Tuesday, December 28, 2010

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.

1 comment:

  1. Comments to Elements of Primal Theory

    I like the image you borrow from Isaac Newton, when he said that the reason he could see far was because he “was standing on the shoulder of giants”. That is the same metaphor, I feel adequate when I am thinking of what Dr Janov has meant to me. This I don’t say just to support his Primal Principle about how pain can be relived and dissolved in the reverse evolution order. I have over 40 years on my own body, in my psyche and behavior experienced this revolution. I now feel that I can see much further than before.

    Last night I brought home “The Neuroscience of Psychotherapy” by Cozolino from Kindle, and read it in order to see if I finally could find someone giving credit to Art and his invention. Of course I found nothing. However, you had in an elegant way bridged over this fact by referring to Carl Rogers and Wilhelm Reich, which both are quoted in Cozolino. (“Rogers emphasized the individual’s opportunity for self-discovery”).

    (Regarding Reich, I cannot stop myself from quoting Ida Rolf when she in her book “Rolfing and Physical Reality” is saying: “Reich began to put a material body onto Freud’s theories, this kind of thinking and working that we are doing is forming the bridge between psychology and physiology. We too are standning at that point, that very vital point. We need to collect our clinical information together so that we can bring the psychologists down from the clouds and put their feet on the ground.” Said in the 70-ties...)

    A couple of days ago NYT had a brilliant analyzes of the Deepwater Horizon’s final Hours in the Gulf of Mexico. http://www.nytimes.com/2010/12/26/us/26spill.html This is the story about what seemed to be an inevitable casualty of the blowout of the Macondo well. It was not. A top paid, handpicked crew of well educated, well trained and experienced, tough, strong and well coordinated people were frozen by the sheer complexity of the Horizon’s defenses and by the policies that explained when they were to be deployed. The chief counsel for the presidential commission that is looking into the Horizon disaster, said Tansocean’s handbook was “a safety expert dream” and yet after reading it cover to cover, he struggled to answer a basic question: “How do you know it is bad enough to act fast?”

    When I read Cozolino’s invaluable book “The Neuroscience of Psychotherapy”, I struggle to find an answer to my problems. How to approach the pain behind my epilepsy and my feelings of not being counted, loved and behind my hurting nose and fingers, etc.. Why doesn’t Cozolino include Janov and the Primal Therapy? Is he so burdened by all the theoretical aristrocrazy in his reference lists that he against better knowledge chooses to exclude him? I like when he’s quoting Albert Einstein: “I never came to any of my discoveries through the process of rational thinking.”

    1977 I had a different epileptic seizure. I didn’t cramp but climbed a high oak tree subconsciously driven by a memory how a boy (in a novel by Danish Nobel Prize winner Pontoppidan) had done the same after his father had assaulted him, very similar to what my father did to me when I was 9. The boy fell down and was killed. I was helped down by neighbors and paramedics and brought to a hospital where neurologists and psychologists gave me a treatment like that Jack Nicolson was given in One Flew over the Cuckoo’s Nest.

    1984 I came to Bergen, Norway, after 750 miles / 15 hours drive from the south of Sweden to visit a Primal retreat held by Dr Janov. I went to the meeting and felt tense and scared. Inside the door in the group room I met Art and he only needed to see me, and he said: “It is a feeling” and I laid down and felt safe to follow my feeling into a deep birth primal, in stead of having an epileptic seizure. Art followed his intuition. He was not bogged down by no handbooks!

    Thank you for your positive comments to Dr Janov and The Primal Therapy.

    Jan Johnsson


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.