What is New About the Imprint?

It seems that new research is confirming much of the Primal position. This is especially true of the work of Michael Meaney and Moshe Szyf (McGill University,Canada). (see for example http://publications.mcgill.ca/headway/magazine/the-nurture-of-things/ or http://publications.mcgill.ca/mcgillnews/2011/06/01/are-your-genes-your-destiny-not-if-your-mom-has-anything-to-say-about-it/ or http://epigenome.eu/en/2,68,1181 ) They are critical work on epigenetics, and how imprints through methylation can be passed down from one generation to another.

They don’t call it an imprint but that is what it is……a key repressed memory that endures and persists throughout our lives; it drives behavior and symptoms. It turns out that imprints can be passed down from parents to baby and from grandparents to baby. Methylation depends on the work of the chemical methyl group which is recruited when there is a traumatic event, and helps embed that memory. . It seems that when there is a surge of methylation part of it attaches to one element of the gene known as cytosine. It is now part of the DNA and turns on or off certain hormones and other neuro-chemical processes.. Once that happens methyl is recruited and the genetic unfolding is thereafter altered.

In short, methylation can be an agent of repression. A study at Duke University showed that when female mice were fed a diet rich in methyl it completed altered the fur pigment of the offspring. In other words, it acted like a genetic inheritance when it was not. It was the result of experience and that is the linchpin of our theory… epigenetics.

As a result of this study the two scientists from Canada, (Meaney and Szyf) thought, if that is true why shouldn’t it be true of other experiences such as bad mothering or negligent parenting? Well, it was and epigenetics research exploded. Think of that: traumatic events in very early childhood leave a mark or tag on a gene that affects us just about forever. They found that even grandparents affected the imprints of the grandchildren, which we will get to in a moment. But suffice to say that the experiences of our forbearers can endure and be passed down the genetic chain, the inheritance of acquired characteristics. This is something science thought impossible decades ago.
 What the scientists found is that the right amount of licking and grooming early on left offspring with less chronic stress hormone output as adults. It is what we all know; that early love makes us stronger and less anxious. But it turns out that if the mothers were licked and groomed early on in their lives, that experience could be passed on. The genes could be modified by the methyl group (and also other chemicals) in a beneficent way. Good history in the mother, good childhood for the children. And more loving by the mother the less methylation in the child . And with less chronic stress hormone production there is far less chance of serious diseases later on such as Alzheimer’s.

To make sure that these changes in the rat pups resulted from experience and not hereditary, they let normally stable rat pups be raised by neurotic negligent mothers. And the result was still the same,; unstressed babies. These babies had mothers who had normal amounts of methyl in their systems. Thus rats raised by loving mothers could pass it onto offspring even when the adopted mother was not loving. The genes for stress hormone output had minimal methylation. In other words love was passed down the genetic chain. So normal babies raised by negligent and inattentive mothers still had low methyl levels in their hippocampus. The babies started life one leg up, a good start in life despite a bad childhood. I believe that changes in the genes, methylation and acetylation, must occur very early as the whole neuronal system is evolving. So before we can state what causes depression or anxiety, we need to observe the early epigenetics at work. Again, pups born to unloving mothers were handed over to loving mothers, and those born to bad mothers reared by loving mothers still seemed to be normal and relatively un-methylated.

Here is one more reason this research is important: they found that unloving mothers of rodents causes methylation of the estrogen receptors in female offspring. Then when they had offspring of their own the offspring were deficient in estrogen which made them less attentive and loving to their own babies.  We as yet do not know how many key chemical processes can be affected by lack of early love. And more, we have no idea how many hormones are changed in neurotic mothers (heavily methylated) and how that affects myriad adult behaviors. Is depression inherited? There may be precursors for it which is never manifested if there were plenty of love later in childhood. Is some of the tendency to methylation inherited or epigenetically passed on? And does that form the basis for depression? It seems from the research just cited that that neurotic mothers (methylated), are ineluctably forced to be unloving, thus laying the groundwork for depression in the offspring later on. And what other hormones are depleted by this scenario? Are we born with a tendency to anxiety? Possibly but then the imprint is not methyl so much as acetyl., in this case. With acetylation there are more faults in the repressive system and “holes” in the gating system. Acetylation (recruiting acetyl) pretty much produces the opposite of methylation, a tendency to open rather than close.

Early trauma produced heavy methylation in those children who grew up in orphanages. And that process then affected much more in terms of brain and neuronal development. So when we find a mother who is not loving we need to know that she may being driven by her epigenes; she is a victim of those changes. Her cortisol/stress hormone level militates against maternal instincts. Methylation shuts down a number of “natural” behaviors. In neurosis we cannot be natural and appreciate nature because we are disconnected and alienated from our own nature.. We cannot rely on our feelings to guide us because they have effectively been shut down; we are alienated from them. Literally, the feelings are aliens. We have found that patients on the verge of these feelings in sessions often run a fever. The body treats the feelings as a menace, a danger and something to be avoided; yet it is also what can liberate us.

Can we reverse or undo methylation? The research informs us that with rats who had been damaged, and raised by unloving mothers, when they were infused with trichostatin did not show evident damage. As though the trauma never occurred. This drug removes methyl from the system. It did, in brief, undo history. This is what I think may be happening with our patients. In the reliving there must be a change in methylation so as to reverse history; this is what we shall study in our future research projects. It seems to me the natural way provides far less possibility for collateral damage to the system. Since we already have found that chronically high cortisol levels have been reversed in our therapy, it would perhaps follow that methylation could also be reversed. In a way, the levels of methylation can be a marker for having been loved early on or not having been loved. We could tell more than the statements by the person who claims he was loved in his childhood if he were indeed not loved. How much denial is there?

Neurochemistry may be better relied on because it has no reason to lie and wouldn’t know how to do it even if possible. It can be a marker for post traumatic stress or how much repression exists in ADD. Or how much pain/repression is there in Alzheimer’s disease? We already have some information in this regard because autopsies on depressive/ suicides found them to have been heavily methylated in the hippocampal area. The more abuse as a child in these cases the more methylation produced. When we add this to our future research on telomeres and cortisol we will begin to have precise measures of the pain in us. And we will know when a drug is too dangerous for us, particularly the drugs like marijuana that tend to open us to ourselves; to our feelings and pain. Finally we will have a marker for the efficacy of certain psychotherapies.  Does the therapy undo the past? Does it help relieve repression and therefore depression? Is there great first line pain in anxiety states? What seems to be the case is that love obviates methylation and produces normal souls.

More on Telomeres

I have written about telomeres before, and it is something we plan to study with our patients. But it is worth another look as it pretty much determines how long we live, but more importantly whether we fall ill prematurely. The research on it is largely about outside stress, never on internal forces. So it is a matter of war, poverty, strikes and parental fights. Yet the key chronic stressor is the imprint that carries forth those parental fights as a fixed memory that follows us for the rest of our lives. And they say that we have to eliminate stress in order to live longer. So how do we do that? We can move to a new city or country but the imprint follows us assiduously and never lets up. We can go to cognitive therapy and talk our feelings to death, or we can attack the imprint at its origin, relive the trauma and finally be rid of it. I know of no other way to do it. The imprint is tenacious and it must be because it is there to guide our lives and control our reactions. It was lifesaving originally and the system remembers and carries it on.


It is clear that stress and its handmaiden, cortisol, the stress hormone does shorten telomeres. Or beginning patients were high in cortisol until one year of therapy; then it reduced significantly. We assume that since cortisol and telomeres work in see-saw fashion: cortisol high, telomeres short; cortisol low, telomeres longer. That is why we will do this research because I am convinced that since we lower cortisol we may also lengthen telomeres. Or at least keep them from shortening. When telomeres get too short so do our lives. There is an article by Elizabeth Blackburn and Elissa Apel about all this in Nature (11 Oct. 2012) (See a short preview:http://www.readcube.com/articles/10.1038/490169a ). Worth a read. They report on a number of studies of telomeres: in 2004 that compared white blood cells of mothers with chronically ill children with those mothers with healthy children. Clearly, mothers of ill children had shorter telomeres. Again, stress is a factor. And that means increased cortisol levels. And that means shorter telomeres. It is not short term stress that is the culprit but enduring stress; and what could be more enduring than the imprint? If only that could be accepted by the scientific
community.


What cortisol may do, inter alia, is increase the action of telomerase which affects the function of telomeres. To be clear: what that enzyme may do is get busy fighting deterioration taking place with the input of primal pain. This, it seems, is happening to prevent further neuro-biologic damage to the system. A research team led by Owen Wolkowitz of the University of California, San Francisco, has been studying telomeres and depression. (May 23, 2013, “Depression linked to telomere enzyme”) (See for example http://www.sciencedaily.com/releases/2013/05/130523004558.htm). What telomerase does ordinarily is help maintain the length of the telomeres, even lengthen them. They are protective. And they go up when depressives take antidepressants; they also go up in animals where it is associated with increased nerve cells in the hippocampus. It appears that the hippocampus deals with the facts of feeling and the memory of it. It is seriously affected by depression. The longer the depression the shorter the telomeres, and it becomes a life-or-death matter. They have found, for example, the very serious pancreatic cancer, is associated with shorter telomeres in blood cells. These people were also studied before the onset of cancer so we cannot say that telomeres shortened because of shorter telomeres. Telomeres maintain the stability of genes; my view is unstable individuals, unstable telomeres. There are other cancers associated with shorter telomeres. We do indeed plan to study them in our therapy. The point is made, but not by the researchers: imprinted pain has a lot to do with depression and with later serious illness. We need to study this among our patient population.


Much of the research on telomeres seems to confirm our hypothesis, that it is the very early experience that stamps in the most forceful and enduring imprints. The work quoted above found that stress in infancy “and even before” erodes telomeres. Children who spent a lengthy time in orphanages had shorter telomeres.


Telomeres are shorter in chronic depressives, and that fact is crucial. Why? We have to assume that there is an imprint of early trauma to set up the depression, in the first place. That means pain. There is a great amount of imprinted pain in depressives, something we have seen over and over again in our patients. And we see depression lift as patients relive very early pain. This seems to be also true with immune disorders, as depression affects the immune system adversely. Chronic depressives have shorter telomeres. That can mean premature serious illness and early death. I believe that our therapy is life-saving, and we are beginning to see why. One problem we have is that when patients get to earlier imprints the pain is painful; but if they stay with it, it does not last, and makes for great changes throughout the system. It is indeed tempting to want to quit when pain arrives but for every pain experienced there is that much less to feel.


And when cortisol is chronically high and telomeres short, there is a much greater chance of suffering from certain cancers, including the deadly pancreatic cancer. What causes this cancer? Early trauma that is imprinted and endures. Another effect is the appearance of dementia in those with shorter telomeres. Again, we need to look at very early trauma, even in gestation, to find the answer to the question, what causes cancer? What causes dementia?


Doesn’t this make sense? When you have a constant pressure and tension on the organs due to the imprint it makes sense that they will give in and break down, The organs are saying, I can’t hold on any more. It is more than I can handle, all too much. It is surprising to me that they do continue to hold their integrity as long as they do.


There is an article in July issue of Brigham and Women’s Hospital, Boston, Mass., 2012 that underlines the importance of anxiety to damaging the telomeres.(See http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0040516). It is an important study in which they took blood samples from 5200 women ages 42-69. It is known as the Woman’s Health Study. They analyzed telomere length among them. Those who reported frequent anxiety attacks (phobias) had significantly shorter telomeres. They implied that it would deduct six years from their lives. They conclude that chronic anxiety in childhood leads to premature aging and, of course, a shorter life. Anxiety will kill us; which is why it is so important not to leave the imprint untouched in psychotherapy. Telomeres will soon be the key marker for not only how how long we live but how many years a key psychotherapy can add to our lives. If we leave it untouched and unchanged the therapy is a failure.


Stress erodes telomeres very early on, according to late research. So children who spent time in orphanages from birth on had shorter telomeres. I think the evidence is there in so many dimensions; early trauma damages the system in every way possible. We need to pay attention when we carry a baby in the womb and we need to pay real attention to our birth practices which are deleterious too often.


The research emphasizes that the early stress carries on into adulthood. Those women in a study in England who had early abuse also had shorter telomeres We can run but cannot hide from our imprint. It follows us everywhere and anywhere until we acknowledge it and relive the damage. Here is supporting evidence for the imprint even if not stated. Why else does it endure and shorten telomeres? Why cannot they make the equation that early trauma stays fixed in the system and drives behavior while shortening our lives? I believe that the earlier the stress, the carrying mother smoking early in pregnancy, the more harmful it will be later on. Let’s teach about pregnancy in school so that adolescents understand what pregnancy means for a human life.

On Suffering and Pain

Suffering is not healing; feeling pain is.  Why is that?  Because they are very different from one another.    There are  pains that are imprinted and thereby made unconscious, because the pain was far too much for a baby or fetus to experience.  This leads to generalized suffering which is the agony portion of the imprint without the connection to its acknowledgment.    Pain means connection, and that is why when our patients feel pain they stop suffering and remove themselves from the pain, as well.  Feeling pain turns into its opposite—feeling.  Once felt that portion of the feeling is gone.    So let us recap:  suffering happens when the imprinted pain is on the rise but still repressed so that it cannot be connected and integrated.  Pain is the specific connection to the original event.  It was so strong that it could not be felt at the time, and due to repression it became amorphous suffering.  Thus, it can go on for all of our lives until its generating source can be found and lived for the first time.   Suffering and pain are mutually exclusive, in the primal scheme of things.

Most psychotherapies extant try to suppress  the agony part of  the feeling, often with drugs, which ensures that connection  will never be made.   The belief is that once suffering is suppressed all is well.  Or another approach is the cognitive that implies that it is just an imagination; thus changing one’s attitude will help repress the suffering.  The problem is that there is the confusion between suffering and pain; the two are conflated, so that there is the belief that they are interchangeable and can be treated through new ideas which amounts to thinking your way to health.  Believing makes it so.

In one sense, suffering is in our head because it is not yet connected  to original imprints in our system.  So we are miserable and never know why.  And if we try to “understand” our suffering through an intellectual analysis we remain alienated from causes.  Origins, generating  sources lie far below our intellectual processes and will never lead to feelings and remote memories.  In other words, whereas in cognitive approaches  the neo-cortex means increased intellectual activity; in primal it  means just the opposite, letting go of the intellectual and dropping below to another level of  consciousness.

If we do not do that in therapy then all of the stress hormones continue putting out chemical  signals and deplete the system over time.  It is much worse to shut down  the suffering because then all hope of a cure is gone.  Feeling pain stops the system from reacting continuously to the alarm bells because  there are no more signals of alarm.  Thus the imprint is ever-present in the system and is a continual menace; the system treats  it as present because it is; it is a continuous danger, of what?  Of the feeling that is so overwhelming.  We need to put it back in the past where it belongs, and we can only do that by feeling the past so that it no longer intrudes into  the present.   We can now live in the present unfettered by our history.  The past is past.  Otherwise we can only pretend to live in the here-and-now.  We are still back in the  there and then.   Our past rules  our  lives.  We can  fight it, deny it or suppress it but it  is  still omnipresent and always will be.

How Repression Works

There is a gating system in the brain that inhibits or slows the message of feeling when it is too much to bear. When the amygdala’s gating mechanism against rising feeling fails, there is a more direct impact on the frontal cortex causing it to be activated, to race, to manufacture ideas, beliefs, and in general, to do what it can to attenuate the onrush. If the hippocampus is overtaxed with many painful memories, then it may be helpless to inform the hypothalamus to soften the amygdala’s output of feelings. The amygdala has direct connections to the frontal cortex so that feelings can also directly affect our thought processes; and of course, it has direct connections to deeper levels of brain function. When gating mechanisms fail, feelings that are rooted in lower levels of the brain, such as terror, can escape control and rise to the pre-frontal cortex to signal danger. The pre-frontal cortex may label this an anxiety attack, and the individual is then aware of great discomfort.

A cognitive psychologist might try to deal with that anxiety as if it were a cortex-only phenomenon, and attempt to control it through ideas, thoughts, logic, etc.: “Look here, you are overreacting. There is no reason to be so excited.” Yet reactions are nearly always correct; they tell us what’s really happening on lower levels of the brain, even though the original context of how they were imprinted may be unrecognizable. We shouldn’t deny or change reactions, but rather find their origins so that the reactions make sense. Without access to our feelings, we would be forced to conclude that some current behavior is irrational because we are unaware of its antecedents. As for example, phobias.

 Driving our behavior, our own feelings, can be a danger to us because they are too much for the higher levels of the brain to accept and integrate. The brain has a warning system that alerts us against potential overload—more feelings than can be experienced and integrated. It says “gear up” for the onslaught of pain, and the system obeys. But if the inhibitory gating system is “leaky,” it allows too much pain to get through. As this overload of pain/hopelessness begins its march to the cortex, alarm bells are set off. Cortisol is one of these alarm chemicals. The alarm is general, however, and many systems are affected. The brain’s own hippocampus can be damaged by too much cortisol secretion over too long a time, resulting in a weakened memory. It is not surprising that those of us who were anxious throughout childhood barely remember anything. Eva hardly remembered anything of her childhood; it was all a “black hole.” She did tell us in the intake interview that, vague though it was, she believed she had a “fairly happy childhood.” It wasn’t exactly the case as she found out in therapy.

A good example of overload is in a recent case. This is a forty-year-old woman who at the age of nine was taking a bath with an electrical heater sitting beside the tub. She reached over to move the heater and received a massive shock. She became immediately unconscious, but the violence of her flopping/seizures tore the heater plug out of the wall and saved her life. She went downstairs to tell her mother who was ironing. Her mother said, “Oh, that’s too bad. But you seem okay now.” She went on with her ironing. The meaning to her daughter at the moment, which summed up many moments before, was, “She doesn’t care. There’s no help for me. She really doesn’t love me.”

For the past several months she has been reliving that shock, flopping, seizing as violently as when it happened. (This has been filmed.) She had no idea that shock was still in there. It was pure electrical energy with no content, yet it shut her down totally. She had a rigid, immobile facial set that did not ease nor loosen until months of reliving the shock. Her whole body froze at the time of the shock, and even today making easy, fluid movements is difficult for her. Her whole system seems to have contracted permanently; a total overload. Her “primals” as we call them, are both of the seizures and then “She doesn’t care. There is no help. There’s no place to turn.” That realization was tremendous pain because it was an augury of her coming life. She almost died. Her mother hardly reacted. The most important thing she is getting out of these primals is that she was never able to express herself. Everything was locked inside. She seemed dead. Now, finally, as she expresses the shock, she can also express herself emotionally. Her face has expression, whereas before it was expressionless and immobile. She has had constant fears of dying, and it hasn’t just been an idea. It was a real experience. Her nightmares were filled with danger where she was on the verge of dying. I have seen many patients who had those fears and it was not like something in the future—it was immediate—“I am going to die now!”

If she never relived the shock, we would have never known of her actual near-death experience. In cognitive therapy, her fears may have been treated as irrational ideas. The electrical shock in the bathtub is no different from an overload by a feeling, “It is all hopeless. No one will ever love me.” That too, is electrical. But it has content. The shock did not. That is what made it so devilish to discover. There was no specific scene to rely on. It was a “neutral” experience; pure electricity, which allowed us to see the overload clearly and how it operates. This overload, although having nothing to do with sex, can and did stunt sexual expression, as well. And any early trauma can accomplish the same thing.

The Veracity of the Imprint

I have written about the UCLA experiment in two of my books but I want to sum up the importance of it.  This is research we did together with Dr. Donald Tashkin, former director of the Pulmonary laboratory in 1992.(see http://www.primaltherapy.com/ucla-experiment.php)  Two patients were wired to many instruments while we helped them into a reliving session, a primal.  They both relived severe oxygen deprivation during a birth trauma and some of the vital signs reflected it.  After being immersed in a memory of oxygen deprivation they
began what I term "locomotive breathing" emanating from the brainstem (in particular, the medulla).  This deep, raspy, rapid, compulsive breathing went on for over twenty minutes.

   The heavy breathing was an attempt to compensate for the lack of oxygen they experienced during the memory event.  This is never a voluntary effort.  It seems “forced” on the person from low in the brain.   When any patient is in full brainstem suffocation mode (involving the medulla) he may begin locomotive breathing,  which is rather hoarse and sounds like a locomotive. It is as though the patient is making up for the deprivation event by gasping for air.  Once begun it is very hard to stop until it has run its course.

 Heavy breathing can go on for many minutes, and then relaxation. It may take many sessions for the cause to be comprehensible. Though this heavy breathing can go on for up to twenty minutes there never is any hyperventilation. We have done experiments with these patients outside the therapy when they were not in a memory; after three minutes they got dizzy and began to faint. It happens systematically to those who attempt to go back to the past without being totally in the memory. In fact it is one of our controls on the veracity of the feeling.  If they run out of air right away it is simple abreaction, and unconnected and not integrated event.  The reason is rather simple; the subjects were breathing voluntarily, not automatically out of the memory.  They were breathing from “on top,” a deliberate decision not from the bottom.  The memory offers us the truth of it.      Ordinarily, they would get dizzy and feel like passing out; there would be clawed fingers and occasionally blue lips; i.e, hyperventilation syndrome, within two to three minutes of this kind of deliberate heavy breathing.


To underscore: being in a past feeling is a total biologic state which permits deep breathing for a long period. The patient is engulfed by the memory of depleted oxygen and at that time needed oxygen. It is one of many checks we have on the Primal state.  The only factor that could account for this was real-life memory--the imprint.  Reliving not just in their heads or their thoughts but with every part of them.  Patients are indeed in the past neuro-physiologically; they are living in their history, living back in their personal past; and, I might add, living inside a brain from antiquity.

   These experiments are the best supporting evidence for primal therapy, as the experience cannot be faked.  The fact that his imprint endures and is immutable means that it constantly affects so much of our feelings, moods and behavior.  It means that there is a profound origin for depression which may have begun its life before we began life on the planet.  In the case of one of our patients trying to get born against massive anesthetic the feeling was, "I just can't try any more.  I have to give up.  It is hopeless."  Here was the deep preverbal forerunner for depression; the physiology of depression. The prototype for a depression foretold.

Once we establish that we are propelled by imprints embedded in an ancient brain we see that it has everything to do with our current behavior and symptoms, then we must acknowledge that the primitive brain affects not only our breathing but also most of our current life, our moods, values and attitudes.   Those imprints must be considered when we want to understand depression.  It is not just breathing that is affected but most of the brainstem functions; digestion, elimination and many mid-line events.  A brainstem trauma means a brainstem reaction.  We go to doctor after doctor to try to solve a stomach problem when the memory will give it all up as soon as we can access it.   It will tell us all because it was there at the scence “of the crime.” It will tell us of the carrying mother’s anguish, her use of drugs and alcohol or her own depression.  Therein lies the answer—history.  It divulges all of its secrets when we descend to meet it.  It won’t come up to confess its history; we need to meet it half way.  Then it may say in its own nonverbal way, my stomach aches, as we plunge into history; my stomach is not working well.   Later on there is colic that speaks more of what is wrong.  And still later possible addiction.   That addiction speaks of early needs going unmet and the pain that follows.  To avoid these imprints means avoiding what may be curative.

On Measuring Pain

Maybe with the new technology we want have to ask patients, “on a scale of 1-10 how much pain do you feel?”  Maybe our machines will ask the brain and body directly and the body will express our pain ineffably.  We will get precise answers and we can judge our therapy and our medication based on what the brain/body relates.   We are just about there.

  New work at the University of Michigan has been measuring the brains of subjects undergoing pain of heat, for example.(see for example http://articles.latimes.com/2013/apr/10/science/la-sci-pain-measure-fmri-20130409).  They show a characteristic brain pattern.   Later pain shows similar patterns and provides the scientist with a measure and brain pattern of pain.  What they found is a typical neural pattern for each person’s pain.   The way they did this is by putting patients in a fMRI scanner and then added warm to very hot stimuli to see the brain response.  They also teased out emotional pain as differentiated from physical pain.  And they could then know what subject was in pain.   Something I did thirty years ago. But we will leave that for the moment.   Just to say that we could tell about patients coming in for sessions as to what level they were on.  Those heavily depressed and deeply into birth trauma had those long slow brain waves and very low body temperature.   The key index for hopelessness is those brain waves and body temp.
It is the rare depressive who doesn’t show those signs.

   The investigators then looked at painkilling drugs  (remifentanil).  It not only suppressed the neural signature but also the subjective report of pain.  Here we see that drugs can inhibit the reactions to pain but perhaps not pain itself; this may be particularly true when pain is imprinted and endures.  What they are hoping for is a reliable measure of pain so they can titrate, for example, what kind of tranquilizers to inject.  And they could measure effectiveness of drugs.  They want to take subjectivity out of the equation so that high-tech scanners could do all of the work.   Yet, they admit, they still will need patients’ reports.

Here is the dilemma: will the suppression of pain eliminate that pain?  Or will there be a rebound with more pain emerging after suppression by medication?  If we only look at current behavior and cognitive effects we may go off the rails and think that the pain has been done away with.  Or, if they rely only on the machines they may falsely see that the patient does not need painkillers when she clearly does.  Our patients descend slowly into imprinted painful memory and we know right away how much pain there is.  But we are not practicing general medicine where doctors need machines like that.  (see: The New England Journal of Medicine. April 2013).

   Our advantage here is that the patient teases out for us the difference between emotional and physical pain.   We don’t have to extrapolate from a number on the machine to the patient’s condition.   When see a patient entering a session with 95.6 body temperature we know what to expect.  And we know where the patient will be going; it is just a matter of helping her get there.  And at the end of the session when body temp goes up three degrees we see a normalization process taking place.   The patient is indeed becoming normal, not only in her “mind” but everywhere in her system.

  Here is the problem with the research: if they see big signatures of pain with no obvious pain they might refer the person for addiction help.  But suppose that pain is heavily hidden and maybe the person herself is unaware of it.  It doesn’t mean she has not pain; it means that it is buried under loads of repression and may be inaccessible for the moment.  It is not addiction; it is simply that we cannot see the pain they are in.