Sunday, January 3, 2010

Why Are We Anxious? (Part 4/6)

The concept of resonance is important in understanding anxiety because situations can resonate within us from language centers to below the level of language where the panic exists. We can be stirred up even when we don’t know with what the outside situation is resonating. Thus, in sex, a nude female body can resonate in a man with an early experience with his mother. She may have been seductive long before the child had any understanding of it. I had one white patient who had a very seductive mother; she French-kissed her son. Later, he could only have girlfriends who were Black or Asiatic—too white a girlfriend would resonate with that early seduction that scared him. Here “White” women resonated with a White mother, something to be avoided. I treated a lesbian woman who was molested sexually by her (white) stepfather. She could only have relationships with Black men. Later, any man resonated with the early stepfather. She switched to sex with woman. It seemed much safer to her. She discovered that when she was with a man in bed she had a chronic low-level apprehension. When she switched to women there was no more problem.

When there is a life-and-death struggle at birth due to lack of oxygen (anoxia), for example, the existing reactive system is activated, but because it cannot fully respond due to the complete load of pain and terror (to feel it completely would be to run a cardiac attack or at least to lose consciousness), it reacts partially within its biologic limits and then puts the excess part of the terror away for good keeping; it houses it until our system is strong enough to feel and resolve it. It lives behind our repressive gates. However, we continually respond to this stored terror with chronically high stress hormone levels, a compromised immune system, misperceptions, strange ideas, nightmares, and chronic malaise and a startle reaction. This high activation level gnaws away at the cardiovascular system so that we fall seriously ill at age 55, even though at the time we seem to be living a normal, relaxed life.

We have done systematic stress hormone cortisol studies with our patients and have found a normalization after one year of therapy. That tells us that the variable, reliving, may well be responsible for the reduction of anxiety. This drop is also associated with a drop in heart rate and blood pressure. The patient also claims to feel better. Biologic measurements are more reliable because they inform us of what the physiology is doing, irrespective of what the person thinks.

Tranquilizers seem to be obligatory to enable someone in pain to function on a daily basis. What is diabolic is that in spite of a loving childhood the person suffers. She may not have been loved on the first-line where good oxygen and nutrients were essential, which were lacking; or there may have been a mother terribly tense over losing her job in the economic crisis. From the baby’s point of view he is unloved; his needs (for calm)are not met. From the mother’s point of view she was doing the best she could and could not help her feelings.

A carrying mother who smokes and drinks is not loving her baby; her needs come first. If she takes drugs such as cocaine she is alterating the physiology of her baby. Male monkey offspring of mothers were given cocaine had poor impulse control and possibly were more likely to take drugs later on. This study went back 15 years to monkey mothers who were given cocaine. Despite the effects from womb-life, too many of us were not loved in obvious ways later in our emotional life when there was no touching or holding.

One of the ways we know where anxiety comes from is the depth and agony of the feeling of terror. There is always the fear of dying because that is what actually happened in the womb or at birth. Fear is second line, organized higher up in the brain. Anxiety is paralyzing because it is how some part of us reacts to terror. When we have chronic over-arching anxiety we are dealing with a mélange of fear and terror overwhelming the defense system; a compounding of a harsh childhood and poor gestational life. Here is resonance. Current apprehension soon turns to anxiety as the feeling triggers off low-level terror. The terror, I remind the reader, is already there. It keeps us from relaxing on the beach, pushing us into constant activity. And we rationalize, “I don’t like the sand.” What we do in the present is usually the reflection of our history. Life becomes a rationale for our imprints. If we have a therapy of current focus we are missing out on all those causes.

In order for some patients to feel the fear and its context we need to tranquilize the terror so that it does not interfere with the feelings the patient has. We offer first-line blockers. In conventional medicine and psychotherapy this is sometimes known as anti-psychotic medication. What is being blocked is the terror that often produces bizarre ideas in the patient. The tranquilized patient will no longer be overwhelmed because we have reduced the overall pain load; she can focus on a single feeling. And there is no longer an overload that caused the generation of all those strange ideas and beliefs. We see here how psychotic ideation develops. Feed in too much pain and the systemic searches for an outlet. Reduce the level of pain and the system calms down and no longer needs the ideas to rationalize what is going on inside. Those strange ideas are like an overflow valve that channels the pain away from consciousness and into awareness. He is hyper-alert.

Feeling overwhelmed happens when something in present resonates with terror, and the combined force is overwhelming. “It is all too much.” We cannot follow orders because there are a string of orders from the past inside that command us; they take precedence.

What is diabolic about anxiety is that many of us suffer from chronic low levels of anxiety, barely perceptible, acted-out constantly. The person is rarely aware of it yet it drives her to go and do all of the time: cannot read a book without that agitated feeling. Cannot focus for long, cannot listen to a long lecture, cannot listen to the children’s stories and above all that agitation catches up with her at bed-time when she cannot fall asleep. We cannot be a loving parent when we don’t have the patience to listen to our children and their stories. It is not that the parent is bad person or unloving in his intentions, but that he suffers and cannot help himself. He rationalizes that he must keep busy to feed his children. We know otherwise. He has to keep busy to discharge all of that energy. If he cannot he suffers.

The low level anxious person can rarely listen; that takes too much patience and the person can’t wait. This individual cannot listen to complicated instructions (how to assemble this table or how he must turn right at a certain intersection); he bows out and glazes over very quickly. If he is given a chore of what to buy at the supermarket, as soon as it gets to three choices he is gone. “I know she said to buy low-fat but low-fat what?”

Sleep is problematic when the low level mobilization (against the early pain) is now active as the third line diminishes its hold a bit. Don’t forget, the higher-level neo-cortex is often pressed into service to control our lower level feelings. It is an escape hatch. As we need to let go of that top-level control in order to sleep we become more vulnerable. We have to release control. Enter a ruminating mind. A very busy, unceasing mind that cannot stop itself long enough to fall asleep. As we get closer to the deep brain in deep sleep we approach those primal feelings. They agitate and move upward to make the thinking brain work very hard. Even in sleep when we begin to suffer from the uprising of first-line terror the brain rushes in to cap it with a nightmare. The nightmare attempts to encapsulate the feeling so that it never becomes conscious. It is not a willful act, that nightmare. It is a built-in survival mechanism that ensures that our conscious/awareness will not be impaired by overwhelming input. The story in the nightmare does not count for much, but the feeling in it counts a great deal. That feeling can give us a way in; the royal road to the unconscious.

The imprint of a memory is really an ensemble of reactions that is impressed simultaneously into the whole system when there is inordinate danger, a smoking mother, for example. It is a total experience, unlike recall, which is largely mental, meaning a left prefrontal cortex operation. We may not be able to recall an imprint. We can only remember it with our entire system: with our muscles, viscera, and blood system, because all of us was involved in the original experience; therefore, it must be relived with all systems involved originally when it was set down. Not only that, but it must be relived with the same intensity in which it was impressed, which is why it has rarely been seen in conventional or cognitive therapy where the emotional level is rather subdued. A few tears is not exactly deep wailing that we see in our therapy.

Let us not confuse recall with memory. Deep preverbal pains can only be recalled with the entire biologic system. Verbal recall is another animal (literally) altogether. It is systemic, organic, physiologic memory that cures; verbal recall does not. When we suffer high blood pressure, for example, we may be suffering from a lingering residue of an overall trauma very early in our lives--in the womb. The high blood pressure has been stripped from the generating memory and lives its life apart. It is trying to tell us something about where it came from; but alas, we drug it unmercifully so that it never volunteers its origin. Same for heart rate. We are forever putting those memories to sleep.

So there are at least two main avenues to provoke anxiety and repression; one, the meaning of a certain look by the parent, (or any negative reaction of theirs) which means I am not loved nor will I ever be. Two, something is happening that is an immediate threat to my life. In either case there is a disruption in the evolution of the organism.

Originally, suffocation during birth provoked repression to order to keep the system on equilibrium and to keep the baby from dying. Two of my patients were later told by a doctor that they had what seemed like a heart attack at birth. Later on, as the feeling was compounded by additional pain and terror it provoked even more shut down. In both cases there is danger. It will be crippling anxiety and not plain old fear (terror-light) when the lower brain centers are actively involved.

When the resonance travels down the chain of pain and reaches low levels of the neuraxis, terror then appears. It is not something new; not something to try to reach. It is an old friend (or enemy). In fact willfully trying to reach a lower level feeling is an oxymoron; the more we use top level will, the less we can descend to where we have to go. The more we let go of the present the more access we will have. The person in terror will suffer anxiety because the body is preparing for extreme reactions in order to survive. You cannot be slow to react if there is a lion coming toward you.

There is usually the gloom and doom aspect of the anxious feeling, “I feel like I am going to die.” Since no one manufactures a feeling that has no basis in reality, we must seek out origins. If we want to successfully treat any of the so-called psychosomatic (migraine, high blood pressure) symptoms we must find the generating sources. Here the feeling needs to meet its maker, and there is a maker. What happens is that a current situation, giving a speech; through the process of resonance, a mild fear and apprehension has set off the original terror deep down in the brain so that the person is not just sort of fearful, but suffers a full-fledged anxiety attack, feeling she is going to die. The feeling is correct! We don’t understand her reactions because it is just giving a speech to fifteen people. Yet she feels overwhelmed. Or someone is criticized and goes into an anxiety state. Why? Because it can mean, “I am not loved if I make a mistake.” Or “catastrophe happens if I make a wrong move.” And no doubt this person in her childhood was not loved when she made a mistake.


  1. "We have done systematic stress hormone cortisol studies with our patients and have found a normalization after one year of therapy. That tells us that the variable, reliving, may well be responsible for the reduction of anxiety."

    May well be? How about "definitely". OK so you can't afford to do a large scale study. But surely you have tested the cortisol levels of a few successful patients, not just after one year of therapy, but say 5 or 10 or 20 years later? We need to know the changes are permanent. I assume you must have tested a few people, including yourself.

  2. bug ticka bug ticka bug bug bam
    bam debam debam dooga dooga BAM



  3. Richard: I wish I understood this. AJ

  4. ART
    your writing is like tsounami in our heads. maybe that's close to what Richard feels about this article. at least that is how i took it. By the way. Great article.

  5. Art
    Richard says… I got no words to tell you how I feel… but I am so happy… overwhelmed about what you wrights… this helps me allot. You are right on the spot for what we all should know… feeeeeeeeeeeeeeel.
    Frank Larsson

  6. Good post, i would like to comment that in one paragrafe you said fear is second line, I don´t know if it is a mistake or you really think so.In one of your videos you weren´t sure about agresivity being a defence or a feelling. In my opinion is a feeling.To finish i want to tell you a impatient to read your new book wether in english or french.

  7. Thanks Athanasios. I would recommend reading it bit by bit and then when the number 6 appears, read it again from start to finish. It is very hard to make sense of it reading it in chopped up fashion. art janov. A tsunami means you are overwhelmed. Is that what you mean?

  8. The reference to Alzheimer's caught my eye in the notice by Dr Janov (above) of a study to be conducted by the Primal Centre and a German clinic. Last night, every major Canadian media outlet came out with a story about the increasing cases of Alzheimer's here in Canada (see one story below, partial contents). I don't usually watch the news , but I did last night, and that kind of startled me. Thankfully, my own paremts, both 85, have been spared. Marco

    Luke Hendry

    The Intelligencer

    There's a storm brewing, and Canada isn't ready to face it.

    This year's Alzheimer Awareness Month comes with that serious warning from the Alzheimer Society of Canada. The society says the country isn't prepared to deal with a "tsunami" — a growing number of citizens living with Alzheimer's disease and other dementia and the projected soaring costs related to their care.

    The finding is one of many detailed in a new major study entitled Rising Tide: The Impact of Dementia on Canadian Society. It was commissioned by the national Alzheimer Society.

    Yet the with warning of a of new patients and soaring costs also comes good news. With quick, concerted action much can be done to ensure dementia sufferers and their families get the support they need, it says.

    "What we're looking for is policy makers to come up with a national strategy coast to coast so Canadians will be supported when living with dementia," said Laura Hare, executive director of the Alzheimer Society of Belleville-Hastings-Quinte. She said the policy is needed to guarantee all citizens, regardless of where they live, will receive the same quality care.

    "The impact of the growth of the population of people with dementia is going to have huge economic consequences,'' said the society's David Harvey, noting projections suggest direct and indirect costs of the disease will multiply tenfold.

    The number of Canadian cases of Alzheimer's and other forms of dementia is expected by the year 2038 to more than double, reaching about 257,800. By then, the report says, direct and indirect costs of caring for people with dementia could hit $872 billion.

    "If nothing changes, this sharp increase … will mean that by 2038, the total costs associated with dementia will reach $153 billion a year," said Harvey.

    Hare said the dementia rates weren't unexpected, but the costs were surprising .

  9. Richard (1st comment): We have been tested and have been low but have not follow up studies over years. It is far too expensive. The average cost of our research study, which we fund totallly is between $300,000 and $400,000. art janov

  10. Art,

    You say:

    "If you are wondering what comments are chosen to publish: the criteria is simple. It must be thought provoking, adding to our general and scientific knowledge, must be understandable, and not so personal that it applies to no one but yourself."

    so this:

    bug ticka bug ticka bug bug bam
    bam debam debam dooga dooga BAM



    meets the criteria? you're kidding, right? I don't particularly care if you publish/reply to my posts or not, (still waiting on your promised reply to my query of how to spot psychosis in a potential patient, btw), but where's the consistency here?


  11. Hey A-Jan: have you recovered from the throat surgery? Are you able to speak now? How is your health in general? I don't want to be nosy - I'm just concerned. I have something else I want to ask you about too. Sorry that it doesn't relate to what you wrote here, but I am new to your work. I just read the Primal Scream for the first time last year. In there, in the chapter on sleep and dreams, you say that people sometimes try to scream in nightmares but can't. What if you do? What does that mean? An answer would be much appreciated. I admire you very much and sometimes I feel like you are the only person who really understands me.

  12. anonymous: Usually it means you are awake, therefore it is not a sleep event. It is waking. Or it means that the pain and terror is so forceful that it can wake you up. AJ

  13. anonymous: Hi My "Life Before Birth" should be out in the Fall. I think it is a very important book. art janov. My throat is healing slowly. It will never be really good as many of the right side cells in the throat are terribly damaged due to surgery that went bad.


Review of "Beyond Belief"

This thought-provoking and important book shows how people are drawn toward dangerous beliefs.
“Belief can manifest itself in world-changing ways—and did, in some of history’s ugliest moments, from the rise of Adolf Hitler to the Jonestown mass suicide in 1979. Arthur Janov, a renowned psychologist who penned The Primal Scream, fearlessly tackles the subject of why and how strong believers willingly embrace even the most deranged leaders.
Beyond Belief begins with a lucid explanation of belief systems that, writes Janov, “are maps, something to help us navigate through life more effectively.” While belief systems are not presented as inherently bad, the author concentrates not just on why people adopt belief systems, but why “alienated individuals” in particular seek out “belief systems on the fringes.” The result is a book that is both illuminating and sobering. It explores, for example, how a strongly-held belief can lead radical Islamist jihadists to murder others in suicide acts. Janov writes, “I believe if people had more love in this life, they would not be so anxious to end it in favor of some imaginary existence.”
One of the most compelling aspects of Beyond Belief is the author’s liberal use of case studies, most of which are related in the first person by individuals whose lives were dramatically affected by their involvement in cults. These stories offer an exceptional perspective on the manner in which belief systems can take hold and shape one’s experiences. Joan’s tale, for instance, both engaging and disturbing, describes what it was like to join the Hare Krishnas. Even though she left the sect, observing that participants “are stunted in spiritual awareness,” Joan considers returning someday because “there’s a certain protection there.”
Janov’s great insight into cultish leaders is particularly interesting; he believes such people have had childhoods in which they were “rejected and unloved,” because “only unloved people want to become the wise man or woman (although it is usually male) imparting words of wisdom to others.” This is just one reason why Beyond Belief is such a thought-provoking, important book.”
Barry Silverstein, Freelance Writer

Quotes for "Life Before Birth"

“Life Before Birth is a thrilling journey of discovery, a real joy to read. Janov writes like no one else on the human mind—engaging, brilliant, passionate, and honest.
He is the best writer today on what makes us human—he shows us how the mind works, how it goes wrong, and how to put it right . . . He presents a brand-new approach to dealing with depression, emotional pain, anxiety, and addiction.”
Paul Thompson, PhD, Professor of Neurology, UCLA School of Medicine

Art Janov, one of the pioneers of fetal and early infant experiences and future mental health issues, offers a robust vision of how the earliest traumas of life can percolate through the brains, minds and lives of individuals. He focuses on both the shifting tides of brain emotional systems and the life-long consequences that can result, as well as the novel interventions, and clinical understanding, that need to be implemented in order to bring about the brain-mind changes that can restore affective equanimity. The transitions from feelings of persistent affective turmoil to psychological wholeness, requires both an understanding of the brain changes and a therapist that can work with the affective mind at primary-process levels. Life Before Birth, is a manifesto that provides a robust argument for increasing attention to the neuro-mental lives of fetuses and infants, and the widespread ramifications on mental health if we do not. Without an accurate developmental history of troubled minds, coordinated with a recognition of the primal emotional powers of the lowest ancestral regions of the human brain, therapists will be lost in their attempt to restore psychological balance.
Jaak Panksepp, Ph.D.
Bailey Endowed Chair of Animal Well Being Science
Washington State University

Dr. Janov’s essential insight—that our earliest experiences strongly influence later well being—is no longer in doubt. Thanks to advances in neuroscience, immunology, and epigenetics, we can now see some of the mechanisms of action at the heart of these developmental processes. His long-held belief that the brain, human development, and psychological well being need to studied in the context of evolution—from the brainstem up—now lies at the heart of the integration of neuroscience and psychotherapy.
Grounded in these two principles, Dr. Janov continues to explore the lifelong impact of prenatal, birth, and early experiences on our brains and minds. Simultaneously “old school” and revolutionary, he synthesizes traditional psychodynamic theories with cutting-edge science while consistently highlighting the limitations of a strict, “top-down” talking cure. Whether or not you agree with his philosophical assumptions, therapeutic practices, or theoretical conclusions, I promise you an interesting and thought-provoking journey.
Lou Cozolino, PsyD, Professor of Psychology, Pepperdine University

In Life Before Birth Dr. Arthur Janov illuminates the sources of much that happens during life after birth. Lucidly, the pioneer of primal therapy provides the scientific rationale for treatments that take us through our original, non-verbal memories—to essential depths of experience that the superficial cognitive-behavioral modalities currently in fashion cannot possibly touch, let alone transform.
Gabor Maté MD, author of In The Realm of Hungry Ghosts: Close Encounters With Addiction

An expansive analysis! This book attempts to explain the impact of critical developmental windows in the past, implores us to improve the lives of pregnant women in the present, and has implications for understanding our children, ourselves, and our collective future. I’m not sure whether primal therapy works or not, but it certainly deserves systematic testing in well-designed, assessor-blinded, randomized controlled clinical trials.
K.J.S. Anand, MBBS, D. Phil, FAACP, FCCM, FRCPCH, Professor of Pediatrics, Anesthesiology, Anatomy & Neurobiology, Senior Scholar, Center for Excellence in Faith and Health, Methodist Le Bonheur Healthcare System

A baby's brain grows more while in the womb than at any time in a child's life. Life Before Birth: The Hidden Script That Rules Our Lives is a valuable guide to creating healthier babies and offers insight into healing our early primal wounds. Dr. Janov integrates the most recent scientific research about prenatal development with the psychobiological reality that these early experiences do cast a long shadow over our entire lifespan. With a wealth of experience and a history of successful psychotherapeutic treatment, Dr. Janov is well positioned to speak with clarity and precision on a topic that remains critically important.
Paula Thomson, PsyD, Associate Professor, California State University, Northridge & Professor Emeritus, York University

"I am enthralled.
Dr. Janov has crafted a compelling and prophetic opus that could rightly dictate
PhD thesis topics for decades to come. Devoid of any "New Age" pseudoscience,
this work never strays from scientific orthodoxy and yet is perfectly accessible and
downright fascinating to any lay person interested in the mysteries of the human psyche."
Dr. Bernard Park, MD, MPH

His new book “Life Before Birth: The Hidden Script that Rules Our Lives” shows that primal therapy, the lower-brain therapeutic method popularized in the 1970’s international bestseller “Primal Scream” and his early work with John Lennon, may help alleviate depression and anxiety disorders, normalize blood pressure and serotonin levels, and improve the functioning of the immune system.
One of the book’s most intriguing theories is that fetal imprinting, an evolutionary strategy to prepare children to cope with life, establishes a permanent set-point in a child's physiology. Baby's born to mothers highly anxious during pregnancy, whether from war, natural disasters, failed marriages, or other stressful life conditions, may thus be prone to mental illness and brain dysfunction later in life. Early traumatic events such as low oxygen at birth, painkillers and antidepressants administered to the mother during pregnancy, poor maternal nutrition, and a lack of parental affection in the first years of life may compound the effect.
In making the case for a brand-new, unified field theory of psychotherapy, Dr. Janov weaves together the evolutionary theories of Jean Baptiste Larmarck, the fetal development studies of Vivette Glover and K.J.S. Anand, and fascinating new research by the psychiatrist Elissa Epel suggesting that telomeres—a region of repetitive DNA critical in predicting life expectancy—may be significantly altered during pregnancy.
After explaining how hormonal and neurologic processes in the womb provide a blueprint for later mental illness and disease, Dr. Janov charts a revolutionary new course for psychotherapy. He provides a sharp critique of cognitive behavioral therapy, psychoanalysis, and other popular “talk therapy” models for treating addiction and mental illness, which he argues do not reach the limbic system and brainstem, where the effects of early trauma are registered in the nervous system.
“Life Before Birth: The Hidden Script that Rules Our Lives” is scheduled to be published by NTI Upstream in October 2011, and has tremendous implications for the future of modern psychology, pediatrics, pregnancy, and women’s health.