Thursday, July 30, 2009

On Being Emotionally Damaged

It seems like in psychology today the lingua franca in describing patients is “emotionally damaged.” So what is that? It means someone who is neurotic, full of pain, damaged by years of abuse, etc. So I got to thinking about it and tried to define it in a more precise way. There are two aspects to this. One: There is a timetable of needs beginning in the womb. How completely they are fulfilled or not determines one aspect of the pain. Secondly, needs that require fulfillment are the most painful the earlier they occur. And this is pretty much true for all of us. Early primal needs are nearly always a matter of life-and-death. Their lack of fulfillment can be catastrophic. This is imprinted and endures for nearly all of our lives. There are secondary, non-lethal needs that require fulfillment but when not fulfilled hurt but do not change our basic neuro-physiology. These needs come late in the evolutionary time-table.

So let us assume that of the many needs, to be touched, talked to and listened to, to have our needs acknowledged, to be understood and have our moods mirrored by parents, there are only one or two that are fulfilled. The rest means pain. There is hierarchy of needs; those that are involved in life and death—oxygen at birth, a calm environment while being carried, feeling safe in one’s surroundings and being protected. Above all, being touched and caressed and kissed right after birth. Parents need to show their love. Lesser needs such as being talked to are important but they do not alter the great pain of not being held and caressed as an infant. We can adumbrate the amount of pain by measuring the vitalness of the need and how much it was not fulfilled.

Those who are most damaged are those who have in my lingo, first line pain. The only damage equivalent is something that is commensurate with first line such as incest at age six or eight. But in addition to that there are other needs not fulfilled, then you have the makings of serious mental illness. When the parent who is supposed to protect you becomes the danger, damage is inevitable. When a child has no one to express her feelings to, damage is also evident. In my books where I write on the nature of love, I have discussed the various needs and their need for fulfillment. If you have been touched and held but not talked to the damage is much less. If you have not been held but have been talked to the damage is much more. So damage increases as deeper brain areas are touched. That is why Hollywood does not ordinarily ruin people. Those who are already wounded seek out Hollywood.


  1. Hello Dr Janov.

    One aspect of needs that I find interesting is their relationship to development. All needs must ultimately be linked to development (otherwise they wouldn't exist), so where we are deprived must also, surely, be where our development is compromised.

    If a baby is not held and loved right after birth then the baby must get the devistating message: "You are not supported, you are therefore in danger". With the defensive reaction: "Prioritise your energy to winning support". And while the baby must prioritise this pure survival need, their core social development (first with their mother) must also be compromised, because the baby--still trying to deal with an emergency--is not fully engaged in learning the link between feelings (through body contact) and facial expression with their mother, etc.

    I would guess that you could get some clues to the nature of an individual's deprivation simply by recognising certain developmental deficiencies. One example (relating to the previous paragraph) might be that an individual who was not held much during their earliest periods might in turn, as adults, struggle to get a feel for where other people are at through their expressions, because that early associative learning was not able to take place (properly).

    To say, I think this effect can lead to interesting compensatory developments too. I think people can become very clever over time, on certain levels, but I think sometimes that cleverness may have only developed to compensate for a more primary "dumbness". In fact I think we all probably have a lot of that.

  2. I totally agree with Andy. Indeed, well as defining 'emotionally damaged' it is worth defining 'need' too in a neurophysiological and biological sense. Clearly 'need' constitutes the fulfillment of a necessary precondition for some aspect of our human development which if not met will ultimately me reflected in and measurable by its effect on our condition. I think someone like John Bowlby is interesting here whose theory of attachment behaviour (which closely relates to Harlow's work and is certainly inkeeping with Dr Janov's in my view) suggests that there are clear phases of development our behavioural systems go through in order for them to become refined (goal-corrected in the context of the human polar affect system) and that if necessary pre-conditions are not met then behaviour takes alternative trajectories e.g. showing clear signs of disturbance caused by dislocation and interruption (although Bowlby over emphasised separation from the primary caretaker as the main cause here)of the mother-baby relationship.
    Ultimately, the extent to which needs are met defines our experience of our environment. This is as much true in the womb as out of it. No organism is able to adapt beyond his environment - it would be a waste of energy and not to mention physiologically impossible. But of course where needs are not met not only can an organism not adapt, this ultimately means he can not express himself and it is this stifling of genetic expression (and therefore physical and mental potential to become socially functional) that causes ultimately the pain and hurt that precipitates the splitting or neurosis.

  3. Hello everybody,

    Yet another aspect of the need issue is that many needs are only PARTIALLY fulfilled. Indeed, a child may occasionally be listen to, stroked or kissed. There might be some situations when the child was shown some attention, when he received a compliment. I found that the less the need is fulfilled, the more difficult is to recognize and feel it. The most difficult needs to feel are the ones that are not fulfilled at all, the ones that stayed unconscious all the time.

    Marjan Tosic

  4. Adding to Andy's comment:
    This urgent 1st line need that is postponing further social development cannot recieve full attention once it is blocked from consciousness. Worse still, the need cannot be fully expressed because it is not fully felt. So no-one can see just how badly the child needs a hug. Not even the child can see it. Even a more feeling person will be less inclined to sense that the child needs to be held. It's a self-perpetuating cycle. If the baby was held by ANYONE during the first moments of life, and was surrounded by people who were more feeling than the mother, then perhaps the baby's 'self-destruction' phase could be halted to some extent.

    How about a Janov Private Hospital for Births.

  5. Richard: You often see the unfulfilled need in the actout. A woman may be hypersexual, trying to get touched. When we start with that and allow her to go back we find the original need. Cherchez le act-out. art janov

  6. interesting info on babies brought up on a kibbutz whose parents may only spend around 2 hours a day with them plus all day Sunday. The rest of the time the baby is looked after by a nurse, in the sense that its physical care is attended to. However, even though the parents are seemingly bit players the child's psychological need for security (as measured in its intensity of attachment) is fulfilled by the responsiveness and social interaction provided by its relationship to its parents and not at all by the nurse who does the caring. So as long as the child has a responsive relationship to a familiar figure and attachment can occur then pain and psychological hurt does not cause damage. It is when kids are farmed out by parents to teachers/nurses as surrogate parent figures that damage is done. I know Dr Janov has commented on the harmful effects of boarding schools in the past. I think this needs to be in the context of parents who are using the school system to evade their parental relationship.
    As a psychology student, combining Arthur's ideas with those of John Bowlby (attachment theory) is proving really profitable. I don't know if Dr Janov ever met Bowlby. Be fascinating to know if they did ever chat.

  7. just to add, i think Dr janov's analysis of the damage caused by lack of touching, mirroring etc. is parallel to Bowlby's belief that the intensity of attachment of a child to its mother/primary care figure relates to 2 variables: 1. responsiveness of mother to the child 2. mutually enjoyable social interaction with the child. It is a given, it seems to me, that if a mother is unresponsive/not interacting then the pain of psychological insecurity, loneliness, stimulation deprivation will be terrible and inhibit social and physiological development.
    Strange to think that both Bowlby's (1969)and Dr Janov's (1970) ideas are about 40 years old now (of course both were built upon research going back to the 50's as well as from direct clinical observation) and science is really only just beginning to run with them in a big way (evolutionary psych, developments in neurobiology). I guess it takes 2 generations for ideas to work through.

  8. I knew about Bowlby decades ago but never met him.
    dr. janov

  9. About Michael Holden. He was a really nice guy -- I knew him quite well (1977). However his primals always went straight from 3rd-line (here-and-now feelings) to 1st-line (very early -- with him it was birth). I don't think he ever felt on the 2nd-line or made any connections there. I think 2nd-line is so important and if we try to jump over it we do so at our own peril.



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.