Tuesday, September 29, 2009

On Evolution and Revolution (Part 1/3)

When scientists were polled recently about the greatest discovery in science, the majority chose Darwin’s Evolution. It explained so much in so many fields of scientific endeavor. That includes psychotherapy. In my opinion evolution is essential in the treatment of emotional problems. To put it differently, no one can make significant progress in psychotherapy when evolution is not central to its process. The brain developed in three major cycles, first described by Paul MacLean. I describe them as instinct/energy, feeling and then thinking. Each evolved and has many connections to higher levels. If we do a therapy with only the last evolved; that is, cognitive/insight therapy, we have neglected a great deal of our evolution. It is tantamount to neglecting most of our ancient history and, of course, most of our early personal history. When we ignore two thirds of our brain how can we possibly get well? I think that the thinkers (the cognitive/insight therapists) “cure” their patients so that they think they are better. This leaves out physiology and feeling.
Therefore, we need to systematically measure physiologic changes in our psychotherapy. Otherwise, we can have great new attitudes but our bodies may be degenerating.
I have often called my therapy, “evolution in reverse.” It includes evolution as its kernel. And it is that sense of evolution that makes it revolutionary. Because it overturns most current thinking about the value of thinking, particularly in terms of measuring progress in psychotherapy. What we feel is what we feel no matter what exhortations take place. And those often buried feelings determine our actions. Feelings can be deviated but there is always a home for them in the brain. They cannot be changed; though we can change our thinking about them, denying or projecting them.
Thoughts, bereft of feelings are, in essence, homeless; they have no roots. So any proper psychotherapy must adhere to the laws of biology and evolution; we need to find our roots, the basis of some many of our thoughts and beliefs. The history of mankind is found in us today, and the history of man/us is found in us, as well. When we follow our history in reverse it again must adhere to the natural order of things. In therapy if we do rebirthing it defies evolutionary principles by attacking the most remote and early imprints first. We must start in the present, give ourselves a good foundation in regard to our current lives and associated feelings and then finally arrive at the reptilian/instinctive brain a long time later. These are biologic laws that cannot be disregarded. Thus it is clear that rebirthing cannot ever work; indeed it most likely creates damage; and I have seen and treated the damage it does.
Any ploy or mechanism by a therapist that defies evolution will end in failure because evolution is merciless and unrelenting; it is how we survived. It will not allow us to cheat on its principles. If evolution is neglected it will perforce end in abreaction; the release of feeling without connection and resolution. Bioenergetics, focusing the body and muscles violates that law. Focusing on bodily release (the Gestalt Therapy, “act like an ape!” is inadequate). LSD and hallucinogens completely disregard the neurologic order of the nervous system, and spray feelings everywhere with no possible connection. A primal will teach us evolution because it will follow the neuraxis precisely and tell us where and how evolution took place.

Friday, September 18, 2009

On the Nature of Science

There are critiques of primal therapy as not having enough science behind it. Apart from the fact that we have done four brainwave studies, neurochemistry and physiologic studies, having done several double blind studies (discussed in Primal Healing), there is yet another aspect to all this apotheosis of science. Before the observations of Jane Goodall and her seminal work on chimps in the field there were hundreds of statistical studies of chimps and apes. But until she had living experience there was not much progress. Her work involved clinical observation and inductive logic. And her impact on the field was revolutionary. I think our situation is similar to Goodall’s. We have done the usual statistical work but watching how it all works out inside human beings is critical. Further, seeing how we can reverse early traumas is of major importance. We can see what causes migraines over and over again in our clinical setting. Patients come in all “down” and migrained and relive oxygen deprivation, leaving without the symptom. We never suggested the correlation, we only observed and wrote about it. We worked in the “field,” as it were. This is not to deride science; on the contrary, it is to state that science has many shapes and forms.

Or in the case of high blood pressure, we watched it rise and fall with the reliving of early pain; in particular, reliving anoxia or hypoxia. And that the deeper we go in primals the more migraine and high blood pressure can be eliminated. These are biologic truths, something beyond facts that clarify the overarching truths. There are layers of truths. It is possible to explore and relive more recent hurts but the migraine will not disappear until the prototype is addressed. Migraine, then, will stop occurring when the original reason for it has been experienced; that is, during birth when oxygen was insufficient, engendering the massive constriction and then dilation of some of the brain’s blood vessels. This is the reason why it is so important not to have a personal agenda for our patient. If we do, the patient will go to where we decide instead of where her biology dictates. Because once there is a migraine the system knows that we must address oxygen impairment. They are tied together. We will start reliving only related pains and finally descend to remote causes. We don’t have to decide anything; her biology will decide for us. But if we don’t pay attention to this basic biologic law the patient will suffer. That is, symptoms are related to specific causes; not immediately apparent.

We are a therapy of nature, of following basic biologic laws, not an intellectual theory to be superimposed on patients. We need to trust biology, not defy it. We need to know that human need is the kernel of civilization and the jewel of any psychotherapy. When we find need we will find deprivation; and when we find deprivation we will find neurosis. And when we relive need and its deprivation we will resolve neurosis.

Sunday, September 13, 2009

On Connection (Part 6/6)

The test of connection is an equilibrium of the nervous system with vital signs falling below baseline. We have done four separate brainwave studies of our patients. Our beginning patients have greater power (hemispheric amplitude) on the right side of the brain, but after one year of therapy, there is a shift of power to the left. This implies for us a more balanced brain. There was a strong correlation between patient’s feeling of well being and the shift in the brain. We have completed a two-year follow-up study of fourteen of our patients. Over time the power of the brain moves not only from right to left but also from back of the brain to the front (higher alpha frequencies) where there is more control. There are higher frequencies in the frontal area, which may mean better integration and control of feelings. An anxious patient, not well repressed, may come in with a higher brain voltage of 50–150 microvolts at 10–13 cycles per second. Just before a reliving (a primal), the alpha amplitudes can reach double or triple the normal resting rate (300 microvolts). This tells us how close to conscious-awareness the memory/feeling is. It gives us a diagnostic tool to measure access in the patient.

Connection means the liberation of the right feeling prefrontal cortex from control by the left. The left can now perform its important function of integration instead of suppression. And of course, the relaxation of the patient and her sense of ease is another key piece of evidence. Most important, once there is a lock-in of feelings, the insights become a geyser. After a feeling, one patient discovered why he could never dine in an indoor restaurant; he wanted nothing over his head (which turned out in a birth primal to be smashing into the pubic arch). He could never have anything above him, even symbolically, like a boss. Of course, his father was a tyrant; he avoided authority like the plague. Thus, there was the first- and second-line components of the feeling. Disconnection often means, “I am relaxed and calm,” while the right side is abuzz with pain.

We cannot be healthy and emotionally strong so long as there is disconnection; so long as there is a war going on between the two halves of the brain, mental health is not possible. Neurosis means there is a disconnection. It is not possible to get well through more of it, which is what happens in hypnosis and all cognitive therapies, where the left is driven further from its right counterpart.

Connection has neurologic roots. The Swedish neuroscientist, David Ingvar, using a CAT scan of the brain, found that a perception of pain involved both sides of the prefrontal area working in tandem. When emotional pain is repressed, I would assume the right side is more involved; the right amygdala picks up volume. There is information that the right amygdala tends to swell when there is feeling. Thus, disconnected pain is more active on the right side than the left.

It is as though there is a secret underground in the brain where messages are passed back and forth, but on the side that should be aware there is no recognition of them. So the right side “tells” the left side, sotto voce, “Look, I can’t take any more criticism. It means I am not loved.” And the left side says, “OK. I’ll defend you against having to feel so bad. Just don’t tell me too much. Anyway, I’ll twist the criticism by the other person, and make them wrong.” And the left side jumps in immediately and automatically as soon as there is a hint of criticism. “Don’t worry, my right-wing friend, I’ll keep those feelings of feeling unloved and criticized under control even though you haven’t told me what they are.” So the left side acts out the feeling; the act-out is unconscious because the right side feeling is not connected. The left is not yet consciously-aware.

Because brainstem and limbic structures on the right largely make up the unconscious the task is to bring the right brain into symmetry with the left. Remember, events are unconscious because early trauma impacts the right brain far more than the left, and that brain loses touch with conscious-awareness.

In order for the feeling to remain in storage the forces of repression must remain intact. That takes effort and chemicals such as cortisol, the alerting chemical for imminent danger. Once memory is stored as an imprint it is always an “imminent danger.” Hence nearly all of our starting patients are high in cortisol.

Any time a therapist orders a patient to do this or that, mistakes are being made. It is now the therapist’s timetable rather than the patient’s. The minute a patient is “done-to” we are in error. Feelings will come up in natural order when we let nature guide us, the patient’s nature and also our own.
There are many levels of connection: it means the right-left brains become coordinated (via the corpus callosum). And not only from right to left but also from bottom to top. This means that the feeling centers are connected to the areas of the neocortex, specifically the prefrontal brain. So that feeling is organically joined with knowledge, not by separate processes but as an integrated whole where feeling seeks out and links to understanding on higher levels. Earlier-on, heavy and painful feelings were too much to absorb and integrate so part of it was rerouted and kept apart from knowledge. It began an underground life, creating damage. The problem is that similar feelings are kindled into similar pain so that the compounding of all of it is too much to connect and integrate. It is like a storage locker; each new added pain builds until there is no more space for feelings.

The true meaning of optimum mental health is harmony and balance. It is also the meaning of emotional-intelligence, which allows our feelings to guide us toward a sane, intelligent life, and not one filled with broken loves, drugs, tobacco, alcohol and esoteric intellectual pursuits. Harmony and balance enables us to lead not only an intellectual life, but a healthy and intelligent one, as well, one not driven by compulsions and the inability to relax. Connection will take care of all of that.

Sunday, September 6, 2009

On Connection (Part 5/6)

Recall is processed by the frontal cerebral cortex. It recounts but cannot relive. Thus, there can be a recounting of an abuse by an adult when we were four, which may not be true—a confabulation. Contrarily, reliving is systemic and all encompassing. In reliving there can be bruises from birth that reappear (the doctor’s finger marks on the newborn’s skin), or one begins to gag and choke as one relives oxygen deprivation at birth. That is a sure event not to be confused with a recounting. Reliving includes how the lungs reacted, how much mucous was secreted during birth—because during a reliving of birth it is again secreted. Recounting has nothing to do with it.

When I discuss right brain control, it is the orbito-frontal right cortex that has direct connections to the amygdala of the limbic system. With a well-functioning right brain, there will be the ability to modulate our emotional output. But we also need right-left connections. There must be right bottom to right top connection, and right top to left top connection, and right bottom to left top for total integration. This may sound complicated, but for the healthy brain it is a “no brainer.” The inhibitory neurotransmitters also work to prevent information from traveling over the corpus callosum to the left pre-frontal area. So we may have an awareness of an early trauma such as, “My mother gave my dolls away,” or “She sent me to boarding school,” but the part that hurts is repressed: “I need my mommy!”. It is the suffering component that remains unconscious in the right brain; it is that part that wants to inform the left frontal area, but to no avail. We have a paradoxical need: to feel the hurt, and not to feel the hurt; to be protected from shattering pain, and at the same time, to connect to it and have it over with.

The encoded imprint is registered throughout the system. Recall treats an encapsulated left frontal brain as an entity in itself—confusing that brain with the whole individual, so when the person understands we believe he is getting well. Only her left brain is getting well. The rest remains sick. The left-brain, expert in strange concoctions, can really believe all is well while the dissociated aspect of memory, the suffering component, is writhing with its silent scream. It is the right that gives us an overview of our lives and how we manage in it. The left dissects, is analytical but cannot see the grand picture. It can criticize but not create. Now we know where critics go. And those in conventional insight therapy are talking to a brain that has no words and wondering why therapy cannot cure anyone. It is a dialogue of the deaf from those who cannot see.
When the critical period is long gone, and we are able to tolerate serious pain we can begin the connection process. In order to change, we need to go back to the critical period when fulfillment was absolutely necessary for life. Recall can never do that. As adults we have a stable environment, are no longer dependent on neurotic parents, perhaps have love in the present, elements that allow us now to face our childhood. Meanwhile, the brain has done its best to block the feeling, providing detours from the right-limbic information highway heading upwards and leftwards. The blockage is not complete, however, because the feeling drives act-outs. “No one wants me,” becomes trying to get everyone to want her—being helpful, kind, unobtrusive, etc. The feeling becomes transmuted into physical behavior. The energy, which needs connection, has gone to our stomach and created colitis, to our cardiac and vascular system with palpitations or migraines, and to our muscles, making us tense. It may make us act meek and diffident as if no one wants us around. It causes an inability for males to become erect. What we try to do in our therapy is to allow feelings to go straight up the feeling highway to the right OBFC and then to make a left turn to reach their destination.

Connection is always the brain’s prime destination. If we only turn left and never go right, we will never make the connection. I believe the system is always trying for connection, but it gets blocked by gating. Because of the constant push to connect, feelings tend to intrude and disrupt our thinking—hence, the inability to concentrate or focus. Once connected, those diversions will no longer be necessary to drain the energy. The energy always spreads to the weakest link. “Weakest” means a vulnerable area or organ either due to heredity or to damage done earlier in life; a blow to the head in infancy may end up as epilepsy. A history of allergies in the family may result in asthma later on.

Our therapy is chosen by those who hurt, who often have too much access (access from below is not the same as access from above. The former means flooding), and not enough control. The therapist needs right brain access so that she can empathize with the patient, sense what she is feeling, and know when pain should be avoided for the moment. A therapist will earn the patient’s trust when the patient senses that the therapist knows what is going on inside of her, does not make inappropriate moves, and allows for the free flow of feelings. A therapist who interrupts feelings, who cannot sense the readiness of a patient to feel certain levels of pain, cannot be trusted. That distrust is inherent in the situation. No therapist who is left-brain contained, who is circumscribed by ideas and insights, can be trusted. None of that sensitivity can be taught. We cannot “teach” feeling. We cannot teach connection to the right brain; we can only allow it.

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.