Thursday, March 31, 2011

EMDR (Part 1/4)

This is the first of a series of four articles I wrote on EMDR therapy.

I believe that, grosso modo, I have outlined the basic tenets of EMDR therapy. I will begin with Van der Kolk’s work first. What I think he is onto is many of the basic tenets of primal therapy but in a less organized fashion. For example, he states rightly that for trauma to be resolved there has to be a high level of arousal since the trauma was stored under conditions of that level of arousal. He emphasizes that traditional therapy focuses on reducing arousal either through the use of tranquilizers or in attempting the calm the patient’s arousal level, also known as anxiety. The question is can his therapy produce the same arousal? Bereft of reliving the trauma I don’t think so.
We control every session in terms of vital signs. During a reliving of the early trauma, and that means pre-birth and birth, which is not in the parlance of EMDR therapists, we see body temperatures climb three degrees (F) in minutes; systolic blood pressure over 200 and heart rate exceptionally high, as well. We have done salivary cortisol studies (stress hormone) on before and after therapy with reduction in levels after one year of therapy; plus four separate brainwave studies where we found, inter alia, changes in the power distribution between left and right hemispheres, which is what Kolk wants to achieve.
We have done several EEG studies on hemispheric laterality. Early in our therapy there is a change in the right hemisphere amplitude. Long term changes, on the contrary, affect the left hemisphere. In an eighteenth month follow-up of fifteen patients there was a statistically significant increase of left hemisphere activation. More important, increased left temporal activation was significantly correlated with the patient’s improvement. (As measured by blind ratings by therapists) What the researchers concluded was that there was an overall greater harmony of the two brain hemispheres. Another conclusion was that with a slight shift in power to the left side there was better control of own’s feelings and impulses.
Some conclusions of our EEG laterality studies: 'Several studies have been done on hemispheric amplitude asymmetry in primal patients. This author (Hoffman, E.) found that primal therapy initially affected the right hemisphere the most, while long-term changes primarily showed up on the left side, in an 18 months follow-up study of 15 primal patients at the New York Primal Institute, a statistically significant increase of relative left hemisphere activation was found for the anterior temporal areas. Increased left temporal activation was significantly correlated with the patients' improvement in therapy as rated blindly by their therapist.
In a recent long-term EEC brain-mapping study at the LA Primal Center a similar significant increase of left temporal activation was found in a group of patients after therapy. In most patents, following one year of therapy, alpha amplitudes were nearly symmetrical in the right and the left temporal] lobes.
Neuropsychologist Rhawn Joseph writes:
"Thus. the left and nght halves of the brain and the mind can, in fact, be influenced and overwhelmed by these limbic unconscious forces simultaneously, independently. These impulses can be transmitted “first through the unconscious mental system maintained by the right brain to be acted on because the limbic system maintains rich interconnection with both halves of the brain.... Whereas these impulses are almost complete; they are foreign to the language-dependent conscious mind, and the left half of the brain. The right brain, being more involved in emotional functioning, is able to discern and recognize these limbica!ly induced feeling states and desires for what they are."

Thus, higher amplitudes in the right hemisphere, as we see in most normals, may indicate that this side of the brain is closer to and more integrated with feelings originating deeper in the brain. If upshooting Primal Pain interferes with left hemisphere functioning we may expect mental disturbance of a psychotic dimension accompanied by larger amplitudes on the left side. This is exactly what several studies have shown. Our hypothesis was that both hemispheres can be differentially influenced by deep unconscious, limbic/
brainstem forces. The right side is more attuned to deep-lying stored feelings. Remember, it is this side that develops earlier and is more responsive to very early emotional imprints. We have found that intrusions of painful imprints impact the right side more than the left. When there is long-term stored trauma the right side of the brain is called upon for the heavier work; it is activated during recall and reliving. It then shifts some of the burden to the left side for control and integration, hence the enhanced harmony. When someone is awash in old pain and cannot integrate there is a right side dominance.
In my book, “The Biology of Love,” I discuss arousal levels and their importance. The point of all this is that Dr. Kolk is on the right track but it is doubtful that any therapy other than a complete neurophysiologic reliving can accomplish that. Secondly, every reliving of a certain trauma, such as being left alone for days after birth (perhaps due to the illness of the mother) produces the same vital signs as the session before. It is one way of many that we can verify the veracity of the reliving. It is accompanied by a later developed, articulated feeling of hopelessness. In these cases the vital signs drop significantly. One can feel hopeless long before one has the cortical wherewithal to articulate it.


  1. Quote: "If upshooting Primal Pain interferes with left hemisphere functioning we may expect mental disturbance of a psychotic dimension accompanied by larger amplitudes on the left side."

    So for the psychotic, not only do they 'dream' an imprinted history dialogue, they cannot see the dream for what it is and therefore actually believe it is real because their left brain, which would otherwise make the higher-level deduction, can't work properly either? Would you say that's right, Art?

  2. Art, this article was not very clear to me.

    You make it sound like most of your patients begin as right-brainers. You say: during therapy there are initial temporary boosts in the right, and then the later long term results show increased activity in the left. This implies that the patient ends up with LESS activity in the right (apart from the temporary boosts) compared to pre-therapy observations. If the patient began as a right-brainer, that would explain your conclusion; a more even distribution between left and right.

    Or perhaps you are saying there is an initial rapid increase in right brain activity, which is sustained over the long term, while the left brain takes more time to increase. The end result is an increase in BOTH hemispheres??

    Another unclear point:
    "It is accompanied by a later developed, articulated feeling of hopelessness. In these cases the vital signs drop significantly. One can feel hopeless long before one has the cortical wherewithal to articulate it."

    The timing and context seems to shift back and forth, as you often do in your writing.

    I guess you are saying the feeling originates as a brain stem sense of hopelessness, which, later in the session, can develop into a limbic (and therefore articulated) sense of hopelessness?

    Can you see why I always get confused? You tend to mix the timing of events that occurred in evolution, with the timing of events that occurred in a single primal session, with the timing of events that occurred over the long term as recorded in your studies. aaaagh. Which times are you talking about?

    "It is accompanied by a later developed..."

    Those are words without context. Forgive me for being so intellectual.

    I've only got through half of Primal Healing. I haven't been able to settle into it. Everything in that book has made perfect sense to me so far, so I'll read the rest of it in case it's explained better in there.

    I'm not criticizing. I'm just showing you the trouble I'm having....maybe I need to develop a more powerful intellect :D

  3. An email comment:
    "> "Rite! The right orbitofrontal lobe is a dredge for the limbic system pressures aka unintegrated feelings. Integration is when they finally switch through 'ethernet' on the other side thus the "resolution".

    There is something about balancing the brain (either through feeling one's feelings or artificially induced) .. something about bringing these two sides to work in concert, harmony and balance that causes unresolved feelings to become integrated once and for all.

    I won't discuss EMDR too much, I don't know "too much" about it. It would be interesting to see EFT -tapping scam exposed ;-)""

  4. Richard: You can feel free to criticize all you like. It is how I learn. Read Biology of Love and Primal Healing thoroughly; the answers are in there. Read my discussion about Eric Hoffman's research. We do equalize the brain. AJ

  5. Another email comment:
    Art...I'll go through it point by point as I read it. Might make the communication a bit easier. (1) Initially we are in a state of stasis "emotionally" {actually...our "feeling".i.e. the general sensation of the body} That state then becomes "arousal"..or "excited"..take your pick.. and then that is delineated into two states...delight and distress. From distress we can eventually get to anxiety...which is non-focused fear..fear being a primary feeling. Now I'll read some more. (2)Trauma does not have to be induced in a high state of arousal. A high state of arousal may be a consequence of trauma...which would be the individuals response to the disorientating import of the trauma. Trauma occurs when our psychological "map" of associated a-priori meaning and perceptual processes of integrating reality is shattered...i.e. the schema is to speak. [aside....reminds me of the situation where that which is learned in a drug induced state...any psychogenic drug..can only be recalled once that drug is operant again. Is this actually true? Can't say for sure.] Onward. (3) The use of the word "power" annoys me. Very vague. Perhaps "Amplitude" or "Activation"...check your biological thesaurus. [never mind...there's the use of "Activation."] (4) Didn't realize the "mind" was a temporal entity that could be divided into right and left. Ummmm..did you ever actually see or weigh a mind? Com'on. (5) limbic unconscious "stimulation"..not forces. Jeeze. (6) Isn't "unconscious" used as a buzz word here...we as creatures are not conscious of 99% of the brains processing activity. I believe we are only aware of the result of processing 2000 bits of information per second...while somewhere in the area of a billion bits are registered. It could be more..I forget. (6) I was just using "veracity" the other day..and had to look it up. Used it the same way you did. You ought to look it up again. But my point of item 6 is that the entire paradigm of right brain/left brain is rather new and without sound substantiation. It's actually more pop-psych than not..and to build an edifice on it is to build on sand. It is good for a metaphore..but not sound science. All and all I don't see the point of this blog other than as an exercise in mental masterbation. Maybe I'm wrong. WHAT'S THE POINT OF THIS BLOG??? I still have Holdens work.,and it rings of the same specious vernacular. "

  6. (continued..)
    " At first it sounds inpressive..but upon serious inquiry it dosn't persuade. Sounds like a vain attempt to "prove" or 'justify" that what dosn't require justification. Most of your interpertations of the data are but one interpertation. There are several explanations. Talk about people having to follow up assertions with reasons... (former blog ). Art..Art... Also, having ratings of improvement as accessed by the administering therapists is laughable. Wasn't it you who once spoke of "vested interests?" Sure was. Or how about self-fulfilling prophecies. To me this blog is superfluous. aaaaaaaannnndddddddd therrrrrrrrre's Art. Try it again. Barry P.S....and talk about people who lean on words...the pseudo "left brain" intellectual...or is it "right brain" intellectual?...or the hung-up neurotic...who cares? What is the basis for your focused attention on this pap? People use jargon and are pedantic when they are insecure and yearn for acceptance... What is this bit about "grosso modo?" you're really attempting to communicate...EVERYBODY knows what grosso modo means. I'm surprised you're not writing in Latin. This entire blog can be reduced to "Look mommy I'm a good boy" and "Look how sophisticated I am." Which you're not. By the way..I wrote an e-mail to you thanking you for a lot of things...but couldn't bring myself to actually send it. Oh well. If you're going to write for gods sake write better. Please. !!!"

  7. Art:

    In response to your recent emailed comment:

    I personally (speaking for no one but myself) think the purpose of this blog is:
    1. Promote primal therapy (fair enough? Of course).
    2. Express how the world works from the 'primal' perspective - that is, demonstrate the pervasive impact of blocked pain - its impact is in fact everywhere.
    3. Give outsiders the opportunity to contribute.
    4. Intellectual masturbation (if it feels good).

    By the way: Grosso modo = "in the rough way". I actually had to look that up.

  8. Hi,

    The article makes sense to me, particularly of the experiences I am having. In combination with the testaments of other posters I find the "gist" of Arts' writing more than adequate.

    There are many claimants for balancing the brain, this is not a new idea. What seems to be Arts point is that it is necessary to relive trauma. Somewhere else Art has already said there's a stage one can get to in therapy where the symptoms disappear but the underlying problem has not. I suspect those researchers who do not believe re-living is necessary are fudging the issue precisely at this point or stage of therapy; Art?
    It's good that Art continues to collect and disseminate supporting research because we need the facts, as they are published.

    By the way (Apollo will like this), the Sophists were an ancient Greek political sect who became infamous for their "sophistry", since then the word has become bastardised to mean its' opposite. Wicked, innit?!

    Paul G.

  9. Andrew: So sorry about Grosso Modo. I live in europe off and on for 30 years and it was de rigueur there. art

  10. Well, some critics will point out how we might struggle in our attempts to describe or understand something. Sometimes what I say does not come out quite right. With time, I pick up on my contradictions or poorly used words and fine tune my ideas. Should this be used against me to discredit what I do? Theories and ideas always need continual polishing and even some modification. That is no reason to bash the theory or those who attempt to explain it.

    And I am all in favor of intellectual masturbation, or any other type, too. What’s wrong with it, anyway? ;-)

    Now on EMDR, I often wonder about various researchers. Some like to exploit previous ideas as being their own discoveries. Others might want to help the ideas along so they join in, perhaps rewording it slightly or somewhat in order to add another witness to the theory or idea. But I am amazed that a number of things have been discovered which seem to touch on PT yet never know anything about PT. Is PT that rare in publicity? I guess it is.

    Consider New German Medicine, Attachment Parenting, and many other recent trends. All seem to tip their hat (probably unknowingly or deliberately conceal any relationship to PT) to PT with their promotions.

    But I also know this. Every truly good movement will cause an Orthodoxy to seek it out and infiltrate it or compete with it, and yet take it off in a slightly different direction at first and then slowly draw it further off and away from the original. They will also try to discredit it and slander it, making mountains out of molehills and molehills into mountains. Being a bit paranoid, I always look for Primal Debunkers, figuring they are just another attempt at distorting or corrupting something they fear. It is always amusing.

    For the record, Sophists were a group who basically argued that arguing what was correct or lawful was not as important as being more convincing or persuasive. We have all seen those who are not good at defending what they think or believe. It does not mean they are right or wrong. But some can make any nonsense sound good to those who are not that bright. These are sophists. They prey on ignorance because those who really know their stuff cannot be fooled by sophistry or sophists. Lies have no real power over truth.

    PT has quantifiable concrete evidence for its operation and resolution. It can be measured, and repeated and has been many times. So much and so many times, that Arthur would not be obligated to continue to do so. You can take it or leave it. But he keeps on and some of us are grateful for that. We all seek to see it further refined and defined. I also seek to see it integrated with a greater philosophy or long term view of human progress.

    I don’t fear or object to other competing ideas such as EMDR. I don’t fear any ideas. I can handle whatever comes my way. Let it come. Glad to see it discussed and dissected.

  11. Apollo i have no desire to bash an old man who suffers from a constant sore throat and tries endlessly to explain things to people like you and me. I've read Primal Healing. Still don't get the above article. I doubt any of the blog readers can understand it. If anyone can explain, i would be grateful and amazed. i don't care anymore. for me personally, some things are best explained in a conversation. and Art has no voice so that's that.

  12. RIchard: wow you are not obligated to read it. maybe it is boring. art janov

  13. Richard, that post was not aimed at ARthur at all. It was aimed at someone who criticized Arthur and I pondered what EMDR might really be up to. Yeah, I speak a little cryptically at times. One of my habits. Its all right if you do not like it or do not understand it. I don't require either from you or anyone else. No one has to read it. I speak and let the buyer beware!

  14. stop bashing on Art you lot, that's my job. And if I'm half as alive as he is when his age I won't care what us little shits say, either.

    a simple Google search on Grosso Modo: ""in a rough way" or "in the rough way". I like it when I learn new things...



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.