainwave studies.
Thomas Kuhn wrote that in the evolution of science there are periodic shifts or jumps that represent major changes in the direction of a particular scientific discipline. He labeled these jumps Paradigm Shifts. In our view, Primal Therapy and Primal Theory represent a major paradigm shift in the science of psychology. And in the course of this new perspective I want to demonstrate how a brain system designed to allow us to function under stress is in fact at the root of our mental problems. It is the story of the evolution of the brain and feelings. And evolution cannot be ignored in the therapy of human beings. Let’s take the case of deep depression. There are now modern techniques to ameliorate it—from tranquilizers and pain killers to drilling holes in the brain and probing deep down. The reason that we have had to used drugs and surgery is because there is no therapy extant that can go deep enough to affect the areas specifically involved in processing emotional pain. We can and we do. It is why we can use the word “cure.”
We in the profession and as patients may have a hard time embracing a feeling approach that seems to contradict what we think is correct. Namely, the value of ideas, insights and beliefs in assessing progress in psychotherapy. Therapists take the patient’s word for it. That should be the last thing we should be doing; for the left-brain intellectual side can imagine all sorts of cures and epiphanies while the subtext, the unconscious, is riddled with agonies. Neurosis is not due to a lack of insights nor cured by them. What is curative is an experiential therapy not a cognitive one.
If all we do in psychotherapy is no better than a religious epiphany, we have not gained much. In religious states the person often does feel much better, is more optimistic and ready to function. At least our field has made some important progress in understanding the life-long impact of early non-verbal or pre-verbal events on adult behavior. And we need to measure those pre-verbal events with non-verbal methods; those machines and blood tests that tell us what is lodged in the deep recesses of the brain.
Each week brings new confirmation of our position: a study of newborn rats who received just a small series of pain pricks showed greater preference for alcohol as adults. None of this is a mystery any more. The question remains, what to do about it? “It” is the imprint. What to do is to understand that the suffering component of early pre-verbal pain has never been felt and integrated; rather, it was coded and stored waiting for its chance to meet up with prefrontal brain cells for integration. We must go back slowly in therapy, neurosis in reverse, to events that carry such a load of pain that only pieces of it can be experienced at any one time; that is what is necessary. As I mentioned, it is neurosis in reverse, a reverse where we must not skip steps in retracing evolution. We cannot go back immediately to the birth trauma.
What seems to have happened early on was that the pain of birth or being left alone for hours right birth or not being touched in the first months of life caused great pain. The suffering component of this pain is sheared off and placed in storage while the precise memory of it may be stored elsewhere. That is why a patient can recall in detail an event, “They gave my dog away,” and yet take months to feel the pain of it. What we do is recapture the hidden pain, the part that was sheared off, and help the patient experience it over time. Never in one session, but in many sessions over months and months. Anything else defies evolution and the understanding of the valence of pain that resides on the deepest levels of the unconscious.
A study by Finnish scientists M. Huttunen and P. Niskanen investigated children whose fathers died either while the mother was carrying or during the first year of the child’s life. The offspring were examined over a thirty-five year period using documentary evidence. Only those who lost their father while the child was in the womb were at increased risk of mental diseases, alcoholism/addiction, or criminal behavior. Clearly, the emotional state of the mother was affected and that possibly had lifelong deleterious affects on the child. The results of this study suggest that the emotional state of the pregnant mother has more long-term effects on the child than the emotional state of the mother during the years following birth. And when we are investigating addiction we must pay attention to womb-life. 
Until there is a science of psychotherapy, one that coalesces with modern neuroscience, there will be human suffering with no real chance at relief and cure. Depressions, anxiety, phobias and obsessions will go on ad infinitum. We need a new orientation to what we are doing, to open up our frame of reference. We need to get away from the perspective that views man as some kind of decorticate brain bereft of a body and its hormones. We need to merge psychology with neurology and biology so that man is not dissected into small pieces for study. And once dissected each aspect becomes a subject for statistical analysis which does not seem to advance psychotherapy as a science. We need a radically new paradigm in psychology and psychotherapy; one that is based on evolution, feelings and imprinted memory. Everywhere we have looked, with thousands of patients from some twenty countries we have found pain at the bottom of it all.
The question is how do we get rid of the pain? Up until now our only recourse was to squelch it with tranquilizers or talk it to death with myriad insights. We know now that the task is not to avoid that unconscious pain, but to be awash in it. First we must go back and relive the past memory in sequential order, a bit at a time, as it was laid down. We need to be submerged in old painful feelings, let them control us for a moment, and dialectically, we can then control them; no longer the unconscious force driving our behavior and symptoms. There is a way to be rid of the unconscious forces that give us nightmares, high blood pressure and a myriad of act-outs, not the least of which are sexual. We need to let that unconscious rise to the surface, shake us, makes us cry and scream amid waves of pain and then, lo and behold, we are free! And that freedom, that ability to feel, is ineffable. We can (and have) measured it in the blood, in saliva and in the brain. And finally, it is evident in the comportment of the patient. But the testimony of patients is only one aspect of what we look at.
If we feel unloved by our parents to the depths of our soul we open the channels finally to accept love—because we can feel. Until that time the imprint will lock-in defenses and block feelings from getting out or in. If we can feel hidden pain, and its context—its origins--we give patients back their feelings, the most important gift any therapist can offer them. This cannot happen if we think the unconscious is some immutable power lurking in the dark antipodes of the mind waiting to destroy us; some unthinking malevolent force of evil. After all, when the disguise is ripped away from this so-called theory, it is just another mystical notion devoid of any reality. Patients will never get well based on mysticism.
I have taken my patients as deep and as remote in their past as possible and I have never found a demon or dark, evil force. All I have ever seen is sequestered pain. All that is there is pure need left over from infancy when those needs should have been fulfilled. They are here now because they were never fulfilled and resolved back then. They drive us now as a reminder of a true lack of fulfillment early on. We act-out now trying to find fulfillment but all we can ever find is symbolic, hollow fulfillment that does nothing about the real need. We must go back and feel that need in its original context and original form; only then will we be free of it. We will have transformed the “need for” (drugs, food, sex) into pure early need for love when it was a matter of life itself.
How can we fight an enemy if we never know what it looks like? Are feelings an enemy? Their force is. They remain an alien power because they could not be integrated at the time; their valence was far too strong. We are older and stronger now and can manage to face it.
I do use the word “cure,” which is not to be treated with opprobrium, but rather a state to be sought after assiduously. If we are able to travel back and down to the earliest days of life and undo and redo imprinted history we can then use the term “cure.” We have arrived at ultimate causes. If we do not travel back to the far reaches of the unconscious we cannot use the term “cure.” We are but skimming the surface, leaving a massive dark force intact. We need to insist on the goal of cure and the avenues that get us there. Insights in therapy will never get us there. Neurosis isn’t caused by a lack of insights and cured by proferring them. It is not enough to state that we want a cure for our patients; we need to see the proof, not just in their statements but in the various changes in hormones, in other biologic changes and in the brain function. In short, we must not leave the body out of the equation, which too often happens in modern day psychotherapy.
So what is it about reliving that is so important, indeed, the sine qua non of any effective psychotherapy? It means acknowledging the evolution of the brain. It means taking into consideration the role of feelings in therapy. If it is done in a systematic fashion over many months it is not at all dangerous. But then the problem is that the the psychoanalytic view of the unconscious is a turn on the old religious notion of the 1800s—dark and demonic forces (also known as the id or shadow forces) marauding on levels beyond our reach. That is one reason they stay away from it. But if they were ever to disregard that warning, bypass that intellectual, insightful brain, and let patients slip into their past they would see what lies in the unconscious. What they would find is nothing more than our history, laid out in order from the present to the most remote including birth and womb-life. And it would not be approximate; it would be precise; memories lying in storage waiting their turn to be connected to conscious awareness We need to understand that the suffering component of early pre-verbal pain has never been felt and integrated; rather, it was coded and stored waiting for its chance to meet up with prefrontal brain cells for integration. We must go back slowly in therapy, neurosis and evolution in reverse, to events that carry such a load of pain that only pieces of it can be experienced at any one time; that is what is necessary. That is what cures.

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.