Monday, December 31, 2012

Psychotherapy as a Cult




Maybe you think this is just a ploy to get your attention, or an exaggeration to ridiculous lengths but let us examine what a cult is and see if psychotherapy fits.  (Some of these ideas were inspired by a new book by Kramer and Alstad: The Guru Papers, and from my own forthcoming book: Beyond Belief).

  So what are the markings of a cult and a guru who runs it?  Absolute authority and someone without faults.   The leader is a know it all,  who runs your life and tells  you how to live.  Who demands obedience.  Someone who does not trust you thinking for yourself.  Someone who knows what is in your unconscious and interprets it for you; this teaches you to mistrust yourself and doubt your previous thoughts;  submission to the leader’s thoughts.  Never to question him or his beliefs even though it can lead to your deterioration…. A military mindset.   Accepting a new moral orientation.  An absolute belief in the leader’s theory. Believing he has a special wisdom and knows the secrets of the universe.   Best if you know nothing of the leader’s life so that he remains a mystery (nearly always a “he”).  Even if the theory makes no sense (as in Freudian theory) there is a need to believe and submit.

  Does this sound familiar?  Yes there are the cults and then there are therapies that fulfill nearly all of the requirements of  a cult. No matter what therapeutic approach it is nearly always the same.. A knowing doctor who knows what is best for you and will either tell you how to live, to find “wholesome thoughts”, or will do something to you to change your life. And what they do is based on a theory with little science behind it but lots of  free-form speculation masquerading as theory.  By and large, as with cults, we are renting a daddy or mommy who will tell us how to live because we feel so lost. They will protect and guide us, love us, be concerned about us and our future, and all they require is obedience; never said as such but implied.  But you do have to pay because the doctor says it gives value to the therapy and helps you treat it seriously.  This is what I was told when I came back from the war a complete wreck and needed help.   I was of course broke and could not pay.  The doctors who stayed home during the war wanted me to value their therapy when I felt I was dying.   And by the way most of them were Freudian psychoanalysts.   And when they gave speeches it was always, “A Psychoanalyst looks at blah blah”. They were Gods, cult leaders in every sense of the term; and my professors expected obedience at every turn and never to question their theories.

  The unspoken contract between patient and doctor is that they know what is best for you. No matter what kind of therapy it is always "I know what is best";   but they don’t.  That is the tragedy, and the patient stays for years thinking the therapist knows best. Since he makes his money keeping you in therapy he has an interest in the therapeutic longevity of the patient.  It is never expressed or even acknowledged but it is there.  Again, guru or therapist, the dynamics are largely the same.  Except in the cult it becomes dangerous to quit and the group can be threatening. That is not the case in therapy except the doctor warns about leaving therapy too early.  It seems to always be too early.

  We have had the experience of patients telling their doctor about Primal Therapy only to be pooh-poohed as a cult and worthless.   This often happens when the doctor knows nothing of what we do.  And what we do is the opposite of a cult.  We teach the patient what we do and want him or her out of there as soon as possible.   The only authority is the patient who knows best what is wrong and what is in their unconscious.    There is no great leader who demands obedience and insists on not being questioned.  Too often in patients, there is this search for certainty and we want a therapist who looks like a doctor and who speaks with an air of authority.  We do not want a hesitant doctor.  We do not want a doctor who is not completely sure of himself.  We want the rock of Gibraltar.  Why?  So we can relax, submit, be guided and taken care of.  Lovely.  And when we get that daddy and mommy that should have been,  we stay in therapy.  It is then a permanent act-out on both their parts.  The doctor gets the glory and adulation, while  the patient gets a kind,concerned doctor/parent.
It is addictive for both and that is why it lasts and lasts.  And never does the doctor call the patient on his act out; he encourages it; you must come three times a week instead of two, blah blah.   It encourages dependence, which is not what we want at all.

   More and more we come to trust the doctor’s advice and he readily supplies it.  We go to find out if we should get married, change jobs, go to school, leave this person, etc.  In our therapy we rarely if ever give advice; we believe in self-determination.  We want the patient to trust himself and not be infantilized.  By the way I finally found an Analyst to treat me for battle fatigue and what did we do? Dream analysis because that was his specialty.

    When your whole world is invested in your doctor you keep on going and do not question.  Your whole world is wrapped around him.  What does he think of my decision?  Would he approve of this or that?

  There are some in cults who change their names and become Swamy da da da.  It is as if  they had no history. But in current cognitive therapy there is also no history;  it is more and more a therapy of the here-and-now.  History doesn’t account for much.  Not a big difference.

  Here is the diabolic part in all this; once we spin a web of belief in our followers all we have to do is manipulate the beliefs. We have control.  Our beliefs/theories are now deeply inside the patient/follower and his life is in our hands.  He believes in the Id or Ego or Shadow Forces and other nonsense.  He has no other frame of reference.   In the cult they keep others away so that you will not have a contrary frame of reference; you are now a true believer.  The cult says the beliefs are our stairway to heaven while the doctor says you are on the way to more healthy beliefs and a stable way of life; ergo a stairway to heaven.
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Sunday, December 30, 2012

What About Drugs to Help Us Feel


It used to be LSD that was thought to help us feel, but then we discovered that it flooded the cortex and took away any chance of connection.  Now there is a new one, Oxytocin, which seems to help us share and trust others.  I call it “instant love” because it causes to act for the moment as though we are and were loved.  And friends have wondered if it doesn’t help us open up and feel more?  Indeed it might but like all temporary panaceas its effects are not lasting and it avoids a key point:  what happens to the imprint?  The imprint of unloved which is infused into our entire system?  No drug will take that away and it should not.   Nothing can take away the engraved memory because it is now part of our neurophysiology.  And my point is that we cannot truly feel loved so long as the imprint remains.

    So yes, there are temporary expedients but they remain that.  There is no magic and no real way to deceive our physiology.   If we spent a lifetime with a harridan of a mother and an alcoholic father, that left us totally neglected and unloved, there is no drug that will take that away.   That is like taking away part of our physiology which reflects that lifetime.    If we were abused so that there were changes in our oxytocin, which does happen, as well as permanent changes in our cortisol levels and various hormones, it cannot be undone by a magic infusion of some chemical help, as much as we may find it wonderful.

  You know,  many addicts have found the magic pill; it is called heroin.  Here is how it happens:  some child is in constant pain and because it is an every day of constant neglect and indifference he is not aware of it.  But someone turns him onto heroin and he suddenly feels normal.  He is relaxed and can work and concentrate.  What happened?  He found something that did indeed normalize him. Am I kidding?  I don’t think so since with constant early pain there are basic changes in stress hormone levels and most of all in serotonin, which helps us repress and keep pain down. But with chronic pain the serotonin levels are reduced and we are in a constant malaise, a discomfort, and we have no idea of its origins.  We don’t even know it is called pain.  But then we take a drug, a painkiller that helps us repress and we feel “normal”.   And for that moment we are “normal”.  Just like with oxytocin; we do feel loved and love for the moment. But it quickly passes, and we must not imagine that any drug will take away our history and renew us forever.  That’s called magical thinking, and we have enough of that extent, as it is.  There are those who got into ecstasy which also produced that wonderful feeling of access to feelings and those who took it swear it helped so much, but trust me, it didn’t.  It couldn’t, because until something wipes away our history there is no profound change.  Should I repeat?  Until something eliminates our history, no drug can make a profound change, no matter what you think.  Oh yes, there are changes in thinking and attitudes but no neurophysiologic change.

  But there is a way to feel that we can love again, and that way is the dialectic: to feel totally unloved again; because it is that feeling that constantly drives us and makes us act the way we do.   We are unendingly sweet in order to get some kind of love. But once we feel what happened to us and our feelings we are ready to get on with life and love again.   So what is addiction all about? Trying to achieve the feeling we would have had if we had been loved at the start.  We take drugs every today that enhances that feeling and allows to relax for the moment.  It is not a bad thing; it is necessary.   It is our past that pains us and also liberates us; our history that is freeing because it first has to be acknowledged and felt.  Once done we are finally free.
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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.
Editor