Elements of Primal Theory (by Peter G. Pronzos, a Friend and University Lecturer)

Isaac Newton, one of the most celebrated scientists of all time, once remarked that he could see far because he was, “standing on the shoulders of giants.” In the same way, Arthur Janov’s ground-breaking approach to psychotherapy, Primal Therapy, combines some of the most important elements of his predecessors while providing a deeper and more complete theory of the healing process.

This became clear to me as I was reading the second edition of Louis Cozolino’s invaluable book, The Neuroscience of Psychotherapy.

For instance, Cozolino writes that Freud’s psychoanalysis and the psychodynamic forms of therapy that grew out of it, share theoretical assumptions such as the existence of the unconscious, the power of early childhood experiences, and the existence of defenses that distort reality in order to reduce anxiety and enhance coping.

Janov, who originally trained with Freudians, practiced conventional psychotherapy until his work led him to discover what he termed “Primal Pain”. In general, this refers to traumas experienced by babies and children which are so painful that the hurt must be dissociated from consciousness. In the more than three decades that followed, he has refined Primal Therapy as a way to allow patients to connect with these feelings in order for healing to occur.

However, in contrast to Freud’s psychoanalysis and some modern psychodynamic methods, Primal Therapists do not interpret or explain to a patient what they think he or she is “really” feeling.

They don’t offer “insights” or speculate about the source of the trauma, nor would they ask a client to do something artificial, such as exaggerated breathing or play-acting.

Instead of such arbitrary practices, Janov maintains that patients must discover their own unique truths for themselves, with the therapist acting as a skilled and empathetic “witness”. This “client-centered therapy” was pioneered by Carl Rogers in the 1960s. As Cozolino explains: “Rogers emphasized creating a relationship that maximized the individual’s opportunity for self-discovery.”

In the same vein, a Primal Therapist does not end a session after 50 minutes or some other artificial time limit. The patient has as much time as needed, and a session often lasts two hours or more.

A session usually begins by encouraging the patient to get in touch with whatever they are feeling at the moment. That is the real “royal road to the unconscious”. It may be an emotion, a memory, a dream, a song in one’s head, or perhaps a physical sensation. This bodily focus was first used by Wilhelm Reich, who had studied with Freud and who, as Cozolino notes, understood “that memory is stored not just in the brain but throughout the entire body.”

In short, trusting the client to find their own way (with appropriate suggestions from the therapist) is not only the most reliable approach to access deep feelings, but, not surprisingly, is vital to build trust between the client and therapist – an element that is essential for a healing relationship to develop. While Janov does not agree with the belief that, “the curative element is the therapeutic relationship itself”, he stresses that the patient must feel that they are in a safe, supportive, and understanding relationship.

This empathetic situation is the opposite of that which existed when the damage was done, and it allows the client to safely re-live the trauma - this time in small doses to avoid re-traumatization.

When all of these elements are in place, the patient has the maximum opportunity to make the healing connection between the conscious self and the repressed pain. When the old pain is felt, there may be crying, fist-pounding, trembling – even curling up in a fetal position when re-living a traumatic birth. (After observing Janov’s tape of a patient experiencing a birth Primal, affective neuroscientist Jaak Panksepp observed that such behavior “could not be faked.”)

Janov’s position is that - most of the time - a therapist must allow the patient to go as deeply as he or she needs to in order to make a full connection (and he believes that too many therapies do not let a patient fully descend into their pain). After a deep connection, patients will have insights into why they felt a certain way or acted out neurotically. It takes many sessions before enough of the pain is released so that one is no longer driven by the old feeling.

Like Cozolino, Janov holds that the, “primary focus of psychotherapy appears to be the integration of affect, in all its forms, with conscious awareness and cognition.” (Not surprisingly, Janov contends that cognitive behavior therapy only addresses symptoms – ideas – while ignoring the cause - buried emotions. Ideas are one of the most common defenses against feeling one’s pain).

Over time, this “integration of affect” leads to increased neural integration and information flow, as Daniel Siegel notes. The healing is not merely psychological - neuroplasticity means that there will be physical changes to the architecture of the brain itself.

On Getting to Need

In the old days I used a fake telephone to have patients call their parents and tell them everything, what they needed, the pain, etc. One patient picked up the phone and then complained to me, “There’s no one home.” This was clearly a double entendre. There was never anyone home, and when they were, there was still no one home. But I used the telephone to make a point: patients were always saying, “What’s the use? They are never going to love me.” And I say, “That doesn’t matter; what matters is that you feel and express your need.” In that need lies a world of pain. We can use the left brain to rationalize, “I don’t need it or them,” but alas, the need remains unabated. It drives so much later behavior.

So we rationalize with one brain while the other is hurting terribly. It does matter whether they can love you or not because that never changes the need; that need tells the truth of our lives, or our history. We do not want to cover over that history. In it lies liberation. For unfulfilled need means pain. Why? Because we are being warned that something essential to life and survival is missing. The trouble is that it becomes an imprint that dogs us for a lifetime. We are on constant alert, agitated and stimulated by that need no matter how much we try to relax. If we successfully repress it, the tension in our muscle system can lead to all kinds of maladies. Or we just ache all of the time.

If we never get to the right brain and the deep brain we will never get to need. It is covered over by the hyperactivity of the left prefrontal brain. We need to find a way to bypass that verbal, intellectual, rationalizing brain and get back to our nature; our feelings, which are our nature. Those who are distant from that nature cannot value our environment, or animals, or anything that belongs to nature. First they have to feel what is inside of them. Not an easy task; worse, when they chose a therapy they often chose one that also bypasses nature and flees to the safety of the intellect. Ay ay ay.

It is interesting about the right and left brain. A new study found that those humans with left brain injury became more creative. (New Scientist. Dec. 18, 2010) That is, they seemed to have more access to the right brain and feelings. After all, it is feelings that allow an overview, an ability to make the connection among facts. The left brain seems more point-by-point, punctilious; seeing each fact as an entity onto itself. Feelings seem to be more global and provide a deeper understanding of events. What the study seems to show is that the left brain can smother creativity, and of course, feelings. Language is wonderful and terrible. The more intellectual, the worse you are, as odd as they may seem. And yet, where would we be without Einstein. He was certainly creative. Yet he never got onto the Heisenberg theory. It is just that intellectuality in the social sciences seems to be deadly. How else to explain the lack of interest in a feeling therapy?