Elements of Primal Theory (by Peter G. Pronzos, a Friend and University Lecturer)

Isaac Newton, one of the most celebrated scientists of all time, once remarked that he could see far because he was, “standing on the shoulders of giants.” In the same way, Arthur Janov’s ground-breaking approach to psychotherapy, Primal Therapy, combines some of the most important elements of his predecessors while providing a deeper and more complete theory of the healing process.

This became clear to me as I was reading the second edition of Louis Cozolino’s invaluable book, The Neuroscience of Psychotherapy.

For instance, Cozolino writes that Freud’s psychoanalysis and the psychodynamic forms of therapy that grew out of it, share theoretical assumptions such as the existence of the unconscious, the power of early childhood experiences, and the existence of defenses that distort reality in order to reduce anxiety and enhance coping.

Janov, who originally trained with Freudians, practiced conventional psychotherapy until his work led him to discover what he termed “Primal Pain”. In general, this refers to traumas experienced by babies and children which are so painful that the hurt must be dissociated from consciousness. In the more than three decades that followed, he has refined Primal Therapy as a way to allow patients to connect with these feelings in order for healing to occur.

However, in contrast to Freud’s psychoanalysis and some modern psychodynamic methods, Primal Therapists do not interpret or explain to a patient what they think he or she is “really” feeling.

They don’t offer “insights” or speculate about the source of the trauma, nor would they ask a client to do something artificial, such as exaggerated breathing or play-acting.

Instead of such arbitrary practices, Janov maintains that patients must discover their own unique truths for themselves, with the therapist acting as a skilled and empathetic “witness”. This “client-centered therapy” was pioneered by Carl Rogers in the 1960s. As Cozolino explains: “Rogers emphasized creating a relationship that maximized the individual’s opportunity for self-discovery.”

In the same vein, a Primal Therapist does not end a session after 50 minutes or some other artificial time limit. The patient has as much time as needed, and a session often lasts two hours or more.

A session usually begins by encouraging the patient to get in touch with whatever they are feeling at the moment. That is the real “royal road to the unconscious”. It may be an emotion, a memory, a dream, a song in one’s head, or perhaps a physical sensation. This bodily focus was first used by Wilhelm Reich, who had studied with Freud and who, as Cozolino notes, understood “that memory is stored not just in the brain but throughout the entire body.”

In short, trusting the client to find their own way (with appropriate suggestions from the therapist) is not only the most reliable approach to access deep feelings, but, not surprisingly, is vital to build trust between the client and therapist – an element that is essential for a healing relationship to develop. While Janov does not agree with the belief that, “the curative element is the therapeutic relationship itself”, he stresses that the patient must feel that they are in a safe, supportive, and understanding relationship.

This empathetic situation is the opposite of that which existed when the damage was done, and it allows the client to safely re-live the trauma - this time in small doses to avoid re-traumatization.

When all of these elements are in place, the patient has the maximum opportunity to make the healing connection between the conscious self and the repressed pain. When the old pain is felt, there may be crying, fist-pounding, trembling – even curling up in a fetal position when re-living a traumatic birth. (After observing Janov’s tape of a patient experiencing a birth Primal, affective neuroscientist Jaak Panksepp observed that such behavior “could not be faked.”)

Janov’s position is that - most of the time - a therapist must allow the patient to go as deeply as he or she needs to in order to make a full connection (and he believes that too many therapies do not let a patient fully descend into their pain). After a deep connection, patients will have insights into why they felt a certain way or acted out neurotically. It takes many sessions before enough of the pain is released so that one is no longer driven by the old feeling.

Like Cozolino, Janov holds that the, “primary focus of psychotherapy appears to be the integration of affect, in all its forms, with conscious awareness and cognition.” (Not surprisingly, Janov contends that cognitive behavior therapy only addresses symptoms – ideas – while ignoring the cause - buried emotions. Ideas are one of the most common defenses against feeling one’s pain).

Over time, this “integration of affect” leads to increased neural integration and information flow, as Daniel Siegel notes. The healing is not merely psychological - neuroplasticity means that there will be physical changes to the architecture of the brain itself.

On Getting to Need

In the old days I used a fake telephone to have patients call their parents and tell them everything, what they needed, the pain, etc. One patient picked up the phone and then complained to me, “There’s no one home.” This was clearly a double entendre. There was never anyone home, and when they were, there was still no one home. But I used the telephone to make a point: patients were always saying, “What’s the use? They are never going to love me.” And I say, “That doesn’t matter; what matters is that you feel and express your need.” In that need lies a world of pain. We can use the left brain to rationalize, “I don’t need it or them,” but alas, the need remains unabated. It drives so much later behavior.

So we rationalize with one brain while the other is hurting terribly. It does matter whether they can love you or not because that never changes the need; that need tells the truth of our lives, or our history. We do not want to cover over that history. In it lies liberation. For unfulfilled need means pain. Why? Because we are being warned that something essential to life and survival is missing. The trouble is that it becomes an imprint that dogs us for a lifetime. We are on constant alert, agitated and stimulated by that need no matter how much we try to relax. If we successfully repress it, the tension in our muscle system can lead to all kinds of maladies. Or we just ache all of the time.

If we never get to the right brain and the deep brain we will never get to need. It is covered over by the hyperactivity of the left prefrontal brain. We need to find a way to bypass that verbal, intellectual, rationalizing brain and get back to our nature; our feelings, which are our nature. Those who are distant from that nature cannot value our environment, or animals, or anything that belongs to nature. First they have to feel what is inside of them. Not an easy task; worse, when they chose a therapy they often chose one that also bypasses nature and flees to the safety of the intellect. Ay ay ay.

It is interesting about the right and left brain. A new study found that those humans with left brain injury became more creative. (New Scientist. Dec. 18, 2010) That is, they seemed to have more access to the right brain and feelings. After all, it is feelings that allow an overview, an ability to make the connection among facts. The left brain seems more point-by-point, punctilious; seeing each fact as an entity onto itself. Feelings seem to be more global and provide a deeper understanding of events. What the study seems to show is that the left brain can smother creativity, and of course, feelings. Language is wonderful and terrible. The more intellectual, the worse you are, as odd as they may seem. And yet, where would we be without Einstein. He was certainly creative. Yet he never got onto the Heisenberg theory. It is just that intellectuality in the social sciences seems to be deadly. How else to explain the lack of interest in a feeling therapy?

To Continue on ADD but on Addiction

to my readers: Before reading this piece please refer back to my recent article on ADD.

We understand how very early experiences even in the womb leave a trace, something engraved in the entire neurophysiologic system—an imprint. The imprints send information to higher levels of the brain as it evolves. The information that sends is loaded with a force, an energy or valence. The earlier the imprint the more loaded the information because it is usually a matter of life and death—not enough oxygen, for example. Or a mother taking drugs or drinking alcohol, or just being totally depressed.

The severity of the experience taxes the strength of the gates. That is, in order to relay information (often via the thalamus)to higher levels there needs to be a smooth flow of information; what helps keeps it flowing and not overloading higher levels is a system of gates. Thus, we produce chemicals such as serotonin and others that impede the flow of information when it is too much. Early trauma can overtax the gating system producing either faulty gates or what I call “leaky gates.” Thereafter those feelings and sensations intrude into our mental apparatus, and cause us to feel miserable or unable to concentrate. As lack of love, neglect and abandonment continue it weakens the gates so that we are chronically anxious or upset. We no longer produce the chemicals we need to hold back pain and keep the gates functioning properly. All this I have made clear.

What that intrusion also does is make us seek out those chemicals that were weakened or depleted in the service of repression early on. We are looking to be and feel normal. So we thrive on pills that enhance serotonin (prozac, Zoloft, etc.)or other drugs affected early on. So of course someone with a parasympathetic imprint takes cocaine or even coca cola and suddenly feels better and energetic. The ADDer often needs a boost for the prefrontal cortex, and so they are prescribed Adderral or Ritalin which is an upper that makes those neural cells more efficient. Or when there are leaky gates there is trouble sleeping as the deep imprints surge upward and force the prefrontal area to churn and ruminate. And there are many of these non-sleepers. But if the pain is great but the defenses hold and the gates are not leaky then we can look forward to cancer, or at least a shorter life. This is only an assumption but based on decades of clinical work. It is when repression is most massive and blankets feelings that our lives become shorter. If one can see the pressure in a Primal one would know immediately what happens to the cells from early pain. It is not simply a theory; it is observable every day in our clinic.

So once we know what happened in our womblife; was the mother a smoker, a pill-popper or drinker we have a good idea why we need the drugs we do. Or to put it differently, once we know what we get hooked on we can estimate what happened to us during womb-life and at birth. It is all no longer a mystery. So if you drink coca colas four times a day it may well be because you mother was depressed and down. She also depressed you. Contrarily, if you need to slow down with tranquilizers it may be because your mother was speedy and anxious while carrying. We are always looking for the other half of our nervous system.

Gates are good because they keep us sane and functioning, but they are not great when we lose access to ourselves and our feelings. They those gates are dangerous. It is usually a matter of too tight gates or leaky gates, and we can make our diagnosis and prognosis for therapy from there. Leaky gates puts us over the primal/feeling zone, while dense gates often place us under the feeling zone. A truly loved child lives in the primal zone all of the time.

From a Patient

"A coward dies a thousand deaths, but the valiant taste death but once"
Act 1 Scene 2 Line 32 of "Julius Cesear", by William Shakespeare.

This was sent to me by a patient:

Throughout my life, in every major endeavor, I have given my all in the struggle for success. Each time I would work long hours filled with enthusiasm, damn the sleepless nights, damn the overwork, damn every obstacle, whether it was my restaurant, my advertising agency or whatever all along the way. And with each I would progress to what I perceived as the pinnacle of success… and then, almost like magic, it would all collapse and turn to shit. I would be left broken, awash in pain, feeling helpless and worthless, and thinking of suicide. Oft times it would take years for me to recover enough to begin anew on to the next big project, culminating with the same results. Over and over I was dying my own thousand deaths.

Finally, in my late 50s, at the end of my last great failure, I became extremely ill and convinced my life was over, I was welcoming the opportunity for death. But in 2005 some weird fortune landed me in Primal Therapy.

I had no trouble getting to my feelings. I was what they call a mélange. All my feelings, at all three levels, were coming up at once. On the surface it was an ugly business with all that pain, but at the end of each session, I would be more relaxed and feel better than at any time I can remember.

Early on in my therapy I began descending into birth feelings. Now I was quite skeptical of the whole notion of birth Primals. I could not wrap my mind around the idea of having a clear memory without pictures in my head. Nonetheless, here I was: I was in the middle of a devastating toddler feeling. At that time in my life I suffered severe eczema. My parents would put socks on my hands and tie them to the bars in my crib, so I could not scratch myself bloody, then leave me there alone to cry myself to sleep. The itch, the helpless feeling of being so restrained, and the abandonment by my mother was hideous.

But then the feeling took a new turn. It slowly became all physical. I started to cough. The itch and restraint became the pain of being crushed. I felt smothered. Then as though there was some camshaft-like machine inside me, my body went into a writhing, waving dolphin motion. My head pushed against the padded wall in the therapy room. Time lost meaning. It was just forever. The feeling of suffocation was like sharp needles from deep inside my chest jabbing out through every pour of my whole body. This next is a little difficult for me to explain because during the feeling there were no words. The words came after, when I was integrating the feelings and connections with the help of my therapist. I pushed and strained and pushed and strained as the feelings became more intense. I felt like I was doing something wrong. There is something the matter with me. It’s too much. I was dying. The terror and panic accelerated until I got to a point when I thought I had made it through, and was finally going to be free… but too late. I was spent. I gave up to die. My whole body gave up the ghost and collapsed. Then my body went into wave after wave of the most radical trembling I could ever imagine.

This sequence repeated itself (I didn’t seem to be in the driver’s seat) again and again until my body just quit. The feeling slowly dissipated and left me drained, but so relaxed. It was as good as feeling gets. No fear, no panic, terror, or tension. Life felt good.

Then in discussing with my therapist what I was going through, I made the connection that what I had just experienced is the pattern of my life: struggle, fight, suffer, and plough forward to success… and then collapse – give up the ghost to death. I was amazed at the clarity, and simple obviousness of the connections.

“So,” you say, “that’s all nice, but what does that get you?”

The short of it, in Janov’s language, is that when those feelings come up at times when they are re-stimulated, the valance will be reduced. (Here I should add that this Primal was not a one shot deal. After some years I am still having to relive that scene or related scenes. This is because I can only tolerate such excruciating pain for from 10 to 30 seconds at a shot, and my birth was besought with all this agony over a course of at least hours. That’s a lot of pain to feel in order to free myself of it.) In addition when those feelings come up, I know what they really are, and I can separate those historical feelings from my present life.

But let me elaborate to give you a more concrete context. After about a year and a half of reliving those birth scenes repeatedly, I realized that I was not close to death, and had a brand new life to live. I decided to go to graduate school and get my MS in marriage and family therapy. Applying and getting accepted is no easy chore, especially for an old man. CSUSB gets a lot of applications but they only accept 12 students a year. From the git-go all those old birth feelings come up. I feel weak and helpless and I’m convinced my efforts will be for naught. I tell my therapist, “What’s the use. Even if I got accepted, which I probably won’t, I’ll be 70 when I graduate.” And he said, “yes, and you will be 70 even if you don’t.” Every time I would think about all I had to do just to apply made my arms feel weak, and found myself thinking, what’s the use? I had to get really great references, and it had been so long since I was in college, most of my old professors were already dead. I had to write a letter of intent, which meant the best pitch letter I’ve ever written in my life. But I could do all that because I have felt my pain in its proper context. I knew the enemy, and had sufficiently weakened it by reliving it to where it no longer had complete control over what I did. I didn’t have to fail.

I got accepted and quickly found out that the battle was just begun. I started the program on my 69th birthday, and found myself face to face with 11 beautiful women, all brilliant scholars, with young facile minds and energy that far eclipsed mine. This is where I really began to understand the connections I had made in my sessions. I continually feared that I would struggle, do well, and just at the point of graduation, or sometime before, I would fall on my face. I felt like it was all over at the end of every quarter. That old feeling would start to overwhelm me, but this time around, I could just lay down and let myself have the feeling, or I could hold off until my next session, and grapple with it again.

This time success was mine. I not only graduated, I managed to get the best possible placement with an organization filled with great people. But I’m not through yet. I’ll have more opportunities to give up and collapse in agony. I’ll also have to feel those feelings so ruinous in my past, and make them work for me as I continue to live my life with all the fullness I can muster. And, of course, I never fail to be amazed with every Primal and the personal growth that comes with it.

By Frank Robinette

More on Attention Deficit Disorder

I would let this go, except that last night there was a one hour special on PBS about ADD, with four major specialists in the subject. The diagnoses they came up with is what I think is the problem with the whole field of psychotherapy, psychology and psychiatry.

Not once in the hour did I hear what the origins of ADD might be and why it occurs. Most of the time, it was spelling out how to cope with it. So we also might add how to deal with phobias, obsessions, migraines, high blood pressure and on and on. It is tantamount to saying that the illnesses stay but how we deal with them changes. It is all about our attitude. So you still have the allergies and you avoid this and that to cope with your allergy. Or you have a chaotic mind, try to avoid clutter.

The first point they made is that diagnosis is essential. And they list ten things that make you an ADDer. You need to be impulsive, not able to focus and concentrate, unable to pay attention, hyperactive, unable to sit still (I am adding here), low self esteem, learning disorders, can’t listen, needs to talk constantly, cannot wait, no long-term goals, lose temper easily, act without thinking, very impatient, a bad memory, an underachiever, etc. I added here some from a list of the Brown Scale for ADD. It pretty well covers it. But you have to be suffering from this for six months or more, they claim.

What the experts concluded was that a diagnosis was critical. Once you are aware, they claim, you are half-way there, because you know what to do; which includes: making future plans, making your environment work for you, find a calm partner and a job that suits you, making an effort not to lose patience, and above all, they claim that the therapy for this is success. Once you have a success you can build on it. And you will have a higher self-esteem and won’t be an underachiever.

So let me see: you tell the doctor that you are impulsive, impatient, cannot wait, cannot concentrate nor sit still, and she says to you that you have ADD. Ok there is the diagnosis, now what? She has told you what you just told her in more simple terms. Have we made progress? Is that what a diagnosis is? Saying things in esoteric language? The doctors have then many suggestions: don’t do too many chores at once, stay in a calm environment, jog to work off tension but do not over-talk. Don’t work amid chaos. I say to the doctor that I cannot stand crowded restaurants and he tells me to avoid them. And he adds “do not take so many risks in your life”, yet he adds it is the risk takers who invent and innovate and tend to be more creative. Now I am confused.

Not once did I hear in one hour the word, why? Where does it come from and what I can I do about it. What is the generating source of all that? So now you will read my opinion about it. It is an educated opinion since I have treated many cases. What happens is that cognitive/behavioral approaches have taken hold so that the psychiatric diagnostic manual indicates all these behaviors, and it is assumed that to treat it all, we need to change behaviors, hence, behavioral therapy.

Let’s go back to womb-life; there is a good deal of evidence that a mother’s hyperactivity, the drugs she takes, such as cocaine can leave an imprint or a residue that affects the offspring for a lifetime. If the mother is “hyper” the child may also be. Just that can set up a child who is revved up from the start. An Israeli study found that the children of holocaust survivors, very anxious people gave birth to anxious children. At first they thought it was because the parents told horrible stories to the children but then they discovered that the anxiety came down through the genetic chain; that is, it was descended from the mother’s physiology—epigenetics. (Laura Spinney, 2,Dec. 2010. Internet) Then there is the trauma of birth and infancy where the child may be left for days without warm cuddling. And then harsh parents who fill the child with feelings of rejection and abandonment. All this sets up imprints down low in the neuraxis. This is then transmitted to higher centers (as they develop and evolve) where the child is filled with input from inside that frazzles his brain; that feeds constant and varied input to the neo-cortex, no different from listening to ten people at once all talking at you. Except...,except that this information is constant from inside not outside. It competes with stimuli from outside but it all gets to be too much. It is paying attention to too much input which is normal, not an aberration. The disease, if it exists at all, is stimulating information that floods the cortex with electrical input just the same as being flooded with shock therapy.

Of course, he is hyperactive, he is being prodded all of the time from below so that any new input is overwhelming and he starts to crumble. He cannot manage complex instructions; you go to the right two blocks and then one block to the left and then go straight to the roundabout and then………we have already lost him because the internal input is crowding out the information. And of course, he cannot sit still because there is information that needs connection and resolution, the integration. That cannot happen so long as he has no access to his early imprinted memories. The information is constantly climbing upwards and forwards for that connection so that the system can function better.

And then he cannot get down to things, quickly start a paper, a project or an article because there is so much going on in his brain for him to focus on just one thing. So others get impatient because he did not turn in his paper on time. He was so busy, doing this or that, as his moods dictate because he is being twisted and turned here and there internally with little cerebral control.

So why so little control? Because trauma in late pregnancy can damage or prevent the evolution of prefrontal cortical cells, as well as the cells that carry information from down below via the right to left brains, the corpus callosum. So there is damage or impairment of sorts. They do not have the cerebral equipment to control impulses thereafter. And we know that the prefrontal area works often times to control right subcortical feelings in order to shut them down for a time. When control is weak it is harder to put off an impulse, to wait for later to do something, to reflect and ponder rather than act. But those impulses are the imprints originating deep down in the brainstem centers. The impulses, the same as with the salamander or snake or shark, are there for an evolutionary reason: to strike, attack or flee at the instant when it is necessary--survival. They come out of those primitive brains and are essential, as well, for our survival—needing to swerve to avoid a car accident, for example. Here we do not want to be too reflective. Immediate reaction is called for.

Now think of the snake; he too must act immediately for his survival. It is not an aberration unless the snake brain overtakes the rest of our cerebrum and runs the show. In a way, in ADD he is running the show. What are we fleeing from? Danger. Menace. Feelings that are overwhelming. Pain that is much too much. Suffering that threatens our mental stability. It has to be contained. Think of this when we are dealing with ADD, and believe that a different turn of behavior can solve things. Think of this when we offer advice to “Make your world comfortable to you. Make your world work for you.“ Think of what and whom we are talking to because the salamander brain is doing its best to deal with matters and it isn’t getting much help from the impaired neo-cortex. Remember, then, it is an ancient survival mechanism there for a reason and very necessary in our evolution.

What is behind a lot of this, is anxiety; that is the major prod. It is pure terror engraved down below from traumas in the womb that have been reacted to just in terms of the non-verbal brain system. Or imprints from a bad birth that was life-threatening.

The ADDer is an underachiever because he could never stay with anything long enough to learn it properly. So he becomes a salesman; someone with a gift of gab who runs off at the mouth, running off part of the tension and energy of anxiety. When he recognizes this maybe he suffers from low self esteem, as the project stated. He must know that he cannot succeed because success requires sustained effort; his scattered mind cannot do that. But he may find a job that suits him and that will allow distractability. But do not ask him to be calm and to follow directions because his brain is revolting. To infuse too much input into his brain, even a simple idea, is overwhelming and that is how he feels—overwhelmed. The cortical level is being overwhelmed so he should feel that way. It is all too much. Literally.

I cannot help but feel that current therapy for ADD and most other psychologic afflictions is just “get over it”. One psychiatrist tells his patient that you must first identify the problem and then develop good habits to overcome it.”Do not live in a cluttered environment.” But he needs chaos because it reflects his brain. And as one specialist in ADD said at the end, “I am not interested in making you normal. I just want you to be successful.” The reason he is not interested is that the depth of the problem and its origins seem so mysterious, arcane and recondite that the condition, like Freud’s Id, becomes a given, not to be tampered with; an immutable force, part of genetics—our inherited weakness. All because the field and the populace is not used to considering womb-life and birth experiences as critical in our development. The science is now there; we have only to use it.

In my previous books I have discussed the notion of the parasympath and sympath. These are two different personality types governed by the hypothalamus. The parasympath is the slow, reflective type and the sympath is the hyperactive unflective type who keeps driving and going and doing. This largely is set up during womb-life and at birth; was the end of the birth difficult? Was the newborn shut down by anesthetics given to the mother, or was the end a success because the child struggled and got out successfully? He learned that he could not wait because waiting could have meant death. He wants out! It sets up an inability to wait, impulsivity and a driven brain. The parasympath is much more passive, less driving and less spontaneous. Keep in mind that those experiences happen to a brain that could register, code and store. The memory endures. And it creates a hyperactive system that is largely beyond our control. It goes to where we are weakest and most vulnerable. Trying to go to sleep is a big effort because impulses from down below are activating the mind into constant rumination and won’t let us relax enough to fall asleep. That is, it won’t allow us to go below the top thinking level and into where sleep might happen.

One of my senior therapists who has stayed with doing therapy for years was a classic ADDer. He never went to college because he was sure he could not concentrate enough to do classes. He can now and is on his way to a Ph.D.

I have treated enough of those who have ADD to know what a successful therapy entails and it is not advice, even though that might help a little. It is a deep voyage to the antipodes of the mind to where it all began.

On Being a Psychopath

We have all met them; they are the conscience-free, manipulative, unfeeling and uncaring humans (if I may say that)that leave a well of destruction wherever they go. They know nothing of love or helping and above all, of gratitude. Once you give they want more and only see you as a sucker and pigeon who can be worked for more. How did that happen?

I could quote statistics. You know that a recent study of psychopaths found that they have damage in their feeling centers; no surprise there. (see “A Brain Gone Wrong.” Scientific American/Mind. 3, Sept. 2010). But we get that. They cannot feel and they cannot empathize; they do not seem to have the capacity for it. They have the shell of a human without the internal mechanisms that gives us our humanity. They have learned how to act charming, the better to manipulate others by obtaining their trust first. But it is short-lived and then the truth comes out. They care about no one. There are partial psychopaths who have some of these traits but manage to care once in a while, sporadically and with no depth of feeling. Nevertheless, they seem to be human. They do not scam or cheat others but they are not against it if they have to. Look at the driving business man or politician for examples. They raise prices, the rent, anything, because they care about themselves and profits and not others. They need to get 10% return not matter what it means to others. They don’t hate others but they love themselves more. That is not exactly true since they really have little love to give even to themselves. The politicians care about votes and staying in power; we all know that. They will say anything to stay in office; they are master manipulators and are able to twist other’s needs to make them vote against themselves and their needs. They all care not about others. It is no doubt the sine qua non of going into politics. There are some exceptions and you know who they are. They tell the truth, which is why they cannot stay in office.

This damage to the limbic/feeling structures can happen during womblife and is highly exacerbated right afterward when there is an absence of close human contact; perhaps weeks in an incubator with little or not human warmth. Then to compound matters there is indifferent unloving parents who never touch the child. I say that there is an “emotional band missing.” They seem to be short on feelings. It can begin when the mother is chronically anxious or depressed while carrying; they baby suffers and is already damaged before coming onto this planet.

So what about morality? Psychopaths seem to be immoral, but they are unfeeling; that is what the research evidence shows. They cannot feel or empathize with others so they, as Clinton said in reverse, cannot feel their pain. So anything goes. They cheat their closest friends, a la Bernard Madoff. They don’t feel bad about this “immoral behavior” because they cannot feel the pain they are causing; cheating people out of their life’s savings without a hint of caring. Their feeling band is missing and nothing anyone can do can put it back. That is why when they are caught they can never confess to their crimes; it is always someone else’s fault. We in Primal Therapy cannot treat them because they incorporate the therapy into their psychopathy and often decide to become therapists with no training. They harm many people and advertise so well that they con many. They scream and yell (we have taken them out of prison for the court) but never feel; they go through the motions of being human without being human. We cannot give them back a full brain. The damage is too early and too severe.

A research study at King’s College, in London, came out explaining the origins of the psychopath. He remains as I have described him (and psychopaths are mostly males) but the origin of the personality disorder needs to be pushed back a few weeks. In the study,[1] the investigators used an imaging scan (MRI), on psychopaths (killers, rapists, etc.), and concluded that there were differences in their brains from those in the general population. Two of the culprits were the prefrontal area of the cortex, and aspects of the amygdala. There was an impairment between the connections in those two areas. In a normal brain, when there are emotionally stimulating events, the amygala responds. But in psychopaths there is a breakdown in this response.

The grounds for this condition, set up before birth, are exacerbated by birth trauma and lack of human contact right after birth. It would seem that in psychopaths the neural circuitry that connects feelings to higher level brain processes is deficient. Another way to put it is that feelings are not part of the conceptual, day-to-day cortical functioning. So while the person can be charming on the exterior, there are no sincere feelings underlying this facade. It is all a dumb show. Perhaps if the trauma did not exist before birth to damage the connection between nerve cells responsible for feelings and those in charge of comprehension the lack of touch after birth would not have such disastrous effects. However, when there is a pre-birth impairment of the connections between feelings and thoughts, the lack of physical contact right after birth is catastrophic. The result can be someone who not only has no control over his impulses but also has no means to experience his feelings. There may be learning but not emotionally integrated learning. The implications of the study were that psychopathy, in fact, could be a brain disease. I think it is more likely explained by epigenetic trauma.

The important lesson, though, is that psychopathy, much like other aberrations in development, bears the signature of what went wrong earlier in our lives. Memories are made indelible in our biology because they form guides to our future, instructions on how to behave in order to survive. That is, they become part of our “apperceptive mass;” always ready to serve our interest for survival.

Here is what one of my students wrote:



Psychopaths shed light on a crucial subset of decision-making that's referred to as morality. Morality can be a squishy, vague concept, and yet, at its simplest level, it's nothing but a series of choices about how we treat other people. When you act in a moral manner—when you recoil from violence, treat others fairly, and help strangers in need—you are making decisions that take people besides yourself into account. You are thinking about the eelings of others, sympathizing with their states of mind.

This is what psychopaths can't do. . .They are missing the primal emotional cues that the rest of us use as guides when making moral decisions. The psychopath's brain is bored by expressions of terror. The main problem seems to be a broken amygdala, a brain area responsible for propagating aversive emotions such as fear and anxiety. As a result, psychopaths never feel bad when they make other people feel bad. Hurting someone else is just another way of getting what he wants, a perfectly reasonable way to satisfy desires. The absence of emotion makes the most basic moral concepts incomprehensible. G. K.Chesterton was right: “The madman is not the man who has lost his reason. The madman is the man who has lost everything except his reason.”



[1] Reported in Science Daily, August 5, 2009. D. Murphy, Marco Catani and Michael Craig. Aug, 2009. See also, Michael Craig, “Altered Connections on the Road to Psychopath.” In Molecular Psychiatry, 2009. DOI 10. Pg 1038.

On Depression

The following letter to my blog was ostensibly about depression but I found something in it that to me is astounding. it also sounds kooky but it is not. She grew an inch at age twenty three. And she made no big deal about. "I grew" and then she went on to other matters. Growth happens pretty often and the patients always seem to have that "belle indifference" about it. Like it is expected and not surprising. I guess with all the other emotional improvement it may not be a big deal, but it is to me because it means that when you undo repression you undo not only a "mental" phenomenon but a total physiologic one, as well. And it means too that the patient has already gone very deep and normalized some hormones, including those that control growth. How else to explain it. My wife's foot size grew by a size and she could not understand it for years until we began to get many other reports about growth. And I have noted that there is sometimes a wisdom tooth growth after the age of forty. I have never much pontificated about this so as not to influence patients and others but it seems to me to be a monumental affair, not because of the growth but because it means that so much has been liberated in the entire system. So, yes, I would expect the depression to be lessened or eliminated. It is all of a piece. The system is one integrated affair so that change in one area means change in many others, as well. Yes, it is great that depression was cured but the "proof" of that is found in bone growth. and....and.....change in brain waves, vital signs, etc.

"Looking back to the way I was at the beginning of therapy, I can see how many things have changed. For a start, I have grown over an inch since my twenty-third birthday. I am much more relaxed in general, able to go out and live life without too much anxiety. I am not nearly as afraid of people as I used to be, and I do not let anyone push me around or take advantage of me. I am more spontaneous, following my impulses whenever it feels safe and appropriate to do so. I have periods of optimism and enthusiasm for life when it seems that I have been given a second childhood. During these times I feel good to be alive whether playing sports, listening to or playing music, watching a movie, talking with friends, or simply sitting quietly and doing nothing. I have more friends, and I can be myself around them, rather than trying to impress them or get them to like me. I have less anxiety during stressful situations, and I make better decisions to resolve problems. My memory has improved; I am not scrambling around to take care of myself anymore. I am less stuck “in my head” and more aware of what is going on around me. (People used to think I was stupid because they would say something two or three times before I heard them.) I have better coordination playing the piano despite almost no practice and I have discovered that I have a fair talent for ball sports. I can cook for myself now, which is a recent and exciting development -- I have had a huge block in that area. Food tastes different as well. Before therapy I had to smother my food with herbs and spices to give it any flavor, whereas now a small amount seems to go a long way. I get depressed from time to time, but even when I feel really bad I know that it is just a feeling and I do not consider suicide. I notice my act-outs and curb them. For instance, when my job is going badly I find myself obsessing about winning the lottery. When I feel bad about myself I tend to bounce from therapist to therapist, afraid to stick with the same person in case he or she grows impatient with me. Going against my fears is the way to feelings. Most importantly, I have a sense deep down that I am going to be all right, which I could never have said a few years ago.


In conclusion, I would say that depression is a state of emotional flatness resulting from a strong system of defenses. There is a voice beneath conscious awareness complaining that all is hopeless and that there is no point in living, but it is never heard because the defenses are working overtime. How does one cure depression? The platitudes my parents fed me certainly did no good, and I suspect that most self-help systems only push the “voice of doom” somewhere more obscure but ultimately just as damaging. The only real changes in my life have occurred after feeling, connecting to the source of my pain. The voice is being heard in part; one is not feeling sad for no apparent reason but for a reason that is known and felt. This second childhood is a great gift. To anyone reading this who is a long way from being able to do therapy, let me say that there really is hope. Above all, find friends that accept you for who you are, and look after yourself. You deserve the best."

More on Self Esteem

There is so much discussion of the notion of self-esteem that I think it warrants more discussion; we need to find out what it is, actually. So first of all, is there such a thing? No. Why not? Because it is not a feeling. It is an idea, one that friends or therapists can use to bolster it or diminish it. So what is it? It is a sense that I am accepted, loved, approved of, wanted, desired, and believed important.

Normal, loved individuals never think about it. They just have it and act accordingly. Those who need to think about don’t have it. And so when others tell you what you need to hear, you are important, valued and approved of, it temporarily lifts the esteem a bit. This is an artificial lift. It dampens the real feelings, feelings that were installed from womb-life onward.

So why do we feel we have low esteem, something that needs to be bolstered? When we are born we begin to follow orders. Parents tell us what to eat and when to eat. Where to sit (and not fidgit or move around). When to go out and when not to. We are not told, “What would you like for dinner?” What time do you want to eat?’ Ad infinitum. Bit by bit it sinks in; “I am not important and no one cares what I think or feel.” Especially at the dinner table where the “important” people talk and we listen; no one elicits our opinion about the color of the walls, the kind of chairs we sit on and when we are allowed to have guests in. This is how esteem is created, not necessarily by a parent saying you are important, but rather by being treated from infancy onward as someone who is important. Parents who value you are governed by their feelings; parents who do not value you also are governed by their feelings, which quickly become the soundtrack of your life.

This can all be compounded by parents who do tell you that you are stupid and incapable. Or they keep you from handling important tools. Or they don’t take the time to explain things. What does that do? It means that you are not important enough to be worth anyone’s time. An impatient parent who is tense and anxious makes you feel unimportant. You have to speak right away and wait for the answer, which may not come. You have the feeling that you cannot take up too much of their valuable time. It creates the subtext, “I am not important”.

Right after birth when the newborn is left alone and not hugged and cuddled right away, the groundwork for low self esteem is created. If thereafter you have to struggle to get them to pay attention, you are building feelings of inferiority. It is those wee events throughout our early lives that construct permanent feelings of being unimportant. If parents wait for you to hug them, instead of them rushing to embrace you, another neurotic block is there to reinforce your low esteem. It is not a thought-out process. When parents are aloof and heavily repressed as individuals, and cannot respond to the child with feelings, with alacrity and passion, there will be another compounded feeling in a child who now feels worthless and not worth anyone’s time or anyone’s love—worth less.

Alright, we now go to get our esteem lifted. Can we do that? No. Our therapist thinks we are wonderful and praises us; that will last for a short time but the real feeling rushes back in. And that feeling is the result of a myriad of events, all of which spell “I am not important. I am unloved.” Those feelings set in during the critical period which probably occurs before the age of six. Anything after that is symbolic fulfillment and won’t last. But we can become addicted and need praise more and more because it is symbolic fulfillment, long past its due date. When we are complimented (and someone who feels unimportant can be “bought” for a single compliment), it eases the pain momentarily. It operates like a tranquilizer; softens the blow. “You are such a good person. You are so important to me.” The reason the real feeling is never thought out is because it is a feeling that is the result of thousands of very early experiences. Those experiences coalesce around very few feelings, but those feelings drive so many symbolic act-outs.

The very fact that a child in crib can cry out for his mother for a very long time instills that sense of being unimportant. Remember, “esteem” is a word. You do not necessarily “feel” esteemed. You feel loved and that does it all. Once you feel loved you no longer search for that elusive “esteem.” Those who go on searching will never find it. It is too late. And it is not one thing you are looking for—esteem. You are really looking for someone to help instill a feeling inside you that he cannot do; someone who can undo what happened to you. No therapist can lift your esteem level; only you can do it by feeling those key experiences where little by little you came to feel unloved and unworthy of it. Until then you need praise and more praise cause the real feeling is seeping through.

Conversely, a single criticism can devastate someone who feels unimportant. Why? Because it triggers off the real pain; “I am unworthy and (you) they just proved it. If there is one thing that most of us cannot tolerate it is criticism, even slight criticism. We spend our lives staving them off so we won’t have to face and feel those feelings. And those who feel bad about themselves do whatever they can to avoid criticism. When it does occur the person can manage to immediately rationalize her behavior or displace it onto someone else. “I would have done better if you had not done………” It can never be their fault because behind that accusation is a mountain of pain.

On Exorcism

There is an article in the N.Y, Times (Nov. 13, 2010. “For Catholics, Interest in Exorcism is Revived”)about a serious trend in the Catholic church which is not so catholic, after all, and not quite sane, to boot. American Bishops are meeting to discuss how to prepare more priests to implement exorcism because the demand is so high. What the clergy say is that they need help to distinguish between those who claim to be possessed who may need psychotherapy, and those who claim to be possessed who are normal or legitimate, and would need the church’s help.

The clergy believes that not everyone who wants an exorcism really needs one. “It is only use in those cases where they devil is involved.” I presume they mean where someone is “possessed” by the devil. Now in case you think this is crazy, just remember that something like 80% of the population believes in the devil.

So let me get this straight. Those who are possessed by heaven and hell will decide on those who are possessed by the devil. None of all of those has anyone ever seen, felt or touched. It is all socially sanctioned delusions; all of it, by definition. But let us not be too quick to condemn it; I think they know that something dark and painful is in there but they just don’t know what it is. So they extirpate it symbolically where believers scream and yell, writhe and roll and do everything but put it all in context, which would really get rid of it. Real bad things did happen but it is not the devil; it is pain, and it is indeed in there and needs to get out.

We must not be too quick to condemn this since it is little more than what the electroshock therapists and the psychosurgery doctors do too. They slam, bang it, cut it out, do everything but solve what “it” is. If all of them, clergy and doctors knew what lay down there, there would be no surgery, shock or exorcism. All of them imply a mysterious, dark force, that like the “id” of Freud is unknowable, immutable and life-enduring.

And, immodestly, if they all knew that there was a way to get down deep in the brain safely without shock and/or surgery they might do it.

Now how on earth can a clergyman decide on one who is possessed be sane and one who is possessed be not sane? Possessed means insane, in my book. It is, as I have stated, a delusion, something that exists only in the person’s mind. But of course, if you believe that he/she/it/they exist you have no choice to agree with possession. And while we are at it I assume that those clergymen who abuse children would be possessed. By what or whom? By their childhood and their parents. They seem to be helpless before their criminal acts of destroying children. Their way out: let’s blame it on the devil. When you deal with “angels and demons” you are not, by definition, in reality, except the one you manufacture. It is called consensual validation; I believe because you believe, and since we all believe it must be true. Wonderful!
The priests claim that they can heal, not because they have the power; the power comes from Jesus. So now you have to believe in another abstraction.

Well you say, the notion of the devil has existed for thousands of years so there must be some truth there somewhere. Yes, the truth lies in the very early imprints that exist in the unconscious, which drive us unceasingly, and which, perforce we must give it a name—the devil. Yes, there is evil, done by humans, and if we do not know how pain drives us to be cruel, how unfeeling humans can be so bad with others, we remain at a loss to understand.

I understand that the church is training to do exorcisms because there are many shrinks doing training in primal therapy who have no idea what it is, what the science behind it is; where all you have to do is scream, beat the walls and wail. So shrinks, in the name of science and psychology, are doing no more than exorcisms.

I have seen films of exorcisms, and I have seen films of the Holy Rollers who roll on the floor and scream and yell, and then feel better afterwards. I call that abreaction. It is Primal without the feeling and the connection; but it is close. I have seen patients who talk “in tongues;” who babble on and on nonsensically but they get relief. The church says that those who can do that are no doubt possessed. In my groups I have patients get on their knees close, face-to-face, and babble but I want them to through all that to express their real feelings without any words. Within minutes the tears and sobs flow. It is a very good technique. When that fails I get the atheist to get on their knees and pray to God for what they really want; again, tears and sobs….and, real needs and real pain. They say that the ordinary work of the devil is giving in to temptation. It is not the devil, it is pure unresolved need and pain. When my patients feel all of that they are no longer driven to cede to temptation.

All of this, the church claims, is bringing back the old church values and “sanity,” I presume. Pardon me if I disagree.

On the Loss of Freedom

The hallmark of neurosis for me is the loss of freedom; and the impossibility of gaining it back. Because unfulfilled need makes us obsessive and compulsive and deprives us of choice. So we have to drink, take drugs, work so hard, eat so much, unable to rest; you fill in the blanks. We have reduced our choices and narrowed our perspective. We lead more superficial, narrow lives; lives bereft of feeling because feeling has been buried along with our basic need.



We keep having broken relationships, brief rapports, truncated love affairs because we started out in life like that; inconsistent love, sporadic affection, parents leaving. We are prisoners of these patterns because we have no idea as to the why of it all. We are on automation; acting out unthinkingly a continuous, repetitive behavior that we utterly cannot control. It controls us. And what is “it?” Need, deprived need that keeps in the unceasing quest for fulfillment. Always symbolic since it is far too late for love from “them.” So we get it from professors, bosses, partners, foremen, wives, husbands, friends. But we never get it and the task goes on ad nauseum. We never get it because the critical window is closed; it is over, done with, finished. Getting that love is no longer possible; the love as that little baby. That is why some women want sex all of the time. They need to be touched like that baby. It was why some of us seek approval over and over to try to get that tyrannical judgmental parent to see the good in us, and above all to say a simple but evasive sentence; “you are really good.” That simple sentence might avoid a lifetime of seeking approval; but ah no! We first get involved with those very critical people and then try to make them approving. Otherwise it would be too easy. We as neurotics never go straight for love. We take the parental route, circuitous; we re-create our childhood again and then try for love. Ay ay ay. We are prisoners of pain. We create our prison and then spend a lifetime getting out of it. We travel the world over trying to find the real home we never had. We idealize the women we meet and do not see who they really are until reality sets in slowly over much time. Another divorce; locked into divorce and broken relationships. If only we had access to our feelings we could get involved with decent, normal, non-neurotic people and be able to stay and grow old together. We could give our partners love and be able to feel their love. Usually, it is the opposite; we don’t want real love, we want a mother or a father, someone to take care of us, indulge us and give into our whims. When there is no old imprinted need we can stop acting out the past, trying to get something from our history and accept the love that may be there now. If we are totally narcissistic we may want total approval, total indulgence and total acceding to our wishes. That is not always easy to find but the one who is totally into herself or himself never stops trying. And they discard what little love there is for them. They look past love to the struggle, the struggle to get more and more of what no longer exists.

On Repression as the Master Gland

I have written extensively about repression and its lifelong damaging effects. The more I see of life the more I understand how deleterious repression can be. First of all, we need to understand that for almost every pain there is the commensurate repression. And the earlier and more remote the pains the greater the extent of repression. These pains call into being their antagonist. And the stronger the repression the more likely there will be disease, symptoms and decreased longevity. It is not the pain so much as the consequences of repressing it. We are putting a lid on an enormous force, a force that requires expression. Because the valence of pain is always higher as we descend down the evolutionary chain, later causes of disease can be imputed to our earliest traumas. Remember again, that lack of fulfillment of basic need even from our time in the womb, constitutes a trauma. It doesn’t have to be obvious; in fact, it is the less obvious of traumas that cause the most trouble. Yet they are easy to ignore.

The more life-and-death the experience the heavier the load of repression; and that can lead to an equally castastrophic life-and death affliction. That is why I believe that womb-life and birth trauma contribute heavily to later disease. It is not simply a belief taken out of the air; it is based on decades of observation of patients from many different countries of the world, to say nothing of a passel of related research.

The evidence is mounting that relates early (pre-verbal) traumas to later disease. In my Life Before Birth book I cite dozens of scientific studies that indicate how heart disease, stroke and cancer have their origins during the time we are being carried by our mothers. The investigators do not allude to repression; these are correlation studies—so many traumas at birth, so great the chance of this disease or that. These are statistical truths. We are after a bit more; biologic truths. We want to explain why these symptoms occur later on. What better way than to probe the unconscious of the patient?

What we see is that the earlier the trauma the more exaggerated/inordinate the response. That difficulties in the carrying mother often lead to an ill child—kidney disease, migraines, epilepsy, unable to sit still, anxious, etc. That these afflictions are also accompanied by deviant/neurotic behavior, high agitation levels, lack of concentration and focus, poor sleep and many other signs of overload. Massive repression can lead, in my opinion, to shattering illness such as cancer. I know it will shorten our lives.

OK so we all agree. Now what? We need to lessen the repression. How do we do that? We attack the pain, not “attack,” exactly. We feel it, as mundane as that sounds. Not so easily done since the defense system and repression won’t let it happen. We have to start with evolution in reverse; we feel small current pains, move to childhood, then infancy, then birth and finally, gestation. It is not done overnight. It takes many months, at the very least. But we cannot abrogate the law of nature and of evolution and hope to help patients get well. So rebirthing is out, period. So is forced crying or screaming or batting the walls. In fact, anything forced is wrong. It is gentle process if done right; no one is rushed into great pain. We know that repression sets in automatically because the system could not accept and integrate the early trauma. As the system is more mature we can tolerate more pain but who decides when and where? The patient’s biologic system, of course.

This is wonderful! Nothing to figure out; nothing to foresee, no special goal that we make for the patient. She makes her own goals; and her feelings does it for her. She feels one pain, it triggers off another related pain, and so on. In French it is called an engrenage. It takes time because we arrive at the heaviest pains last, and therefore the most obstinate symptoms or behavioral deviation is resolved last; for it is the very early traumas that pack the most lifelong impact. We can measure that impact through brainwaves and the vital signs, as well as through the biochemistry. We don’t have to guess as to impact; it is right there in the vital signs. We only need to know how to interpret them. So what makes for suicidal tendencies? When we see a reliving for birth or infancy trauma we know. And the patient tells us about its power.

With biologic truth so much is clear. With statistics we have to find a control group and do fancy calculations. And what do we find? A correlation between this set of facts and that set. We don’t really have to think much because the figures tells what we want to know. There is a difference between statistical calculating and real thinking.

The Conversion Experience

The conversion experience is an important aspect of belief systems. Due to one cataclysmic event, a person "sees the light" and is inalterably changed. As a rule, this epiphanic moment happens suddenly, converting the individual from a suffering, despairing human being into someone who has found peace and salvation. It is a seemingly magical experience that appears to happen without rhyme or reason.

Many of my patients have talked about their earlier conversions. Things must be going badly — this is the sine qua nonfor the conversion experience. Further, the difficulties must have endured for some time before the defense system begins to crumble. The individual's current situation, compounded with past trauma, becomes more than the person can handle. Suddenly there is breakdown and conversion.

I recall how one patient put it: "I was broke, divorced and alone for some time. One day, sitting in the park alone at dusk, I felt something grab me and I screamed out all to myself, 'I’ve been saved!' What I discovered later in therapy was that I had been saved from a feeling that I was never saved, that my parents let me drown in my misery without so much as batting an eye. They did nothing to help me, turned me out at the age of 15 because I didn't behave, and let me flounder in life through drugs and alcohol without once reaching out to help.”

Naked before this neglect, unloved, alone, she fled into the arms of the mystical, where she no longer felt alone or unloved. Now that she had been saved, she no longer had to feel that there was no one to save her from her childhood hell. She now had renewed hope, the same hope she had lost very early in her life. This was the essence of her conversion; she had converted hopelessness into hope.

Therein lies the paradigm for the conversion experience. I call it a primal crisis. It usually occurs to people when they are in enormous pain or on the brink of it. It is really the snapping point and it occurs when the person can no longer defend. There's nothing else left for her to do but to be "saved" by God.

Very often, when my patients are on the verge of tremendous feelings, particularly the feelings that predate verbal abilities, they begin to shake and tremble enormously; they thrash and writhe as the force of the pain almost lifts them off the ground. One patient, while convulsing violently, screamed out that she felt a "force" shaking her. Finally she cried, "I’ve been saved, I’ve been saved!"

This occurred during a personal crisis, a period of utmost despair and hopelessness. For weeks she had been seriously contemplating suicide. Finally, her conversion experience told why she was suffering so much. By being "born again," she had been "saved" — saved from the discovery that she had absolutely no one in her life, not now, not ever. Her "rebirth" spared her the profound hopelessness that comes with the realization that she was utterly alone in an indifferent universe, that no one loved her.

Why do people tremble and shake while undergoing "religious conversion?” It's really a very short leap from the feeling fueling these convulsions to sensing a new, magical, benevolent force that controls one's destiny. It is childhood pain converted to a belief in childhood magic, the belief that anything is now possible. The form doesn't matter: Jesus, Buddha, Allah, pyramid power, communication with an omniscient seer from centuries past. One is now in another realm, another universe.

What we see in the conversion experience is how pliable feelings are; how easily they are turned into ideas and how those ideas have the strength of feeling. This process is not as freakish as one might imagine, since it aids in survival.

Prototypes and Sex: The Hijack

I have written about the prototype before. It is that traumatic event that impacts the fetal system and changes its evolutionary trajectory. It helps set up who we become later on and warps our personality. It also directs how we react to the trauma at birth, (if there was one).A carrying mother smoking a half-pack a day, and then suffering from lack of oxygen at birth. A lack of oxygen would compound the prenatal asphyxiation and warp the development of personality. The memory is then stamped-in so that it governs all future behavior in the event of stress.

It is the limbic system, most particularly the hippocampus, with a bit of help from the amygdala and striatum, which scans history and automatically finds the prototype, the imprint that originally fixed the survival mode for the organism. This survival reaction becomes fixed and directs us for a lifetime. Of course it can be compounded by later events in childhood.

Let us keep in mind the prototype when trying to understand sex. To reiterate: high excitation in sex can be taken as a danger by the system because the original high level of excitation was a danger. The system cannot distinguish between the two since they have an equal force or valence. In this way sexual stimulation can trigger off the original trauma and our reaction to it. The brainwave patterns of past and present become indistinguishable so that sex and trauma fuse and run off identically together. It is the hijack. They are old friends. Sex climbs aboard the trauma vehicle and goes along for the ride; but it goes where the trauma takes it and no place else. It leads the way because it involves survival. That is what is reawakened during sexual activation. That is why we can examine sex life and look back to the kind of birth and pre-birth that the person underwent. In this way when there is an excess of stimulation there is an immediate shutdown or shut-off; the very same reaction as originally. Sex stops abruptly when a certain level of excitation is achieved.

We can look at birth and predict the kinds of sex problems there may be in the future. This is in general terms; there are many other factors that play into this equation but in an overall sense it holds true. I am focusing for now on what has been left out of the equation. Conversely, we can look at sexual behavior and post-dict (look back) on the kind of prenatal and birth-life one has undergone.


Because pain insinuates itself into sexual behavior with the identical imprinted force, it seems clear that once pain is felt for what it is there will be radical changes in sexual conduct. Sex will no longer be a conduit for something else but will be what it is. Pain will no longer be rerouted into sexual rituals by the limbic system because pain will no longer be a factor.

During the reliving, the whole physiologic system joins in the fray. It must be; otherwise it is not a valid, complete memory, and not curative. The same blood pressure, heart rate and vascular processes are there. We can measure the trauma and its force in this way. We can estimate the effects certain events have on sex, as well as other behaviors. Ordinarily, the voyage to our depths is not a difficult trip when we consider that current feelings are an elaboration of early sensations.

If we take care to allow the brain to follow its own evolution and do not talk too much or exert too much control in therapy the therapy is usually successful. If we abstain from intellectual control and third line discussion we will find the patient going back in time in ordered fashion. This will happen if we have no preconceived ideas or anti-evolutionary theories about what the patient has to do. We need to trust the process and above all, trust feelings. These feelings lie in a different universe of discourse from conventional therapy. Follow the brain. Follow evolution because evolution follows us. That is the key to successful therapy of sex problems.

One final word: Yes, it does help to deal directly with sex problems just as one would give shots or pills to the migraine sufferer. Palliatives are sometimes very necessary. No one should suffer until final cure is achieved.

The Role of Evolution in Pscychotherapy

I have been thinking about evolution in regard to psychotherapy. Last night there was a program on evolution; scientists from several countries convened to discuss the possible evolution of dinosaurs. There were many explanations, none satisfying. One, however, seemed credible. The question was which came first dinosaurs or birds?, since fossils were found of dinosaurs with feathers. They studied birds found near the site that had similar appendages as dinosaurs and filmed them. They found that these birds were born knowing only how to run; as their personal evolution continued they began to fly. This seemingly added evidence to the notion that birds came second, not first; that birds evolved out of dinosaurs, not the reverse. It is still a moot question but it led me to think about our own therapy; observing a primal session explained so much about evolution. Specifically, about the primacy of thoughts over feelings.


In a reliving, feelings come before thoughts, as they did in evolution; and indeed, as feelings become preponderant they nudge thoughts and beliefs into action. Those thoughts evolve out the feelings—being suffocated during birth—leading to, “he suffocates me.” “There is no space for me,” etc. What resolves this is not a change in attitude or thoughts but feelings; the imprint, the generating source needs to be addressed and relived because it was not fully relived originally. It was at best partially experienced when it happened and then shut off due to its load of pain. It needs to be fully lived, connected and resolved.

When we look at the session we are exploring evolution; observing both phylogeny and ontogeny. It is my position that unless the system is allowed to follow evolution exactly there will only be abreaction and not a connected, resolved feeling; that is the reason to pay attention to evolution. During a reliving of birth where we find skyrocketing vital signs there can be no crying like a two year old, no radical movements of the legs and arms and no words whatsoever. All these come later in personal evolution (ontogeny). To do all this now is to defy evolution, which violates biology and how it progresses.
We cannot get ahead of ourselves in therapy. Evolution is not to be fooled with. If we do not believe in it then all is lost and therapy is a useless exercise.

The minute a patient who is reliving something in early childhood uses words like entertaining, satisfaction, disappointed, we know she is not in the feeling brain and it is not a real experience. A five year does not normally use those words. In other words, evolution is a check on the reality of what the patient is undergoing. If we don’t know how the brain develops, at least minimally, then we might err in therapy; worse, we might push the patient beyond her tolerance level, beyond where evolution allows her to go for the moment. We might push her back into her history where massive pain lies; and all that will accomplish is overload and then symbolic acting out or acting in. Example: a patient was coming close to a feeling of a sexual seduction by her father. The therapist was pushing for her to get there. She reached the lip of the feeling and then sat up and said, “I’ve been saved! Saved by the Lord.” She was saved by the thought of the lord as the feeling nudged the thinking/believing centers into action to protect against feelings. Here evolution rushed in to save the situation and it did so in orderly fashion.

So when we observe progress during a session we are seeing how the brain works; what functions it uses to protect us, how it recruits thoughts to make us safe and neurotic, at the same time. We see how neurosis can take place. Most of all, we learn how to do the therapy; what biologic laws not to violate. What we also learn is how impossible it is to fulfill needs that are long past their due-date.

When we look at the evolution of babies we learn the laws of fetal and infancy evolution; what are the key needs and, above all, when they can be fulfilled. That critical window of need cannot be violated. After the window is closed there is no fulfillment possible, only amelioration. We cannot love neurosis away. Pain is stronger than that.

Once we begin to understand all this we know that we cannot use a later-developing mechanism, thoughts, to bring about change in neurosis. Thoughts then become a cover for feelings, not a resolving process. One reason this is not Primal Scream Therapy is that screams come after grunts in evolution. On the way out of the womb but not as yet out, there seem to be no screams. If we force screams we are wrong. If we try to make something dramatic happen to prove how smart and effective we are the patient will suffer. If we are patient and trust evolution we are on the right tract.

More on Intrauterine Life

I am convinced that whatever a carrying mother puts into her body the results on the fetus/baby will be deleterious. There is a study reported in Ethical Human Psychology (Vol 10, Number 1, 2008) that when a pregnant mother takes ordinary tranquilizers such as Prozac so Paxil she could be harming her baby. The investigators looked at mothers who took the serotonin-enhancing tranquilizers and found that the offspring had serious brain and body changes. It was linked to several afflictions, not the least of which were changes in the structure of the brain. When depressed mothers took those pills the offspring suffered from pulmonary hypertension, meaning that the baby had a hard time catching her breath. She could not get enough oxygen in her lungs. (The critical period was in the first trimester).



Serotonin is very important in brain development, and what these pills do is interfere with that development, culminating in possible withdrawal symptoms in the new-born:. Pure muscle tone, poor sleep patterns, respiratory distress and other factors. This is to say nothing of later effects on depression and suicidal ideation. So it is not benign to take a seemingly banal drug while carrying. What is important here is that it sets the stage for later addiction to drugs. The gap between uterine life and later behavioral effects can be decades, which is why it is so hard to detect. So a mother taking drugs to alleviate depression could be setting up depression and the need for uppers in the offspring. The baby can be born depressed; that is, she is low on alerting chemicals such as dopamine. Her whole system has been in suppress mode since entering planet earth.

Science Writer, Bruce Wilson, adds a quote from an article on the subject by Peter Breggin:



“Not only is the unborn baby trying to deal with a flood of maternal stress hormones transmitted to it through the placenta, but it also must deal with a drug that is affecting the very development of its stress response system and its brain.”

SSRIs (the tranquilizer acts to keep serotonin at the ready in the synapse), “actually work on the whole stress response system, which includes a host of neurochemicals and hormones. So on top of the onslaught of maternal stress, the fetus has its defense system knocked out before it has a fighting chance. A fetus whose mother took antidepressants is more likely to be born with ADHD.”

The baby can’t win. It is depleted of what it needs to respond properly to stress and then goes to school and is blamed because he is hyperactive and cannot concentrate—ADD. And here is what is worse. Later to he goes to a shrink to find out what is wrong with him and they give him drugs again. Ay ay ay. And he needs drugs because nowhere in the shrink’s armamentarium is there room for a theory of gestational life, which would allow for a treatment without drugs. With the knowledge that is out there about this it is almost criminal to not acknowledge this crucial time in our lives. It deprives patients at any shot at health and stability; any chance of good relationships, any chance that their heart will go on working into his nineties. There is too much evidence now that drugs given to the pregnant mother produce later heart disease (See. Robert Whitaker. The Anatomy of an Epidemic. Robert Whitaker.org)

Panic and Suffocation

The problems with breathing, the shortness of breath and panic in the face of suffocation are rampant among my patients. Most of it stems from real suffocation at birth where for many reasons there wasn’t enough oxygen for the newborn. The most frequent reason was the massive anesthesia given to the mother or heavy doses of painkillers which effectively shut down the neonate’s breathing. Even epidurals can cause the shutdown. The baby cannot catch its breath. And because of that there is a panic state as death approaches. It is the same panic that adults suffer from time to time; a state that seems to come out of nowhere. Anything that is suffocating, even a biology class or a crowded noisy restaurant can set it off. The breathing problems are part of the reaction syndrome to lack of air early on. It would seem that it all comes out of the blue but in reality it is a reaction. Nearly always a reaction since panic is not a natural state in us humans. The question is “a reaction to what?”. If only we therapists could get use to asking “to what?”. Instead, we often stop there and begin our regime of suppression with pills. We are suppressing memory, and access to ourselves and our feelings.

There is research into this subject that claims it happens when a trigger is set off erroneously. It is not erroneous. It is precise, albeit symbolic. The feeling is the same whether in a room with lowered oxygen or in a crowded noisy restaurant. What is most likely to trigger off panic is the feeling of being trapped, stuck and unable to escape. Being in a situation that evokes all that; being trapped at the DMV in an interminable line and when you get to the counter they tell you that you need to fill the papers better. Or worse, being trapped in a home with rules and discipline and no love. Or being trapped in a job that has no future and no “room to expand.” That is the compounding factor. There are many ramifications that ultimately trigger off the earlier imprints. Being in a car with windows closed can do it, or in a room that is very stuffy. All roads lead to Rome. Sometimes just a passing thought can trigger the panic and the person is not even aware of what that thought was.

There is real suffocation and often the compulsive sighing that goes along with it. I call it the “Jewish mother-in-law syndrome.” But what seems to happen is fluctuations in what is known as the PC02 and lactate. PC02 is an index of the partial pressure of carbon dioxide and tells us how much carbon dioxide is in the blood. When they are high there is also a higher level of lactate and the result is the physiology of panic.

And what is this trigger? Remember there are higher levels than the pure physiologic one. And each higher level represents the basic brainstem reaction in its own way. Each higher level of the brain adds a different quality to an experience. So the second-line feeling system adds emotional tone and images, while the neocortex puts it all to words. And it works in reverse. A certain emotional situation or certain words addressed to the person, a demand or an insult, can run down the chain and trigger off the original panic. The origin is so deep down and so remote as to make the reaction a mystery. With deep personal access it no longer is a mystery.

Thus, the imprint of suffocation changes the physiology toward panic. Deep breathing diminishes panic for the moment. As does primal because a session that includes heavy breathing and crying lowers the levels. Later on, it will be painkillers (opioides) that will suppress panic; yet it is the deregulated painkilling chemicals associated with the early suffocation at birth that are partly to blame.

I have discussed the compounding process elsewhere; a lack of love, an oppressive household, an overprotective, suffocating mother can all add to the symptom. A mother’s real love and affection early on can also diminish the force of panic attacks by raising the inhibitory/repressive chemicals in the brain. There is an important difference between a suffocating, over-protective mother and one that offers true love. I had a mother like that; she had a terror of her kids getting sick and her having to take care of them. So she watched over them all of the time, never giving them freedom to make a mistake, i.e., suffocation.

There was, and is, a window of healing. To achieve that now means traveling down the chain of pain to origins and opening the window again. Otherwise, we are only left with pushing down the panic which can go on for a lifetime. What makes it all worse is when the mother is distant and unloving with her baby. It is why some children go into panic as soon as they cannot see their mother. It triggers off, perhaps, the anoxia again. A lifetime of disordered breathing can be set off during this critical window. This may be due to affects on some brainstem structures such as the medulla. In short, breathing difficulties can be first line symptoms, which can only be treated by descending down the levels of consciousness to the first line.

Let’s not make the mistake of considering the panic syndrome a maladaptive response. It is perfectly adaptive and commensurate with the asphyxiation that went on at birth or before. It would be abnormal if there were no “abnormal response.” When someone shuts off our air we all get panicky. That means we have triggered off our alarm system; cortisol pours into the system as we get ready to flee. And what we are fleeing from? Our memory.

Don’t be mislead about taking pills or shots to push down the panic. Pushing it back is not the same as erasing it. It stays and gnaws away until other organs, not the least of which is the heart, cease to function properly.

On What Tranquilizers Do

I often talk about our internal pharmacy. When pain enters the arena our brains go to that pharmacy and order what it needs; say, more serotonin for the synapses to help with repression. What the commercial pharmacies do is produce the precise molecules that we manufacture inside our brains; and they do it because we cannot manufacture enough ourselves. I am convinced that most of us manufacture what we need in the ordinary course of life. But we know that just as the brain is developing in the womb there are traumas that beset us that cause lower serotonin set-points; that is, we cannot secrete what we need because pain (noxious elements such as a mother very anxious or who smokes), has caused the brain to use up its reserves in the battle to stave off being overwhelmed. And this sets up a permanent deficit. And then what happens is that the offspring/now adult, is also chronically anxious because her gating mechanisms are faulty; and so the cycle goes on.

There is a debate going on now about the advisability of using tranquilizers in the womb to normalize the mother’s system. There are minuses in both directions. If there is no medication given to the mother than she is anxious or depressed, and will pass it on to the baby. If we do give tranquilizers while the fetus is still in his womb-life, then that can be transmitted into the baby, as well. We are overloading the fetus’ serotonin levels with medication. There is no great solution except one: normalize the system before getting pregnant. That can be done, and we have shown in any number of studies that we tend to normalize the brain system after one year of primal therapy. This is preferable to messing with our inner manufacturing plant.

Frederich van der Veen presented his findings on serotonin to the Forum of European Neuroscience (July 2010). They gave one dose of a serotonin enhancer to subjects. They then watched sad films. Those on medication cried much less. It effectively brought down the levels of pain and opened some access to tears and the sad feelings. We are not normally low in serotonin except for trauma; and those traumas that occur the earliest in our lives are the most powerful, dealing as they do with life-and-death matters. Crying less doesn’t just mean less flowing tears; it also means less access to ourselves and our feelings. The purpose of serotonin enhancers is to numb out some of our feelings and reactions to them.

Taking shots or pills does not eliminate the pain or the churning of the system; it hides it all, making us more unconscious. But that unconsciousness can kill; what you don’t know can hurt you. Taking medication needs to be seen as a stop-gap method and not a cure.

Sculpting the Brain

How does a cross word by a father become a chemical in the child's brain? The angry words portend possible danger and rejection. There are clues in the tone of voice, the look, and the words themselves. What is going on inside the child is that the hypothalamic-frontal cortex axis is en­gaged to send messages to all other systems to be on the alert. This mes­sage is sent by chemical courier. It is the meaning implicit in the message that begins the chemical transformation in the child's brain. The hypo-thalamus then triggers the endocrine system to release catecholamines, making the heart speed up and the blood flow. Generally the process goes from the perceiving frontal cortex and other aspects of the cortex (hearing, sight, etc.) to the hypothalamus to the pituitary and then to sympathetic nervous system neurons which organize the flight or fight response to danger.

How does a loving look by the mother at her baby change the baby’s brain? It is responsible for the increased serotonin output that keeps him comfortable. When the traumas are severe and early enough the brain and particularly the brainstem, cannot manufacture enough. The setpoints may be altered. The child then overreacts because it cannot dilute or vitiate feelings. This child may become terrified of a slightly angry father, while another loved child would not. A deviated personality is on route.

Terror of the father now becomes permanent increases in stress hormone levels. The frontal area, now signaling extreme danger, interacts with the medulla in the brainstem to affect heart and lung function. In turn, the brainstem maintains the tone and vigor of the frontal cortex, constantly adjusting it to react to stimuli. When the brainstem is in a hyper state due to early trauma or lack of love, there is chronic, dramatic overreaction. "Hys­teria" is the label we attach to this. "What are you get­ting so excited about?" "Dunno." Now we know. The brainstem has been primed and too ready for action.

When warmth is expressed in the actions of a parent toward a baby, the baby's brain is suffused with opiates, resulting in a feeling of well-being in her. I have heard many of my patients cry out, "Show me that you want me, Mama!" In animal research, the loving handling of speci­mens just after birth increases the anti anxiety chemicals such as serotonin. This level endures so that later in life there is still an adequate mechanism to handle adversity or stress.

When a father never touches his infant, is impatient and angry, and demands obedience from a two-year-old, the frontal cortical neurons are going to be impaired, perhaps for a lifetime. Hugs and kisses during these critical periods make those neurons grow and connect properly with other neurons. You can kiss a brain into maturity.

A father who never shows happiness to see his baby, never responds with kindness to her cries is forming a new brain in her. Every action of the parent may exude unhappiness with the child who did nothing more than get born and interfere in his life. The stage is already set for later unhappiness and depression. She is now on a lifelong struggle to make the father happy to be with her—a fruitless effort. The baby can feel unwanted long before it understands the concept. And what can the baby do about it? Nothing. Her brain goes on the alert, and stays that way until later on she finds a downer or painkiller and suddenly finds what she needed all of her life — comfort and relaxation. Who can live with such a feeling when you are totally dependent on people who don't like you? And in the child’s brain that feeling remains intact and present. Drugs are calming the child, the child who feels unwanted and unliked. Drugs do exactly what would have happened if the child were adopted out to a loving, kind, warm family. Drugs become the family, and now if the adult is in a 12-step program he has another family of addicts beside him. That support bolsters the second-line limbic function and calms pain on that level. Thus the agglomeration of pain on all brain strata has been reduced on one of those levels making the search for drugs that much less importuning.

On Training in Psychology and Psychotherapy

I have two advanced degrees in the field of mental health. Despite about 12 years of university I learned almost nothing about how to do therapy. It was always hit and miss, never a science. It was “do what you feel comfortable with,” which is a license to do terrible stuff. Since neurotics are comfortable with neurotic goals and neurotic techniques; witness cognitive therapy, intellectuality raised to the level of a principle. Head lucubrations converted to a theory. The training was useless and meaningless and could help no one. Why? Because it was not and never was a science with testable hypotheses that one could suss out and discover things that would enhance our techniques.

I was also trained, a residency, at the Freudian clinic of the west, a sort of Meningers on the west coast. Also useless. I never learned a single scientific principle, nor how to put the therapy to the scientific test. The reason was there was no science and still is not: except, primal therapy. When I do training all of my advance therapists know the minute a mistake is made; it is that precise. And we do training in science as well so that we are all aware of the scientific method. Our training never stops. It goes on for years because there is so much to learn. We have done several double blind studies in Europe on our patients; and what did I discover? No one cares. It is the syndrome, “I won’t believe it even if you prove it.”

Is this sour grapes? Maybe, but when trying for research funds we are always turned away as unscientific.

Our patients are always our scientific subjects. We do vital signs before and after each session. I have written earlier on my blog about their importance. We have studied the immune system, the brain function, the inhibitory/serotonin system, and on and on (see Primal Healing for a discussion of all this). But for those shrinks who are left brain the greatest voyage they are ever going to make is to the right brain, and alas, they cannot do it. No one can do it voluntarily. We need to open the gates between the hemispheres and that takes time and serious scientific therapy.

We try to make sure that our therapy coincides with current physiology and neurology; you will see that I write a lot about that. Because we cannot concoct a psychotherapy that flies in the face of how the brain works; for example, believing that ideas change feelings, when it is just the opposite that is true. We have spent something like one million dollars in scientific pursuits, often using outsiders who have no idea what we do. But I am convinced that you cannot “prove” our therapy but these facts alone. It has to hit you in the gut. And who does it hit there? Those who suffer. Those who are close to feelings. Those who cannot make it, who are constantly depressed and anxious. They understand my theory right away and come from 26 countries for the therapy. I am not sure I would read a book by a curly haired shrink and travel 10,000 miles for help. But they do and they get help. They do not care about statistics. They care about their feelings and their misery. We are the therapy of last resort, a therapy of misery where patients can finally let their misery out. Almost every single therapy extant works to push back feelings. Isn’t that strange? Feelings need to be expressed and they push them down. The result is more depression and anxiety, more not getting along with others, more dysfunction and later, more serious disease. And worse, they have the statistics to prove their case because it is all in the definition of what is success. And if they say better social adjustment and self-described feeling better, then you cannot beat that. Because nothing is as infinite as self-deception.

More on Psychosis

How do you know when someone is crazy? Not easy because we can all go crazy in different ways. If that is so then how can we possibly define it. And, as I often say, someone can go crazy to keep from being insane. This is not just a joke but a truism. Let me explain. What psychosis is about generally is when the first line (in my lingo) moves into the third line. When deep pain and remote trauma occupy the thinking, present day frontal cortex. When the inhibitory gates are so leaky that traumas in the womb, at birth and in the first year cannot remain repressed but instead move higher in the brain and interfere with present-day functioning. Those events are so shattering that sometimes they cause aberrant ideation, paranoia, and bizarre beliefs. But those ideas and beliefs are relating to the traumas; that is, they arise out of them, so that these beliefs have been formed out of the sequestered pains, however remote.

Psychosis and neurosis are not different diseases, psychosis is the more heavily loaded pain affliction causing exaggerated beliefs and reactions: pounding a door shut with nails to keep the devil’s rays from penetrating the brain. What happens is that the heavy-valence early traumas are the kind of events we cannot see yet are the predominant factor in later psychosis. It is the result of preverbal events that provide a shaky couche upon which later events are compounded. They are so severe, near-death experiences that the gating system is weakened; and by that I mean that among other things, they put such a drain on the inhibitory chemicals in the brain that we are chronically deficient in them; hence leaky gates. It doesn’t take much neglect or loss of love later on to overwhelm the gating system completely leading to psychosis . And when a stressor such as adolescence occur there is apt to be a frank outbreak of psychosis because the body, already in turmoil due to hormones, is weakened again by raging hormones.

Because the early imprints are most often of near-death experiences when they provoke paranoid ideation it is nearly always to do with death; someone is after me and is trying to kill me. Or they are shooting rays into my head. Or they are poisoning my coffee. There is an immediate threat which forces the person to wear aluminum foil on his head to ward off rays from the helicopter above. Logic is out the door as the cortex strives mightily to concoct a rationale for the upcoming pain. In the person’s mind that rationale makes sense since the feeling he is dealing with seems very real to him. “They are trying to hurt me,” is the leitmotif from perhaps a birth experience so terribly painful and hurtful that thinking someone wants to hurt us makes sense. It is the first terrible experience occurring to the baby who has been comfortable in the womb. He is suddenly plunged into a pain that is excruciating but for which he has no scenes or explanation since he had no words nor capacity to produce scenes at the time. So of course it is bizarre since it is an event that never had words nor understanding.

So the paranoid has to compile a complex reason for what he is undergoing. Sounds crazy and it is. He is going crazy to keep from being insane. That is, he is keeping much of his cortex intact with a set of compartmentalized, cohesive ideas but so he can function. If the early pain is catastrophic it might completely overwhelm the neo-cortex and we get a babbling idiot who cannot function at all. In this sense psychosis is a defensive measure against complete mental collapse; meaning the kind of person who enters a school house and kills fourteen people. His past became his present. There was nothing left in his brain to inform him of the different between past and present.

In a sense, neurosis/psychosis is the difference between a dream and a nightmare. Dreams weave acceptable stories that are ego-syntonic. Psychosis produces stories that are ego-dystonic. Still they both attempt to ease, filter and defend against the pain. The source of the pain and its force may be the critical difference.

So how do we know that this is true? When those who had horrific birth, gestational and infantile life approach those imprints in my therapy they can undergo transient psychotic episodes. When they approach not-so-devastating events they do not go crazy. But we have to be careful because putting a fragile person into very early horrific imprints can be dangerous; and it can be lasting if the therapist does not know what she is doing.

A paranoid belief is at least a structure that keeps the psyche from fragmenting into pieces so that a person can function and repair bicycles during the day. I had one patient who was a knife sharpener; completely delusional, and yet housewives would let him in their living rooms and kitchens to sharpen knives.

The stuff of psychosis is the same material from which our brains make nightmares. They are the intrusion of very early womb/life events into the top level brain that produces ideas and some scenes to go with them. One classic one: I am in a washing machine whirling around and drowning and I am going under and cannot stop myself or the machine. His primal was of being the womb, thrashed about, drowning and feeling powerless against it.

We all go crazy or become neurotic in different ways. It depends on so many factors: where we grew up, in institutions or foster care, during war time or not, how anxious or depressed was the carrying mother, etc. These are all influences but the amount of pain and how early it started largely determines psychosis or neurosis. There is in my opinion nothing more psychotic-making than incest. I have rarely seen an incest victim who was not pre-psychotic. It depends on how early it started but when the person who is supposed to protect you becomes the danger it is crazy-making.

So what does the anti-psychotic medication do? It is largely a first-line blocker. It holds down the pain of those very early traumatic imprints. And when effective there is much less paranoia and bizarre behavior. All this means is that someone with heavy early pain needs massive painkillers to keep it all in check because those same imprints depleted the inhibitory, repressed chemicals that we produce ourselves. The levels were permanently suppressed. When early pains occur they affect the production of serotonin (think Prozac). Later that is exactly what needs to be added to the mix to keep the pain down. Ideas do help produce those chemicals, as well; so in a way, delusions are pressed into service to help secrete pain killing chemicals. The system is always trying to right itself; to normalize. Most of what we do and what our bodies do is a constant attempt to achieve normalcy. That is, to function, protect ourselves and our loved ones. Normal means survival in every way. Our physiology when normal lets us live a longer life. We do not fall so easily into disease. And in my books I have quoted study after study that shows how early trauma leads to later cancer and heart disease.