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.

1 comment:

  1. A wonderful series. I feel I have learnt plenty and understand so much better the memory of which has been a definite No No for 40 years....after having been unfortunate enough to have been 'on that couch'.
    Its good to have most of it's mysteries for me now unveiled, and thank you.
    Love these series Art. Any chance of another one soon?


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.