Saturday, December 20, 2008

Original Conflict: The Biologic Motor That Drives Us

We in clinical psychology today are in a strange position. We see people, both in and outside of our practices, suffering from some insidious condition that cannot be seen, tasted, touched, or pinpointed in any single location. The condition is often called mental illness or neurosis. A few question whether the suffering is real, describing the experience as a "trip" to be savored, and terming mental illness a "myth." Others see mental illness as merely a function of distorted thinking, something that will disappear with new thoughts. Among schools of psychotherapy that do admit the existence of mental illness, each one has very different ideas about neurosis and its genesis. Indeed, in no other area of medicine is there such disagreement about the nature of a disease, what its symptoms are, and how it manifests itself, not to mention its causes.

In short, the field of psychotherapy today is nothing less than chaotic. Why?

First, I believe, events that may cause mental illness or neurosis begin so very, very early, and remain so barricaded in unconsciousness, that the notion that early trauma affects how we act at the age of, say, 45, is beyond ordinary imagination. Second, we react with incredible diversity to early trauma, and we may imagine that phobias, migraines, compulsions, obsessions, depression, addictions, etc. must all have different functions. Third, psychologists themselves have blind spots of a function of their own neuroses - they cannot see, cannot bear to see, their patients' deepest pain - and find themselves gladly distracted by symptoms and by ideologies that do not directly address pain.

As a result, the field of psychotherapy may be characterized by a remarkable absence of cohesion, and patients' pain is addressed diffusely at best. Some psychotherapists will consistently prescribe anti-anxiety and antidepressant drugs for varying neuroses, in essence trying to kill patients' pain, but not identifying the pain or where it comes from. Others may manage symptoms through various techniques associated with different schools of psychotherapy: They may have the patient "dissociate from" a symptom in hypnotherapy; cognitively "analyze" it into oblivion; "act -out" the symptom symbolically in gestalt-type therapy; beat it back with mild shock as in conditioning therapy; chalk it up to "faulty beliefs" which simply need to be willfully changed, as in rational-emotive therapy; "control" it in biofeedback therapy; or reroute it in directive daydreaming and imagery therapy.

The myriad approaches in psychotherapy are treatments rather than cures. They all focus on the symptoms of neurosis instead of probing for its cause. It is possible that they all help somewhat; they do not cure, however. They may help control the symptom, not the disease.

The only hope for cohesion, and lasting help for patients, is to address the generating sources of neurosis or mental illness. What and where are these sources? I believe that the conflict between the imprinted Pain of early trauma and its repression is the central contradiction that generates neurotic reactions both internally (physiologically) and externally in the form of behavior. Repression, or the loss of access to feelings and sensations, is an evolved function that allows us to survive unmitigated pain early in life. The pain, however, stays in the body, unavoidably - as unavoidable as the experiences that originally caused the pain. And the pain will perpetually fuel a dislocation of mental and physical functioning to keep itself unfelt, for as long as it remains unfelt.

Therapies that do not address this original, central conflict at the root of neurosis may succeed in reconfiguring a symptom pattern, but cannot eliminate the fundamental illness. Why do therapies and therapists not go deep? Because of our Freudian legacy, which dictates that fooling around in the unconscious is dangerous and must not be done. And it is true that without a proper scientific theory and therapy it can be dangerous; witness the many mock primal therapies damaging patients every day by plunging them into rebirthing and other dangerous ploys. It has taken some thirty years to figure out this theory and therapy so I don’t wonder that many therapists avoid it altogether. But it is essential if we want to put an end to neurosis as we have seen it for one hundred years.


  1. Sorry but I view 99% of the field of therapy as useless at best and damaging at its worse.

    I work for a large managed care company in Southern California, and talk with hundreds of patients on the phone each week. It’s my perception that they get very little for their money, and some are quite damaged by their treatment. Their care is little more than a cattle drive, controlled by psychiatrists who blithely dispense dangerous drugs.

    There is so much money invested in keeping the profession just the way it is, that I don’t hold out much hope that things will ever change from the inside.

    My only hope is that people who have had the courage to get well, will be open about the process that they have gone through, and how much their lives have changed.

  2. So what can a therapy that doesn't address the hidden pain of a patient do at best? Alleviate or control his or her symptoms and strengthen his/her defense. This may work for many people though it may be very expensive - several doctors/long lasting therapies for several mental and physical symptoms - and though the result is not healing but better control of the diseases/disorders at best.

    However, presumably there are many people who cannot cope with life at all and who really need something like "heavy surgery." I believe those are often that kind of people who fall a victim to mock primal therapists. They have read one or some of your books, they know and feel that there is a lot of pain in them and though they are warned explicitly in your books they go to the nearest therapist who offers "primal therapy."

    A more harmless result may be that the patient will be tempted to chronic abreaction (though I don't know whether enduring abreaction really is a harmless thing for an unstable person). Or - as you said - those mock therapists use heavy hammer techniques like hyperventilation or LSD in order to push through to very early pain and "resolve" it. But you can't reach and resolve very early imprints immediately, can you? The normal, logical and natural way would be third-second-first line (present-childhood-infancy, birth, prebirth). Any attempt to take a short cut seems like violating the brain and I wouldn't be surprised if psychosis would be the result.

    I remember having read in one of your books that there are few (highly disturbed) patients who are able to access and relive birth imprints right from the start of their therapy. But these persons are rare exceptions, aren't they?

    It seems that the current field of psychotherapy can be divided into 3 sections:

    1) One main section consisting of therapists who obviously know little about the human condition. They cling to antiquated, purely psychological theories (Freud, Skinner, Perls etc.) that can't be brought in line with modern neurobiology, they ignore the existence of imprinted early pain and exclusively deal with their patients' surface - with their thoughts, symptoms, behaviours. I would call this section the "dinosaur section." Nevertheless these dinosaurs are still in control. Usually they dominate academic psychology/psychotherapy.

    2) Second, a small group of well trained therapists who have undergone primal therapy themselves and are able to carry out this therapy systematically and correctly. (Usually Janov-licensed therapists).

    3) Third, a group of therapists who claim to be primal therapists but are not able to carry out proper primal therapy. What they usually cause in their patients is abreaction and fragmentation but not access, connection and reliving.

    All in all, this is really a very chaotic and unsatisfactory situation. The old schools fight for their position of power and the new school must stabilize and try to get a grip on detrimental and undesired trends (mock primal therapy).

  3. I totally agree with you, thanks for the perspicacity.

  4. I do hold out hope for "neurotics"- all of us, I suppose. I have been teaching psychology at the high school level for many years, and almost without exception, my students understand, at some level, that their behavior is driven by early- sometimes very early incidents (imprinting ?) and that to address the symptoms is a losing battle. They read the research, they connect the findings with the concept of repression-physiologically and psychologically.

    They are very much interested in the concept of repression and "get" the fact that the repression of pain drives much of our behavior.
    They "see" it. And, I think that it gives them a better chance of feeling it some day.

    At least, they are open to the fact that current therapies are missing the central component of not addressing the cause- the source, as you say.

  5. In those American tv crime series C.S.I.- Miami, New York, Las Vegas one sees how and to what extravagent lengths forensic cops delve to reconstruct cause. In pschotherapy today there is no such accuracy, the standard for success is still usually symptom relief or behavior modification. Why this unbelievable superficiality regarding human shortcoming? I believe there are acouple of reasons for this:

    -Many people still believe that one deserves exactly the neurosis one gets, this is the American "tough shit buddy" attitude where victims are seen as perpetrators and are either ridiculed, locked up or ignored. Why is never a question asked or cared about.

    -Not many mainstream psychologists know that there is a therapy that can bring about profound change. Primal therapy is often not well known or discarded. Many psychotherapists think profound change is impossible because mental illness is not seen as a biologic state but as a tick.

    -The mainstream cannot tolerate people blaming their parents for their problems anymore than understanding why a person has to writhe in agony and cry deeply for years(primal)to get rid of their imprints. To acknowledge pain is also to recognize that society hands over toxicity to its members, not just wholesome building blocks for a higher education.

  6. Eddy,
    You are so right, please write some more about how society hands over its toxicity.


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.