Sunday, November 27, 2011

How to Measure Progress in Psychotherapy

Look, we all agree; we have a triune brain--3 brains in one, each with different functions. So one brain can be sick and the other two not so. Or two brains can be sick as a result of compounded early trauma. So isn't it silly to measure progress in therapy and leave out half or two/thirds of the brain? This is what is going on in psychotherapy today. We do followup studies with paper and pencil tests of mood, attitudes, comprehension and other intellectual/cognitive tests. And what do we get? A one third appraisal. So the mind works but the body is a wreck. The engineer functions very well at work while his body is preparing itself for cancer. Or the mind does not work, as in attention deficit disorder, but the body still gets migraine; or the get the idea. Part of us can be more damaged then the rest of us. But all three parts need to work well and in harmony for us not to get seriously ill.

Can you imagine an MRI specialist studying only the cells in the kidney but not the mind? Not a good idea because the sickness starts up there. And we need to cross-reference all parts to see how they interact. We need to get out of the fragmented approach, taking the head and muscle cells to understand migraine, when all we will understand as a result is how those cells work, not how the system works together with other systems., and how that interaction produces symptoms. Again, I am pleading for a unified field theory of illness; illness of all kinds. Yes we need specialists who know more and more about less and less, know how the muscles in the neck work, how they contract and what happens to the blood vessels, but not anything about headaches, their cause and sudden appearance. Yes, they say the vessels contract and this or that happens to them but never why; never the ultimate cause, and certainly never the demise of the symptom and how we can achieve it.

So we treat a drug addict and we measure him afterward. And she feels great; all those great meals, massages and lectures. They work to drown the fish. But we measure the biology and there is a raging cauldron down below; the cortisol level is chronically high and can be life threatening. So much for self-awareness. Or vice versa: we are strict medical scientists and we measure cortisol and the person seems OK but he still feels terrible.You see what I mean? There are parts of us that need to be examined. It may take a combined crew but it will be more accurate. We have been fragmenting the patient, dissecting her because it is easier to study than the whole system as an ensemble. And we get a full blood panel, and we read the numbers and they tell us whether the patient is sick or not. Not much interpreting going on. We become bean counters, so much of this, too little of that and voila, you got diabetes. And of course it is worse in psychology because we do not have enough precise measurements to give us a precise diagnosis. So we ape medicine and imagine we do. We don't.

What Did You Do in the War Daddy?


Thursday, November 24, 2011

On Being Crazy and Creative at the Same Time. How Come?

There is an article in the May/June 2011 Scientifc American Mind on creativity. Here is what they propose: Creativity flows best when barriers are down. (Good). Creative people do not fit in very well socially. Both creativity and eccentricity are the result of genetic variations. (Not Good). That unfiltered information reaches conscious awareness in the brains of people who are highly intelligent and can process this information without being overwhelmed, leading to creativity and exceptional insights. Creative individuals are more likely to believe in past lives and other mystical and mysterious unsubstantiated notions. That they all have what is known as cognitive disinhibition. That their mental filters do not work properly. They may suffer delusions and hallucinations, which I think is another form of creativity where we create scenarios that come out of our deep-seated feelings.

If we can indeed create a mysterious scenario we may avoid cancer, in my opinion, because it means that there are leaky gates which allow feelings to push upward forcing new ideas. We need to study to see if creative people die of cancer versus the more likely possibility of strokes and heart attacks, because lack of creativity in my opinion often indicates massive repression and therefore great pressure on the cells.

And of course when you have leaky gates it means massive first line trauma and damage that can lead to strange and mystical ideas….unidentified flying objects, for example. The more unidentified the better. Vagueness allows all kinds of kooky interpretations. Leaky gates, you may remember from my writing means broken defenses and unfiltered input. What we have in the author’s schema is a group of correlations; they then try to put them together to draw scientific conclusions. But correlations do not delve deep down where generating sources live; and that is what we need in order to understand the phenomenon of creativity.

I use myself as an example. I always was interested in music but I was never really good. When I play in a mental hospital band and played alongside a great but crazy trumpeter I realized that I was never going to be as good as him. I was too anxious to learn properly. My gates were more than leaky; they were flooded. I was totally right brain where the origins of creativity and nutty ideas and beliefs reside. Later on, much later on, as I developed an intellect I could see and feel feelings and how they drove behavior. I had creative insights mostly because my gates were still leaky. And I also needed and finally had a working intellect. I could think and feel, and think what I felt. And that is one reason it led to primal. I had basically illiterate parents so I never had to be smart for them. And I wasn’t. They lived in their own world so there was no way I could be to get love from them. The good part is there was no neurosis I could adopt that would work. I was an anxiety case completely.

Creative people focus on their inner life. Non-creatives focus on the externals. They effectively lack an inner life, an internal access to their feelings. They are blocked off from their feelings and from creativity.

Sunday, November 20, 2011

On the Origins of Comedy and Other Neuroses

There was a story in a paper about the French comedian Dany Boon, famous over there and genuinely funny. But where did it come from? He says it: “My mother was pregnant with me at 17. “ She was then disowned by her father because her husband was a French North African. (Black). His mother cried all of the time because she was totally rejected by the family. Dany tried always to cheer her up. He needed a happy mother, and he did his best. He had no father, of course, who took off early on. So he was reared by a young kid was neither ready for motherhood and had no support. Dany shifted from child to parent; he found he could make her laugh by acting funny and telling jokes. He elevated his neurosis to an art form, which is what a lot of us do, perhaps not so successfully but we try. We get smart in school in order that one’s parents have an intelligent child. We all try to get love in the way that parents point us, even unconsciously, both them and us.

But we see here how what happens to us as young kids has a lifelong effect. Some of us have the means to please the parent and others don’t. When we do we don’t suffer as much; we transmute in this case depression into humor. We no longer feel the hurt of not having a normal, loving mother; we are too focused on pleasing them at all costs. Dany later bought his mother a house that made both of them happy. He became what parents usually do; help out the child, and she was a child.

This cannot happen to everyone. Another child might work hard in business to support the child-like mother. Dany perfected his neurosis. Anyone else would have had to find another way to get the mother to love him. His way of trying would become a template or prototype that would follow him throughout his life. He would go on doing his schtick everywhere and for others as well. His behavior would become fixed and enduring. It starts with a parent and ends up as a lifestyle.

Dany might take drugs later and never know why. He would not know that he hurts too because he was too busy attending to his mother. All of his life would involve taking care of her so that he could finally have a loving, happy mother; something that will never happen. She was and is an unloved child. She needed a father much more than being a mother. Her need became his life. Isn’t that true of so many of us. A failed athlete like Andre Agassi’s father became Agassi’s life. A failed actress becomes the destiny of her daughter, and so on. Parental need becomes our destiny. My father felt stupid and the only way he could feel smart was to make me stupid, which he did at every turn. Later, I would never consider college because I felt too stupid to do it. I would ask him something like the meaning of the word, which he never knew, so he would say, “Look it up, dummy.” That feeling stayed deep inside and colored all of my life. Until…….I was sent to college as part of going to flight school, and I got “A’s”. For the first time I began to feel not stupid.

So to reiterate; your parent’s needs become your destiny; not only any parent but the one where there was some possibility of love to be had. That is the one that sets you on the struggle. Once the prototype sets in it applies to everyone and everywhere. It becomes your personality. All to handle a pain when you were very little.

Thursday, November 17, 2011

On the Abuse of Xanax

In the NY Times of Sept 14, 2011, there is a front page piece on Xanax and its abuse.

It is an effective medication for anxiety. And it can be addictive. Indeed, any drug that reaches down deep to suppress pain and terror will be addictive, by definition. It is addictive if it works. 
So what do the chiefs want to do? Eliminate it; not exactly eliminate it, but not write scripts for it. And they want to do that because there is a great clamor for it. In short, it helps. So of course, they want to stop it. 
 In the accompanying photo is a woman who has debilitating anxiety attacks. For those whose defenses work, they cannot imagine what that is. But it is terrifying and no one seems to know what to do, except push it down. But what it if we finally know what it is, and instead of pushing it down we let it up in small doses and be done with it? We can do it and we do do it. And it is pure imprinted terror set down in the first months of life, and by that I mean during gestation and at birth. Once we know what “it” is we can start to find a cure. We have done exactly that, and it is no longer a mystery. 
 The earlier and deeper the imprint, the more pain, and the stronger the pain medication needed to quell it. Of course, it is addictive, meaning sufferers want more and more. Why not? If you had leaky gates, you would want it too. The original terror and pain weakened the gates holding it back and when that pain and terror was compounded later in life by a tyrannical shrieking mother, for example, then the gates are under assault. The results are panic attacks and bouts of anxiety (the same thing) that seem to come out of nowhere. It seems like nowhere, because the origins are so deep and so remote. It is not an abuse of xanax. It is the proper use of it, given the level of pain and terror involved. If you’re the chief doctor and your gates are solid as a rock then of course you cannot sympathize with all this.

If we are so worried about all this why not try to find out what “it” is and find ways to deal with it; maybe put it under some kind of control so that the users can be watched and helped. Then we don’t have to waste time pushing back all of those forces in the unconscious. Dr. Scott Hedges seems to think we don’t need Xanax at all. He thinks there is trouble in paradise because the patient habituates to it and needs more and more. Of course it needs to be supervised, but no eliminated. The chiefs are worried about withdrawal, which is a legitimate concern, but here again we can control withdrawal with so many new drugs (have they looked into oxytocin spray?). Let’s not stop the pain killers that ease the suffering of so many. Let’s work around it in order to control adverse reactions. If we learn what “it” is we will have a better handle on it. Making it an opprobrium to take something that eases hurt seems to have it all backwards. Let’s get it straight.

Sunday, November 13, 2011

Everybody Hurts

When I watch TV it seems like every commercial is about some kind of pain killer: Tylenol, ibuprofen, pills for stomach distress, headaches, high blood pressure and on and on. The best kept secret is that we are nearly all in pain but nobody says it; the emperor is really naked but we all are looking the other way; we are looking outward instead of inward. The distress is caused by this or that in the environment, we think, but never what is inside. That is obvious since few of us can look inside.

We are all hurting but in different ways; the hurt goes to where we are most vulnerable. That is the health crisis that no one speaks its name. So why is that? Because no one can see it! It was installed so early and so subtly, long before we had conscious-awareness, that it doesn’t even have a name. So I give it a name: Primal Pain. And a location: the imprint: and the chemical means: methylation. But what we may not be aware of is that its one of the leading causes of death among us, more so than deaths in traffic accidents, according to a recent study. Some of us are in so much agony that we take far too much medication and threaten our lives. We use Xanax, Vicodin, Fentanyl, Demerol, Oxycontin and Soma; we are treating the wrong thing, and that is why we do not get relief. We treat the symptom and not the person; we treat appearances and not generating sources. That gap I call the Janovian Gap. It is between origins and our conscious awareness of them. So long as Primal Pain exists it will militate toward wherever it can. Worse, sometimes we have both headaches and back aches so we take pain killers for both and again risk an overdose. The medication normally will not kill us but when we take more and more it will.

And what are we really killing? As trite as it seems, it is lack of love. Not just hugs and kisses but any lack of fulfillment of need very early on is also a lack of love. You know, the child is hungry and we say sorry it is not time to eat; or I just don’t have enough today. It is the equivalent of saying, “I know you need love. I do love you but I cannot show it; but you know I do.” The body knows no such thing. It marks the event with a marker that says, “Pain.” And we carry that pain for a lifetime. When the carrying mother wants to keep her figure and diets while pregnant the baby hurts. It is all so subtle and that is why we do not recognize it later on except what is obvious: a migraine, stomach ache or back aches.

And then there are more needs as we grow up that need fulfillment. When there is more deprivation there is more imprinted, enduring hurt. And it goes on and on. The migraines keep on coming back because the generating sources have not been touched; the same with high blood pressure or allergies. There is plenty of evidence now that a mother’s unhappiness while carrying can end up as serious allergies in the offspring. So let’s all understand what those TV ads really mean; and let’s all agree what is really wrong. OK?

Thursday, November 10, 2011

On the Need to Believe

Yep. There is a need to believe but not in the way you might imagine. There is a neurotic need to believe that comes out of pain, more specifically hopelessness. And in that kind of belief there is nearly always an element of hope—the deity will watch over you, protect you, love you and not let any harm come to you. You can name the hope of our choice but what we are exploring is the process of dialectics; how one thing mutates into something else, usually its antagonist. Dialectics is basically the interpenetration of opposites: here, hopelessness becomes hope. Hopelessness drives hope, and the more fervent the belief the deeper and more powerful the hopelessness; and of course, vice versa.

We are discussing the motivation behind beliefs. The brain doesn’t give a hoot what’s in the belief, just so long as there is one; otherwise we would have no defense against the unutterable pain of hopelessness. Yes, beliefs can be defenses, especially those that grow out of pain. So some can believe in God, others in Brother Bubba, still others in the Hinduism; and they all may derive from the same feeling. The choice of belief depends on life circumstance. You can see how useless it is to spend hours in therapy analyzing the belief when it is not the content but the very existence of it that is important. I have seen time and time again a patient coming close to a very terrible pain and switching into some kind of belief; “You don’t understand. I know they don’t like me and want to harm me.” They switch into beliefs when the feeling tends to overwhelm the cognitive system. And the choice of belief emanates out of the feeling: something or someone(a feeling) wants to hurt me. We rarely allow an overwhelming feeling to come close to conscious/awareness. It usually means that a feeling/sensation is rising out of sequence and must be dealt with immediately.

It isn’t always just a feeling; it can come from the deep brainstem where so many excessive sensations lie: the sensation of being crushed, pushed, suffocated, drowned, etc. All of these sensations and associated traumas can be imprinted very early in our lives, even while we are being carried in the womb or during birth. The hopelessness can derive from so many sources: a carrying mother drinking and smoking where the baby cannot escape the input and is suffocating. Or a birth process where the mother is given anesthetics which are far too much for a five pound baby, and again there is suffocation with no escape—hopelessness and helplessness.

Ordinarily, the biologic system tries to deal with the onslaught with a biologic shift of weight or force to counterbalance the deep feeling. The system tries to balance it so that it does not get out of hand. But still, if the sensation/feeling is very strong and the imprint is already sealed in, then the various high levels of brain function will try to deal with it, as well. The highest level will pitch in and offer up a belief as a way of counterbalancing the imprint. That is worth repeating: the newfound belief is a measure of counterbalance, of equilibrium. So first there are purely biologic efforts, pitching in with gate-enhancers such as serotonin, and later on, as the brain evolves, bolstering it with beliefs; all part of the same process of defense, all linked together. So for example, let’s suppose that the baby’s blood pressure goes up, which is the most she can do at the time. But later that blood pressure, heart rate and many other physiologic effects become part of the defense system. They have to be addressed as an ensemble, not simply separately as discreet entities. And now the defense system is sealed in. The beliefs are not just something to be changed apart from the system but are part of the personality. What someone believes is a part of her and is not just some whimsy or caprice. In our therapy we never just deal with strange and bizarre beliefs; we always try to get beneath them and find the driving force.

Sunday, November 6, 2011

On the Frequencies in the Brain. How the Brain Learns About Feelings

In my book on life before birth I talk about the 3 levels of consciousness and how the imprint that is laid down deep in the brain while we live in the womb has spokes going higher containing that information which is integrated on the feeling level/limbic system, and finally on the cortical level where beliefs and comprehension lies. Through a process of resonance each level relates to the others in what I think is a matter of frequency. So suffocation even before birth when a mother is a heavy smoker or drug taker sends up antenna to the feeling centers where we manufacture a dream where we are suffocating and then finally to the frontal cortex where we believe someone is suffocating; “Leaves me no space to breathe.” And what is reciprocal is that currently someone leaves me no reason to breathe, crowds me, and then the cortical brain sends antenna down to the lower levels where each level reacts in terms of its capacity. The feeling level adds emotions to the mix while the very low brainstem level enhances all physiologic reactions and provides much more charge value or energy.

That is why I say that primal therapy is neurosis in reverse. We use the same electrical brain networks going up and down. They are all related through, I submit (only a hypothesis), frequencies. Each level has its own contribution to the totality of a feeling—energy/force—feelings—comprehension/insight. Painting a feeling is not feeling; it is painting…..symbolic of a feeling. Not a total physiologic affair, and hence never curative or ameliorating. It is basically an act-out. Nor can you play your feelings and make progress. Of course, if you are close to feelings you can play more "feelingful" but it is not therapy. I know. I used to do music therapy with psychotics in a mental hospital. We would play jazz for the catatonics who could barely move, they had what was known as “waxy flexibility.” We bent their arm to the music but it stayed there. I never saw any progress.

What they also found is that very high frequencies are not conducive to feelings and their connections. There is a feeling zone in my opinion, and when patients come into therapy with beta waves, very rapid waves, they are far above the zone.

It may be that a new patient will lock into a feeling for a moment and then skid off into an abreaction, because it is less painful. She has been detoured off the proper frequency; there is something “off” there and when one is tuned to feelings one can sense it. This is no more than to say that each synapse has its preferred frequency and may not accept any other. And the frequency is perfectly rhythmic. When the rhythm is thrown off there is less learning and less cohesion; less cohesion of feeling. What I think we do in our therapy is retune the brain, especially those who have imprinted stress. Once the pain and trauma is relived the brain normalizes; goes back to its proper tuning. And, lovely, we go back to the proper inner tune; we are finally in tune with ourselves: literally.

Friday, November 4, 2011

On Murder Again

I am going to explain what happens when someone “snaps” and kills. Specifically, regarding Scott Dekraai who killed eight people recently in Seal Beach California. He says now, some three weeks later, that “I know what I did.” So how is that possible to know what you are doing and still do it? The catch is he didnt’ know what he was doing when he did it, only later.

Is that possible to know one minute and not know the other minute? Absolutely.

Let’s talk about the crackup. But before I do that let me offer a little reminder; There are three levels of brain function. The top level is the thinking, comprehending one; externally oriented. Lower down is the feeling brain that adds emotion to the mix, and still deeper there is the instinctive reptile brain that processes the same instincts as the reptile. It adds urgency and power to emotions and to beliefs. All three have separate functions and yet are interrelated. And they communicated with each other by chemical means and also by electrical frequencies. And when something happens in the present it resonates with similar feelings from the past and they join forces. When defenses are weak, something in the present can trigger off allied sensations and feelings and then we get a powerhouse response. All three levels are involved in a conjoined reaction. Normally, there is a good defense apparatus so that the resonance does not reach too far deep down, thus limited the force of the reaction.

Here is how resonance works in the domain of anger. Something in the present makes me very angry; my wife is divorcing me and trying to keep the kids. My money is running out and she still wants more. She refuses to see or talk to me. She turns the family against me. I have been let go at my job due to injuries and I have no prospects for a new job. All looks bleak and I have no alternative. All these are assaults on my defenses. And they weaken so much that it all crumbles and there is no barrier holding back deeper pain. The problem is on the feeling level there are powerful emotions, but as they resonate with still deeper levels, anger turns to rage and fury. Human mild emotion becomes murderous feelings as the deepest animal/survival levels move to the higher cortical areas, levels. In my lingo, the third line gives way to the first line reptilian brain where violent feelings reside. And for that moment the third line inhibitory brain is ousted by the first line instinctive brain and there can be murder. The deepest brain level becomes the highest one temporarily. There is nothing left of the top level of the brain whose main function it is to inhibit. But that overwhelming force may only last minutes. Once the rage is expressed the pain level diminishes and some of the third line thinking, reflective brain returns to function. And Scott can now say, “I know what I did.” And he knows now but at the moment of crisis he did not know what he was doing: his rage machine took over and he became the reptile spewing out fury indiscriminately. After all, it is the top level that discriminates. It was usurped for that moment, the critical moment when he murdered eight people. It is not unlike orgasm. There is a heightened agitation followed by release and calm. In sex we begin to lose sensations such as hearing as the whole organism is involved in a non-verbal highly emotional response. For that moment there ceases to be high level intellectual capabilities.

I have seen this rage over and over again when very disturbed patients begin to relive a memory on the emotional, feeling level and suddenly are impacted by the lower levels. They begin to pound the mattress and the padded walls with an enormous fury that can go on for thirty minutes to one hour. In therapy they can direct the rage, connect with it and not be overwhelmed by it. Not so, on the street. I have filmed this rage, and those interested will see it when we release the film. The patient seems to be out of control because he is in the grip of powerful deep forces. But it is a therapeutic situation and is not acted out. It becomes acted-out when someone has no idea that he is in the grip of powerful feelings emanating from deep in his unconscious. He is helpless before them and has no idea about how to control them. His unconscious has taken over. And he kills.

And we can say of these people who are sometimes out of control that they may be pre-psychotic. All that really means is that their defenses against the deepest level of the brain are very weak due to the constant onslaught of pain early on in their life. And what do so-called anti-psychotic pills do? They dampen the lowest brain levels from responding. They help hold back the first line. They do this by souping up the top level so that it is more active and effective; and at the same time there are inhibitory medications in it that block the lower level pain; thus, we get a more active cortex and a less active brainstem and limbic/feeling brain. And in this medication there are chemicals that we should produce ourselves, such as serotonin. But we don’t because very early trauma has exhausted supplies, and we cannot make enough to blanket the pain. So when our inner pharmacy cannot do the job we need help from the external one. We can call it anti-psychotic medicine but all it is doing is making up for what we can no longer manufacture ourselves. Poor Scott had so many current assaults coupled with a lifetime of them that he could no longer inhibit nor defend. His defense system was not up to the job. Now when it is far too late he probably has a somewhat weak defense system that can inhibit. That won’t do his victims any good.

The lesson we can take from this is that when deprivation and severe trauma exists while we are being carried, the first-line defenses are already in a weakened state. As a kid he may have had uncontrolled temper tantrums which evolved into murder. Was he responsible? Yes and no. But we can go a long way to avoid murderous rage by making sure there is as little trauma as possible when we live in the womb and of course, a good birth followed by a loving childhood. No drinking and drug-taking by the mother. No fights with her husband. No crazy diets while carrying. It is easy for me to say. I am only the messenger. It is up to all of you to listen to the message.

Thursday, November 3, 2011

Serotonin and Anger

In my writings I have emphasized that early experience can deplete supplies of pain-killing chemicals that we produce, such as serotonin. And then we need to take medication that enhances supplies, medication found in many tranquilizers. Now there is a study of this in the journal of Biological Psychiatry (Sept 15, 2011). Here is one thing they found: reduced levels of serotonin make us more prone to aggression; something I have discussed for over thirty years. In other words, serotonin helps regulate serious emotions, especially those that can cause harm. And when there is very early trauma or adversity in the womb and at birth our ability to control our impulses is compromised, because our systems over a long time have evolved in order to keep anti-social impulses under control; otherwise we would all go around killing each other. Still it seems like all too many go around killing. Those, in my opinion, had very early trauma and neglect, and have diminished repressive capacities. Their brains are deficient. It might not show up for decades but they will be a danger.

What the research showed was that low brain serotonin made communication between certain areas of the brain more tenuous. Not any area of the brain but specifically in those areas dealing with feeling. Not just the feeling centers but their connections to the top-level control centers, the prefrontal cortex. So here we have confirmation that when there is diminished serotonin the prefrontal area has a much tougher time to control feelings. The researchers discuss the emotion of anger but I am certain that it applies to many of the deepest feelings we have, whether terror, hopelessness or helplessness. One way we know this is that we prescribe tranquilizers for depression, which has at is base both hopelessness and helplessness. When we suppress those feelings we tend to feel better. And when a carrying mother feels depressed there is a good chance that the offspring will also have a tendency to those feelings, as well. It all depends on later life experience.

We see again how the top level thinking area and feelings work in see-saw fashion so that the very active top level cortex can control the lower level emotions; or not. That is, when the top level is compromised the control evaporates and we have an impulsive individual. And we may have a criminal or someone who takes risk when he shouldn’t. Or we have a volatile husband who beats his wife. And so they go to a counselor who encourages him to control himself—anger management. But the cortex cannot manage the fury that lies sequestered just below the surface. And no counseling will ever, ever, change that. Exhortation does soup up the prefrontal area a bit, and in so doing arrays the forces of thought and belief against feelings, but that is at best ephemeral. The faulty equation between feelings and control centers still exists and will continue to exist. And obviously, we must address that equation and normalize it, which can be done. No amount of talk and encouragement will achieve that. That is the trouble with anger management; feelings were never evolved to be managed. They exist to be expressed.

And now the investigators concoct a new nomenclature for this: “intermittent explosive disorder.” (Now officially known as IED). Isn’t that the same as blowing up every now and then? Again, we are trying to ape medical diagnosis, while the inventor of this new diagnosis bathes in glory. Oh my, that love of diagnosis with fancy sounding names that does nothing to enhance science. But the behavior/cognitivists hold sway today and so they continue to add this behavior or that to a long list of so-called neuroses. And they believe that behavior is indicative of neurosis, rather than what drives it. It is as if there is no unconscious. Everything for them is observable. They believe only what they can see when most neuroses are hidden and not observable. Can we “see” depression? Can we see anguish? Can we see rejection internally? These are not single behaviors; they are systemic problems that affect the whole system. The real culprit here is the psychiatric diagnosis manual, which has as many pages and afflictions as the Manhattan telephone book. It is that thick because the behaviorists control all this.

When professionals limit themselves to the here and now they have eliminated the time and epoch where and when they could understand origins and generating sources. They have cut away the elements that could offer understanding. And who suffers? The patient.

Tuesday, November 1, 2011

An Examination of Psychoanalysis (Part 13/13) ... The End

  Let us use an example. A young man does everything he can think of to please his therapist. He tries to be an exemplary patient, admits readily to all resistances, produces insights with great mental clarity, shows concern for the therapist's own feelings, finishes early to avoid being boring, and so on. Clearly there is an underlying feeling. Now therapist and patient could sit and discuss what is going on between them. They could even uncover the fact that the young fellow never could please his father and is, through his relationship with the therapist, still struggling (symbolically) for parental blessing. Further, the young man might wind up with insight into his relationships with men in positions of authority.
From the Primal perspective, however, we feel that he has still only shaved the issue. His behavior represents an act out of a need. Until it is felt no amount of insight is going to eradicate the motivating force behind it.
In Primal Therapy we may use a head-on confrontation of the behavior. "You seem to want to please me and impress me," the therapist might say. Since the therapist has so openly put his finger on the sore truth, the patient might admit it with words like, "Yes, I want you to think I'm a good patient." The next step depends largely upon the patient, but one course open to the Primal Therapist is to request that the patient say exactly what he does want from the therapist. He would be encouraged to use words that really express the pleading displayed in his behavior: "Please think I'm a good patient. Please think I'm a good boy. See how much I do for you. Give me a word of praise. Say you see how much I do just to please you. Please like me." And so on. The therapist doesn't choose the words. The patient finds the ones which help to evoke what he is already feeling. And the words usually become that of a young child as does the tone of voice.
This type of direct speech serves a number of purposes. It gives direct, succinct focus to the feeling, expressing it without distance or elaboration. It enhances vulnerability to the feeling and thereby helps to diminish the time barriers. The patient finds himself a child pleading for love. The time dissolve is not complete but it has begun. Often at this point the patient is swept into deeper feeling (which means deeper into his past), without any additional interaction with the therapist, who now sits back and watches quietly. At other times the dissolve into the past can only occur after steady probing by the therapist. "Who did you want to please so much?" might be asked, along with similar questions which lead to previous experience.
Through his response to the therapist the patient now may find his father clearly and vividly in his mind's eye. The symbol (the therapist) has faded into the real person. The Pain and need previously transferred onto the present is returned to its original target. It is no longer the therapist the young man is trying to please, but his father. He is right back in the old situation. His body and mind are beginning to respond with all the reactions he sat on for so long and which he rechanneled into a never-ending struggle to please.
At some point it may be appropriate for the therapist to interject an instruction for him to speak directly to his father. "Tell him what you need," might be suggested. With the emotion welling inside him, the patient speaks to his father. "Please see how good I am, Daddy." He might repeat it, or try several different ways of saying it, as the feeling moves him. The feeling will put the words into his mouth if he gives into it. He will not have to search for words. They will literally come to him, riding on the waves of Pain which now engulf him. "Daddy I need you, can't you see. Please love me Daddy, please." There is a simple, heart-wrenching quality to the expressions of grief which rush through and out of him. This finding of the real voice can be one of the most moving events to observe.
I do not suggest that one such experience will cure transference. The needs which promote and sustain it are strong; they have been there a lifetime, embedded in the body and bound by defenses of all kinds. But this "inside-out" experience of the underlying Pain does in time fade the filter of symbolism so that the patient comes to see the therapist much more as he really is.
It is not the place of the therapist to provide any corrective emotional experience. He is there to help the person liberate his own innate corrective processes. Sometimes it is helpful if the therapist reveals an aspect of his own life. For example, one therapist tells of a patient who was recounting how he never did anything with his father. The therapist remarked how much it had meant to him that his own father had often taken him to baseball games. This contrast opened some inner door; the patient broke into tears and was able to feel his own loss.
Does this mean that a Primal Therapist be himself totally? Obviously not. The session does not have the equality of a social setting. The therapist implicitly agrees to keep his personal business out of the way. He agrees to be there for the patient, using his skills, sensitivity, and the intuition honed through his own Primal experiences to help. In real life there are no guarantees against being exploited or threatened by the reactions of others. The formality of the therapeutic setting provides those guarantees. Knowing that there is someone competent in charge makes it safe to give in, be little, and feel the Pain of a suffering child.
The authentic corrective experience is the correct experience. It means a "matching up" takes place on all levels of consciousness. Thought, emotion, and sensation realign, not separately but wholly and simultaneously. The patient now not only thinks he needs a father to love him, he feels it and succumbs to the sensations which are inherent in that feeling. This is the vital point. He is not just aware of the sensations, nor simply made uncomfortable by them, he is overtaken by them. Sensation and cognition meet at the point of emotion.

In sum, modern analysis departs from traditional methods in several basic ways:

  1. Although early life experience and repression of trauma are seen as causative of ongoing psychological conflict, therapy is centered around the patient's functioning in current life situations.
  2. The neo-Freudians downplay Freud's theories on infantile sexuality and libidinal drives while focusing on the patient's present intellectual (ego) defenses, interpersonal relationships, and particularly on his interaction with the therapist, which is seen as the key to providing a "corrective emotional experience."
  3. A therapeutic course is typically much shorter, because a) it aims for observable change in "adjusting" to current circumstances, and b) much of the past, and particularly repressed experiences, are excluded from therapy. 
  4. There is less free association and more "directed talking." The neo-Freudian therapist is more active in guiding and evaluating the patient's thoughts and words and in supplying "insights."
  5. Therapists are more apt to encourage patients to explore what they feel, but only up to a certain point. Freud and early post-Freudian theorists better saw the importance of both uncovering "forgotten" memories and of permitting memory's feeling component to surface simultaneously. 
Overall, in steering clear of the patient's traumatic past in favor of the here and now, neo-Freudians ensure that their therapy remains in the realm of talk and ideas and that it will gloss over what causes and continues to fuel neurosis. When feelings do surface, the analyst usually encourages the patient back into a cognitive mode, in search of insight and understanding, not realizing that it is not insights but Pain that is curative. The patient is not sick because he lacks insights; he is sick because he needs to feel his Pain.
Thus, like hypnosis and traditional analysis but in contrast to Primal Therapy, modern analysis is non-dialectic and non-curative. Analysts do not see that it is in feeling utter, abject hopelessness that the patient can finally achieve real hope for himself. That in feeling his fears he can become courageous, in feeling rejected he will no longer have to isolate himself. In feeling small he can finally grow up and leave the past behind.

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.