Saturday, April 18, 2009

On the Corrective Emotional Experience

In the era of Freud and psychoanalysis the linchpin of the therapy was the analysis of transference: how the patient responds to the doctor and (counter transference) how the doctor reacts to the patient. The whole idea was to change the patient through a corrective emotional relationship. Helping her to be more independent, not rely for advice or love and guidance from the doctor. Now decades later, that notion of the corrective emotional experience has gained many adherents. It is still in essence the analysis of transference.

Their theory is the following: it is not enough to relive early trauma, you must follow it with a corrective experience that will allow the patient to make progress and change. They believe that allowing the patient to wallow in pain only reinforces neurosis.

So why not have a new ending to a feeling/memory? Because it is not real. It is a concocted scenario that defies the patient’s reality. It is not our job to rewrite history. It is enough to help patients learn about themselves and their history. But is it true that patients who relive without rewriting the ending continue to suffer and be neurotic? One could only come to that conclusion in the absence of clinical experience. What we have seen year after year is that reliving in and of itself leads to profound changes in the neurologic, psychologic and physiological systems. Over and over in double blind studies there have been changes in brain functioning, hormone secretion and, above all, changes how the patient feels about himself and his world. There is a systematic alteration in body temperature and blood pressure, (lower) which does not happen in those who abreact. That is, there is practically no change in those who fail to connect their feeling to conscious/awareness. I call that abreaction, a discharge of the energy of the feeling on a different level of consciousness—in symbolic channels. It is a random event that does not follow neurologic/evolutionary functioning. The problem is that so many clinics and mental health professionals claim to be doing Primal therapy yet the results seem to be that the patient continues to suffer; hence, the notion that patients after a reliving wallow in pain. If only the higher level is addressed and even resolved on that level it does look like the patient is wallowing in pain. Without having the theory and techniques to go deeper it can lead to misinterpretation of what is happening. Providing a different ending depends on the unconscious of the doctor who needs to supply it. Clearly this is not an organic affair, emanating out the patient and her unconscious. And what about if each doctor provides the corrective emotional experience in a different way? Are there several different scenarios for the patient? Implicit in this is that the doctor knows best; whereas it is the patient and her unconscious who knows best. If there were no connection we would not see systematic changes in cortisol levels in our patients. Clearly, reliving is sufficient. But it must be a true reliving; and it is clear that when we provide the script for the patient reliving is not really reliving. It is rewriting history. It is the fulfillment of need on the part of the therapist who is supplying a good script with a happy ending. Is that our job? To cheerlead the patient away from reality? To help him lead a symbolic life? It is perforce a happy ending because why else would we want to channel the patient away from imprinted reality? It is that reality that has been driving the patient to act-out, develop migraines and high blood pressure and remain unable to relax. He, in his constant behavior is doing exactly that: trying to produce a happy ending for himself so he can get out of pain. It is that reality that makes a patient exhibits himself in public time and again, or bedeviled by an inability to orgasm or to shy away from all human contact. We have all heard by now of erectile dysfunction. The penis is not the problem; the brain is. It is history that largely determines all this. And responding to that history instead of repressing it is what leads to liberation. How do we do that? Penetrating the deeper levels in a slow methodical manner.

After all, when a doctor prescribes Zoloft for a patient he is producing a happy ending. Instead of feeling pain the patient has become, “à la Candide”, egregiously sanguine. He is happy now, or is he? His stress hormone level is still very high. Unconsciously he is not happy but he has convinced himself that he is. But that delusion will kill him or make him prey to serious disease too early in life. Repression to me is the number one killer in our population. When we supply a happy ending we are aiding repression. We are aiding delusions by the patient. We as therapists have become cheerleaders, trying to find a happy ending for our role as doctor. It is a mutually shared delusion that fits into the zeitgeist where we all want to put on a happy face. So we do; and then try to develop a rationale for our choice. We don’t have to redo history. The patient, after having made his unconscious conscious will rewrite his own scenario as time goes on. He will lead a different life; the exhibitionist will stop showing himself. This, with simply reliving his pain. Don’t forget that the deep experience of a feeling leads to the cortical understanding of it automatically. In my jargon it is the third-line component of the feeling.

There are so many levels to pain that a person can relive higher representations of it and still have enough pain to continue to be driven by it. It is not that the therapy is faulty; it is because the road is longer than we thought. It may be because a therapist has not acknowledged the depth of pain nor has she produced the techniques necessary to probe down deep that she can believe in the happy ending. It took many years for us to develop those deep-probing techniques so I am not judging therapists, but I do know what it takes to go to the antipodes of the unconscious. It is not a trip taken lightly because meddling in the deep unconscious requires precision in one’s therapy. It is not that everyone does what they feel comfortable with. It means adhering to very specific clues and following them back into history in an ordered manner. When one of my students shows a tape of his therapy on other students, (which we do systematically) we know immediately when a mistake has taken place. There will not be integration. So there are two different ways to go amiss. 1. To believe what is not there. 2. To refuse to believe what is there.

It is when the doctor forces the patient into too much pain that he must supply a new ending. If therapists have not seen what connection can do, then they forcibly choose a happy ending script. If the doctor does not force the issue and drive up out-of-sequence pain, there is no need for a different ending. Connection says and does it all.

59 comments:

  1. I think most psychotherapists don't so much serve their patients, but their defense systems. But if that's what most patients want (well, what they think they want) then how could it be any other way? Commercial law (i.e. consumer demand) dictates which professional psychology survives. Not necessarily the truth.

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  2. I sent away for a free DVD once of a clinic offering therapist training. It was designed to be an advert. But when i played it i was horrified. One ten minute (the most dull 10 minutes ever recorded) segment was devoted to a female patient sitting with her eyes closed while the 'therapist' told her how comfortable and relaxed she was feeling and how all her troubles were 'melting away'!! He kept coming back to this phrase. It was unbelievable tosh.
    So I really respect Dr Janov's detailed account of his practice and the considered scientific motives behind it.
    There is one aspect of the human condition that is responsible for repression and which I would like to know if therapy can ever really address. John Lennon's famous lyric was, 'We're afraid to be alone..' Fear of being alone is I think a number one cause of repression. If you are unloved you are as alone as you will ever be therefore neurotic defence protects you from that realisation but blocking your capacity to feel your isolation (comfort eating is another aspect). Yet, even post-therapy, even though you may be better equipped to love are you better equipped to cope with being an isolated individual in the world (being by yourself)?

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  3. It is amazing that Dr.Janov wrote about this - this week...because it has been on my mind. Though I have been in and out of therapy since my 20's (I am now in my 40's)...I began to resent therapy because I felt I lost time each each visit - it was empty. It would go on and on without ever getting "deep" as Dr. Janov talks about. Even with EMDR...with my therapist we identified the source of pain...but then I didn't know what to do with it. My family thought I was wallowing in pain and kept telling me to "move on" but I couldn't. Scott Peck's book, "A Road Less Traveled" talks about finding a committed therapist...but they are hard to find - I have always felt let down...and that would add to my pain. I stopped therapy because I was tired of being sandwiched between patients and having a therpist with one eye on the clock. I just couldn't turn on and off my feeling on schedule. Primal therapy seems different and I am intrigued.

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  4. Dear Dr. Janov,
    this publication is very timely. I wish it would be available in German.
    In 2005 I conducted 36 interviews with German psychologists and therapists, to provide information for traumatized people who had previously contacted me for help. Only one was fairly skilled, according to my own experience, to address early inflicted childhood abused. Clinics in Germany, so victims telling me, aim for “Einstellung” which is nothing more then a forced guidance to live in the here and now. Their motto is: , - don’t look back, forget the past. If this controlled method, however does not work, the patient is labelled (bipolar, aggressive depressive, unwilling to change, etc.) and find it self on very heavy antidepressants. In other words, they hurt the one in pain.
    It is a fact, according to my 42 years personal experience, that the imprint to control (not by genes, more through traditional learning pattern) instead of understanding and not respecting the individual, is an overwhelming approach in Germany. Thank you for confirmation which lays in On the Corrective Emotional Experience
    Sieglinde Alexander admin@aaacworld.org

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  5. Andy,

    I think what most patients really want is a little different from what most psychotherapists serve up. The patients want to be listened to. Given a good listener, their want to be listened to will become more and more a want to have their feelings listened to. That's what most psychotherapists don't do, but a lot of them could be trained to do that. They don't need to have Primal Therapy first, but they do need to have an experience where they can feel what it feels like to be listened to properly. Some of them won't get it, but many will.

    It's not so much commercial law or consumer demand that's keeping things boxed in, at least in the U.S. It's dependency on insurance, and it's a particular "cornering of the market" by therapists who fix their patients by fixing their thoughts who have the insurance companies in tow right now. If you can feed the addiction to "quick fixes" you can get the money. There is a tremendous "groupthink" dictating all of this. Psychology students today are afraid to answer the question "how would you treat ... ?" with anything other than "...Cognitive-Behavioral Therapy, and medication". They don't want to be left holding the bag. They are a well meaning mass in search of some leadership.

    Walden

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  6. Will: Don't simplify. Once you feel your feelings you will find someone. That is what I have seen after many years of our therapy. Dr. Janov

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  7. Cathy: Stay intrigued. We have no clocks and no time constraints. dr. janov

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  8. Dr. Janov,

    Are you open to the idea that it may not be enough to just relive early trauma, especially in the cases where that reliving becomes an end in itself and displaces having a good fulfilling life in the here-and-now?

    Walden

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  9. dear Art, Dear guys,

    From your article and from the comments belows, it seems to me that there is an important point missing. THE NEEDS that we feel in primal therapy.

    From what is written above, it looks like primal therapy is only about feeling pain. If it was so, i would probably have stopped. Some may believe we feel relief only because of the pain we get out, it is not enough. A complete connection can't happen whitout reaching the need behind the pain and feeling the need is usually for me a good time.

    The first time I understood a need was in a session, feeling hurt about the way someone was treating me. After complaining about it, I did remember one particular day in my youth where my mom had been nice with me (something not usual), taking me, and me only to the pier. I cried a lot and realised that I needed the person from the present and my mom in the past to be nice with me. That was the need and feeling it was remembering that nice event from the past, crying and missing it so much. That was a very enjoyable thing. I would leave my session in a very calm and good mood, a little as if the need had been fulfilled, no need to create an artificial happy ending.
    Feeling the need help to get back to "equilibre" after feeling the pain.

    Another exemple : One session after feeling some kinf of preverbal disconfort of beind touch in a bad way, I felt the need to be touch in a good way. that was the first time in my life I felt the physical need to be touch. It's a need that many "regular" peoples can feel without therapy, but not me. So I came to a session feeling some kind of disconfort and i left the session feeling the need of being touch. Not so bad.

    Recently I had sessions where I would leave with feeling like "I did'nt get it (wathever was the need)" but still, feeling it (I didn't get it) was the end of the suffering or the struggling.

    Now I have no experience of birth feelings so that I can't say if there's any good need or whatever to feel after an horrible birth primal. There may also be some horrible things (incest for exemple) were patients just feel pure hell and nothing good.

    So I just wanted to say that primal therapy is not only feeling pain again and again and that getting connected to our needs (which were locked before) may be the only real happy ending.

    Olivier from France

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  10. Dr. Janov:
    In Germany there is a “Society for Integrative Primal Therapy”. They write that “Integrative Primal Therapy” is an “advancement of Janovian Primal Therapy” and that “working with feelings has become much more differentiated and present-oriented.” Furthermore they say that “various therapeutic approaches are integrated” (in their therapy)….and that “the relation between therapist and client is seen as a key operating factor and is properly paid attention to.”

    Is this ultramodern “advanced Primal Therapy” or rather a kind of jumble therapy crowned with the “Corrective Emotional Experience” ? My guess is that the latter is true. My point of view: better 5 therapists in the world who really do proper Primal Therapy than 500 therapists who do some kind of washy and messy therapy which they call “primal therapy.” Why can`t they find a different name for their therapeutic work? Primal Therapy must not be falsified!

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  11. There is no contradiction between feeling and living a good life. We encourage patients to live good lives, never to wallow in pain. If I thought it were necessary to do other things I would recommend it. You forget "self-determination." Or chacun sa vie. We don't presume to tell people how to live. It is not our job. We give them the possibility to live in freedom. After that it is up to them. dr. Janov

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  12. Olivier: I absolutely agree. dr. janov

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  13. Ferdinand: You are so right. They would like to discredit me so instead they claim to advance the therapy. Where is the research? dr. janov

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  14. It would be nice if they used the term "trauma integration therapy" rather than "primal therapy". But then they would have to write their own books - too much work!

    -I hate it when you write in French Dr Janov. I don't understand a word of it. (smile)

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  15. When I read this week's essay, I was curious as to the origins of this "Corrective Emotional Experience" concept. The term was coined by Franz Alexander in a book published back in 1946. Here is a link where you can read parts of that: ( http://www.psychomedia.it/pm/modther/probpsiter/alexan-2.htm ). In the first section, he gives a condensed history of the different periods of Freud's work, spanning from the initial period which focused on "hypnotic catharsis" through the later periods in which the center moved toward transference relationships. Actually it was Freud and Breuer who observed fairly early that emotional release alone did not seem to produce lasting results.

    If you read through the material at the URL above, you'll find (near the end) a passage which is ambiguous because of the way it uses the term "re-experience" when talking about the "corrective emotional experience". But in context, it's pretty clear that Alexander is not proposing to tack a happy ending onto a primal reliving (something he would have called, after Freud, a "hypnotic catharsis"). I'm not sure how Dr. Janov came around to that interpretation, but I suspect that something got lost in translation somewhere.

    What Alexander is talking about is having a little mini practice session for being straight with another person. That's the corrective experience. Dr. Janov argues that there is no need for that because we all have self-determination. That means once you remove enough pain, our soul should spring back into the shape it would have taken if there had been no neurosis. That may be true, but when and at what cost? It reminded me of Ed Wilson's ants and the pheromone experiments. It takes the little buggers hours to find food at the opposite end of a sheet of paper on their own. But when he traces a pheromone trail for them, the discovery is quite rapid, and they take over laying down and reinforcing the chemical signal. I think there is such a thing as "conventional inertia". Maybe it's stronger in older people. Basically what it says is that when an obstacle has changed a traffic pattern and then after time that obstacle leaves, the pattern stays put until it has motive to change, because change is expensive. This to me means that we cannot trust all our patterns to spring back just because some pain is gone. We also can't expect the old abandoned routes to still have drivable pavement. There is work needed in these areas. I think, in the context of therapy (including Primal), "corrective emotional experience" is just part of that work. That, and the fact that those experiences set up the conditions for deeper feeling as well.

    Walden

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  16. And where is their science? Dr. Janov

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  17. Walden. I knew Alexander. Does that date me? Read it all again. You need to understand self-determnation. Once someone has been liberated from repression IT IS UP TO THEM TO CHOOSE THEIR LIFE! We are not life coaches. We are hopefully scientists practicing science. dr. janov

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  18. Hello Dr. Janov,

    I often have trouble deciphering your terse replies. Does "Read it all again" refer to you or to me?

    I've read it all enough to form my own opinion on what Alexander and others meant by "corrective emotional experience". I guess I have enough personal self-determination to choose that I don't like your interpretation and I don't think the text supports it. If anything, please compare this technique with purely cognitive approaches and appreciate that the focus is on the emotional aspect, a step in the right direction. Maybe it's still not quite "talking to the right brain", but at least it's getting warmer. Too bad you lack so much of an instinct of synthesis to see when things other than your specific Primal formula can be helpful. Beyond that, though, I'm convinced you use this technique and don't seem to realize it.

    Briefly on life coaches and scientists, then. Yes, as clinical psychologists with deep and important techniques for healing you are not in the business of long term life coaching. That's your choice and I understand that. However, as clinical psychologists, you are in the business of temporary coaching, if that's what's needed, in the interest of a positive therapy outcome. Sometimes coaching can be critical to the success of therapy, too. I refer you (and your readers) to the video interview with “Marmot” on your www.primaltherapy.com website. The first two minutes are enough to get the idea. That said, the technique in question is not really even coaching; it's therapeutic intervention, analogous to innoculation in the field of immunology. And I see nothing unscientific in a therapeutic intervention that is "behavior first" if it facilitates the deep experiences and not-so-deep experiences people need in order to get better.

    Dr. Janov, I'm very sorry to disagree with you so much on this, and at the same time hopeful that the apparent conflict will not just drop into the cracks again and be lost as so often seems to happen when I put a lot of thought and effort into a reply and then you don't publish it. I may not have convinced you of anything, but either way I'd like your readers to have a chance to read and respond. If you feel this post needs editing before approval, I'm amenable to that as well.

    Sincerely,
    Walden
    waldenm@optimum.net

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  19. What I would suggest is a follow-up study of a major number of individuals (let’s say 500) having started with Primal Therapy at Dr. Janov’s Primal Center at least 5 years ago. It may be difficult to get all these “veteran primallers” to agree with such an investigation, to “get them together under one hat”, as they would say in Germany, but it could answer so many important questions:

    For example, what has changed for these people, what symptoms have disappeared, diminished, returned or worsened (e.g., depression, anxiety, migraines, hypertension), what impact has Primal Therapy had on their social life, their human relations, sex life, profession and so on. And how do they feel about their lifes in the Here-and-Now? Do they have a need for a life coach (psychotherapist) who would tell them how to live their lifes or can they rely on their feelings, intelligence and (possibly improved) biochemical, hormonal equilibrium to safely and successfully navigate through life and society? Among them, is there any need for corrective emotional experiences (transmitted by a guru or psychotherapist or priest) or for psychotherapy in general? And how many of them feel that they are able and want to choose and determine their own lifes?

    As much as I know there is only one study about Primal Therapy including a small number of individuals (32). Tomas Videgard, a Swedish psychologist, had done it in the 1980ties and documented the outcome in a book. So what is really needed is a NEW SCIENTIFIC INVESTIGATION about or into a large number of primal patients who had started with Janovian Primal Therapy some years ago. There are so many psychotherapy researchers in the field - so why is none of them interested in undertaking such a study? Who is afraid of the outcome? Dr. Janov and his team? I cannot imagine. It is the psychological, medical and pharmacological establishment that is afraid of the results because those results would possibly force them to admit that their pills and surgery and talk therapies have so little to do with healing and so much with patch-up jobs, repression, defense, being in control and making money!

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  20. Walden:

    Neurosis shows itself in *compulsion* - not habit. Habits are not neurotic in themselves. A habit is just a more automatically operated learned behaviour; it's only a problem if the individual does not like the habits that they have. Habits are open to change, whereas compulsions -being compulsive- are not (or not really...they can be superficially modified I believe).

    I think what Janov is saying, to reinforce his point, is that an individual free from their pain can choose to move in whatever direction in life that they wish - they are no longer a "prisoner of their pain". Once an individual has that core freedom, they do not need to operate on someone elses behavioural philosophy. I believe it is as simple as that.

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  21. Well Walden. I was psychoanalyzed after the war by one of the honchos of the field and I had a uncorrective emotional experience. We were so busy with our psychologic repartee that nothing spilled over into real life. I am speaking from experience. I was trained at the most Freudian of clinics where the staff were either students or patients of Freud (yes, I am that old). I gave the intercollegiate lecture on Freud at Claremont/Pomona colleges. There is a big discussion on Freud on my Grand Delusion on our website. You can stretch your logic to change the real meaning of the corrective experience but it is still a "bavardage" , an intellectual exercise about something I underwent. It does not work and drowns real feeling in an interminable analysis. Get one of your friends to play it out with you. It is useless. dr. janov

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  22. Walden,

    Prinal therapy is about integrating blocked pain, by bring it to consciousness in non-symbolic form. Ok, so once an individual has achieved that, then what do we do? Better question: What do we need to do?

    No one of us can seriously answer that question until we have been there in practice. We can only "wildly speculate", because we just don't don't know (and CAN'T know) what we're dealing with when it comes to people going through the true integrative process.

    My point is that we need to be careful with what we interpret here, because we can only be operating on essentially vague and scant information. I don't mean to patronise, but you (and me!) should be careful not to from any premature conclusions.

    Ps. Dr Janov doesn't publish some of my posts too. I wouldn't take it personally. (smile)

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  23. Perhaps this blog post by Dr. Janov seems overtly simplistic because it does not mention the role of insights in Primal Therapy. There is a video on primaltherapy.com where France Janov discusses the role of insights in PT.

    In it France Janov talks about a patient who is afraid of social situations. In therapy the patient has connection and insights about his fear of socializing. France tells us that even after the connection and insights, the therapist has to urge the patient to go to a party where the patient does not initially want to go. The patient does go to the party, and has a good time overall.

    The relevant point here is not that the patient went to the party and had a good time, but that some situations at the party, later addressed in therapy, triggered even more primals and more insights, and deeper access.

    I remember France saying in the video something to the effect that it is not enough merely to experience early needs and relive early traumas (although that alone normalizes a lot of the system). To change your life, you have to have the courage to pursue whatever it is that you want to do with your life. Something to that effect, anyway.

    Of course, a therapist can urge and urge the patient to paint/write/sing/whatever it is that the patient realizes the he wants to do, but it is ultimately - and always - up to the patient himself.

    In a nutshell, I would describe (successful) Primal Therapy as a continuous process, or a lifestyle, where more primals equals more insights (and access), which in turn trigger more primals, insights and access.

    Do you think that is a fair assessment, Dr. Janov?

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  24. Dr. Janov,

    Can you give a link to that discussion you mention,I cannot find it.I had to use google to get to 'grand delusion' but didnot find a discussion.
    There is a lot of recognition about what is being said here but I don have a clear view.
    The psychiater from the institute where I have been in therapy lectured that it was not enough to just relive things,she was a big fan of Anna Freud with her discoveries of all kinds of defence mechanismes.When I started therapy I was completely convinced of your point of view.
    I don't know if this is corrective emotional experience but somewhat indirect I learned that it is good to share with others what you are enthousiast about,for instance in music,and not to hide it or keep it for yourselve.

    Paul

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  25. Paul: I don't know what discussion you are talking about. dr. janov

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  26. Hi all,

    As I'm reading through these comments, I begin to sense little frustration in Art's style of answering since the point of his writing seems to have been missed by some, to an extent at least. I'm not going to hook on the current/last comments. In my humble experience, I agree with Janov in that need is a profound mechanism which - if not repressed and redirected - informs the higher levels of consciousness to efforts to keep the psycho-physiological homeostasis. And yes, attachment and love are crucial parts of that homeostasis. And what results, I think, is that if the needs are allowed on the cortex, we have a conscious-awareness and thus "know" about ourselves in a more holistic manner than a 3rd-line-only awareness would do. And this should, according to my logic, mean that we would get our major guidance from the right hemisphere and all structures below. We'd have access. Thus we could balance the force between the internal-oriented and external-oriented hemispheres and adapt better to our environment.

    I think so many people are so repressed that the needs have to be dug from so deep, that it can almost produce such a delusion that the needs themselves can't guide us enough. But that means there's not enough connection and repression still rules. There is an important remark in The Biology of Love (which I'm translating into Finnish) that the thought patterns by pure neocortical processes are clearly different from the thought products of consious-awareness. So, if we have based our lives on faulty and bizzarre philosophies, and then begin connecting in therapy, the result might be that our entire set of schemas will be changed. Cognitivist Piaget said that "accommodation of schemata" produces anxiety, and that's why we are more likely to use "assimilation" when forming perceptions. I think that anxiety is there, but it may not be coming straightly from the changing of the schemas, but from the threat of losings one's intellectual defenses against the pain. In primal therapy the schemas will be replaced by more deeply rooted ones, less symbolic ones, as the pain gets felt.

    I've been repeating these things you all know. But my point actually was, what kind of external guidance we do need once we've been liberated from repression and become able to sense what we need and feel that? What else could we even ask for? Or is it just the neurotic society that sets us with expectations, since I don't think that this society has much activities for people who have a connected brain.

    E.Kr.

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  27. How people live after PT?

    May I offer Walden one very personal experience of how PT can change lives?

    In 1991 I came to the USA for one reason, to become rich. I brought with me a very promising pattern design that would guarantee me more money than I had already made in Germany.

    What I hadn’t counted on was the pain that I checked in with my suitcase and that reached me quicker than I thought. A few triggers unpacked the whole past of my childhood, which I had thought to leave 10,000 miles behind in Germany.

    In 1992, I wrote a book about my childhood and plunged into a deep depression. In 1993 I began to primal without knowing what I did. I called it regressing to the ‘dark places’ (among other names I invented for my experience). The reason I addressed my pain by myself was that 3 therapists tried to manipulate me, coach me, and a psychiatrist filled me up with antidepressants, because I was suicidal. I finally quit all medication and addressed the dark past by feeling.

    As I felt how deep the pain was connected, all the way down to being unwanted in a toxic womb, and later as a child to function as the garbage container for my abusive parents, I began to understand that way below the surface was a valuable human being.

    Years went by and I released one pain after another and connected feelings I was puzzled by and sometimes afraid of... Gradually my view of life began to change, without instruction from anyone. I read much about psychotherapy and enrolled in college to study psychotherapy. I even read theories contrary to what I FELT was right, just to test myself and remain objective. In 2000, I heard for the first time about primal therapy. Suddenly, everything I felt about my unknown but very natural process had a name.

    Meanwhile a transformation has taken place.
    The woman who was dressed in the haute-couture and wore $300 Italian shoes, was wearing cut-off cotton pants and plastic slippers. Instead of driving a Mercedes, I felt comfortable in a 1980 Chevy Caprice, and began growing my own vegetables instead of expecting meals from a Michelin 3star restaurant.

    For 42 years I needed this luxury to camouflage the pain, hide the shame and insecurity. Then I became a person who no longer needed “symbols” to hold me upright, to make me secure.
    The change I experienced, after the paralyzing pain was gone, was being guided by my original autonomy, (brainstem) we all can come learn to know and trust.
    Sure, there is some pain left, which I cannot release by myself. However we have a chance to find our true identity by feeling and releasing the pain of early inflicted trauma. No science can explain this feeling of change - only the one who felt it, knows the depth of it.
    Sieglinde Alexander

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  28. Paul, I think this is what you are looking for: http://www.primaltherapy.com/GrandDelusions/

    Walden

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  29. Andy,

    I don't think it's so much a question of "what do we need to do after we've experience blocked pain?". That represents an artificial sequencing that says feel your pain first, then change your life. That's one of the misunderstandings about the CEE. It is better to look at it as an integrated part of the process. If therapy is not part of your life, then what is it?

    There is this very purist idea that all you have to do is feel and all else will correct itself. I think that's a bit too simplistic and not quite real. Somewhere in the back of the book "The Feeling Child" Vivian Janov comments something to the effect that "sometimes you just have to take someone by the hand...". This is not about telling people how to live, from a position of authority. It's about being in their life, as opposed to taking an artificial stance outside of it because of some assumption about the holy high position of feelings above all else. I don't know about you, but that just doesn't feel balanced to me, and it seems like turning your back on the obvious. If you see someone with their shoelace untied, tell them to tie it. There is nothing wrong with corrective experience.

    Andy, just as a note, I have trouble sometimes tying your comments back to the thread. It would help if you were more specific with references.

    Walden

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  30. Paul: Here is a link to Grand Delusions. It is another phenomenal book by Dr. Janov!

    http://www.primaltherapy.com/GrandDelusions/

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  31. This is very well put. I am always amazed at the pure intelligence out there. Thanks E.Kr dr. janov

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  32. Alexander: This is so well put and should be a definitive answer to those who think the therapist can direct a patient after she has felt, telling her how and where to live. Remember, each one her life. No one can improve on that. If anyone tries we arrive at a fascist state where the chief knows better and will gladly run your life. dr. janov

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  33. I have just finished Life Before Birth. I will inform all of you when it is bought. dr. janov

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  34. E. Kr: you are translating The Biology of Love into Finnish? Cool. So far the only Janov book translated into Finnish, at least that I'm aware of, is The Primal Scream, which is a shame. More need to be translated.

    I study English Translation and Interpretation (got my B.A degree last November) and I'd like to translate Janov's books as well, especially Why You Get Sick - How You Get Well (by far my favorite Janov book).

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  35. Hello Please keep me informed about translations. I think that the most important of all of my books is The Primal Scream and also Primal Healing. the latter is the most scientific of them all. dr. janov

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  36. Hi Walden,

    Thanks for your reply (I'm responding to your most recent comment).

    I was basically trying to make a simple picture in my last post, for the sake of one key point. I wasn't trying to be explicitly accurate. My only real point is that when you're dealing with people who are going through the integrative process we, on the outside, can only speculate as to what is and is not necessary for a primal patients ultimate progress, because we don't know what we're dealing with when people are going through the primal process. Though yes, clearly our lives will never be as black-and-white as just de-repressing ourselves. And indeed, the primal centre has asserted in the past that the therapy should not become the 'ends' of peoples lives. That just turns Primal Therapy into a defense in itself.

    According to Janov (and we can't judge until we've been there) once patients have felt their pain they *know what they want*. Likewise, there is no need or argument for telling them how to live on any fundamental level.

    An example: Maybe if a patient says..."I really want to go for that job that I want so much, but I feel too nervous to apply and assert myself so I haven't"...then the clinic might try to insist that they go for that job anyway, knowing that the patient is probably being blocked by an unresolved feeling and that going for the job will help them to bring up the feeling, not to mention making positive practical moves for lives. But that sort of stuff is of course is a far cry from actually telling people whether or not they *should* go for a given job (or whatever) if they don't even feel the desire for it. I think that's the critical difference. You don't tell people what they want - you shouldn't need to. You just help them to get what they want.

    Primal Therapy, without meaning to be too simplistic, is about getting people in touch with themselves and their real needs (be what they may!) so they can know what they want, and experience the lives that they want.
    That's great by me!

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  37. I'll sure inform you, Dr Janov, when the translation is ready. It may take some time, but I have the enthusiasm to do it, because I know some people who definitely need to read it, and unfortunately cannot do it in English very well.

    Hienoa, Antti, let's keep up the cool things. People will need it.

    Dr Janov, you have defined neurosis in a large, psychodynamic manner. Could you sometime write more on the dynamics of psychosis, because people have very unclear conceptions about what psychosis really is. Some psychoanalytic-minded people struggling with constantly intruding and agonizing 1st/2nd-line traumas easily mislink the concepts of primal and psychosis together. To them it all just means something painful and going crazy. It is understandable though that such people want to avoid pain and horror to all extents as they've wallowed in it their whole lives and want to idealize for something better.

    E.Kr.

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  38. E.Kr.:I will do, but I may have already discussed it in one of my books. But which? dr. janov

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  39. There is an urgent need to translate “On the Corrective Emotional Experience” in to German.

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  40. E.Kr.:We do not see many psychotics because most need inhouse help and we are not set up to do that. My guess is from those patients I have seen is that the trauma definitely begins in the womb, which makes it look genetic, and that it happens early in gestation. When later in adolescence the hormones begin their roller coaster ride there again is a vulnerability and a breakdown of defenses into psychosis. A lot depends on compounding of early pain by coldness, trauma, and lack of love during infancy and childhood. A mother smoking and drinking from the time she gets pregnant can do it, as can a father leaving the mother in the middle of her pregnancy. There are all kinds of combinations and circumstances but I think the rock bottom is trauma when the whole physical system is just being organized. It is not a mental illness. It is a mental manifestation of an ineffable experience very early on. dr. janov COMMENTS??

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  41. Dr. Janov: “So why not have a new ending to a feeling/memory? Because it is not real. It is a concocted scenario that defies the patient’s reality. It is a concocted scenario that defies the patient’s reality.”

    This is what I was looking for!
    A therapist, who is convinced the, ISF (Richard Schwartz) is the solution!
    Locating the pain in the body (torso, limbs etc) and asking the foot (as example) what the pain in the foot needs to tell; acknowledging (cognitive) this message as the source of the trauma and final answer. Afterwards talk or write about the pain.
    I believe as long as we are guided by cognition we are misled, - it is no more than catharsis (tension relief). Am I correct?

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  42. REPOST: Sorry - I made a dumb mistake.

    Am I ranting?....

    I think Imprints are like black holes. You can't see them directly from the outside, you can only see their manifestations. Likewise, the development of the science that relates to the [supposed] dynamic link between Imprints and their affective impact on neurological functioning is probably going to be a hard and long road.

    In the sciences we see theories working with observations for where direct external observational capacity breaks down, due to the limits of our instrumentation. My point is that there is an important place for theory for where we can't directly see - if a given theory is right, we can usually validate it, in time, with consistantly accurate predictions of which a correct theory should provide. But of course you need the theories in the first place so as to begin testing and validating them. So, I hope more neurologists take the theory of the Imprint more seriously (and that likewise means neurosis as a dynamic system originally established as a natural defense...and not just a "mess of chemicals") as time goes by. It's an idea to progressively test and experiment with, not shy away from.

    (Of course I'm making my point as though subjective experiences and patient reports are not considered valid in themselves for the purpose of creating proven science).

    Maybe there's just one key question scientists need to ask: Are non [directly] recalled memories affective on neurological function? If so, then in what way and when?

    It's a perfectly reasonable question if you ask me.

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  43. "Remember, each one her life. No one can improve on that. If anyone tries we arrive at a fascist state where the chief knows better and will gladly run your life. dr. janov"



    Dr, Janov, after reading ideas like this and the article 'Government as a Cult of Trust', it confirms this very surprising and totally unexpected change taking place within me after reading your books; as a process of distancing myself from being an Obama drone towards individual rule, not government or majority rule. It just seems contradictory to this statement from the description of Beyond Belief about the party of minimal government: "That the brain doesn’t care if it is Islam, the Republican Party or “the secret,”".

    ?? I'm very confused!!

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  44. Traudl:
    I do not understand this letter. what is ISF?

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  45. Ferdinand: Every time they decide that they have a better idea for how to do the therapy, let us see their research, their statistics and more information other than bragging rights. dr. janov

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  46. Kaz. no be confused. Any belief in a storm, is my position. All unreal beliefs, symbolic beliefs are designed to block pain. We after all, do live in a society with rules and order. So the brain does not care what you believe, so long as you believe. Words are anesthetics for intellectuals and other neurotics. Yes, intellectual is a neurosis for those who live predominantly in the left brain. dr. janov

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  47. E.Kr: I know I can't say it better than this. dr. janov

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  48. AnttiJ:Primal therapy is a lifestyle. Absolutely. It is not the exclusive domain of the cognoscenti. dr. janov

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  49. Andy you need to write. You write well. Do an article for a magazine. I think you can do it. dr. janov

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  50. Traudl: "There is an urgent need to translate “On the Corrective Emotional Experience” in to German."
    You have my permission. dr. janov

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  51. Walden: Listen. I studied at the Menniger of the West. Strict Freudians. I know what one means by corrective emotional experience cause I did it for years when I did not know any better. It is another word for analyzing the transference. Something I also did. Useless. I underwent psychoanalysis. Also useless. I was a combat-fatigue veteran who needed help. I never got it. dr. janov

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  52. Walden: There are those in the New Age group who write about the corrective emotional experience. They do it because they do not know how to help patients integrate. Theory is one thing but we see the effects of what we do every day. dr. janov We are making a documentary. Then you will understand.

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  53. Dr Janov: Sorry to be this late to comment. I agree with what you wrote and am not expecting a better elaboration... A lot of adversity happens in the adolescence, but many don't realize that it is likely to be only manifestation of the trauma which is surging up, since the fluctuations of the endocrinological system are on the run. And I think even those hormonal variations can be to some point affected by womb/childhood experiences; for example, the amount of repression in childhood might even change the natural starting time for puberty. This, of course cumulates on the chain of pain, where the imprint might be: you must conserve energy not to die. So, the energy originally needed for puberty would go to repression instead to prevent the early pain from the lack of need-fulfillment from disturbing the daily life on frontal cortex. If we think in the sense of the gate-control theory, could we even say that depression (gates closed) were the opposite to psychosis (all the gates open, and thus vain defensive attempts in the cortex in order to preserve the status quo ante bellum erat)?

    In many cases Janov describes that it's very probable to have an unloving childhood after a bad birth. This is of necessity a generalization, but it is a bare fact though that the earlier the repression has to be harnessed, the less the child will receive the love availble. I was delivered, after a long day of trial to get out, eventually through Cesarean because my mother's pelvis bones were too narrow. At the time of this unnatural delivery the amniotic fluid had turned green (due to lack of oxygen). My father was very pleased because I didn't scream and cry like other newborn children, (because I had shut down these mechanisms). Subsequently - not hard to guess - my strategy to please my father was not to show him any negative or selfish feelings, because he only gave me good credit for my passive and decent personality, and in a way compounded my chain of pain and created a self-fulfilling prophecy on that parasympathetic imprint. My mother was quite different; she was with me (after the first delivery days) all the time for the three first years. She was exceptionally unneurotic in the sense that she couldn't close her eyes in front of any basic needs I had. She has kept mentally alive by giving me love that has strenghtened me against my father's narcissism that I was a victim of since my parents divorced when I was about four. After the earliest critical periods, a lot of repressive stuff has compounded to my mother relationsip because my father always attempted to brainwash me against her, usually leaving me with the feeling that I can't trust my mother and that she doesn't really love me. I never wanted to believe it. Always, when I returned home from my father's place, my mother had to calm me down, because I was so frightened. At the age of 7, when my pool was full of anxiety and fear for the first time very critically, I couldn't have survived with the overwhelming feeling that I have no safety, so having demonized my mother I projected my needs on my last hope - my father. He became my god. Nearly for the ten following years my life seemed okay and my defenses were strong enough to believe that, but in fact it was a horrible and cold, unemotional period of repression. As a result, I've developed a very controversial relationship with my mother; you couldn't probably see any defects in the intellectual side of our communication, but my emotional deprivation has been projected elsewhere, where it results in problems insolvable on 3rd-line, unless I try to go and dig it deep. (I put this here in case someone is interested, but I save you from going further now.)

    My point was that my life seems like a cake: there are different sorts of layers including love and deprivation. Not everything is just the same chain, but of course everything has been percepted from the view of the earliest imprint and what has compounded on that. This goes on to speculation, because I haven't got any very deep resolution. I have witnessed that we can speculate one's life and its psychodynamics ad infinitum, but we can never know the order or the real significance of our historical events before we actually let the up-surging stuff loose.

    (I'm sorry for my for-the-time-being inconsistent style of writing. I have lots to say, but I'm not used to cramming it into fine-shaped messages.)

    What kind of documentary are you making, Janovs? Will it be on video and when shall it be out?

    One more question: Are you always using interpreters in the sessions when the patient is not a native English-speaker? You surely cannot benefit a deep therapy in other than your native language, can you? I bet my limbic system won't go English.

    Yours,
    E.Kr.

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  54. Happy ending? Ridiculous.

    How can you create a new ending for an old reality? You would have to actually believe that the fantasy is real. Psychologists who promote this are promoting a state of delusion.

    Obviously creating artifical realities on top of old traumatic truths is just another way of running away from the truth - another welcome distraction, another defense. Superficially related to the orginal hurt to create the facade of cure.

    It's interesting, Dr Janov, how your therapy parallels with what we see in relationships. When 2 people deny an important reality between themseves, and are not fully real between each other, there is always tension from the unreality. When the truths are confronted, accepted and resolved, there is less tension and room for a more real and ultimately much more fullfilling relationship. Being fake is hard work and very boring - it suffocates the feeling out of the air. Primal Therapy seems to be about the same basic dynamic, only the realtionship is with ourselves.

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  55. Dear Art,

    I want to give you a site about PTSD that talks about "post traumatic GROWTH". This reminds me of the attempts to create a good ending to traumas. Then I will post a very humorous and revealing come back to this. Here is a site discussing this growth: http://www.psychiatrictimes.com/display/article/10168/54661?verify=0
    Ok but this is a response to it with a video clip from the "Life of Bryan" Monty Python film: http://crooksandliars.com/susie-madrak/proposed-army-program-will-encourage

    I believe the second post puts the other into much better perspective.

    I do my own therapy after having had help from a "renegade" chain smoking primal therapist (but I love her still). I find that people putting "positive spins" on things and pushing that we only think positively are actually very neurotic and selfish individuals. Getting "help" from them would feel like I was being re-traumatized. Why don't they just say "Sounds like a PERSONAL problem." and have done with it?

    My father once said that at a funeral tried to comfort him with things about "she's in heaven" etc. (putting a positive spin or ending on things). He said that the person who comforted him most was a lady who sensitively put her hand on his shoulder and just said, "I'm sorry."

    You can tell when someone is empathizing with you unless you are very split from your feelings, (and that can be over come if the empathizing individual is creative in my opinion), and "putting a happy ending on things or rewriting history" unless its done to trigger feelings, is not empathetic in the least.

    What kind of therapist would someone reliving pain want? Someone who pastes on platitudes and shows they can't go the distance with you empathetically, or someone who even quietly demonstrates they are there with you in the depths of your sadness etc.?

    Give me the latter and keep the "less than real" folks, who have never been where they want to take me, as far away from me as possible.

    Also, for their own good, they might refrain from such tactics as it could in some circumstances trigger rage from the "patient" (as if in such and instance you could tell patient from therapist in the first place).

    If I was too graphic, as my ex wife used to say, "Pardon my French". Perhaps since so many know French I should say "Swahili".

    Anyway, thanks for the chance to see this interchange of ideas. I hope you're doing well Art.

    Still say, "Let em stumble around, maybe they might get it right some day."

    Me I am just trying to get through the night. For all you who are thinking of therapy, Janov's clinic is probably the only best way to go.

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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