The Die is Cast: Early Trauma Affect Us for the Rest of Our Lives

It seems like I am still drowning the fish, so I won’t write too much more on this but the evidence is now overwhelming that very early childhood, and that includes gestation time, changes us for a lifetime.

Here is an example: scientists have found how certain birth defects take place. It turns out that it is not just a birth defect but also experience plus the genetic defect that makes for serious illness. A group of scientists from many universities showed how a genetic tendency plus a period of low oxygen during gestation led to a malformation of the spine (scoliosis). In another related study, they discussed how early trauma led also to later heart problems, as well as impaired kidneys and cleft palate. Low oxygen is often the culprit due to the mother smoking, living at high altitude, diabetes and other diseases. But the point is that the environment working on a gene can produce an affliction, often much later in later in life. Cleft palate certainly looks like a genetic defect but perhaps it isn’t. I call this “envirogenes”; how the environment intersects with genes. Two siblings may have the same early life but differ in their genetic makeup and in their womb-life. What this research shows is nature and nurture working together.

What the researchers on scoliosis found is that having one defective gene allows the womb-milieu to have a great affect on the genetic apparatus. Lack of oxygen working on different genes can produce a different kind of malady; again, later on in life. This is especially true in heart disease. Investigators have found that very early trauma can set up an inflammation in the heart that endures, ending up finally as a heart attack. I have written about low oxygen during womb-life for many years. This is particularly sharpened during the birth trauma where a mother, heavily drugged (and therefore low on oxygen), produces an offspring low on oxygen as well. The problem is that his low state doesn’t just pass away, over a bit of time; it is an imprint that produces an alteration in the system over years. One of those alterations is an inflammation around the heart. Later on, with smoking, drinking, being overweight, lack of exercise, it becomes a full-fledged attack. Did bad diet do it? All of the above did, working on a weak heart muscle. Those with inflamed hearts nearly always have a bad outcome prematurely in later age. And the doctor then wonders what happened to make that appear; and the answer is way back in history; and that is the history the doctor must take, at the outset.

Does bad diet do it? Usually not one factor alone does it. It has to play on a weakened heart, and now we know that this happens so early in our lives as to seem mysterious and unknowable. Yes, we have to die of something, but we shouldn’t have to die before our real time, not on neurotic time. Real time means without excess imprinted trauma early on. And I suggest again that we can get rid of those early traumas in our primal process of reliving. I know a lot about the scientific literature, and I have not seen another way to do it; to do it naturally, without drugs and mechanical intervention. If we take pain out of the system, it seems to me, we won’t die on neurotic time.

Primal Therapy Research Proposal

What you find below is the outline of a proposal for research. We have neither the funds nor personnel to carry it  out. We seek help from all of you. I do believe we lengthen lifespan, and I want to confirm it. I also believe that gestational trauma is behind so much later dementia and other disease. art janov

Research Question: Can Primal Therapy reverse biological markers caused by early life stress and slow the rate of aging? Epigenetics, telomere length, and Alzheimer’s Disease

Background

Primal Therapy is an affect-based psychotherapy created and developed by Arthur Janov, PhD, of Los Angeles, Calif. First popularized in 1970 after the publication of The Primal Scream, Primal Therapy has undergone continuous development under Janov’s direction, both in theory and practice. Now in his 80s, Janov and his wife, France Janov, PysD, continue to practice and train therapists at the Primal Center in Santa Monica, Calif.

The fundamental tenet of Primal Therapy is that the cause of most psychological disorders (and many physical disorders) is early life trauma. From the moment of conception, humans have needs, and when those needs go unmet, the result is trauma. A vast body of research conducted in recent years demonstrates that trauma begins in utero when the fetus is subjected to environmental stressors, including maternal stress hormones, malnutrition, tobacco, alcohol, drugs, chemical toxins, and a host of other stressors. The result is a biological imprint—or wound—that lasts a lifetime. Later events, such as birth complications, poor maternal attachment, parental neglect or abuse, bullying, failure in school, etc. add to the earlier trauma and reinforce the imprint. Janov has made the hypothesis that a neural resonance exists within the brain that “links” earlier and later trauma. For example, when an adult is rejected by a love interest or frustrated at not being able to find a job, the feelings of rejection or futility may trigger implicit memories of neglect in childhood or maternal separation in infancy. This in turn may resonate with implicit, physical memories of a life-and-death struggle at birth or toxic stress in utero. Although controversial, the idea that fetal memories and learning can influence later life is supported with recent research (Wintour, et al., 2006; Entringera, et al.,2004).  The end result may be an overwhelming feeling of despair leading to suicidal depression. In other words, a psychobiological response is evoked that involves the entire body and mind. Janov calls this the Primal Imprint. This imprint endures and affects nearly all systems during our evolution. It is the key motivational entity.

Rationale for the Study

It is established that early life stress leaves a permanent imprint on the physiology, predisposing the individual to a wide range of diseases, including coronary heart disease, hypertension, metabolic syndrome, diabetes, obesity, autism, depression, anxiety, schizophrenia, learning disabilities, accelerated aging, cancer, etc. This is known as the Early Life Origins of Health and Disease paradigm (Wintour, et al., 2006). One of the main mechanisms by which this imprint is encoded is through epigenetic changes. Meaney and colleagues have shown that parental neglect leads to changes in genetic expression via DNA methylation and histone acetylation. (Meaney, 2001; Weaver, et al., 2004; Weaver, et al., 2006; Weaver, 2007; Diorio and Meaney, 2007; McGowan, et al., 2008) In another study by the same group, suicide victims who had been abused in childhood showed methylation of the glucocorticoid receptor (GR) gene promoter in their hippocampal tissues, indicating lower GR expression. GR is a key component of the hypothalamic-pituitary-adrenal (HPA) axis and necessary for downregulating the stress response (McGowan, et al., 2009).

Long-term clinical observation has shown that many patients undergoing Primal Therapy become both physically and psychologically healthier, suggesting that the therapy ameliorates the biological imprints caused by early life trauma. Over the decades, Janov and his therapists have routinely monitored clinical signs such as blood pressure, heart rate, body temperature, serum cortisol levels, EEG patterns and others. As the therapy proceeds, these parameters tend to settle toward healthier set-points signifying lower levels of chronic stress. Emotional regulation, resilience, and stress tolerance also increases for many patients, suggesting that Primal Therapy effects a fundamental change in the underlying neurohormonal mechanisms regulating the stress response. In other words, Primal Therapy appears to normalize the physiology of many patients.

For some time now we have been preparing to do a research project about telomeres, which cap the chromosomes and keep the DNA of the cell stable. Telomere length is known to be associated with aging: when the telomeres are longer, we live longer, and when they are shorter we know life gets shorter. It turns out that telomeres do get shorter with stress (Epel, et al., 2004) and shortened telomeres are associated with depression and high levels of the stress hormone cortisol (Wikgren, et al., 2012). Our thought was that since cortisol levels come down in our patients, it should be reflected in longer telomeres. Further at Brown University (Carpenter, et al., 2009), they studied those adults who had been abused as children. Their telomeres shortened more rapidly. One of that study’s authors, Audrey Tyrka, stated “It gives us a hint that early developmental experiences may have profound effects on biology that can influence cellular mechanisms at a very basic level.” More recently, researchers have found telomere shortening with deprivation in early childhood (Drury, et al., 2011) and, importantly, that intrauterine stress led to shortened telomeres in young adults (Entringer, et al., 2011); the authors of that study state: “To the best of our knowledge, this study provides the first evidence in humans of an association between prenatal stress exposure and subsequent shorter telomere length. This observation may help shed light on an important biological pathway underlying the developmental origins of adult health and

disease risk.” Again, the kind of abuse we know about and write about is even more profound, more remote in time and deeper in the brain than the obvious kind of abuse that is ascribed in the literature.

The purpose of the first leg of our research project is to examine whether or not Primal Therapy has an effect on: (1) the rate of telomere shortening, an indicator of aging; (2) DNA methylation and histone acetylation caused by early life stress; and, (3) whether Alzheimer’s Disease is related to fetal or early life stress in infancy. Epigenetic factors (environmental effects that result in functional modifications in the genome without changing the underlying DNA sequence) are crucial, since we may have a way of measuring how the imprint is laid down and how the imprint changes with reliving of imprints in Primal Therapy.

Study #1: Measurement of Telomere Length in Patients Undergoing Primal Therapy

Purpose: To correlate the rate of telomere shortening (a correlate of aging) with progress in primal therapy. The hypothesis is that Primal Therapy will correlate with reduced rate of telomere shortening, indicating a reduction in the rate of aging.

Patients: All incoming patients at the Janov Primal Center will be eligible for the study.

Inclusion criteria:

·               Age range: ??

·               Clinical assessment: any diagnostic criteria?

·               Access to primal feelings (therapist assessment)

·               Subgroup: Access to first-line feelings (therapist assessment)

·               Others?

Exclusion criteria:

·               Unable or unwilling to commit to at least one year of therapy (may need longer period of time)

·               Unable or unwilling to commit to regular follow-up (e.g. interviews, taking tissue samples, etc.)

·               Others? (e.g. psychosis, substance abuse, smoking, HIV-positive, etc.)

Study Design: A prospective, non-randomized, non-controlled, case series study of one year duration or longer (whatever is needed to observe significant changes).

Methods: Baseline assessments will be made on the following:

·               General physical health, medical history

·               Psychological diagnosis: levels of the imprint; what level the patient presents at the start of therapy

·               Psychological scores: life quality, anxiety levels, depression, etc. Many scales for this. We should do this to make it more objective.

·               Vital sign measures: blood pressure, heart rate, serum cortisol, deep body temperature, other?

Blood samples

At regular intervals over one year blood samples will be drawn and stored. These samples will be used to analyze leukocyte telomere length (telomeres can be measured in several ways: see Aubert, et al, 2012).

Physical and psychological measures of stress

All baseline measurements will be repeated at the same intervals (physical health, psychological assessment, vital signs, cortisol, etc.)

Statistical analysis: To be determined. Factor analysis will examine interaction between telomere length and other outcomes.

Outcomes:

·               Leukocyte telomere length

·               General health

·               Vital signs

·               Serum cortisol

·               Psychological outcomes: anxiety, depression, etc. (Patient and therapist assessment using recognized scales.)

·               Success at Primal Therapy (therapist assessment)

·               This is important for we hope to show that Primal therapy can help lengthen life and make it healthier; not a negligible effect.  In other words, if we normalize function, if we normalize the rerouting of the neurobiology due to primal pain and right the dislocation of function the normal system would have a chance of a longer life.  

    

Study #2: Measurement of Epigenetic Changes in Patients Undergoing Primal Therapy

Purpose: To examine the effect of Primal Therapy on epigenetic imprints.

Study design: Design will be similar to study #1, however, DNA methylation and histone acetylation in certain tissues will be examined.  The implications are the same as the above.

Study #3: Correlating Alzheimer’s Disease with Early Life Trauma

Purpose: To correlate the incidence of Alzheimer’s Disease (AD) with scores on an Early Life Stress survey. The purpose of this study is to determine whether or not there is a link between early life stress and later Alzheimer’s, according to the LEARn (Latent Early-life Associated Regulation) model of AD (Lahiri & Malony, 2010).  The hypothesis is that gestational stress (as well as infancy trauma) may be a prime factor in the development of later Alzheimer’s. 

Design: Survey

Methods: The ELS survey will be given to all patients or caregivers of patients diagnosed with AD.

Statistical Analysis: To be determined.

Survey:  

1.     Can you describe your birth? Was your mother given any drugs or anesthesia? Was your birth natural, breech or cesarean? Did you have a pre-term or late birth? Home or hospital birth? Were there any complications associated with your birth? Were you breastfed or bottle-fed? If breastfed, how long? Did your mother have adequate milk?

2.     Can you describe your gestation period? Was your mother and the household calm and not under stress? Was there marital discord of any kind? Was the father in the home through your being carried? Was there any talk of separation or divorce? Was there a recognized marriage before your birth?

3.     Was the external environment benevolent? Were there environmental stressors, such as poverty, war, strikes, or natural disasters?

4.     Were one or both parents under stress? For what reasons?

5.     Did your mother regularly take medication, tranquilizers or pain killers?

6.     What did your mother eat during your gestation. By today’s standards, was her diet considered healthy or not?

7.     Would you describe the family as loving or unloving?

8.     Was your mother chronically anxious or depressed? For how long?  Was she exceptionally tense?

9.     Was your conception planned or accidental? Were you born long after your next oldest sibling?

10.  Were you held immediately after birth? Were you sickly as a newborn? Describe.

These are the factors to be scored to determine how much trauma there was and the valence of the trauma.

All the above is preliminary, possible hypotheses to be fleshed out over time. It points to what we want to try to accomplish both in our therapy and our research on that therapy. We already have many studies (see Primal Healing for discussion), but now we want to refine our investigations.

References

Aubert, G., Hills, M., Lansdorp, P.M. (2012) Telomere length measurement-Caveats and a critical assessment of the available technologies and tools. Mutat Res. 730(1-2):59-67.

Carpenter, L.L., Tyrka, A.R., Ross, N.A., Khoury, L., Anderson, G.M., Price, L.H. (2009) Effect of childhood emotional abuse and age on cortisol responsivity in adulthood. Biological Psychiatry, 66(1), 69-75.

Diorio, J. and Meaney, M.J. Maternal programming of defensive responses through sustained effects on gene expression. (2007) J Psychiatry Neurosci. 32(4):275–284.

Drury, S.S., Theall, K.P., Gleason, M.M., Smyke, A.T., Devivo, I., Wong, J.Y.Y., Fox, N.A., Zeanah, C.H. and Nelson, C.A. (2011, epub). Telomere length and early severe social deprivation: Linking early adversity and cellular aging. Molecular Psychiatry, 1-9.

Entringer, S., Epel, E.S., Kumsta, R., Lin, J., Hellhammer, D.H., Blackburn, E.H., Wüst, S., and Wadhwa, P.D., et al. (2011) Stress exposure in intrauterine life is associated with shorter telomere length in young adulthood. Proc Natl Acad Sci USA, 108:33, E513-E518.

Epel, E.S., Blackburn, E.H., Lin, J., Dhabhar, F.S., Adler, N.E., Morrow, J.D.

and Cawthon, R.M. (2004) Accelerated telomere shortening in response

to life stress. Proc Natl Acad Sci USA, 101(49):17312–17315.

Lahiri, D.K. and Maloney, B. (2010) The “LEARn” (Latent Early–life Associated Regulation) model integrates environmental risk factors and the developmental basis of Alzheimer’s disease, and proposes remedial steps. Exp. Gerontology 45(4):291-6.

McGowan, P., Sasaki, A., Huang, T.C.T., Unterberger, A., Suderman, M., Ernst, C., Meaney, M.J., Turecki, G. and Szyf, M. (2008) Promoter-Wide Hypermethylation of the Ribosomal RNA Gene Promoter in the Suicide Brain. PLoS ONE. 3(5):e2085.

McGowan, P., Sasaki, A., D'Alessio, A.C., Dymov, S., Labonté, B., Szyf, M., Turecki, G. and Meaney, M.J. (2009) Epigenetic regulation of the glucocorticoid receptor in human brain associates with childhood abuse. Nature Neuroscience, 12:342-348.

Meaney, M.J. (2001) Maternal care, gene expression, and the transmission of individual differences in stress reactivity across generations. Annual Review of Neuroscience, 24:1161-1192.

Weaver, I.C.G., Cervoni, N., Champagne, F.A., D’Alessio, A.C., Sharma, S., Seckl, J.R., Dymov, S., Szyf, M. and Meaney, M.J. (2004) Epigenetic programming by maternal behavior. Nature Neuroscience 7:847−854.

Weaver, I.C.G., Meaney, M.J. and Szyf, M. (2006) Maternal care effects on the hippocampal transcriptome and anxiety-mediated behaviors in the offspring that are reversible in adulthood. Proc Natl Acad Sci USA, 103(9):3480–3485.

Weaver, I.C.G., (2007) Review: Epigenetic Programming by Maternal Behavior and Pharmacological Intervention. Epigenetics,2:1, 22-28.

Wikgren, M., Maripuu, M., Karlsson, T., Nordfjäll, K., Bergdahl, J., Hultdin, J., Del-Favero, J., Roos, G., Nilsson, L., Adolfsson, R., Norrback, K. (2012) Short Telomeres in Depression and the General Population Are Associated with a Hypocortisolemic State.Biological Psychiatry, 71:4, 294-300.

Wintour, E. and Owens, J.A. (Eds) (2006) Early Life Origins of Health and Disease (Advances in Experimental Medicine and Biology, Vol 573). Springer.

On the Memory of Killing Afghan Civilians

I read a piece in the paper about a soldier who killed 16 Afghan civilians. He claims he can remember before and after, but not during the crime. His attorneys are going to argue in his defense that he had a “diminished capacity”. I assume that means he didn’t have all his marbles. Let’s look at it from a Primal perspective.

After several deployments where people were trying to kill him, and shortly after a bomb went off that injured his teammates, he finally cracked. What does that mean? The pain from his early life and his current traumas all merged and edged out his third line; the pain replaced his perceptive, critical apparatus and flushed out all ability to hold back impulses. It also replaced any reflective capacity for what he was doing. It was as if he was in a dream: what happens in that dream is that lower-level processes take over; logic is abrogated and feelings fill all cognitive space. No wonder he cannot remember. His conscious/awareness was missing. All the past and current pain merged together to blot out any awareness. He was acting as if sleepwalking. (We have had a patient who walked to a store and bought gum while asleep and later had no memory of it. He was in the same state as our soldier/killer: unconscious.) That is, his unconscious replaced conscious/awareness. When he discharged enough rage, fear, and pain he could finally realize what he did, but not during his act.

This is the classic Primal definition of transient psychosis: pockets of insanity due to being overcome with a combination of past and present pain. The third-line cognitive functions cede to the lower levels, which are in overload and need expression. It is all acted out as if in a dream; the perpetrator doesn’t know any better because there isn’t any functioning top level for the moment.

Now what is strange in all this is that in a Primal the patient’s brain must cede to lower levels so that she can have access to deeper levels of consciousness. And when that happens the patient is again in the past, reliving being yelled at by her mother, seeing her earrings and smelling the odors in the kitchen. She is “back there”; there is little top-level functioning. If there were, the Primal would be aborted and she would be back in the present. And she would be in control again. And patients who need control have a hard time letting go of top-level cognition. They often must exert control because of the power of lower-level pain.

Our killer was “back there” too, but he was not in a safe clinic where he could act out violently by punching the walls or screaming out his hate. He took his feelings into the present; he had no one to help him into his feelings. He didn’t even know that he had feelings or that they were hidden somewhere inside of him. But the signs were there, and if there were a shrink around who knew the signs the killing could have been avoided. If there were a group culture of knowing about feelings and understanding that it is important to see a professional when the pressure builds, there might not be any murder. We need to teach kids in school about feelings, not just punish them when they act out, but help them understand how feelings push them to act out and what they can do to avoid it. Everyone in the class must pass a test on this subject; it is essential to the learning process. They need to learn about ADD and what causes it, assuming the shrinks manage to learn about it as well. We can feel for all the murder victims and for the killer too. It is too late for him, his life is over; but let us change the zeitgeist of schools and the military and save lives.

On the Real Meaning of LSD and Hallucinogens

There is an article, I believe, from the recent New Yorker about someone who took Acid (LSD) in the seventies and wonders what happened to the youth of today who prefer the shutting down drugs such as Prozac versus the opening up drugs such as Acid. He claims that society no longer wants to take risks, preferring to keep it safe. He believes that our choice of drugs is indicative of the general zeitgeist, reflecting the world we live in. In the early years (the 70’s) we craved freedom; now we crave security. He seems to be nostalgic for those old Acid days. And doesn’t discuss their dangers enough; and I believe it is one of the most dangerous drugs around. What does it do?

Grosso modo, it immediately depletes serotonin and other Gaba chemicals, and diminishes the work of the gates, thus allowing all kinds of pain on all levels from surging ensemble toward the prefrontal cortex. Gamma amino butyric acid is a repressor holding down pain and blocking against feeling hurt. What Acid does is disrupt gating and allow us to feel our pain…..but all at once. Since that constitutes an overload, the exact feelings are blocked or disconnected but their energy level gets through to higher centers. And what do those higher centers do? They absorb all that force and begin the cognitive defense against it. They do what any person does when overloaded with imprinted pain; they manufacture far-out, bizarre ideas to encapsulate the force. This is true with LSD and in everyday life. That is why LSD is sometimes called a psychotomimetic. The ideas are far out because they are forced by a heavy load into concocting something. And the leitmotif of the feeling, the feeling of feeling, gets through so that the content of the hallucination somehow reflects what the person is dealing with. Someone is trying to kill me (death is near). Or they feel a cosmic oneness with the universe, which seems like an hallucination to me. Since what the person is thinking is idiosyncratic solely to her. And what helps eradicate the hallucination it for the moment is a tranquilizer/pain-killer. It is so easy to see the connection between pain and hallucinations since pain-killers stop those beliefs in their tracks.

The frontal cortex is the last refuge of defense; going psychotic to keep from becoming insane. Absorbing heavy energy with beliefs before they can affect the heart to produce a fatal cardiac arrest. It is not the drug that makes hallucinations; it is the pain that has no specific context that drives the higher levels to become exotic. There is a context but it is usually a very early imprint with no specific scene attached. Its force, however, is preverbal with life-threatening consequences. There is no specific scene for the cortex to hang onto.

If at first you had a good trip, it is because you have a good enough defense system to allow only some of the pain through….like smoking pot. But you will have a bad trip when first line terrors and rage surge through to produce the equivalent of a nightmare. And indeed, the trip is a nightmare. Daymares are nightmares with the sunlight. Otherwise, no difference. Terror is terror, day and night. The physiology does not change when the sun goes down. It bursts through unchecked because beliefs which work in see-saw fashion with imprinted feelings, are not strong enough to hold them down. Then you make no sense. These neural gates are not Huxley’s ‘Doors to Perception; on the contrary they block perception in specific ways and allow only global perceptions”; so-called Universal Truths. You are never “one with yourself or with the cosmos.” You mind has flown into pieces and you can only recapture pieces of yourself. You feel liberated because the lid of the repressive load has been temporarily lifted. It is primal therapy on speed. Instead of getting to one feeling at a time and integrating it; you get to all at once and it is really too much. But you do not have enough critical faculties left to understand what is happening. We did LSD research decades ago and found the brain very speeded up but with low amplitude which means to us the breakdown of defenses. We see on patients on the verge of deep non-verbal feeling that defenses mount with the heightening of the amplitude. When they crash, so does the amplitude. And after some ten trips the effects last for years; trouble sleeping, needing tranquilizers, cannot concentrate and unstable behavior, in general. That is the danger of rebirthing and drugs that prematurely unleash early pains out of sequence. You can and do often get hallucinations; “at one with the cosmos,” etc. I have seen it over and over in those who take drugs, smoke pot all of the time, or go to rebirthing centers. They come to us overloaded and seemingly “in space.” They are not all there. When a booga booga therapist thinks this is a good response to his therapy, watch out. When his beliefs merge with the patient all is lost. When the therapist thinks that “at one with the universe” is to be fervently sought they are both hallucinating.

Integration is the sine qua non of progress in psychotherapy. Nothing artificial can make that happen. It is a biologic law; not to be abrogated because someone has invented a quick way to ourselves. To defy biologic laws is to contravene nature and natural law. To bypass nature means not to get well, for it is only through nature that we can be cured. We need to go at nature’s pace, follow the rhythm of the evolution and not hurry the process up. The human brain is a delicate instrument. We need to play it carefully.

LSD has been used for treating depression. What it does is ease the cap of repression and thereby easing depression, which, as I have said over and over, depression is repression elevated to a high level. One no longer feels the specific feelings; they are usually preverbal and heavy valence so that they cannot be accessed easily.

The writer in the article (Marc Lewis) went from LSD to heroin. No surprise since the gates had been flung open by LSD and needed closing. What better way than through a powerful painkiller. If he did our therapy he would not need heroin. He would have felt the pain in all its agony one piece at a time. LSD shows us nothing except how it feels not to repress pain for a brief moment. That is good. Getting there through drugs is definitely not good. Doing the artificial can never produce natural responses. And it is always nature we are after. We are after inner harmony, and only nature can provide it.

On the Use of Medication in Sleep and Psychotherapy

There is a recent piece in the NY TIMES (“Pills’ Risk Complicate Long Wait For Sleep,” March 13, 2012, Science section) that states that those taking sleep medication on a regular basis are nearly five times as likely as non-users to die over a period of two and a half years. Now why is that? Before I answer, let me say that in my life and in my practice I find that at least half the people I come into contact with have trouble falling asleep or sleeping more than an hour or two without waking up. So many of us cannot sleep, and sadly that includes doctors and surgeons who really need their sleep, not to mention airline pilots. The article states that there were 60 million prescriptions for sleeping pills last year in America.

Of course, those who need sleeping pills are already in trouble, usually suffering from anxiety disorders and/or deep depression. And these people may already be on daytime pills for a variety of psychiatric disorders. So why no sleep? I think that lifetime sleep patterns are established in the womb and at birth and just after. A carrying mother who is highly anxious or depressed may interrupt the fetal sleep patterns. It dislocates how we sleep thereafter in the same way that trauma while we are being carried produces lifetime patterns of behavior or symptoms such as headaches. It is also the time when our hormone, neurotransmitter, and neuromodulator output all begins, so that traumas during this period can change the setpoints of so many neurochemicals that affect sleep. Just not enough serotonin can do it, as well as alterations in dopamine. The system may be imprinted with too high a level of vigilance hormones that work against sleep. Or there may be compromised gating functions that prevent us from blocking low-level imprints.

But let us not concentrate only on sleep because any serious anxiety imprint that the carrying mother suffers means the baby suffers too. And that means overloading the gating system early on. The result is that when we try to cede high-level cortical alerting functions in order to reach down deeper in sleep levels, the pain is there waiting and prevents any rest. This is usually the result of serious neglect and trauma while we are living in the womb. And so because the gating system is weak we cannot block enough of the pain in order to get some rest. And we take pills in order to quiet the onrush of pain. And those pills work on pain centers; some work directly on the vigilance centers of the brain stem such as the locus coeruleus. They do what they are supposed to do: quiet the agitation.

The faulty gating system already means serious pain when the gating system was being organized, sometime around the midpoint of pregnancy. An anxious or depressed mother can overtax the baby in the womb; too much input from the mother, so much so that the inchoate gating system becomes defective. And later in life when we try to sleep our minds are racing, racing because the first line is in a hyper state. Why hyper? Because there is danger from the imprinted deep first-line feelings, and so the system must stay alert against the feelings. So long as that imprint of a turbulent agitation remains in place sleep will always be a problem. That imprint has no doubt already lowered the effectiveness of the gating system, making sleep problems unavoidable. So of course we take pills to try to make the physiologic function be normal; those pills are an attempt to normalize the system, to establish a brain system that can shut down when necessary. So they are life-saving and life-threatening. In the daytime we see this in the anxious patient who is go-go-go all of the time, unable to sit still and relax. Sleep problems are only an extension of the daytime behavior. It is still the same person, night and day. He may also exhibit impulsive behavior during the day, as an expression of impaired gating. It isn’t that we have sleep problems at night but are perfect during the day. It is the same system misbehaving at night: on the go when one shouldn’t be, night and day. Same imprints driving it all.

Taking sleep pills is, of course, life-endangering. But here is what an expert, the president of the American Academy of Sleep Medicine, says: “If someone comes to me on a sleeping pill, usually my tactic is to try to take them off it.” Without looking into its biological necessity? Maybe one needs it to equalize the psychic economy. It is clearly what the system needs to go on functioning. Today the experts believe that it is safer to take non-benzodiazepine sedatives than benzodiazepines or barbiturates. Not sure. Maybe, although it is still suppressing the pain, just by a different method. How about discussing the pain, what it is and how to get rid of it? Why is it always a given that we must suppress? Why don’t we express? Assuming we know what we are dealing with, that is. Ah, that is the problem—not enough knowledge about what is behind sleeplessness. It is, after all, a big leap from womb-life to not being able to sleep last night. I could never have figured it out without observing patients who have sleep problems relive first-line feelings and begin to sleep peacefully at last. We see the great inner agitation during the primal, and then see the drops in blood pressure and heart rate and later, reports of sound sleep. One piece of advice: when there is that stab of some feeling upon arising in the morning, instead of running from it, lie back and let it sweep over you. It often helps, and you will eventually understand why that problem is there in the first place.

Another Look at Electroshock Therapy

Years ago my team and I watched something we had never seen before. Someone reliving something that looked like a birth primal and yet quite different. We let him go through it for about a half hour and then asked him what it was. He wasn’t sure. We then found that he’d had ten shock therapies in England for depression. He was reliving the shock, in the same way that another patient, also from England, was reliving her shock therapy (which we filmed). It looked to me like shock therapy and when I put a pencil between her teeth, her back arched and she went into what looked like an epileptic seizure. She knew when she came out of it what it was. It seems clear to me that what goes in has to come out; it is a shock just like any other shock we go through in our lives. It overwhelms the system and shuts down large parts of it. Patients need to relive electroshock therapy without a specific event in the same way as reliving the shock of seeing their parents die in a car crash. The system is overwhelmed in both cases. Part of memory is shutdown in both situations. The doctors find shock therapy helpful since it hides away past memory, keeps the person unconscious; but, as I have said before, “You cannot get well unconsciously.” It’s no different than hypnosis.

The authors of a recent study on shock therapy noted that over 10-20% of depressed persons unaffected by psychotherapy go on to shock therapy. This also seems to be true for tranquilizers, which often cannot touch depression. The doctors conclude that the only option left is to blast the patient’s brain with electrical energy. And again, there is no asking “why?” Why is depression there in the first place? Or even, what is depression anyhow? There is no thought that perhaps we need a therapy that goes deep enough to effect deep, suicidal depression.

The template here seems to be that a first-line imprint from gestation or birth leaves the prototype of hopelessness (or terror or rage, etc.), impressed into the system. Until that original imprint is addressed and relived there will always be a tendency to deep depression. Yes, it will help to discuss one’s feelings with another person, a therapist, but that still leaves the template intact. Still, talking it out eases the load a bit, even temporarily, and is a good thing.

It is not that depression is refractory to psychotherapy. It is that psychotherapy is refractory to depression. It is that current psychotherapy is too superficial to change anything profoundly. It is the fault of the therapy, not the patient. Once we know what it is and have the proper tools it is no longer untreatable. Cognitive therapy only worsens matters by remaining in the realm of cognition instead of feelings. Thinking “positive thoughts” will never change the feelings that are at the heart of depression. It isn’t that depression cannot be touched by therapy because it is such a serious affliction; it is that conventional therapy is not designed to probe the depths of the unconscious where generating sources lie. And today it seems that the only way conventional shrinks can get to those deep-lying imprints is through jolts of electricity.

Doesn’t it seem bizarre that when we are at a loss we start to blast the brain with electricity? But the shock doctors, they don’t see it as a loss. Of course there is memory loss in shock therapy; it is meant to happen. We are programmed to forget. In a way, our therapy is shock therapy in reverse. In reliving we are feeling shocked again but we can integrate that shock and so be done with it. We become superconscious, hyperaware of what went on. We don’t blast away the imprint; we approach it and finally welcome it. We don’t make it an alien force; we make it become part of us. Until that happens we must take measures to put down the force—pills, shots, shocks, endless discussion, cheerleading, jogging and exhortations to get going. And in cognitive therapy, the advice by doctors, “You see there is no reason for you to be depressed; your kids are healthy, your wife loves you…blah blah blah.”

The force is that ancient engraved imprint. The doctor is sitting behind his desk and cannot see an event that is forty years in the past. He therefore can draw no other conclusion: he (the patient) needs to get over it. For the cognition/technician it is all in the present, and seems to be irrational. They try to make it all rational without noting that the symptom has antecedents far back in history. And for such antecedents there are consequences—depression. It is all a logical extension, reacting to something specific in the past; once we get to the past it becomes eminently rational. To be bereft of the past makes it all seem irrational. We cannot make sense of any of this without referring to history. It is not just some bad thing we must blast away but specific feelings that need to be felt.

What is being blasted away? Often it is hopelessness and helplessness, the bedrock of most suicidal depressions. Those feelings are trying to make it up to the top for release, but alas, pills and then shock therapy keep it down. So the one thing that can cure is seen as the enemy, something to be avoided. What a strange paradox!

In shock, as in both that form of therapy and life, there is a fundamental disconnection from feeling centers to the top level comprehension areas of the brain (see Perrina, et al., 2012). A sort of functional lobotomy. The brain is saying, “I can’t take any more input so I will just shut down.” And with that shutdown come hidden forces that constantly render the person uncomfortable, like he is carrying a heavy load that he cannot get rid of (which he is—of feelings). His movements therefore are slow and labored; he has trouble breathing; it all seems like such an effort. There is no energy left to do anything in life, even eat. Repression is at an extreme,  and it weighs the whole system down. All energy is being used in the service of gating/repression.

The current rationale for depression seems to be that it comes out of nowhere (some textbooks state it thusly—“endogenous depression”), like some phantom to haunt us. And if we do not understand the imprint we are forced to call in the phantoms. We need to know that suicidal depression is something knowable and genuinely treatable. We don’t need to insert something like a shock machine into someone. All we are doing there is ensuring that would-be liberating memories are more hidden and inaccessible. There are treatments that are much easier, safer, and quicker; and a way to truly get rid of depression.

Perrina, J.S., Merzb, S., Bennetta, D.M., Curriea, J., Steelec, D.J., Reida, I.C., and Schwarzbauerb, C. (2012) Electroconvulsive therapy reduces frontal cortical connectivity in severe depressive disorder. Proc Natl Acad Sci USA, 109(14):5464–5468

On the Mystery of the Unconscious Part 2/2

We have seen in my past blog how we go in and out of consciousness in ordered fashion. In therapy we start at the end and move to the start, evolution in reverse. We start in the present and move to the past, to the origin of the nervous system. The thrust of the therapy is to begin with the end product in our evolution, the neocortex and move slowly downward. And this order is unshakeable in every way. An approach that defies this order is doomed to failure. The brain is an orderly entity that brooks no insurrection. So we begin on the third line (present) move to the second line (childhood) and finally the first line (after conception to months after birth). When we are anchored in the present it then allows us to dip into feelings, and those feelings become the vehicle for a deeper descent in the brain. Words are not the primary vehicle, feelings are because their origin is lower down. It is like a mine elevator that takes us ever so slowly into the lower depths. Words cannot be the primary vehicle because they exist on the top level. We descend in therapy to where feelings lie, where they begin their organization; those feelings begin their and our liberation. Evolution dictates how our therapy works; for if we want to provide connection to feelings we need to be cognizant of where feelings lie. And obviously, we cannot produce connection only on the cortical top level of the brain; we are connecting lower level imprints to higher level understanding. We need to learn how to descend to lower levels of consciousness where our pain lies. Our job is the opposite of most other approaches who cover over the pain. We let it rise in ordered fashion. Perhaps more accurately, we descend to meet them.

When deep levels rise faster and higher than higher levels, as in rebirthing, we’re in trouble. This defies the natural order of the brain. That is why hallucinogens are so dangerous; unleashing deep levels prematurely. They are too powerful to allow connection so they produce only abreaction, or they rise to produce strange ideas, sometimes psychotic ideas. These are never connected but simply the effluvia of too many and too strong feelings. All because the doctor has decided to skip evolutionary steps and produce what looks like super dramatic results; too dramatic to be of any therapeutic use. What I am describing is a neurologic dictatorship; it allows no disobedience and demands absolute loyalty. It is merciless, permitting no second chances, no opportunities to take a different route. Follow the prescribed evolutionary route or suffer. Evolution, as I have said, is pitiless. If we want to get along with it we must learn its rules. So of we want to take a fast route to the depths of the unconscious and use drugs we will pay a heavy price. We can’t trick mother nature.

We know more about how drugs work now based on the neurologic hierarchy; how we react to them, how we come out of them, how we suppress different brain levels with different kinds of drugs. And because of this evolution we never want insights, ideas, to precede feelings; that is not how it happened in our history. We didn’t speak before we had feelings. Why should we speak our insights now in therapy before we get to feelings? Evolution! We were first all brainstem, then limbic, finally neocortex. Each brain has its secrets, and it is our job to find them out.

Each new level absorbs part of the previous level, which is why as we descend down the hierarchy of consciousness and feel on one level we are also feeling part of the previous deeper level; we feel about our childhood but it may incorporate without our knowing it, aspects of the birth trauma, as well. When the previous level is too strong it may well interrupt the feeling. So we feel on the level of childhood and suddenly there is gagging and choking as the deeper level of the birth trauma is surging forth. It does this because our gating system between levels is impaired. It is impaired due to the heavy load of pain which has weakened it.

Only when we follow evolution do we have a chance to get well. We need to know how to read the instructions; they are there and are obvious to the attentive. When we try to outsmart those instructions we get in trouble. And those who want to outsmart it are those usually in their heads: the intellectuals who believe they know better. They think that way because they are bereft of access to their feelings; they do know more and would inform them of evolution. There is nothing like access to feeling to keep us straight. We can think straight when those ideas come fluidly out of our feelings. When we don’t feel, our ideas are not anchored, become detached, and can be anything. That is why when doctors concoct a theory from their heads it may have nothing to do with us humans, and their therapy goes off track and cannot be curative. The reason is that it is all intellectual and ignores the human body and physiologic system. Theory must evolve out of the human experience, and not out of the head of the doctor. So intellectuals become therapists and superimpose their beliefs on to how we do therapy. (I am not against intellect, only intellectuals). They superimpose their beliefs onto feelings, and what that does is suppress feelings and make it look like the therapy is a success because the patient can no longer feel her pain. But it won’t last and she will keep on having to do it. Because feelings will surge their head again and again upwards, searching for neocortical connection. Connection means final relief. No connection, no relief, no matter what anyone believes. Well yes, a bit of relief for a short time but nothing definitive. When I discuss connection it means taking a lower level feeling towards the neocortex. We need to access feelings to do that.

Scientific American just published a piece called, Decoding the Body Watcher. (4-5-12) They ask the question, what is the difference being attentive to the outside world as opposed the inner one? They explain that while the top level cortex can attend to the outside, the older more buried parts (Insula and posterior cingulate cortex) specialize in our inner world. If we want to appeal to the inner world we need to go there, and we cannot do it by an act of will or conscious deliberation. “Will” is a top level event that has no roots. We need to go to the unconscious. If we remain on the level of ideas we cannot get there from here. We go there via the lower structures but need the higher levels to start us on the track. Descent can never be an act of will (top level); it is an act of total submission as we leave the neo-cortex behind. When we usually say “Pay attention” we mean using the top level cortex to focus. Abandoning the top level and sinking into feelings is the proper way to get feeling’s attention.

When we stay on unanchored cortical level the lower levels can dominate perception so that we mistake someone’s intention or their interest in us? Those lower levels can make us suspicious and untrusting. What the university of Toronto researchers found was is that we become victims of our feelings and have little control over them. Segal and Anderson found that feeling perceptions rely on deeper level brain processes, lower level consciousness—older brain systems.
So here is the key: we cannot rely on newer brain systems to access the older ones, especially the very old ones that lie deep in the brainstem. We mistakenly think that we can resolve our emotional problems from the top down; using the new brain to figure out the old one, the one that is millions of years away from the present. They suggest that we need to bypass the cortical area to get lower to feelings tapping directly into body areas. That describes what we do completely. When you do that you eliminate what Freud used to call the superego; you bypass critical judgment and let the feeling rise. You are not endlessly ruminating about what you are thinking or believing.

Imagine now going to a shrink who makes a mystery of the unconscious and presumes to tell us what is in our unconscious; something millions of years away in neurologic time. He will need something more powerful than the Hubble telescope to do that. It is impossible yet many therapies are based on that; thinking our way to health. Too often, we seek out doctors who will tell us what is wrong with us. They tell us what to do to improve when, as I repeat ad nauseam, only we can do that in a proper environment where we can access deeper levels. In our case, a quiet padded room with softened light. And unlimited time for the session.

Too often shrinks tell us what and how to think; to think positive and deny what our body is importuning all of the time. When doctors have little access to feeling, they can manufacture a therapy that offers us little access, as well. When we ignore access, all the other ways of therapy become alleviating, palliatives, quick-fixes, and don’t last. That doesn’t stop millions from trying it. They seem to want to learn how to stuff back those naughty feelings. Yet it is so much easier and freer to let it all out. But all of these old conventional theories come out of ancient times when feelings were an anathema. Feelings became equated with nuttiness; true to this day. You know, “John is so emotional. We need to be careful around him. “ Or, “so and so can’t think straight because he is so emotional. “ What this usually meant was that his feelings overwhelmed his rational mind. So long as his feelings meld with understanding he is rational.

It seems to be true that the only way we are willing to go deep into ourself in therapy is if we are already suffering; which means that the pain has risen into conscious/awareness. Otherwise, we seem to look for a little touch-up, a bit of suppression so that we can go on with our neurosis. We don’t seem to want change; we want to make our neurosis work.. I believe that in doing that we are surely shortening our life. The pain doesn’t leave; it stays and agitates and eventually will get at our heart or brain. There is no escape, just evasion.

On the Mystery of the Unconscious Part 1/2

There are two new and very important research studies that I will discuss that helps clarify what our consciousness is all about; and more, what access to deeper levels of consciousness mean. This is part one. Tomorrow part 2.

There is a scientific piece by a group of Finnish scientists on how consciousness emerges. Here is what they did: they took twenty healthy volunteers and gave them drugs that made them unconscious. Drugs similar to what Michael Jackson got(Propofol). Then they measured them with brain measurements (PET scans), and watched what brains were active as they woke up and came out of unconsciousness. You would think it would be the higher level (consciously/aware)neocortex (1). But no. What seemed to happen is that we come out of unconsciousness as the brain evolved. Deep brain, brainstem, then limbic system, then top level cortical areas. These brain structures. Brainstem, (1)thalamus and hypothalamus (2) were activated first. We start with the most ancient phylogenetic structures first, then limbic second; no different, by the way, from how we come into and out of primals. We call it, the 1,2,3 hierarchy; and coming in—the 3,2,1 hierarchy. The point is that there is a neuro-biologic schedule for going in and out of consciousness, and it must not be abrogated for convenience. And that is how we know we are getting proper primal therapy. There is specific hierarchy for feelings and they follow evolution, of course. They follow how we became feeling then thinking human beings millions of years ago in evolution. And that structure dictates life and above all, dictates how psychotherapy works. There is an order to how we become unconscious and conscious; an order to how we descend into the deep reaches of the brain in therapy and how we ascend back up to the top. So when someone tells you, as in EMDR, that you can access feelings through thoughts and ideas, with a current focus, they defy human evolution; when they say we can access the limbic areas without ceding top level consciousness they misread science. You cannot be on the top level and in lower level feelings at the same time. They are two different universes; two different brain regions; two different brain tissues.

On the contrary, when we plunge patients into deep brain structures with LSD or rebirthing we get overload and often delusions—“cosmic consciousness, at one with the world,” etc. We have defied evolution and we arrive at mental illness. No mystery, the top level is overloaded by the lower levels and it is all too much. It can well be a description of psychosis. When we first wake up in the morning we are briefly in touch with our deep brain (brainstem). And we briefly feel what is there; a stab of anxiety or depression or hopelessness. We are in touch with our beginnings; but before we can feel it we get ready for the day, get busy and ignore it. We move out of the lower level into the higher levels (the precise order in which we wake up). But if we lay back and allow that stab of anxiety to overtake us it would help make us free. It is that deeply imprinted feeling we have touched.

There are drugs that suppress the first line, brainstem and leaves the emotional level intact. There are drugs that suppress emotions and leave the top level neo-cortex intact, and there are drugs that suppress top level cortical cells that block inhibition and give us some access to feelings. That top-level suppression inhibits some of our inhibition and makes us feel somewhat freer for a time. Think of hypnosis. It blocks some of our top level critical faculties. It begins as something psychologic--suggestion, which then becomes chemical-- enhancing unconsciousness). But it allows us to descend to our past. The problem is that there is no final connection that would really free us. We need conscious/awareness for that. And again, when we defy evolution we fail. But it does show us our unconscious and how memories reside on lower levels. Hypnosis allows us to travel back to old memories. But as I noted, there can be no long-lasting cure there. There is no organic connection.

What we have done is set aside the top level for a moment, allowing lower level imprints surge forth. The imprinted memories were not suddenly manufactured; they reside continuously below higher levels of consciousness. They are active all of the time below the level of conscious/awareness. And they agitate us all of the time; hence we cannot sit still and relax. We are unable to relax, because in ordeer to relax we cannot be hyper-vigilant. We are hyper vigilant because down deep there is danger---of the imprints and their force. It is a vicious circle. When we let go of vigilance we get anxious because the feelings are right there. So we still can’t relax. Visiting them for a moment in hypnosis versus experiencing them are two different universes of discourse. It looks magical that hypnosis but it cannot be curative. The laws of evolution won’t allow it. But still, many of us want that magic. That is the attraction of EMDR, a magic wand (literally) that passes before our eyes and makes us well. Unbeatable. So even better, we take tranquilizers which take only minutes to work. That is good except it shortens life. Someone says, “yeah but it is only at the end.” So ask yourself when considering any therapy—does it follow evolution? It is not a theory; it is a fact.

When we look at evolution we also see confirmation both of the unconscious and the hierarchy of the brain. There are indeed three levels, as I have describing for forty years. Those levels have to do with neurosis, depression and cure. They cannot be ignored or defied if we want to provide a cure; neurobiology leads the way for how to do it. There is are brain processes underlying our actions, thoughts and beliefs; we cannot forget them to produce some psychotherapy that is not based on how our biology functions. What all this means is that a proper therapy must obey strictly to how we evolved.

We can say that ideas are strong and change feelings when science shows that is exactly that opposite. This is the dilemma of the cognitive-behaviorists who do indeed believe that beliefs and ideas are the sine qua non.: change ideas and we change feelings. They develop a therapy based on a falsehood. No one can get well that way; in the mind alone. Ideas only slightly affect feelings but they do not radically alter or transform them. Only experiencing those feelings, back then when they were imprinted, can there be a cure. Feelings are stronger than any ideas; don’t forget, ideas and beliefs came along millions of years after feelings. When a theory does not correspond to the reality of how our brains and bodies work there is no way to get well. And neurology teaches us that when feelings get to be too much the neo-cortex whips into action to stop them. Evolution dictates how therapy should go, not some intellectual notion from a therapist. Humility is foremost; and let us not imagine we are smarter than evolution, probably the greatest discovery in history.

Nutiness Apotheosized

Here below is  an example of today's psychotherapy. Look at her honors; a consensus of dunces, a complicity  of intellectual fools bereft of feelings who know  nothing of neurology or any understanding of what is going on in the brain.    And she has inveigled top ranking shrinks and neurologists into her scheme. The  is Booga-booga brought to its asymptote.  She is approved by a body  representing all psychiatrists  in America.  It is all about "taking   control of your life," that is distracting your mind away from reality.  Yes she does genuflect before old memories but then she uses that only to identify what is below current complaints. But if the memory is too powerful or too early or nonverbal, then what?  I have written a very long piece on this in my blog (in 4 parts, here is the first part.  Look it up.   art janov

____________________________________________________________

(from http://consults.blogs.nytimes.com/2012/02/27/ask-an-expert-about-e-m-d-r/ )

Ask an Expert About E.M.D.R.

By TOBY BILANOW

The psychological therapy known as eye movement desensitization and reprocessing, or E.M.D.R., has gained increasing attention in recent years as a treatment for post-traumatic stress disorder among returning war veterans and others suffering from the results of serious trauma. The integrative approach uses rapid eye movements and other procedures to access and process disturbing memories.

“Recent research has demonstrated that certain kinds of everyday life experiences can cause symptoms of P.T.S.D. as well,” says Francine Shapiro, the originator of E.M.D.R. “Many people feel that something is holding them back in life, causing them to think, feel and behave in ways that don’t serve them. E.M.D.R. therapy is used to identify and process the encoded memories of life experiences that underlie people’s clinical complaints.”

The therapy has been recognized as effective by numerous organizations, including the American Psychiatric Association and the Department of Defense, but controversy exists as to how it works.

This week, Dr. Shapiro joins the Consults blog to answer readers’ questions about E.M.D.R. She is a senior research fellow at the Mental Research Institute in Palo Alto, Calif., director of the EMDR Institute, and founder of the nonprofit EMDR Humanitarian Assistance Programs, which provides pro bono training and treatment to underserved populations worldwide. Her latest book is “Getting Past Your Past: Take Control of Your Life with Self-Help Techniques from EMDR Therapy” (Rodale, 2012).


By TOBY BILANOW

______________________________________________________

Here are the links to the 4 part article I wrote about EMDR in March 2011:

EMDR Part 1/4
EMDR Part 2/4
EMDR Part 3/4
EMDR Part 4/4