Monday, September 12, 2011

On Hypnosis (Part 24/26)

Guarding Against Suggestion in Primal Therapy

It has been argued that suggestibility operates in Primal Therapy; that patients come with certain expectations which they self-fulfill. Because a patient thinks he will get well he does; he feels Pain because he expects to feel Pain; he has a Primal because he thinks he will, and so forth. Certainly the potential for suggestibility exists. But if the therapist does not offer suggestions, that possibility is no longer possible. Wherever there is primal need you inevitably encounter suggestibility; because it is ultimately need that you are manipulating. There is no power greater than need to move and motivate human beings. A neurotic is always in search of a suggestion. "Do you think this dress suits me?" "What shall we order for dinner?" "Do you think we should go to the Jones house?" Suggestibility, whatever its form, must hook on to basic unfulfilled need to gather its sources for power. 

We are well aware that people come to us full of hopes and needs, both real and unreal. It is up to us to recognize which are which. We can do this best by first having sorted out our own needs before listening to someone else's. Then we may better trust that our judgment, perception, intuition, and instinct are not being distorted by our own Pain and need. 

In Primal Therapy we recognize the possibilities for suggestion but we take measures to counteract them. For example, we might slow down the defensive maneuverings of the rational-analytical mind so that feelings have a better chance, but we do not attempt to dislocate or hide this level of consciousness. We aim instead to see that feelings pass through it. We want the patient to be fully aware of what he is doing, saying and feeling. He is engaged in a profoundly important experience, so it makes no sense for part of him to be off somewhere else.

The patient-therapist interaction is also an important tool of therapy. The trust of the therapist and a willingness to follow his suggestions in the therapy in order to get to feelings do contribute to success, but there must be a crucial balance. We do not want the therapist to be a pied piper while the patient, in trance, follows passively along to another's tune. It is the patient's life, it is the patient's sickness, and above all, it is the patient's therapy. He is not simply a passive recipient of "suggestions" or insights from a therapist. His unconscious "knows" what happened to him, even if his conscious mind does not. He has the answers. We don't. It is only arrogance that would lead us to believe that we know better what is inside someone's head than he does. His reality sets the scene and determines the course. The patient, then, must lead the way.

Sometimes the neurosis tries to take the lead because it resists the move towards Pain. At this point the therapist intervenes in the role of the agent supporting the expression of Pain. The therapist may see ahead of time where the patient is headed, but, unless a helping hand is clearly needed, he lets the patient arrive there in his own time. Although the "lead" keeps changing hands, the direction is determined by the patient's history and physiologically-imprinted experiences. Healing is not a question of the therapist trying to influence or "change" the patient. Healing does not emanate from outside. It develops from the inside, like all healing processes, from a cut to a burn.

The argument that Primal Therapy operates by virtue of suggestibility is invalidated on several points. One factor is that a person without Pain would not invest the time, money, and inconvenience to come to a therapy, particularly one that offers pain, not pleasure as its immediate goal. Inevitably, the pleasure will follow the Pain. But Pain is primordial and there is no fully enjoying pleasure until Pain and its handmaiden, repression, are removed. Physiology does not permit us to skip steps. We have no need to act out Pain or to expect it unless it is there. At least I have yet to meet a truly healthy person who would choose to spend his time and money acting out a painful childhood and then act as if he had recovered from it. By virtue of such behavior a person would reveal himself to be staging some sort of neurotic scenario.

Secondly, the notion that one can suggest oneself into being well is to seriously mistake the meaning of the word "well" and the state which it describes. Suggested health is shallow and unreal because it is global; it is simply superimposed. This kind of mask of health does not look, sound, or feel right to those who enjoy a more interconnected consciousness, but it can fool others. We never automatically accept a patient's professions of himself as well because to do so would be to take a superficial view of health and human reality. For it would ignore the deeper physiologic processes of brain and body and the disease which permeates them. Someone can think "well," look "well," behave "well," but still not be well. This is why Erickson's claims that one hypnosis session can forever banish violent lifelong somatic headaches or make the adult affects of childhood trauma totally vanish do not ring true to me. 

In Primal Therapy we know that we can use (and have used) objective indices of change to guard against suggested cures as a result of patients reading my books and acting out preconceptions. These objective indices are based on the knowledge that Pain has physiological correlates. Patients who do not truly feel Primal Pain will not register significant short-term (after a single Primal) or long-term (over a period of therapy) changes in their vital sign readings. Even if the patient expects to get better and believes that he is better, we do not consider this valid unless his vital signs so indicate. (This form of assessment is not always necessary because an experienced and sensitive therapist can reliably match the conclusions drawn from vital signs readings by intuitive judgement.) The point is that we, like other therapies, would be as vulnerable to the argument of cure based on suggestion if we were to accept the subjective, third-level reports of patients alone. 

The third important reason for the lessened possibility of suggestibility in Primal Therapy is that generally one suggests someone away from Pain not into it. The classic experiments in hypnosis nearly always involve not feeling pain. It is far more seductive to be offered something that will counteract suffering, that would allow one to conquer it, to surmount it, to rise above it, but never to feel it. People are attracted to hypnotherapy precisely because they want the easy way out; they are already seduced by the notion of a magical therapy where everything happens unconsciously. They already are ready to flee Pain.

As the intellect becomes increasingly overtaken by the rising feeling of need and of Pain, one sees how easy it would be to inject the patient with one's own interpretations and suggestions -- to brainwash. One witnesses the susceptibility and gullibility fostered by years of unmet need. There is the need to trust and believe in someone, the need to follow and be taken care of, the need to be told what to do, the need for explanation and comfort, and so on -- all of the urgent needs that in some cases make a person believe it will be beneficial for her to be seduced by her therapist, as in Erickson's case study.
From a psychotherapeutic standpoint, when one sees all this, one has a choice. Either you suppress the need and Pain with mollification, "education," substitution of ideas, and counter-suggestion, or hand back the need and Pain so that it may be experienced through to its roots and finally resolved. Any therapy which does not deal with Primal Pain as its primary goal can never resolve neurosis or its symptoms. It is ineluctably non-dialectical and reactionary. The same can be said of any political system, as well. Either you fulfill need -- personal or social -- or you suppress it.

The pervasiveness of need explains why someone who can elicit Painful scenes in hypnosis stops short of allowing the patient to experience these traumas consciously. The nerve ends of the therapist's own deepest hurt are too exposed for comfort. When the discoveries of the patient put him disquietingly close to his own unconscious Pain, he may take repressive measures by encouraging the patient to "shove it back down," or by diverting him with suggestions which counter the painful reality. This is what we might call Painwashing .


  1. Hi,

    well I hope this isn't too personal to be published:

    -"Sometimes the neurosis tries to take the lead because it resists the move towards Pain. At this point the therapist intervenes in the role of the agent supporting the expression of Pain. The therapist may see ahead of time where the patient is headed, but, unless a helping hand is clearly needed, he lets the patient arrive there in his own time. Although the "lead" keeps changing hands, the direction is determined by the patient's history and physiologically-imprinted experiences. Healing is not a question of the therapist trying to influence or "change" the patient. Healing does not emanate from outside. It develops from the inside, like all healing processes, from a cut to a burn"-.

    My bodywork therapist could have written this for me at the beginning so that I understood what he understood about the process (and therefore what he was trying to allow me to do for myself in relationship with him).

    I liked him not only because of his genuine, warm and engaging self but I also liked his personality.

    After a long time I found that my personality could engage his personality in conversations about this very, very process and in the end we argued about the details of the theory. . . but we never touched on the impact on me. This took me a very long time to understand.

    I really liked this guy, he IS a good man. There are a few of us out there. Anyway, it all fell apart when I found out about Real Primal Therapy. Then I realised why the nice drawings on the wall on my therapists' new therapy room (in a new posher and richer part of town) were better and more expensive and the nice couch and the nice Victorian drawing room all this was happening in was totally inappropriate for me.

    (I was also breaking down as a consequence of his excellence in this particular quoted field of "intra-personal excellence").

    I finally realised that I am enthralled by intellectuals who can feel. I love intellectuals who can feel but they are very dangerous for me because they have always made me (and my particular instinctual type) into "Lady Chatterlys' Lover" or the "Working Class Hero", or the 'Puer Eternous' (or the progressing patient).

    It is the intellectuals who seduce us into yet another 'cultural narcisism' and I could not go to that nice drawing room any more.

    It's a shame this guy couldn't get some advice from Art Janov by reading this blog and seeing that his practice is only taking some people so far and then leaving them with an impossible decision to make about how to proceed.

    In the end I realised his particular personality was controlling me. He "Knew" my pain. . . but he did not understand it. . . and that is why he can carry on practising with great skill but not actually be equipped to take his "Clients" where Primal needs to go.

    Paul G.

  2. art, you are feeling sleepy. your eyelids are getting very heavy. you will answer the following question without any fear of putting suggestions in my head...

    when i am at the primal center, am i likely to adversely interfere with highly suggestible patients?

  3. Richard: now open your eyes and all is forgotten. AJ

  4. A facebook comment: "I have done self primalling for 15 years now, day in and day out. Nobody has been there to give me any suggestions and it still works. The first two sentences here made me laugh. Thanks Art, for the laughs!"

  5. Hi Art , is there something like "counter-suggestibility " resp. would u n b e l i e f ...(after all that reading in all those Years) about the efficacy of P.T. in m y case ...would prevent a successful P.T?!
    My mother once named my the "unbelieving Thomas "
    You that guy with Jesus... who did n o t believe...
    Jokes aside :prevents any scepticim a good outcome in P.S Yours truly! emanuel

  6. Emanuel: You need not worry about that. It doesn't matter. It helps not to be too intellectual but other than that.......AJ


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.
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Quotes for "Life Before Birth"

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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

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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.
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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.