Friday, August 31, 2012

The Nuts and Bolts of Sobriety

I kid you not when I say that the august journal Scientific American Mind, publishes some strange articles. This one, the “Nuts and Bolts of Emotional Sobriety” by Herbert Wray (March 2012), is about being sober. Persons must attain “emotional sobriety” before they get too far along; and that means—hold on!—you must learn to regulate negative feelings that can lead to discomfort, craving and ultimate relapse. The maxim is “Don’t think and don’t drink.”

What the article goes on to say is that this is a lifelong effort and requires new ways of thinking. There are so many loose intervening variables involved, so many ill-defined notions that I hardly know where to start, except that this appears in an important scientific journal. But if we suss out the hidden text it is “thinking will make you well”. Oh yes, that is not exactly what they are saying but it really is. You need a new way of thinking and where does that come from? And by the way, where does thinking come from, in any case? Thinking is not so deep, not deep enough to change deeply embedded feelings that drive cravings. You can only agree with that notion if you do not understand where addiction comes from, and it is not, not, not from faulty logic, where you just need to change your attitudes, and voila. Ideas and attitudes are late arrivals in the brain and are never strong enough to combat feelings, instincts and sensations, which preceded them by millions of years in evolution. There was this life going on a long time before ideas came along. This is true in antiquity and in our personal development. And we hurt and imprint that hurt long before we have ideas to describe it.

They go on to say “take it one day at a time,” because there is nothing else you can do, and you are always susceptible to falling back into drinking and drugs again. There is this rock-hard belief in all these booga booga approaches that there is nothing you can do about addiction except beat it back every day—hence, one day at a time. But suppose we know what causes it and can eradicate that cause?

Then you don’t need one day at a time. You can get your whole life back. The answer lies within us, not with some self-styled guru who assures you he has the answers. No one has a single answer about your life; only you do. We want to lean on the all-knowing savant but, unfortunately, he does not exist and never will.

This is denial at its zenith; don’t pay attention to those negative ideas! What? Those ideas arise from early life trauma that makes them painful, not pesky. And addressing those feelings, integrating and resolving them, means liberation from addiction. Our bodies cannot ignore them; they are there for a good biologic reason—to warn us of trouble inside that must be dealt with. They have it backwards; it is not thinking about those feelings that produces discomfort; it is that we are not at all comfortable and the only way to get comfortable is to plunge into those feelings. Instead, they recommend distraction as a way of dealing with it all; my mother could teach them about distraction, every time I whimpered she would start raising her voice and saying look over here, look at that dog, etc. Forget your real feelings and look somewhere else. My god! That ploy is a hundred years old. Their idea is that distraction helps you not focus on alcohol and drugs. But the craving is real! It is telling us the truth; there is pain and suffering that we must address and experience. We must definitely focus on it and not look away. That is the way to health. Does anyone think that when we ignore pain it just goes away? No, no. It buries itself deeper and becomes unreachable. This for the scientists is called a “strategy.” I call it neurotic acting-out; not facing reality. Can anyone get well not facing reality? What happened to “you shall know the truth and it shall set you free”? The whole idea, they say, is not to ever let those negative feelings gain force over you. What they believe is that once we can identify our “processing” style we will do better. Pure cognitive therapy.

And so they go on to say that recovery programs teach this method of self-regulation. This is the old wives tales raised to the level of a scientific principle…but faulty as hell. Do I sound angry? Yes. It is a continuation of nonsense masquerading as some kind of psychological science. And whom does it hurt? Those who suffer.

Tuesday, August 21, 2012

On Saving Lives

There was a piece this summer from BBC News and other scientific sources about a  new therapy to help in the fight against cancer. (
It has to do with part of the immune system known as Natural Killer Cells  (NK cells).  These cells I have written about for years because they seem like advanced leaders looking out for the appearance of newly forming cancer cells;  hurrying over to attack them, destroy and devour them.  They are very important.  And what is even more important is that we have found a  way to increase their presence and their fighting force. Thus, we may have found a way to help in the fight against cancer.  I say "MAY" because these are always complex issues that we don't want to oversimplify.

  But let's look at the evidence.  The new therapy goes under the name of immunotherapy, and the theory is direct and simple: there isn't enough NK cells in the cancer patients to fight off the disease.  So the scientists decided to infuse additional NK cells into the patient's system.  Initial reports seem favorable.  It seems as though our bodies produce adequate amounts of killer cells to combat ordinary assaults, but somehow  some of us do not manufacture enough.
I will offer my perspective which is that very early in our lives, especially womb life, there are traumas that overtax our immune capacity; in fact there is not enough to combat that specific challenge  for that specific trauma. The trauma during womb-life may alter the set-points for NK cell production for a lifetime.  This is particularly so  when the immune system is forming and the set-points for immune function are established for a lifetime.  We do know that this is true for many hormones such as cortisol.  In a sense, the immune system has been compromised and remains defective and insufficient to do its job.  Thus, it may be that as new cancer cells are first forming, there is not enough warriors to fight off the carcinogen.  Malignancies will remain uncontrolled.  So it would make sense to add to the mix something that enhances NK production.

  There may be another way to accomplish this.  We did a double blind study of NK cells at St. Bartholomew's Hospital in London some three decades ago.  We found enhanced production of NK cells after one year of our therapy.  It was a significant change and it allows us to consider that what we do is buildup a anticancer force in our patients.

  So here is the question:  what is it about our therapy that changes NK cells in patients?  I believe that when patients go back to womb-life (explained in my Life Before Birth), they enter into the epoch of  development when many hormones were beginning their evolution.  It is again a chance to go back and undo and redo history, as strange as that may sound.    In reliving that time  we are able to normalize distorted and dislocated function.  We can, in short, change history.  And in this sense we produce NK cells that are prolific and strong enough to do the job they were intended to do.  We "right" the system and make it stronger.
It is why, in my opinion,  mentally healthy people should suffer a lot less cancer.  There are many contributing factors here, not the least of which is the reduction  of stress hormone levels at the same time.  What we do in our therapy is therefore reduce the strength of foreign intruders while building up the standing army. We go to the source of the problem: how the system was compromised at the beginning.  The memory of that traumatic event forced a permanent dislocation of functions.  The imprinted trauma  keeps the dislocation  alive as if the danger was always there and imminent.  Therefore the system is reacting, perhaps, to a mother who is and was chronically anxious and stressed.  It seems as if the system "used up" its supplies of NK cells.  And the set-points were set lower than they should have been.  This is no different from the case of serotonin.  We manufacture our own but early on, traumas can compromise its production so we manufacture less.  And the set points are changed to lesser levels, as well.  When our patients relive very early experiences their serotonin production normalizes, as well.

Wednesday, August 8, 2012

How to Relive Trauma That Happened During Life in the Womb

I want to talk about the long-term effects of our experience while in the womb and how we resolve intrauterine traumas by reliving in Primal Therapy. One question arises immediately: how on earth can anyone relive those events—a mother’s depression or anxiety, her drug and alcohol use, poor diet and lack of proper physical care by the mother?

We need to go back to our evolutionary roots and note that as the brain develops a different animal appears in the brain; first the snake, then the chimp, then the human. Each new structure/area incorporates and re-represents events imprinted on lower brain levels. Thus, there are spokes radiating out of our primitive nervous system that travel all the way to the neocortex (new cortex) via limbic structures to inform the higher levels of what happened on the lower brain levels. So when we feel helpless in the present—no one can process our application until we fulfill impossible requirements—we can begin to experience that feeling now in a session as “I can’t get through,” which will then take us back via the vehicle of feeling to the origins of that feeling. The feeling could be “there is nothing I can do to get through”. The basic feeling is hopelessness. And the prototypic event could be trying to be born amidst numerous obstacles. That is the heavy valence aspect of it. Before we get there, we first travel to childhood and feel that very same feeling on the second line, “I can never get through to my parents.” So the first thing we feel is in the present; we are at the DMV and the registrar is happily putting one obstacle in front of us after another. Next we feel the hopelessness of trying to get through to our parents in childhood. The feeling seeps in: it is all hopeless and I am helpless. We can stop therapy or go on to deeper levels over time; feeling the prototype is the final stop on our journey. There is no cure until all parts of our consciousness and unconsciousness are involved. The deeper we go the more powerful the feelings and sensations. That is why it should it should take some time to get deep down. We must avoid overload at all costs.

Once we are locked into a feeling the brain takes charge, it listens to its prototypic message and we must make no deliberate effort to go back into our past. We go back not deliberately but the opposite—by letting go of deliberation and giving into feeling. In therapy, the human first needs to have a long conversation with the chimp, who months later will deliver the message to the snake. Down deep, the conversation is neurologic and physiologic. It adds punch to our reactions and we are not sure why.

We feel helpless in the present but it is not a “normal” feeling; it carries with it the force of the beginnings of the feeling when it might have been a matter of life and death. We seemingly overreact, but we are reacting as well to our history, which has embedded itself into the feeling. When we relive that feeling completely we have automatically relived earlier origins of the feeling; and we can be liberated from its deleterious effects without once understanding what the primordial aspect of the feeling was all about.

Let me be clear about this because it is a significant point: each earlier event or trauma is registered (and methylated) so that how our genes behave or express themselves changes; our experience is imprinted epigenetically. And then as we evolve, the information of the early imprint is re-represented on each higher level. The snake speaks to the chimp about it, the chimp to the adult human, each in his own way. The problem occurs when the snake tries to communicate with the human neo-cortex. We don’t know what it is trying to say; all we know is that we feel antsy and anxious. That is the language of the snake. It forces us to slither and move but we are stuck. If it remains inside that force can produce an epileptic attack, a migraine, high blood pressure or what have you. It is powerful because it is the survival brain at work. Usually, repression sets in, blocks the sensation or feeling and creates maladies, including depression. It is the repression of those first line gestational events that lead to catastrophic diseases later on.

Each level, as it comes online, becomes mature. We now can be fully informed about our earlier life. The information is neurophysiologically coded by the kind of feeling so that similar feelings are combined in similar neural circuits.

At age thirty we might relive a feeling of hopelessness that seems to come out of nowhere, and the body temperature drops 3 degrees, as it easily can. When we check the scan we know the patient has dropped into a deep-brainstem-limbic trauma, touching preverbal events. That is why the big drop in temperature, with a commensurate drop in blood pressure. This is basically a parasympathetic nervous system response; we go into a “freeze” state, conserving energy. We become hesitant and unsure. We hold back, and that becomes our personal leitmotif, the matrix of our personality. And it started long before we could speak.

Where does it all come from? The mother may be smoking and drinking, harming the baby in the womb. He cannot evade the input and he begins to sense hopelessness. It is the template that is now installed—hopelessness and helplessness first started out as a sensation of impending death, and remains a sensation for the rest of our lives; it is not cerebral. Look closely: below every event in the present lie those impending feelings. It is only the strength of the gating system that keeps them at bay. But the pressure builds and the defenses give way a bit. Depression looms, as the building blocks of hopelessness and helplessness get close.

The vehicle of feeling will not let us drop too deeply all at once. The system knows that is dangerous. But we will automatically go back past defenses to earlier times as the pain level allows. So now the current hopelessness dredges up (resonates with) lower levels of the same feeling. When there is a reliving, all of the levels combine and produce a very heavy feeling. The current feeling at the DMV has brought up the earlier pain and it is all relived at the same time. That is, the current feeling brings forth the same feeling but with a different early event that has a much greater force to it, until the gating system gives way to the earlier imprints; the primordial hopelessness, perhaps of not getting out of the womb due to a cord obstruction.

Now heavy pain is on its way. If you are an advanced patient, you can feel and integrate it; the therapy has been done correctly. But if the therapy is not done correctly or drugs have been used, the feeling rises abruptly and forces its way into the top level, where the thinking and believing cortex has to manufacture symbolic beliefs to accommodate the pain; it must be symbolic because there is an overload. If there is no overload the feeling can be felt, experienced fully, and finally integrated: the pain is resolved.  Thus, when the therapy proceeds in a logical, evolutionary way there is no danger and the person is getting well. When the process is hurried, there is great danger because overload always produces symptoms, often of mental derangement.

This brain circuitry is a two-way affair: the lower levels get re-represented on higher levels, while access to the feelings on higher levels allows us to descend lower down through our chain of pain. It is an integrated circuit, not haphazard and not by chance. We rely on the veracity of evolution to guide us. If we leave evolution behind we will lose our way for sure. The correct way is to follow how our brain evolved and what lies on the various brain levels.

The brainstem doesn’t speak; that is why in a reliving of very, very early events, if there are any words it is a false experience. So there may be a body temperature of 96 degrees that informs us that it is preverbal. If we try to get a patient to express her feelings verbally the session is ruined. You see why? Discussing a feeling and experiencing it are two different brain structures. We must not ask one area of brain tissue to do the work of another. We can only heal where we are wounded. If the wound happened during gestation we will eventually have to go there, and in the manner I have described—slowly, in increments, deeper and deeper. And we may never know that we are also reliving a time in the womb; the first line response is purely physiological. It makes our heart race while we are reliving something far removed in time from the womb and by comparison a bit innocuous. It is one aspect of the experience that is wordless. So we relive the criticism by one our teachers in high school, and the response is inordinate. We are plunged into an anxiety state and can’t imagine why. Resonance has taken place. Old sensations have been triggered off, and now we can see how something trivial in the present can set off rage or terror from the past. We see how someone loses control.

In these situations, we must eschew verbal explanations or cerebral understanding because the body is speaking an entirely different language. And when high blood pressure or a racing heart normalizes after a session, we can assume that we dipped into ancient origins of the feeling and have resolved aspects of the prototypic imprint itself. That I have observed this kind of reliving resulting in the resolution of serious symptoms is considered by some in the scientific community as not enough. It is believed to be anecdotal and unworthy of science. Lately, however, there is a plethora of research to bolster the point. K.J.S. Anand is one of the premier investigators of this research. (“Can Adverse Neonatal Experiences Alter Brain Development and Subsequent Behavior?” Biology of the Neonate, 2000(77):69-82).

He and his associates have produced a compendium of many research studies on the subject. He begins: It is “suggested that imprinting at birth may predispose individuals to certain patterns of behavior that remain masked throughout most of adult life but may be triggered during conditions of extreme stress.” (p. 70) This seems like a direct quote from some of my writings. The reason they are similar is because we are describing the same event, they from a scientific research point of view, I from my clinical observational post.

Anand goes on to observe: “for suicides committed by violent means (firearms, jumping in front of a train, hanging, strangulation, etc.), the significant risk factors were those perinatal (around birth) events that were likely to cause pain in the newborn.” The harmful factors included forceps delivery and other neonatal complications that were significantly correlated with adult suicide attempts. Lack of care just after birth was also heavily correlated with later suicides, especially adolescent suicide attempts. Sedatives and/or other drugs given to the mother during delivery were noted to increase the incidence of drug addiction. Karen Nyberg also found that drugs the mother took during pregnancy or at birth led to a greater tendency to drug addiction as adults. More recently, Sonja Entringer and her associates found intrauterine stress led to shortened telomeres in young adulthood (“Stress exposure in intrauterine life is associated with shorter telomere length in young adulthood.” Proc Natl Acad Sci USA, 108:33, E513-E518). Shortened telomeres are associated with premature aging and the development of cancer. In short, experience in the womb has, as we have noted for decades, enduring effects. If we want to know the whys of certain behaviors such as suicidal tendencies or drug abuse, we need to go way back into our remote history to find the answers. What Anand points out is that we need to study in humans the long-term changes in the brain from traumas in utero. We know, for example, that certain kinds of cells (NMDA receptors) are permanently altered as a result of lowered oxygen levels in the womb and during birth. The effects of low oxygen on the brain are particularly profound in the womb and during birth because the prenatal and neonatal periods are marked by very rapid brain growth.

I have written extensively about critical periods: those times in life when irreversible changes occur that we cannot change no matter how hard we try. I no longer think that the major critical period is in infancy. It seems irreversible changes are most apt to occur during our life in the womb, and secondarily around birth when we have peak brain growth. It is here that the neuronal circuitry and gene expression can be altered forevermore. In a number of experiments with animals, those who were delivered in pain or deprived of a mother’s care just after birth had a greater tendency to drink alcohol. In other words, very early pain persists as an imprint and leads to all manner of deviate behavior. Clearly, for any therapy to be successful we need to address those early imprints, the origins of the deviation.

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.