Monday, October 10, 2011

An Examination of Psychoanalysis (Part 6/13)

Freud’s Theory as Therapy:

The Talking Cure That Doesn’t Heal

The Aim of Psychoanalysis

The goals of a therapy offer a clear definition of what the therapy conceives health to be . In Outline Of Psychoanalysis[1], Freud offers his idea and goal of analysis: "Is it too bold," he asks , "to hope that it must be possible to submit the dreaded spontaneous illnesses of the mind to our control and bring about their cure?"

Obviously, Freud conceived the task of therapy to be one of control -- of getting the illness to submit. Later, he uses the metaphor of war to describe the alliance of the patient and analyst against the illness:
The analytical physician and the weakened ego of the patient...are to combine against the enemies, the instinctual demands of the id, and the moral demands of the superego.
Freud is saying that patients must exist in a state of permanent warfare -- cold warfare, perhaps -- and that the analyst must join the battle as an ally to help the ego in its task of "keeping down the instinctual claims of the id." The chief armament is the intellect, both the patient's and the analyst's:
Our knowledge shall compensate for his ignorance and shall give his ego more mastery over the lost provinces of his mental life.
Unfortunately, neurosis is not an illness of ignorance, and the business of therapy is not compensation -- especially not in the currency of "our [the analyst's] knowledge." Neurosis is an illness of feeling, and the patient has his own knowledge to discover through his feelings. No amount of received information will make up for what he can recover from his own unconscious. Furthermore, "the lost provinces" is what has made him unwell in the first place. Therapy must be a voyage of discovery. A patient must never lose his curiosity or the thrill of self-discovery. If the dialectical process of Pain and liberation, agony and discovery is not addressed, than a "cure" will remain elusive.
The cognitive focus of psychoanalysis is made plain in the Outline. So is the canonization of the analyst as a beneficent provider of health-giving wisdom. No matter how knowledgeable and wise the analyst, his wisdom is not curative. No amount of his acquired learning is as valuable to the patient as the patient's own history and feelings. Only the patient's own natural processes can bring him health.
Freud wrote in the Outline:
The new superego (analyst as substitute father) now has an opportunity for a sort of after-education of the neurotic; it can correct blunders for which his parental education was to blame.
And later:
The method by which we strengthen the pa-tient's ego has as its starting point an increase in the ego's self knowledge. Thus the first part of the help we have to offer is intellectual work...
(We are) in a position to conjecture the nature of his repressed unconscious material and to extend, by the information we give him, his ego's knowledge of his unconscious.
From all this we learn that analysis works from the premise that the problems and solutions to neurosis lie in the thinking brain -- and more often than not, in the thinking brain of the analyst. We also get an idea of how Freud saw his own role in therapy: "We serve the patient in various functions as an authority and a substitute for his parents, as a teacher and educator..." Add to these interpreter, sage, restorer, ally, corrector, critic, detective, historian, persuader and superego, and we have quite a formidable figure. Certainly Freud's followers took their cues from this vantage point.
For many, the Freudian therapist is too presumptuous, and condescending, shrouded in the veil of his own fund of esoteric knowledge; knowledge which was itself intellectually obtained like a catechism. The analyst's attitude is built into the theory, for the analytic process assumes the omniscient, all-powerful authority figure therapist. Her presence should not intrude upon the patient nor obscure the patient's own light.
Since the patient is suffering from a disease of feeling, it is erroneous for the analyst is treat him with intellectual medicine. The power of the process must be shifted from therapist back to patient. One principal task is to provide an environment in which a patient can stop intellectualizing and start feeling. A restrained, intellectual, "proper" analyst exudes and circumscribes the kind of atmosphere in which the patient behaves. A stiff-tie, starched-shirt milieu is not conducive to feeling. It is no different for a child with his parents. If they are free, warm and feeling, the child automatically becomes feeling without one word said about liberty and freedom. The atmosphere is absorbed by a child who lives inside it with no particular awareness. The same is true in the therapist patient relationship. Humility is built into that relationship when the ultimate power and knowledge reside in the so-called "sick" one.

[1]_Translated by James Strachay (New York: W.W. Norton), 1949.


  1. An email comment: "Yep. and transference is just the Kid in someone wanting love and still stuck in symbols of the pain. Right?"


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.