On the Difference Between Abreaction and Feeling... The End (Part 15/15)

  We Are Specialists of Joy, Not Pain

 Primal Therapy is no quick fix. We are attempting to redo someone’s entire life. It will be done in a slow methodical manner so as to never overwhelm the patient and make him suffer all over again, as happens with abreaction. If he can experience just enough to have a full experience that is enough for a session. We do not want him to suffer any more than necessary. He will suffer when the pain comes up arbitrarily, prematurely so that he cannot integrate it; the pain hangs there in an ego-dystonic fashion (Freud again), meaning alien and apart with pure pain that cannot be made ego-syntonic or integrated.

 So why do we have to trace back our evolution again? One reason is that we never sever anything permanently in our evolution; we suppress the old and add on the new. Sometimes the primal pain vestige is so powerful that it exerts a constant force that disrupts our functioning. In my patois, the first line erupts and surges higher. Then it has to be dealt with and relived. I call it “intrusion,” an imprint so strong that it interferes with our personal evolution and our current functioning. We see it in physical symptoms and deformation of organs and growth; we see it in diseases such as hypertension, cancer and heart failure that are actually offshoots of the central damaging memory, locked in as an imprint, out of reach and out of touch. This is also the case with Attention Deficit Disorder where forceful imprints constantly surge toward the top level to disrupt concentration and attention processes. Remember, earlier, I explained that evolution always moves the imprint higher so that first- line damage may be expressed on the upper levels of brain function, where attention and concentration are mustered. Training a person how to concentrate is not the answer; feeling the force that scatters thoughts is the answer.

 Once we lift the repressive lid (done in orderly fashion) there is no longer unconscious forces driving behavior and symptoms. And as repression lifts, the patient’s truth becomes self-revealing. Bit by bit his unconscious tells him what he needs to know, but not too much, just enough to integrate the pain and its information. His orderly descent into feelings eventually informs him of what it all means. Everything he needs to learn is already lying inside of him, waiting for discovery. It must come from inside, never outside, just as the feelings were laid down by the system and not by executive order.

 The aim is not insights; it is change in all aspects of the person: his behavior, biochemistry, neurology and feelings. We are after total change because there was total change at the time of the imprints. We want normalization of the whole person. We are not there to give love; we are there, paradoxically, to help patients feel unloved so that they recapture the ability to feel and then can feel love when it is there.

 If a therapist needs to be loved he will act out on the patient and give him what he, the therapist, never got. He has become a “pal” not his doctor. The patient feels loved, it feels good...and he loses! Or there are great discussions about music and art and politics, and the patient becomes an intellectual pal, and again he loses. He has been transformed from a patient who needs treatment into a good friend. Nice idea but very wrong. We are not there to give love; we offer kindness and caring but also science. We don’t replace science with pseudo caring. We adhere to key principles. The patient begins to suffer; we do not rush in to stop it and make him feel better. We don’t do him any favors suffocating the pain with “love.” His feelings are about real suffering. It must not be tampered with. That is the part he has kept hidden for years; it must come out and be experienced. Then we will be free; free of that pain which has made him depressed or anxious for so long. The patient is himself at last.

 It is dialectic; he has to feel unloved so as to unlock the feeling gates. He will never do that with therapeutic approval and warmth and understanding. He will get that after the feeling, not before. When he has made a breakthrough, we rejoice with him. It is not just about pain; it is about contentment, ease and relaxation. It is about joy. It is what we want too for them; why else do the therapy? I received over fifty letters on my birthday thanking me and my staff for saving their lives or improving them greatly. That is the reward and the meaning of our lives. We are not pain specialists; we are joy specialists who need pain to help joy along.

 There is a reason the patient has to feel unloved. He needs to go back to the open sensory window when “unloved” dominated. That is the essence of our therapy; travelling back in time and undoing the original damage. We cannot do any better than that.

The Nature of Tears: Restoring Natural Human Responses Through Primal Therapy

Primal Therapy is not magic. All we do is restore a natural function, one that has been deformed and deregulated so that natural human responses are no longer possible. Take tears, for example. The average child who grows up untouched and ignored has no idea he is suffering. Nor any idea he needs to cry. Why? It is just the way life is. There is no love in the house; no one hugs, kisses or even laughs. Life becomes a grim affair. That was my life and that of many of my patients: the Silent Scream. Allergies aplenty, obesity out of control, withering migraines that are a chronic mystery, nightmares as one more unfathomable event. No cries, just pain. Cries are beaten out of children because crying reminds the parents that they may be doing something wrong. It must be hidden, out of sight and out of mind.

Yet, crying, in and of itself, is not the sole goal of Primal Therapy. The original damage, the deepest hurt that is so early and so horrific, is registered in an infantile brain that knows neither tears nor cries. Oh come on! What proof of that? We know that babies are not capable of producing tears until they are at least a few weeks old, sometimes a few months. That’s because the tear ducts of a newborn are not fully formed yet. So we don’t expect to see tears when a patient in Primal Therapy relives a trauma at that very early age, since the return to the past must correspond to the way we evolved. If the feeling is early first line, how could there be tears if no tears were possible at that stage of development?

In my patients who have descended down the neuronal chain and arrive at the lower brain and brainstem areas, there are no tears and no cries. The nervous system is not that mature as yet. There are grunts; if they use words we know it is “bidon,” which is French for phony. It is a false or faked effort to look like one is feeling but it is abreaction pure and sure. So what? So without feeling there is no healing. We cannot trick the system into a false piste (to borrow a skiing term for groomed path) that is only a byway on the road to feeling. These abreacting patients, coming to us from mock primal centers all over the world, do not get well; they do not normalize the biologic system because they are stuck in a false feeling groove. Hence, they do not restore natural functions because they we did not take a natural route to feeling. The system always knows what it needs if left to its own devices; when it is pushed this way or that it follows the dictates of someone else’s notions, which is often the misguided therapist.

The patient may have been pushed to scream and cry long before it is neurologically possible. So that tears are momentarily relieving but not curative. Abreaction means going through the motions bereft of feelings. Primals mean emotional actions derived from emotions. It means a context, not an action forced on the patient. Indeed, any suggestion by the doctor is apt to be wrong, on the face of it because it is emanating from the head of an alien source—the therapist. It has taken us fifty years to figure all of this out and it did not come easily or by whim or impulse. It seems so easy to do….if you do it wrong; and so very difficult to do it right. The therapist has to be feeling to sense when is the right time to help the patient down one path and not another. The patient will often choose the wrong one because it is less painful. Or for many other reasons. And he will choose this path over and over again until it becomes a neurotic abreactive groove which is chosen because it is a way out, not a way into the feeling. It has all the accouterments of a Primal without one key ingredient; feeling.

These Primals look like feelings but they do not smell like it. A good therapist can smell a Primal and more, can smell abreaction. The sound of it is hollow and unconvincing, like the sound of a political speech that looks sincere but takes those in who lack the emotional depth. Mistakes here can be lethal because at times there is aggravating depression, unresolved, because no one has seen, and thus corrected, the abreactive groove. This is often pushed by the patient who complains, “I am not getting anywhere.” It must be treated as part of a deep feeling, often pre-birth, where “getting somewhere” can mean life or death. Too often, the threatened therapist reassures the patient and himself, “you are doing fine; it just takes time.” He has mistaken the beginning of an old feeling for a current complaint. And worse, this confusion has settled into the patient who now believes that he will get somewhere. But where? He believes it is in therapy when it is millions of years earlier, in the need to get out; an urgent feeling that has to be faced for what it is. The doctor and patient have now missed what brain we are working with.

And here lies one key difference between Primal and other therapies: ours will lead to resolution, the others will lead to palliation. One is curative and the other is simple soothing. Why curative? Because we are restoring natural functions. And we have seen this in our research where we have elevated the natural killer cells that combat cancer significantly. If we cannot restore nature and natural reactions in our patients we cannot speak of cure. The immune system has to be able to carry on its natural functions. It too has to be normal and/or approaching normal function. We cannot take a single function and make it normal and then imagine that we have normalized the system. We must normalize the system as an integrated biologic event.

What if we do not know we should cry? As we discuss our past with a feeling therapist the body will do all the informing. Why? Because we can now react normally and that always means tears, not just analysis of why there are tears. “Why” is far too cerebral for the process of cure. It has to be out of experience; we are offering experience to those who have lacked it. That is already a lot.
       

On the Difference Between Abreaction and Feeling (Part 14/15)

The First Science of Psychotherapy

 The task of normalizing a patient’s entire system is a complex proposition because not all nervous systems are created equal. In the case of parasympaths – those low-energy types predominantly  controlled by the parasympathetic nervous system due to re-shaping events in the womb and at birth – reactivity slows down. They remain passive and lethargic throughout life, permanently stuck in the energy conservation mode. That mode of operation becomes stamped in, imprinted as a life-saving device. This imprint is a memory of what the whole system did under threat in order, for example, to conserve oxygen, bind energy and slow down the metabolism to combat the deleterious effects of a mother taking drugs, drinking or a hundred other kinds of abuse. It differs from the revved-up sympath who is dominated by the sympathetic nervous system, the alerting, aggressive, fight (to get out) and battle system to save one’s life. For the patient who is a sympath, a typical session begins with higher vital signs, and tends to militate to lower levels as therapy goes on and feelings are experienced and connected. Not so with the parasympath whose body temperature often drops into the area of 96.0 degrees, steadily moving higher over months. It is the key distinguishing mark to differentiate the person with different kinds of nervous system dominance. And it is the marker for progress in Primal Therapy. Each nervous system tends to move toward normalization in our therapy; the parasympath toward higher levels, while the sympath, lower. This is what we expect to see over time in our patients. We cannot fool our biology. When we try to fool our nature, we put the patient in danger.

 The parasympathetic system, as the energy conserver, is dominant in feeling. We can see this dynamic played out in sports, especially at the end of games when athletes often show emotion. It happens to many tennis players, win or lose, after long, grueling matches. Some just collapse on the court in tears. In one famous case, Roger Federer was so crushed by defeat following a hard- fought, four-hour-plus tournament in 2009 that he could barely talk during a press conference. He cried so hard and for so long that observers at the Australian Open were shocked and felt uncomfortable. With a “torrent of tears” streaming down his face, as one writer described it, the only thing the defeated champion managed to say was, “It’s killing me.” What happens is that athletes gear up for battle and maintain an intense, fighting (sympathetic) stance during the game. When it’s over, the activation dials down and they are able to feel, so emotions overwhelm them. The neurological pendulum has swung to the parasympathetic side.

 The importance of the sympathetic/parasympathetic dominance is that it provides us with a biological basis for understanding personality development. At last we can leave abstraction and metaphor behind, and replace the vagaries of speculation with the precision of verifiable processes. We no longer need to talk about the "will to power" or the "will to meaning" or the "transcendent function." Instead, we can talk about the precise ways in which the brain and nervous system react to concrete events, and how those reactions become the physiological basis for the elaboration of personality. The precision of the theory and therapy leads to a precise knowledge of what is happening in sessions; we have a better fix on what may go wrong. If the theory is imprecise so will be the measures taken in therapy. It is why I call Primal Therapy the first science of psychotherapy. We don’t have to rely on patient reports to see if there is progress; there are many neurologic and biologic tools that can inform us.

 For example, when the sympath is reliving first line, we see high vital signs and accelerated brain wave frequency as well as higher amplitude waves. As we descend deeper we find the limbic system at work and then, further down, the brainstem and its cohorts. So one way we see evolution at work is by which nervous system dominates. If there is crying, chances are it is limbic and not brainstem. If there are grunts and no tears, we see a nervous system at work that predates limbic evolution. We cannot deceive the brain because it tells us in its own ineffable neurologic way what we are dealing with.

 What we have found is that very early events in life determine the settings of our nervous systems. What sways the two key nervous systems – both under the aegis of the hypothalamus – is the kind of biologic and neurologic reaction that is forced on us and our brains while under specific kinds of threats very early in life, during gestation and birth. There is the struggle-and-succeed syndrome, the sympath, and the struggle-and-fail syndrome, the parasympath. This latter gives up easily and smells failure. Not so the sympath who tries and tries and does not give up. And when a new patient struggles to feel even when he is not ready, we generally have a sympath on our hands. The parasympath comes in listless, down regulated, worn out, unmotivated and depressed. He sees no point in anything. This is where the therapist needs his full capacity to meet the challenge. Should he be encouraged? These are the questions we take up constantly in our staff meetings. We often bring the patient in and ask him what works. He sometimes knows and sometimes does not. With long-time patients I ask them if I made a mistake and what was it? I get good answers and I learn.

 One key problem in therapy is when the doctor tries to force the patient onto a nervous system that is not his. For example, the therapist may try to get the patient to act more aggressively with his boss when his whole system, the one that helped him survive, is in the energy conservative, passive unaggressive mode. So it is like deciding that someone should be right-handed and we force him not to use his left hand. We are confounding nervous systems (run by the hypothalamus) with terrible results later, such as stuttering and cross in reading and writing. In therapy, a comparable situation is created by abreaction: forcing the wrong nervous system into action.

On the Difference Between Abreaction and Feeling (Part 13/15)

How Good Primal Therapy Should Work

 Now, let us look at how a Primal Therapy session is supposed to work.

 A patient comes in for his session feeling anxious and not knowing why. “What does it feel like?” we ask. He doesn’t know. It is all agitated and “jumpy” and cannot sit still. And here we do not make any effort to get him into a feeling. We spend a lot of time just on understanding the feeling: when it is worse, how it affects work and sleep, etc. What it feels like. He cries a bit and we let it happen; he is overwrought. We embed the current feelings solidly before we travel back in time and deeper in the brain. The present becomes the platform from which we work. We want to establish as much as we can in the present and embed the feeling in the present. No going back right away unless the patient leads us there. But we want to take easy steps with the feeling going back to childhood later on, and in each stage settle the feeling deeper. The patient begins to feel more deeply; this can go on for many months and then, after a year or more the feelings will take him down to first line if there is a traumatic first line, and if the feelings are very disturbing. It is not always necessary. Then the patient may alternate first- and second- line events for reliving which get deeper and more powerful over time. We keep the pace even and not too overwhelming; otherwise we get abreaction due to overload. It is an ordered process as much as that is possible. We help keep him on track when he diverts from the beginning feeling so he doesn’t get grooved into a new channel of feeling. That is our skill, knowing when and how to keep patients on track. We follow evolution in reverse at all times.

 Remember, each level of consciousness is an entity unto itself. If someone is reliving something emotional and then begins birth movements, it means to us that there is intrusion from another level; it may be that it is a defense against too strong emotions. And of course, if any words leak out we know it is not a preverbal imprint we are working with, another sign of abreaction. Similarly, if the patient doesn’t have her feet and arms in a specific position during a first-line Primal, we know it is abreaction. Defenses are tricky and we need a long training to pick them up correctly. In Primal Therapy we make it safe not to block pain. Since each higher brain level elaborates the same sensation/feeling/need differently, we can ride the top level down and it will eventually take us to the bottom—to origins. Once down there, the system on its own will move upward toward connection automatically, following the paths of evolution for connection. That is, we then move back up toward the right orbitofrontal cortex, around the orbits of the eyes, and then to the left prefrontal cortex for final connection.

 How do we go back in time? Good question and the answer is simple. We don’t deliberately decide to go back and visit our early lives; that is a recipe for abreaction. We cannot engage the higher- level cortex; we must disengage from it. Cede to feelings. And that is our scientific mission: to provide access to feelings and let the whole organism proceed in an ordered, slow descent into the deep unconscious. As odd as that seems, feelings are the vehicle that take us where we need to go. Deep feeling has little restraint and flows effortlessly. There is no such thing as trying to have a deep feeling; it flows and pours like the well-known salt.

 Again, it is not for the therapist to determine what the patient should feel. Our system has a biologic sensor that knows not only where we have to go in the past, but also how far, and above all, when. During therapy, when the body temp reaches a low of 96 degrees it often means that there is a first-line component. The patient has touched on the brainstem part of the feeling and therefore it drops inordinately. So the patient feels depressed and his vital signs indicate that he is close to the original imprint. Otherwise, we would not get such low readings early in therapy. This physiological reaction gives us a clue about the beginnings of depression. Some life-and-death threat during womb-life forced the system to a last- ditch defense to conserve energy. All systems slowed down and went into energy conservation mode. Worse, that mode gets stamped in. Then we spend a lifetime depressed and have no idea why. To end depression – notice, I did not say “to treat” depression – we must address those origins fully. It means going back a long way. In our therapy, we have patients reliving remote deep pains, those with no words nor tears, and we see it over decades.

 In Primal Therapy, we seek access to those deep recesses of the brain, where ultimate healing lies. First-line is always more powerful than later imprints; so the insights that flow from first-line feelings are widely encompassing because they are the basis for so much later behavior. There are fewer words in these insights to match the preverbal pains that give rise to the insights. But they have weight and importance. Reliving on the brainstem level means complete connection as the driving force of impulses are experienced at last. We connect, in short, on the level of the trauma and in that context only. Here we are dealing with the shark brain: no shouts, no words and no tears. Evolution has taken over. It means the patient has gone back in time and is living again what went on decades before. Then it was too overwhelming for a naïve and fragile brain to integrate. Now, perhaps, he is ready for it. This is the true meaning of facing yourself and accepting yourself; not in the booga-booga, new- age sense but in the biologic evolutionary meaning of it where the feeling is now integrated into the physical system. It is ego syntonic. (Excuse my use of old Dr. Freud for this contribution he made which expresses exactly what I mean to say.) As the reliving goes on, the feeling is fully integrated and there is a continued drop in vital signs, arriving below baseline. The body temperature lowers to real normal, rather than “average” normal. In this sense, “integration” is a new biologic state where the whole system can re-regulate itself. Blood pressure drops and heart rate slows.

 But a word of warning: vital signs are a symptom, not the problem. Treating the symptom alone is a mistake, one that can make matters worse. So when doctors see someone with very low vital signs, they look around for a good diagnosis. They work on his blood pressure, for example, in a medical effort to “normalize” it without understanding that the patient is already in his normal, life- saving mode. In Primal Therapy, we do nothing to address vital signs directly. We work to change the whole neurobiological system by addressing the repressed pain which vital signs only reflect. The difference is between a temporary effort, which has to be repeated into infinity, versus a basic biologic change which lasts.

The Anthony Weiner Sexting Case:When a Picture Is Really Worth 1,000 Words

Believe it or not, this is the third time I have written about the lurid sex scandal involving disgraced politician Anthony Weiner, a former U.S. representative and New York mayoral candidate. He was caught years ago texting his crotch shots to women. As a result, he lost his reputation and his career, and almost lost his marriage to wife Huma Abedin, a close aide to Hillary Clinton, who had previously decided to stick by her man.
What truly defies belief is that Weiner was caught doing it again. This week, the incorrigible ex-congressman was busted sending sexual images to a busty woman who, this time, reciprocated with pictures of herself.
And so history repeats itself, inexorably. But we should have known it would, as I suggested the last time I wrote about the sad case:

“A year ago, I commented on Congressman Anthony Weiner’s resignation in my blog, ending with a line that turned out to be prescient: “He went away, but his needs didn’t.” On the surface it may sound like a simple thought, but the idea of being driven by insatiable yet unconscious needs is key to understanding why smart men do such dumb things.”

I am sure that at some point his wife must have given him an ultimatum, “Never again or I will leave.” Well, she finally had to go trough with her threat. After the latest expose, she announced she was finally leaving. I guess finally it became clear that her husband’s outrageous, unfaithful behavior wasn’t going to stop.

The poor woman, like the public, must still be at a loss to explain how the man could continue to risk the only good thing he has left, his family life with his wife and young son. So my point bears repeating: Needs don’t just go away.
How can we explain Mr. Weiner’s odd behavior, and especially his choice of sexting as a vehicle for release? Why send pictures electronically when he knows full well they can easily be made public, providing proof of his perversions?

In order to understand Mr. Weiner, the man, we must focus on the child he still has inside. As early as age one, children start learning rudimentary language so they are no longer frustrated and can communicate with the rest of us. They can signal us when hungry, thirsty, annoyed, tired, sleepy, etc.  And the message gets through. The child is relieved because he can deliver his feelings.
Well, Mr. Weiner can do the same.  He can speak in a language with no words that conveys his needs and feelings. And what do they say?  “I am a man, strong, tough,” or whatever his unconscious dictates. Perhaps he is trying to say, “I am worthy of attention and caress and adulation.” Whatever it is, this message has to get out because it represents a deep need/feeling inside of him that he has no idea is there. It is saying what he feels unconsciously. It is saying what his parents deprived him of: A feeling of being loved, worthy, important.  That is what he needed way back when, and he needs it NOW.  The need has never left and never will, until it is felt and made conscious so it no longer has to be acted-out.

Obviously, it can be overwhelming. As long as the need remains unconscious, it is out of his control and will continue to drive his compulsive behavior.  
So when his wife says,  “Next time I leave,” he may want to do the right thing, but he can’t. He is forced to act out again even though it means divorce and being bereft of his young child. There has to be something very strong to defy that and put his marriage in danger.  Having seen the force of Primal pain I do know of its force and pressure; it has to get out.  The only way nearly all of us have for relief is acting out the feeling.
The experience of the one year olds tells us about Anthony. They both speak in symbols, not words, to express their feelings.  They speak on the brain’s second line, the limbic system.  And Weiner is back down in time in the brain speaking with the same language. The force is enormous and demands relief from the pressure it exerts.
The act-out doesn’t have to be sexual. I once had a patient who refused to use her turn signals while driving because, she’d rationalize, “it’s no one’s business where I go.” She realized later, through therapy, that her unsafe driving was driven by defiance of her mother who constantly kept tabs on her as a child, relentlessly asking her where she was going.
It can also happen when a drug addict has found relief.   He falls prey to his buried Primal Pain.   It is all done without words, mind you.  Whether the person shoots up, or he flashes or texts or he takes one more drink. We all understand that alcoholics find it hard to quit drinking. Well, for someone like Weiner, flashing one’s sex is compelling and irresistible as one more drink is to an alcoholic. They both know it’s ruining their lives, but they can’t help themselves. “Knowing” is a weak combatant in the fray. It is a latecomer to the cortical armamentarium and a weaker force than the dinosaur brain spouting out its memories.  When there is deeply buried, embedded pain, it often takes a non-verbal method to combat it.  Like drugs, which are immediate and powerful.
For dear Anthony to put a long-term marriage in danger has to involve an equal and opposite force, something possibly life saving.   I have observed that force in hundreds of patients over fifty years, and it is an ineffable experience. We do see near-death events, the strangling and choking and suffocation that cannot be faked but it is there.

I cannot possibly know what is behind Weiner’s acts act-outs but we know it is there, as we have stopped it in so many other similar cases. That act-out It is
saying something, that act-out, and but only he can decipher the meaning.  There is no expert alive who can do that job.  That is why we need a therapy of deep memory, a therapy of feelings and of embedded and hidden memories.  A therapy of experience, not of insights.  No one alive can bestow that truth on anyone else; except that contained within that act-out lies a secret, symbolic message betraying what it is.  So if you read hieroglyphics you get it; if not, you don’t.
It is the feeling that remains in the memory/feeling system, and it gets transformed into an act later on.  The act can only be approximate, because it if were exact it would be a Primal, and the level of pain would not allow it.  But the feeling drives the act-out, and that involves all kinds of different experiences.  If he finds playing  football early on that may fill the void.   Life circumstance fills the void.  But the act-out has to be close to the feeling and it usually is.
There is no way to know what that need is until he feels it in a Primal but rest assured, it is there, in force. Until then, the act-out relieves the pressure of unfelt feelings.  If it did not, then all manner of afflictions may occur as the person is bottled up with his pain. What the act-out may block is deep depression as one sinks with his load of unfelt feelings, or a different balancing act such as overeating or heavy smoking. There is only one way out, and that is the scientific way in which I believe we now have. Aah.

Preamble by A. Gurza of my next book: "The Psychology of Every Day Life"

Here is the preamble of my next book, "The Psychology of Everyday Life", by Agustin Gurza.

 Preamble: A Primal Primer


            When Arthur Janov wrote The Primal Scream almost 50 years ago, he revolutionized the field of psychotherapy with a treatment he boldly called the cure for neurosis. Since then, he has written more than a dozen books and countless articles expanding, refining and enriching his theory. However, the fundamental principles he laid out in the original book remain unchanged. The clinical practice of Primal Therapy has evolved over time. But the basic discovery – about why people get sick and how they can get well – has yielded a set of truths that have proven as immutable as the laws of nature.
        Yet, Primal Therapy is not just a treatment modality for people with private problems. It is a unified worldview, a Weltanschauung, if you will, that helps explain so many of the ills afflicting man and mankind. It is a theoretical framework that helps us understand not only the psychology of the individual but also the dynamics of what was once referred to as our “sick society.” Just as Primal Therapy helps unravel the mysteries of our personal neuroses, it also sheds light on those monstrous forces that frequently shock the public and repeatedly cry out for explanation.
        It is this primal perspective that informs the essays Dr. Janov has written in this collection. Behind every commentary and critique lies this deep understanding of how the human mind works, and how it can be twisted and distorted through physical abuse and emotional deprivation in childhood. For those who have followed Dr. Janov’s work through the years, the primal context for these essays will be taken for granted. You might say that we speak the same primal language.
        To some degree, these essays stand-alone. Readers will find the topics provocative and the language accessible. Dr. Janov observes the world with a wonder and awe that we all can share, in a language that eschews dense academic jargon, which tends to obfuscate rather than clarify. However, a basic understanding of primal principles can surely enhance the reader’s appreciation of this work, since Dr. Janov’s observations arise out of primal thinking.
 With that in mind, this preamble is offered to help explain some of the ideas that form the pillars of Primal Therapy. It’s not intended as a crash course in the theory or therapy. It’s only meant as background for those readers unfamiliar with the basic tenants of the therapy. The only caveat is that the following summary strips the theory down to its most elemental form. For a full understanding, readers should still consult the source.
        Here is Primal Theory, in a nutshell.
        

 We Are All Creatures of Need

        The first and most fundamental primal principle was stated in the short but powerful opening line of The Primal Scream: “We are all creatures of need.” Truer words were never spoken. Any understanding of mental illness has to start with that premise. All human beings have needs, from the primordial (“feed me”) to the psychological (“praise me”). And when those needs are not met, the human organism goes awry. Why? Because it hurts when needs go unmet. We seem to understand this so clearly when it comes to plant life: flowers need a certain amount of sun and water and a certain type of soil, or they wither and die from the lack of life’s essentials. The same is true for our pets on both a physical and emotional level: we respond instinctively when they crave affection and attention.
        Yet, it seems we are not as attuned to our own human needs, which are so much more layered and complex, like our brains. The consequences of ignoring needs are also complex. We suffer from the deprivation, we struggle to absorb the pain, we find a way internally to suppress it and overcome it and move on, but at a great cost. 
        The price of unmet needs is neurosis.
        The entire theoretical structure of Primal Therapy is built on that basic understanding of human need. Those needs evolve over time, in successive stages. As the brain grows, so do our needs. As infants, our needs are few, but they are critical. We need to be fed, to be touched, to be soothed, to be cuddled, to be kept warm, safe and comfortable. The needs are simple but for a helpless baby they hold a life-and-death urgency. Of course, babies can’t feed themselves or cover themselves when they’re cold. So instinctively they know they will die without food or perish if left alone. That’s why when babies start wailing to signal their needs, their cries sound so alarming. To them, the danger feels imminent because they don’t have the intellectual capacity to reassure themselves that help could be on the way shortly. In fact, they have no way to measure time, except by the satisfaction of their needs. If their needs are promptly met, they feel loved and can continue to grow and flourish. If not, they are plunged into pain that they must now overcome. The crisis posed to the infant organism is commensurate with the urgency of the need. For adults, it is sometimes hard to grasp the intensity of the pain a neglected or traumatized baby can feel. That is why some parents still believe it is harmless to let their babies cry themselves to sleep, inventing a rationale called self-soothing, which is an oxymoron at that age. These are fragile human beings at their most helpless and vulnerable, with brains that are not developed enough to help them understand what is happening, much less resolve it with some sort of mental process that soothes their own fears. This is where feelings of terror, despair and hopelessness begin. This is where the seeds of neurosis are planted.
        In childhood, our needs become more complex. Our brain is growing; we are acquiring language and a sense of self. We still have basic needs for shelter and food, though we can now keep ourselves warm and get milk from the fridge. We now also have a need for approval and encouragement as we learn new skills and try new things. We need to feel comforted when we fail, and appreciated when we succeed. We need our parents to calm our fears and support our first steps toward independence. Most importantly, we need to be given the freedom to express our feelings, be it hurt or anger or fear. When our needs are met at this level, when our feelings are accepted, we feel loved. We feel strong enough to grow and take our first steps out into the world. This is how we acquire self-esteem, something that cannot be taught or acquired later on. If instead, the child faces neglect and disapproval, the pain is compounded and added to the stored pain and need from infancy. By adolescence, the child can already be a full-blown neurotic, in primal terms. We’ve all seen teenagers who are angry with their parents and starved for love and approval from their peers. The psychic/emotional system has already gone haywire, and parents throw up their arms not knowing how to handle their tempestuous teenagers. They ask: Where did we go wrong?
        Our needs continue into adulthood. We have a need to find mature love, to succeed in our work, to have fulfilling friendships, to eat healthy and get enough sleep. If however, we carry the old baggage of unmet needs, we might find it difficult to become a successful, happy adult. As we shall see, we cannot escape the unmet needs of our past.
            
 Repression and the Three Levels of Consciousness

        The notion of the subconscious is crucial to Primal Therapy. It is not a mysterious subconscious in the Freudian sense, a dark and violent depth that is to be avoided. The primal subconscious is filled with the pain from all that unfulfilled need, all those unfelt feelings from childhood. And this leads to another main pillar of primal theory: repression. We are all familiar with the way the brain represses awareness of traumatic events in adulthood, such as severe car crashes or violent sexual assaults. Victims often say they remember everything up to the moment of the catastrophic event, but not the event itself. Clearly, the mind is capable of blocking awareness of extremely painful experiences to protect the organism. The same is true for traumatic events from childhood. The human brain is capable of burying painful memories, along with all the feelings attached to those memories, as a way of protecting the individual from an unbearable realization. And for vulnerable children exposed to abuse or neglect, that realization represents a threat to the system: “I am not loved.” Repression, then, is a survival mechanism that allows the child to encapsulate and bury the awareness of traumatic experiences when they are too painful to take, at that stage of growth.
        There is much new scientific research that illuminates the neurological way this happens, including methylation. For our purposes, we just need to understand that traumatic memories and feelings are blocked from awareness at the time they take place. Thus, repressed memories are laid down and layered over time, creating levels of consciousness corresponding to each stage of an individual’s development. In Primal Therapy, there are three levels of consciousness, all inter-connected via memories and their feelings.
        The first level of consciousness we call the first line. It is the earliest level corresponding to the pre-verbal experiences of infancy, including birth.
        The second level, or second line, encompasses the experiences of childhood that include all the emotional responses arising from the evolving interaction with our parents.
        The third level of consciousness, the third line, represents our current experience as adults, which includes our relationships with our loved ones, our endeavors at work, etc. This is the level of our awareness in the present that, barring one of those catastrophic events, is not unconscious. The normal neurotic is generally aware of feelings and reactions on this level, though they may not understand why they feel a certain way in given situations. In extreme cases, however, even the awareness of feeling may be blocked in the third line, although the subconscious levels are still driving behavior in the present. This is the case with psychopathic killers who feel nothing while committing horrible deeds, which is why witnesses often describe mass murderers as acting calmly with blank looks, or even a smile. The lower level rage that drives these murderous impulses is so buried from consciousness that some killers later confess they don’t know why they did it.
        There is an important corollary to the theory of three levels of conscious, and that is the notion of resonance. This is the idea that similar feelings are connected to each other across the levels of consciousness, from the present to the past and back to the present. Resonance is crucial in clinical settings, because it provides the vehicle by which patients can follow a feeling from the present and be led back to similar, inter-connected feelings in the past.
        Neurologically speaking, the three levels of consciousness correspond to the structure of our triune brain, which, broadly speaking, evolves in three stages. Thus, first-line feelings are registered in the earliest, most primitive parts of the brain; second line involves the mid-level, feeling centers; and third-line engages the higher and last-developing part of the brain, the neo-cortex. This brief summary does not do the science justice, but suffice it to say that Primal Theory is in sync with the way the brain is built, and the way it evolves and grows.
        For our purposes, it’s important to know that these primal fundamentals – pain, repression and levels of consciousness – help us understand many of the mysteries of human behavior. It all comes clear with one kernel of primal truth: Humans hold repressed memories and feelings from the past that drive our actions, thoughts and emotions in the present, without our even knowing it.

 The Act-out and the Divided Self

        Repressed memories and painful feelings are not simply buried from consciousness and forgotten. They remain as a powerful force within the individual, constantly pushing for resolution. Repression produces a divided self, the conscious versus the unconscious. The split creates a constant state of conflict and tension that can only be resolved by making the self whole, which means bringing the unconscious into full awareness. That, in brief, is the goal of Primal Therapy, to unite the self and make the person whole again by systematically retrieving buried memories and finally experiencing the pain and need that had been kept at bay for so long. The cure lies in the reliving and integration of those traumatic experiences.
        Without that resolution, the force of those old, buried feelings continues to impact a person’s personality and take a toll on their health. While repression might keep a neurotic comfortably unaware of the demons inside, the pressure on the system can eventually lead to cancer, heart disease, and dementia. The body breaks down, so to speak, under the stress of holding so much back all the time.
        In order to work effectively, repression requires defenses. Some defenses are built into the system naturally through bio-chemicals produced by the body itself.  These help create a gating system that keeps the traumatic memories unconscious, allowing people to become functional adults. In some cases, however, the pain is so great that it damages or weakens these natural gates, bringing the pain closer to the surface and thus making the person suffer. These are often the people who come to Primal Therapy, because their pain is breaking through and they desperately need a way to resolve it. Others may turn to drugs or alcohol to soothe the suffering, risking a lifetime of addiction since unresolved pain will always be there, requiring more and more drugs to keep it down.
        Our behavior can also constitute a line of defense. We keep our old feelings away through act-outs that can take many forms: Chasing women, acquiring wealth, keeping busy, seeking more and more diplomas and professional recognition. Drug use is also an act-out, but one which directly quells the system though chemical intervention. Behavioral act-outs work symbolically. We try to satisfy our old needs by creating current symbols for what we were missing in the past. So if a person lacked the warm touch of a mother or loving hugs of a father, he or she may constantly seek human touch through sex. Or if a child was constantly put down and never praised, they may become performers always seeking applause.
        Dr. Janov puts it this way: 
        
            “We keep busy and doing things to keep from feeling there is nothing I can do. We keep having new projects to give us hope to keep from feeling there is no hope. We keep controlling things to keep from feeling I am helpless. We keep making phone calls to keep from feeling I am all alone.
            Now why would we do that? Because the feeling “I am all alone” isn’t just something from yesterday or today; it is the primal aloneness in the first minutes or weeks of life when mother, who was sick at childbirth, abandoned her baby. It became a life and death matter. It is a devastating aloneness that can be triggered off in the present whenever we are left alone for a time.
            We are acting-out against the pain, so that the act-out is unconscious; we do not know what drives us and we usually don’t even know that we are driven. It is all automatic. We keep from sitting still by much travel all to keep from feeling confined at birth, stuck in the canal, then later stuck in a tense and depressed household which was again “suffocating.” So we drag along our past but never know it is there weighing us down. One reason we know the pain is there is by the act-out, obsessive, continuous behavior that seems irrational. We are acting-out the feeling/pain, trying to get over the feeling but never knowing what it is or how to get rid of it.
            I used to think that it was the act-out that would be the death of us; but I now believe it is the underlying feeling that keeps the system activated and forces the act-out. The daredevil is constantly doing something death-defying. He is facing death and conquering it, a replay of his early life. But the imprint of approaching death is still imprinted and forces him to do it again and again.
            A counselor can insist that you stop this negative behavior but she doesn’t see the force below that drives it. Need forces unrelenting behavior. It is out of control because it is already controlled by unconscious forces, which are stronger than any act of will.
            Check your act-out and you will get a good idea of what your pain is. Now the tough part: feeling it.” 

 Insights and Essays

        In therapy, the final stage of a primal is the moment at which the patient emerges from an old feeling and realizes the impact it has had on his life all along. This stage is called the insight. Finally, the repressed feelings are made conscious, and with that comes an often astonishing new understanding of why we have done, or failed to do, certain things all our lives. The therapist never provides the insight for the patient. The insight arises from reliving the old pains, or rather, experiencing them consciously for the first time. Making the connection to the old feeling in its original context is what brings relief, and healing. Once the old pain is felt, it no longer exerts its subterranean force, and we can stop trying to symbolically satisfy the old need that created the pain in the first place, and kept us crazy all our lives.

        Dr. Janov wrote the essays in this book using this primal insight into how human behavior works. You might say he is using the insights achieved by hundreds of patients to help explain the inexplicable: Why mass killers kill, why successful celebrities commit suicide, why people feel the need to travel all the time, why so many kids suffer from ADD, and why it’s so hard to find true, fulfilling love. Primal theory provides the powerful lens that allows him to probe beneath the surface of this array of befuddling, frustrating, shocking and mystifying human behavior. Like a primal, the analysis is often illuminating.