Tuesday, August 16, 2011

On Hypnosis (Part 17/20)

Hypnosis and suggestion can then be used, in Hilgard's terms, to restructure communication between cognition and response. He's not sure how, but in some way hypnosis results in the erection of two separate communication barriers. One barrier (running vertically in the diagram) splits cognition into two disconnected compartments and similarly splits voluntary and involuntary responses to pain.

Now what we have – at least diagrammatically – is a brain split in half. On the left side all channels of communication in the overt hypnotic reality of no pain are open and consistent; the subject registers no felt pain consciously, expresses no felt pain bodily, and communicates no felt pain verbally. On the right side we have an additional barrier (running horizontally) between cognition and communication so that the felt pain is not communicated unless a technique such as automatic writing or talking is introduced into the hypnotic situation. So in the covert hypnotic reality of felt pain, the subject registers pain unconsciously and expresses it involuntarily through vital sign indicators, but cannot or does not communicate it. Hilgard believes this model explains how a person can feel neither pain nor suffering at the conscious level within hypnosis, yet still register the physiological signs of pain unconsciously.

Pain and Awareness

As yet, there is no scientific definition of pain. It can be described and its components listed, but investigators have been "unable to come up with a definition that (catches) the single 'essence' of pain, beyond the common sense notion that we are dealing with what hurts."[2] It seems we have made little progress since Aristotle's day, when he himself omitted the sense of pain from his list of man's five senses. It was not until the nineteenth century that the sensory component of pain was recognized as a physiological and psychological reality. Before that, pain was linked to its maiden-opposite of pleasure, and both were viewed as "passions of the soul" rather than as provinces of science.

The "hidden observer" has enormous implications for psychology. It means that while we have the capacity for concealing, repressing, denying, and dissociating from pain, we are not actually getting rid of it. We may be able to remove it from awareness, but it still exists in the lower levels of consciousness. This is the crux of neurosis: while we may split off from Primal Pain, it remains within us, exerting a real force and producing all manner of symptoms. Now we have corroboration that out of mind is not out of body. Hypnotic pain control techniques can temporarily relieve us of physical pain, just as our absorption in a certain task or spectacle may allow us to forget about physical pain for a time, but sooner or later we again become aware of it. Similarly, to repress emotional pain does not eliminate it nor alleviate the symptoms it produces.

Today it is recognized that pain contains both a sensory component and a suffering component. The presence of one does not necessarily mean the presence of the other. We can be in physical pain without feeling badly emotionally, and we can feel badly emotionally without being in any sensory pain. For most of us, however, the two go hand-in-hand: being physically ill is emotionally upsetting and being emotionally upset is physically painful.

The distinction between the sensory and suffering components of pain has many significant medical and psychotherapeutic ramifications. This was demonstrated several years ago, when an experimental operation was performed on a group of patients who were suffering from intractable pain. The operation involved a pre-frontal lobotomy, which means that a group of connecting fibers between lower and higher (cortical) brain centers were severed. After the operation the patients reported that they could still feel the sensation of pain but that it did not bother them. In other words, the suffering component of the pain was alleviated surgically while the sensory component remained.[3]

This is also the situation in neurosis.–– A neurotic may feel neither pain nor suffering, depending upon the degree of defense, or "gating" of pain between levels of consciousness. The neurotic's face may show a good deal of misery while he remains unaware of feeling miserable; his body may be stiff with tension, yet he doesn't know why. He can talk about his deprived childhood with complete detachment. No feeling of suffering or distress reaches his awareness.

Thus, in all three conditions – neurosis, hypnosis, and lobotomy – awareness and recall on the cognitive level are effectively disconnected from the emotional components of what is remembered.

There is obvious value in using hypnosis to remove the suffering component from organic pain when it cannot be alleviated in any other way. No one benefits from unbearable pain related to terminal cancer, constant back pain caused by a genetic spinal problem, or from constant residual pain after a serious car accident.

The numerous techniques for removing the awareness of pain and the everyday distractions that achieve the same thing show us the dramatic abilities of consciousness to alter its own perceptions. And we certainly need hypnosis to achieve this. In everyday life, we are very adept at keeping ourselves distracted from what is going on inside. A busy, even hectic lifestyle is probably the main defense today. Phone calls, letters, business deals, discussions, movies, television, are all part of the hypnotic process. It seems that half the people watching TV are indeed mesmerized – as if half the population is in a coma after six p.m. One lets in the message, particularly the commercial message, without any critical capacity, whatsoever. One is simply the passive recipient. The next day, as if in a posthypnotic suggestive state, one goes to the store and buys Crest and Kellogg’s Corn Flakes, just as one has been programmed to do.

Hypnotic pain techniques demonstrate how far cognition can go in structuring a false reality. But how is this possible? By what physiological mechanism is it achieved?

The Endorphin System

I have already discussed the plasticity of the third level of consciousness and its role in susceptibility to hypnosis. There are additional, more specific neurological factors which help make dissociation possible. One is the left brain-right brain dichotomy referred to by Hilgard to illustrate his "hidden observer" discovery. Another is the system of "gating" which exists between levels of consciousness to inhibit or facilitate the flow of information.[4] Still another is the body's capacity to produce morphine-like substances called endorphins. And the neuroinhibitor, serotonin. These chemicals block the message of pain from crossing the cleft between nerve cells, the synapse, in effect gating the message from reaching higher brain centers.
The neuroinhibitors function as the biochemicals of repression and its twin, dissociation. They are produced to quell both physical and emotional pain. Although the body does not differentiate between the two types of pain in qualitative terms, it does respond differentially in quantitative terms. As I pointed out in Prisoners of Pain:

The Swedish pharmacologist Lars Terenius has discovered that patients suffering from emotional Pain produce more endorphins than those suffering from physical pain. Emotional Pain is real and often physically more intense than "physical pain." Those with emotional or psychological Pain in Terenius' studies had less tolerance to physical pain. Their bodies were hyperactive, producing more Pain suppressants.[5]

When the amount of pain assaulting the system can no longer be integrated, endorphins are mobilized to repress the experience and the memory of the event. These endorphins can be many hundreds of times more powerful than commercially produced morphine. They keep events out of full consciousness by interfering in the connection between feeling and the realization of feeling, between injury and reaction to it, between sensation and cognition. Nonetheless the trauma remains in the system, full and intact.

Through the production of endorphins, the person may be able to dissociate from the pain of his hand submerged in icy water, but the icy water nonetheless causes his vasomotor system to contract in pain. Similarly a child may be able to dissociate from the Pain of losing his mother, but that Pain is still causing his system to siphon off its impact in some way – be it through acting-out behavior, compulsive eating, chronic depression, or whatever. The child may simply "numb-out." He is no longer emotionally reactive. He's inert, immobile, and emotionally "dead". He no longer suffers the horrendous pain of losing his mother. He goes on with life in a very "dead" fashion. Nonetheless, there is always some physical manifestation of the presence of pain in the system, regardless of what one is consciously experiencing.

[1]See Hilgard, p. 48, Figure 15, right diagram.
[2]Hilgard, Hypnosis in the Relief of Pain, p. 29
[3]The same effects can be achieved with marijuana, morphine, and other drugs that suppress the suffering aspect of pain more than the actual sensation of pain. Aspirin, on the other hand, does just the opposite: it reduces localized sensory pain but does not reduce anxiety or suffering. Localized sensory pain has a specific physical location in the body; anxiety, by contrast, is a non-specific and diffused state of being.
[4]For a brief discussion of "gating," see "The Gated Mind" in my book Prisoners of Pain (New York: Doubleday, 1980) pp. 111-114. For a more technical discussion see "The Gating of Pain" in Primal Man (New York: Thomas Crowell Co., 1975 ), pp. 126-134.
[5]Arthur Janov, Prisoners of Pain, p. 85.


  1. I have to admit that your approach to psychology is real refreshment.
    I studied psychology and always believed it should be approached with a the standard scientific method.
    After the studies I worked in other fields but I must say You awakened the interest in me. Your work and thinking is very much in line with my own perceptions of human behaviour.
    For allmost 15 years I have been working in the gaming industry and the pieces of my observations just seem to come together.
    A. Rejec

  2. I've said it before, but this series has been a great study and critique. It might serve a purpose in a booklet form or however long it would be. Not sure who might care but I do. It deserves to be heard and made use of. But we could say that about PT in general, right?

    4 more left. Maybe a big PDF file in book form?

  3. Hi,

    -"Nonetheless, there is always some physical manifestation of the presence of pain in the system, regardless of what one is consciously experiencing"-.

    These physical manifestations also take the form of subtle (rather than gross) 'act outs'.

    These may not be obvious to any-one at all (least of all myself) because we tend to incorporate them into our belief systems, y'know, that hall of mirrors in the mind. . .

    I mean, I always like to 'review' my tool kit, take out all the chisels, oil them & so on, clean the boxes etc. On the face of it, this is commendable. We should all take care of our tools.

    But underlying my healthy and sensible care of my kit there is interwoven a dreadful fear of loss, fear of being ill-equipped, fear of lack of readiness or knowing what to do. So interwoven are these 'good & bad' things that now I am psychologically sewn into my tool kit. If that tool kit were lost or stolen I would become torn apart and bereft.

    I know some people who are chronically untidy, they have never discovered the joy of knowing where their shit is because they have never woken up to where they dismissively left it the last time they discarded it. These types are a nightmare to work with. One of these types I know even has books on how to tidy up, books on Feng Shui, books on organisation, books on cleaning. . . These books crop up in different places after the latest "tidy up". . .

    In England we call people like this eccentric.

    I hear in California there are psychotherapists who don't need to call a spade a shovel and describe this sort of behaviour as "neurotic".

    I'm neurotic too. So frightened of losing stuff.

    Paul G.

  4. Art,

    Continuation of Charlie Parker

    If I illustrate a feeling as a ton... it will be like this… I feel love to my mother as a ton on a string… my mother gets me to hate her… I cut the string… but... as my life must continiues… the string will then be on a ton of hate for the rest of my life... if not something can tie it together.


  5. Apollo: I never thought about that. Coming up a long series on psychoanalysis. art

  6. Hi,

    I've been trying to get my senses around the idea of gating pain with inhibitors and how the correspondingly leaky gates from deficiency may begin a track in the mind (rather than down ones' cheeks). Still further on, how this can precipitate connections between the left and right hemisphere.

    It beggars the question: "what is the point of unlocking traumas if the gating works adequately"?

    So, I begin to ask myself if the plethora of psychotherapies that command the industry are basically looking for ways to boost the inhibitor systems, to help us carry on with the repression but with a new facade?

    A psychosynthesised facade.

    Meanwhile I found myself also wondering if it's possible to see an emotional person with one eye and his rational counterpart with the other.

    When I was in the Cadets I found out I was a good shot and could skive off sports by joining the rifle target shooting team. We did exercises to see which of our eyes was dominant. Apparently one or the other of our eyes predominantly focuses attention, then the other eye moves into the line of sight thus forming a 'right-angled triangle of focus'. Never two eyes moving equally into an Isosalese Triangle but always the dominant eye down the 'run', the passive eye to the 'diagonal' and the gap between the two eyes being the rise.

    So, the ocular nerve runs opposite to the brain (as does the rest of the body senses excepting the ears, am I correct here)? which implies that there could be a feeling eye and an empirical eye with some variation of trigonometry describing the relationship.

    Perhaps I'm just an obsessive carpenter!

    Seriously though, at what point in evolution did sex appear and at what point in evolution did light sensitive cells (as in eyes) appear and. . . for how long have these 'eyes' been wired into the brain stem?

    Seeing is a complex thing, our perception is altogether intrinsically interwoven with that ocular and image making/remembering function.

    -"If I hadn't seen it with my own eyes; well, then I wouldn't have believed it"!-

    Paul G.


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.”
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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.
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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.
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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.
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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.
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“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.