PRIMAL THERAPY EMPTYING THE PAIN TUB - DR. FRANCE JANOV | Being Human

Government as Cult or The Cult of Trust

(Originally published September 18, 2008)

The United States is becoming unified. People are thinking more like their leaders and our leaders are thinking more like the people. It looks like unity but it has its dangers. We are becoming welded together into a specious form of homogeneity where leaders exhort us to trust in them; the experts then poll us and find that we do; and the government issues statements that they are carrying out the will of the people.

While this might appear as democracy at work, I submit that what results from this Cult of Trust could be a highly anti-democratic situation. In every democratic country the elected officials eventually reflect the populace. They are, in a single person, the condensed symbol of what the masses are supposedly thinking. The danger is that a mergence of the attitudes and beliefs of the people with those of their leaders becomes a locked-in consensus, with each side afraid of being out of step with the other. This political lock-step seems to be strength but in actuality it is too often no more than a fear of being disloyal. Hesitation, doubt, distrust, dissent and disloyalty have become synonyms in the current American patois.

In the name of unity democracy finds itself submerged beneath the philosophy of "my country right or wrong". If we look at history; of the Hitlerian and Stalin era we see what blind trust can lead to. The Germans and the Russians wanted to be good, loyal citizens. There, too, it was, "my country right or wrong, "and the result was mass destruction, starvation and death. What their leaders asked for was complete trust. What they meant was that the people should abjure all critical ability and passively agree to whatever the leaders decided. Even now in the Soviet Union the leaders are asking for complete trust based on their distrust of past leaders. "Trust me, because I'm not like the rest." And we are very aware of the trust the Iraqis have in Saddam Hussein.

At a time when the functions of democracy are enhanced we seem less inclined to use them lest we be accused of shattering American unity. The cult of trust is supplanting independent thought, and we are moving towards a democracy by indirection wherein the people's will is polled rather than meaningfully voted. The poll is king and when it indicates that the time is ripe for a vote, democracy becomes official. We can see objectively what trust did in other countries, particularly Iraq, where they are en route to having their country demolished. What we can't see so easily is our own devotion to trust. Don't trust trust too much.

Government by survey is becoming the mode, and judging by a recent survey we are all in trouble. Though Americans are reluctant about a ground war in Iraq they are nevertheless willing to go along with the judgment of our leaders. In a recent poll the people agreed with the generals that they shouldn't be given too much information. When information lacks, trust makes its entry.

On the CBS "News Special" in the 1960's Eric Sevareid indicated that, in terms of the course the war had taken, none of the government experts has guessed right. And now the news seems to be highly managed by a series of press briefings.

The cult of trust seems to grow in inverse proportion to the amount of information received. The less information the government offers, the more we need, obviously, to rely on trust. We are told that some information must be withheld because of the "national interest." What I am suggesting is that too much trust based on too little information is truly against the national interest because the people don't really know what is going on and cannot make informed opinions.

A situation is occurring wherein those who want to know more, who hesitate or question, who are restless because we are not given the facts, are considered out of line and castigated for giving "aid and comfort to the enemy." In Germany in the early 1940's anyone who thought Germany might be losing the war was termed, most pejoratively, a "defeatest." That kind of label could bring about a stiff prison term and even death. Germany's leaders demanded trust even while the country was being decimated.

The problem is that preservation of democracy becomes secondary to the preservation of a united face before the world. This is not necessarily a conscious plot by secret conspirators but the culmination of a situation in which the people and leaders unconsciously manipulate each other to preserve a mystical strength. We are caught in the "consensus bag" and no one seems free to inject new ideas or new moves. The danger is that America's historic dialogue may be coming to an end - replaced by an executive monologue orchestrating a consensus and sowing suspicions against those out of tune with the jingoistic melody.

THE SUPER PATRIOT

Years ago I published psychological "Portrait of the Cold Warrior" (The Minority of One, April 1963). It was an analysis of thirty related research studies from which a composite of the super-patriot was drawn. It presented a hypothetical man, found on the far right, who stresses violence as a solution to complex problems and who emphasizes power in both interpersonal and international relations. The portrait was thus summarized: "The Cold Warrior is neither bright nor imaginative. No matter how much protection he has, he can never have enough to quell his inner insecurity. He is an impatient man who disdains talk in favor of action; who wants immediate and single solutions to problems. He sees the world in terms of black and white and distrusts his fellow man. He cannot see cooperative solutions to problems, and sees all relationships in terms of power- of dominance or submission. Any attempt by others to gain equal status is seen as a threat. He believes in power first, last and foremost. He relies on violence to solve personal and social problems. He is cynical, suspicious and misinterprets most moves by others as belligerent. He is a hostile person who rationalizes his hostility as justified by the continued existence of an aggressive enemy. He is so torn by conflict that he does not know peace and harmony when they're upon him. He lives by the slogans. . He is rigidly inflexible, emotionally isolated and lacks both personal and social insight. He decries critical introspection; has few ideals and less hope. He sees only the daily practicalities and dismisses theoreticians as fuzzy idealists. He is anti-science because he cannot imagine an orderly and predictable world, shorn of chaos. He is dedicated only to his own survival and believes that all those not for him are against him, and all those not over him are under him. He sees those who fear war as weak, neurotic, oddball agitators and believes that to find conciliatory possibilities in an opponent is traitorous."

In the period since this portrait was drawn, what were the psychological properties of busybodies on the penumbra of the political spectrum have been ever more completely absorbed into our national ideology. Perhaps in time of war these characteristics are national necessities. Perhaps our leaders are correct in contending that we must kill to save lives. But what if they are not correct? It doesn't hurt to ponder that possibility for a moment.

We seems to be caught in the vortex of a synergistic process wherein each increasing physical commitment of troops and guns brings with it an increased implicit demand for psychological commitment as well. Each category of these commitment potentiates the other - a process that augurs ill. Indeed, the Gallup Poll, in two survey taken three months apart, found a thirteen per cent increase in those favoring a greater military commitment in Vietnam. (Los Angeles Times, November 21, 1965.) This psychological shift paralleled the great increase in the actual commitment of troops during that same period. In addition, there was a two percent drop in those willing to negotiate for peace.

One danger in this synergism is that one does not shut off internalized attitudes and beliefs as readily as one might cease bombing villages (as those who fear German rearmament know all too well). The Zeitgeist outlasts the environment in which it was begotten and prepares the soil for future wars.

An interesting study by sociology professor Seeman of the University of California in Los Angeles helps clarify our dilemma. Emotionally alienated persons were investigated and it was found that there is a relationship between emotional alienation (social detachment) and powerlessness. With the feeling of powerlessness goes lower political interest, lower political knowledge and a lack of motivation to learn more about politics. One of the questions asked was whether "the basic decisions on political and social questions should be made by experts." Not surprisingly, those who felt powerless tended to answer affirmatively. When people feel powerless they prefer government by experts over government by the people. In short, they prefer to continue their powerlessness.

The majority of us are perhaps unaware of our growing powerlessness. We have been encouraged to believe that we live in a democracy which rests on the strength of the people. All too many are oblivious to the fact that their growing trust in leaders is but a manifestation of their own powerlessness. Such "trust" offers a way for eschewing personal responsibility in matters of government. And what democracy is about, it seems to me, is just that matter of the ability to judge and evaluate what our leaders are doing.

The Seeman study found that those who placed a higher value on political control by experts were less interested in knowing more; more willing to follow the dictates of others- in short, they tended to shift from democracy to autocracy. It is this shift that allows people to abdicate personal decision, to avoid a search for information and most important, to abjure a personal morality. As shown in the study, the shift inspires a deepening unresponsiveness to new information. Reflected in this attitude is the loss of control over one's destiny. Not only is this control lost in the cult of trust, but the individual hardly aspires to develop control, for with it would go responsibility and decision-making -tasks that cannot be welcomed by those who want others to make all the decisions for them.

In this frame of mind comes reliance on fate and chance. What happens to us we believe to be in the hands of a higher power, whether deity or government. When we defer to external regulation of our own lives and minimize the value of personal efforts in affecting problems, the result is government by the cognoscenti, rule by a knowing elite that knows best what is best for us. War itself is then left by us to fate....and to the elite.

But what is good for us is not merely a matter of facts known to experts. It is a matter of morality. It is the matter of differing viewpoints. What differentiates us from our Government is not merely the respective quantities of facts at our disposal, but a different frame of reference for approaching and assessing these facts. The difference is between humanism and power politics.

When a government gets a people to think in terms of power politics instead of human needs, the people have been had. Yet, through clever use of the mass media, we have become "expert" on foreign dictatorships but benighted children when it comes to the ways of our own government. When my barber tells me, "We cannot afford losing Southeast Asia to the Communists," is it really that he thinks himself to possess a proprietary interest in a country he has never seen, and which until a few years ago, he had probably never heard of? When he comes home to his $85,000 tract house, is it really the first order of business that he tells his wife that they must not "lose" Asia, when she is worried about not losing the house.

TRUST BY ORDER

Our existence can be in danger precisely because of the inflexible idea that our existence is continuously in danger. So war has become necessary to prevent war : bombing necessary to save lives; and death an unfortunate by-product of the fight for life.

Given the baseline that our existence is in danger, much must logically follow. Thus, peaceniks and their ideas becomes dangerous, while agitating for death—"death to the enemy," means that one's sanity presumably has been vindicated. It is a strange equation—death and sanity, killing and mental health, bombing and democracy.

"Kill" seems to be "in" in a nation huddled together in its patriotism and righteousness and fearing most of all to sow disunity. Three university professors were put to death by the Ky Government during the Vietnam war for circulating a petition demanding a cease-fire. The leaders had made the leap from a request for trust to a demand for it.

GOVERNMENT BY CRISES AND MONSTERS

From a psychological point of view, the ability to wage war revolves around the concept of trust. And that is not only a bad thing, but a necessary one to make any government viable. The rationale for the need to trust out leader is that in time of crisis we must act as one. When your ship is sinking there is no time for hesitation, debate, or going in separate ways; it is time for united action. More than anyone before him. Hitler mastered government by crisis.

Crisis has a number of psychological functions that help keep a people in line. Crisis galvanizes, mobilizes and, most importantly, legitimizes excitement. Violence toward the "enemy" (whether internal or external) becomes acceptable because "we are in a crisis." All means become acceptable.

By embroiling his country in continuous conflict and war there was always a crisis, always a need for the savior and always a justification for the suppression of those who disagreed. The German people trusted their leaders, and the German leaders trusted their leader. What enabled them to feel guilty with a clear conscience was that their leaders must knew what they were doing while they themselves were only carrying out orders. There was "unity." But it is just such unity that one must fear most. This is not to say that we should never have confidence in the leadership; after all, we elected them. It is just that healthy doubt is always important.

This is the same kind of psychological mechanism that gets people hooked on horror movies. In a horror film, one is placed in a situation of mounting tension and terror, but in the back of one's mind one knows that really there is nothing to fear. The monster on the screen mobilize our indigenous fear. In the end, the monster is killed and we feel relieved, for nothing inside us was wrong; the monster was the source of our fear.

The "monster" today keeps changing. It used to be the Chinese. Now they are sort of friends.It used to be the Japanese and Germans. Now they are our closest allies and we worry when they hesitate to go into war. Not exactly the worry we used to have about them. We become convinced that when our enemy is exterminated we will be able to breathe freely again. The problem is that our enemy keeps changing. During the Iraq-Iran war, Iraq was our friend whom we armed. That wasn't very long ago.

We have a problem in Iraq because we've got a man who doesn't do things rationally. Albert Camus said it a long time ago, "A man with whom you cannot reason is a man to fear." Those who might try to reason with him take their life in their hands. He demands trust. He doesn't even demand it; he expects it. There is no will of the people. The progression seems to be to asking for trust, getting it, demanding more until all decisions are left in the hands of the leader; and that is the danger to democracy. Too much trust in "them" means not enough trust in ourselves. If the leaders then do things that we don't like; if like in Iraq they are intent on destroying their own country, it is because the people implicity trust their leaders. They are willing to die for whatever decision is made by them. They too say, "We've got a job to do and we are going to do it.". Killing the enemy becomes a "job to do". Killing is not done in anger, which is, one thinks, the logical result of fury. Rather, killing is done, sang froid, as another task that must be accomplished. Anger has been removed from the killing process; cold calculation has taken its place.

THE MONSTER BEGETS HEROES

One searches in vain for something to say other than "kill" and "war" that would not be considered as giving aid and comfort of the enemy. No matter how aesthetically articulated by our State Department or Rand Corporation academicians, the message is the same - our fellow Americans have every right to protest, but what they are doing amounts to treason. They are considered as lacking in trust and as sowing the seeds of disunity. Somehow we believe that Iraqi soldiers in the sand will read The New York Times, assume wrongly that Americans are for peace, take heart and fight all the more -ergo, more American boys will have to die fighting and increasingly stubborn enemy. The fact that Hussein took Kuwait without the aid of The New York Times, is somehow overlooked.

No one doubts that Hussein has acted monstruously. Monsters have to be fought. But the idea of a monster helps detract people from the fears of daily life. To combat him offers us surcease from the humdrum of routinized existence and presents a chance for what Aldous Huxley called "individual nobility." All of us want to feel noble; that we belong, share the major view, and that we are not set apart. We want to be the best kind of citizen. Loyal and devoted. Like in the movie, the monster is at the source of our fears; stamp him out and ease will return. And most importantly, trust your leader to know how to handle the monster. But fighting the monster also helps us find our place and meaning in this complicated society. It is something in which we can all share. We are united in our sacrifices and misery, and this seems far better than to suffer from personal problems and private agonies individually. Suddenly death has a meaning in a nation of senseless automobile deaths. We can die for a cause, rather than from pollution—a rather ignominious way to go. Death has meaning even when life does not. It is a time when one of the necessities of life is death. To question this necessity becomes disloyal.

Iraq has become a nation in search of treason instead of reason. We have to take care that we don't fall into that trap. Whatever our personal view of the war, remember that we are fighting for democracy, and the hallmark of democracy is dissent, to have a differing view.

What is needed is a new atmosphere wherein the real enemy is war. Only then will efforts toward peace not be considered treasonous. When the enemy is war, peace is in the national interest.

What is needed today is a cult of mistrust and skepticism. Let us heed the warning of Andre Gide, "beware the man who has found the truth; follow the one who still searches."

On Drugs And Tranquilizers

(Originally published September 10, 2008)

The choice of tranquilizers or pain-killing drugs depends on very early life experience, even during womb-life. It is this fact that makes a cure so difficult to achieve; yet without delving down into the antipodes of the brain we cannot resolve the need for any kind of drugs, from cigarettes to alcohol to illicit drugs.

No one takes drugs chronically if there isn’t some lack in the physical system. An addiction, first of all, is not to alcohol or drugs; it is to need. (either trying to fulfill it or repressing it). We are addicted to fulfillment but because the critical period is past when need could have been fulfilled; we become addicted to substitutes. We are forced into seeking symbolic substitutes so long as the real need is heavily suppressed. And the urgency of the drug seeking is the same as that of the original need. The person is not only suppressing current pain but also the past pain which he or she may not be aware of. That is what makes addiction look like—addiction. The original need is sequestered and unreachable. 

Drug or alcohol taking is overt, something obvious, a behavior we can treat by redirecting behavior through, not so oddly, Behavior Therapy. It is something we can see and measure; so many months off booze and drugs equals a successful treatment, in their approach. The success is measured in terms of external behavior, not internal processes. Yet it is those internal processes that count the most in the use of drugs. Addiction most often results from very early painful imprints, even during womb-life. It is this fact that makes a cure so difficult to achieve; yet without delving down into the antipodes of the brain we cannot resolve the need for any kind of drugs, from cigarettes to alcohol to illicit drugs because, again, it is not the need for alcohol, it is THE NEED.

Since we needed love early on to stabilize the system, we must make up for its lack by taking something that does what early love would have done: with alcohol or drugs we feel warm, relaxed, untroubled and energetic. And, important, they are immediately available. All of these are temporary solutions; the only permanent solution is to have been loved very early on, or to feel the need and pain from that lack. That re-balances the system. Love in the present won’t do it, but feeling unloved in the past will. 

Our former speed (amphetamine) addicts cannot imagine taking speed when their systems are normal. Perhaps one may consider this a simplistic approach but behind these statements are many decades of experience and much new research that clarifies our position. For a bit more detailed explanation I am indebted to Myron Michael Goldenberg for his description of drug action.

("Pharmacology for the Psychotherapist."Accelerated Development Inc. 1990). 

We need to understand what addiction is and how it works. We need to know what we mean when we say that a drug binds to a receptor, which is how it may work to calm us.

For primal pain to be acknowledged it must arrive at conscious-awareness. If the message never arrives, if it is blocked by any one of the neuro-inhibitors we produce in our brains, we may feel a vague uneasiness, a tension or amorphous suffering, but we will not know what it is specifically. And we will go on suffering. The central aim of those inhibitors is to block too much information, too strong an emotional message from rising to conscious-awareness. When some of the message gets through there is active anxiety, symptoms and impulse-driven behavior. How does that happen? 

Receptors and Receptor Theory

Several theories exist on how drugs actually act in the brain and body. These are by (1) attaching to cells called receptors, (2) interacting with cellular enzyme systems, or (3) affecting the chemical properties of the outer cell membranes. (Goldenberg. Pages 36 & 37)

Many drugs are believed to combine with chemical groups within the cell or on the cell wall. These drugs combine with specific agents known as receptors. The theory is that these receptors actually attract the drug by having a molecular shape that fits with the drug. This is sometimes known as the "lock and key" theory. Think of the shape of a key that will only fit into a certain lock. When the correct shaped key and lock are matched up then the lock can be opened. The receptor theory is much the same. A certain shaped drug molecule is attracted by a receptor site on the cell wall. When the two shapes fit or line up together, the drug acts the same way as a natural body chemical does to set off a chain of events. The key here is that the drugs mimic what our body should have done if we were loved as infants or even before. What almost any drug does is somehow mimic what we should produce naturally. For example, the naturally occurring body chemical acetylcholine combines with receptors in the membranes of muscle and nerve cells that are chemically specialized to receive it. Certain synthetic drug agents can duplicate the action of acetylcholine by combining at the cell wall. These drugs are sometimes referred to as agonists. They boost the action of the cell. The antagonist, in this case atropine, competes for the receptor site which normally accepts acetylcholine. It says, “get out of the way. I will now take your place for the moment.” It will block or dislocate the normal physiological function. Why dislocate? Because the energy and its tendency still exist but must be diverted somewhere. It noses around finding another vulnerable place. The person acts out by overeating, is made calm by drugs, and then suffers from high blood pressure. Sometimes the attack site is not apparent until years later. 

There are drugs that can block the receptor site and interrupt its effect. If there is too much stimulation and we feel that we are about to jump out of our skin there are medications that can stop that stimulation. The pressure is so much from inside that we literally feel that we need to get out of our skin. It is the message lodged deep the nervous system that is doing it, mostly of not being loved or early trauma, a chronically depressed mother both while carrying and afterward, for example. Not being loved has always to do with not having needs fulfilled—from lack of oxygen at birth to lack of touch right after birth. There is a timetable of needs that form a critical window when they must be fulfilled. Once past that window needs can only be fulfilled symbolically. Feeling unloved cannot be eradicated in adulthood by more love. 

One way to rid of the feeling of being so anxious and agitated is to slow down or stop the transmission of messages between neurons (nerve cells) so that the message of pain (which stimulates) does not reach higher levels. We then feel calm even though a grand tumult is going on in lower brain centers. We never change the pain, only the appreciation of it. That is why we can take tranquilizers and pain-killers and feel good, but damage is still going on. No matter what we think or what we think we feel, it is an unreal state. In cognitive/insight therapy they change the way patients think they feel, not the way they really feel. To change the way they really feel means pain. If there is no pain there is no addiction or need for a drug that is calming.

The aim of therapy must be to establish fluid lines of communication among the levels of consciousness. This communication is a given when we have positive experiences from conception on. But when noxious stimuli--pain--intrudes, gating intercedes and blocks information between the levels. Communication is halted or misdirected, and one level doesn't know what's going on in the other levels. The true meaning of "holistic" is when all levels speak a common language and contribute their share to a single feeling. To make a patient whole is a desired goal so long as we know what that means in the brain. This is, grosso modo, the overall scheme, the goal of our efforts.

To be human means to be feeling. Inordinate, noxious input very early on provokes repression and blocks an aspect of feeling. Fully feeling beings are not blocked off from any aspect of themselves, that is, there is no massive gating that has sealed away major portions of brain function from access. Thus, each level of consciousness is able to contribute its share to an experience. This means being able to feel great joy as well as sadness. It means to sympathize and empathize. When a depressive tells us that he is not getting anything out of life, no interests, no joy, we know that he is carrying a load of repression and that repression is the underpinning of depression.

So what’s wrong with taking tranquilizers and pain-killers? Their primary job is to gate emotional pain. It keeps feelings unconscious. The result is that the cortex cannot signal emergency; thus keeping reactivity within bounds. The key here is that with pain-killers reactivity is blunted in order to save the system from massive over-reactivity (or occasionally, under-reacitivty). That reactivity, when enormous, can threaten one's life. This is what we see in our therapy when defenses are dismantled. Vital signs mounting to the danger area. Feelings are responding realistically to some unknown hidden force. If we do not acknowledge that force we are helpless before it. If we measure lower brain activity we will understand immediately; there is tumult going on below decks that we never dreamed existed. The ship is sinking; there is water below decks and we carry on as if nothing were happening. 

Quelling the deeper centers with drugs eases the so-called "thought" disorders. As our patients ease their defenses in a session, and great pain begins its march to prefrontal areas thinking centers, their cortex will ruminate about this danger or that until they actually lock into the feeling. In short, there is an anxiety attack as the system tries to stave off the approaching pain. Great terror pressing against cortical centers creates paroxysms of obsessive thoughts: "There's no space for me." "I am stuck and no one is helping." These often are birth statements. But because the actual feeling is so well buried, the person is left only with a vague anxiety. She will manufacture things to be afraid of but it is all a rationale. 

In the hierarchy of the nervous system the comparative force of imprints on the different levels diminishes as we move up the scale of evolution. Thus, something that happens at two months can alter the brain structure permanently, whereas if that same trauma, lack of touch, happens at age ten it will not produce serious brain impairment. There is clearly a timetable of imprints depending on the critical period; what characterizes the critical period is its irreversibility. Once the cortex is diminished it is not going to flower in adulthood. And the brainscans bear this out. There is less activity in the prefrontal area in certain impulse states. 

In our Attention Deficit Disorder research, hyperactive patients we have seen had elevated cortisol or stress hormone levels. (Our research in salivary cortisol, St. Bartholomew's Hospital, London) After reliving very early trauma, including the birth trauma, there is a normalization of cortisol levels. So dampening of pain is no longer necessary because the pain is gone—shorn of its original power it is now but a memory. 

Based on our own research, we can find no other explanation for chronically high cortisol levels other than the imprint. There is also a normalized brain system with a better balanced right and left hemispheres. 

We are all of one piece; part of an organic whole. Thus, we cannot isolate one factor, serotonin, or another factor, time off drugs, to make definitive statements about addiction. No can we attack only one aspect, lack of serotonin level, to achieve our goals. We need to attack the central organizing principle, and then the rest will take care of itself. The brain can no longer be considered an isolated organ encased in the cranium but must be considered part of an entire physiologic system. Thus, when the body is in distress, that distress can be found not only in the brain but in hormones and in the blood system.

It is our hypothesis that drug addiction is made up largely of early pain, i.e., lack of love, and that pain sets in motion its countervailing forces, namely repression. When repression is in place but faulty or failing, when the serotonin-endorphin systems are inadequate to the task, there is suffering and the need for outside help in the form of drugs to dampen that suffering.

Often the outside drugs utilized mimic the exact biochemicals we should produce internally, and that is what makes it so addicting; drugs are normalizing the system. We need them. We will go to any lengths to get them, even risking jail. The strength of internal imprinted pain can often be measured by its opposing forces--the repressive system. It is the dialectic again. Pain provokes its opposite and turns feelings into numbness. Then the person feels like she is in a bubble and cannot reach out of real life. It is all grey and dull. That is the price we pay for tranquilizers. Feeling no pain equals no life.

Turning Back Evolution

(Originally published September 4, 2008)

Primal Therapy is based on evolution. Further, it is also based on devolution. Are we nothing more than a time machine where we can visit our history in a precise way/ turning back the clock to a previously neutral non-neurotic state. Is that really possible? Scientists are now learning how to wind back the developmental clock—taking a skin cell, for example, and treating it so that it returns to a previously neutral uncommitted state. Once that is done it can be reprogrammed to become yet another kind of cell.

It is not such a big leap to apply that to humans, who after all, are but complex accumulation of microscopic cells. What may happen in our therapy is having patients go back and relive events that preceded and caused a neurotic deviation; going back to relive the great traumas, resulting in a return to a neutral state of internal harmony.Going back down the chain of pain to a physiologic memory of wellness and internal balance. It is evolution in reverse. We start out as a collection of uncommitted cells, finally resulting in a collection of different organs and brain neurons that have distinct and separate functions. In our therapy we go back and become our old shark/salamander selves (basic brainstem and limbic behavior). And then become our old Bonobo/chimp organism with its feeling brain, finally arriving at our late developing human selves. Those ancient brains still exist in all of us, performing different kinds of functions that finally add up to us humans. If we do not understand that we are made up historically of all those brains and focus only on the human thinking brain in psychotherapy, we can only get “well” in the thinking brain, excluding a vast treasure of lower brain experiences. In this way getting well on all levels of brain functioning is impossible. For example, we have found that high blood pressure and migraines often have pre-birth origins, imprints set down before we make our lives on this planet. If we do not address the brain that mediated life in the womb we cannot hope to make a profound change in these maladies.

If we want to eliminate ulcers and colitis we need to know where in the brain those responses are organized and return to that brain for cure. What we want to do is reprogram a neurotic brain system into a purer normal one. We want to lower brainwave amplitude and frequency to slower and lower levels, which we have done in our therapy. We cannot do that by making the thinking brain more active; the task is to make it less reactive while the feeling brain becomes more active. And now we know that the hyperactive prefrontal cortex can often be used to suppress the limbic/feeling output. So a busy intellectual brain can be seduced into thinking one is well, when all that has happened is self-delusion; a distanciation from feeling centers of the brain, and a flight to the thinking structures. In a psychotherapy based on language the most that can be expected is to run along superficial ideational tracks leading to other ideas, i.e., insights. The lower brains do indeed “speak” another language; and we must learn that language if we are to make deep, profound change. And obviously, we must not couch “cure” or “improvement’ simply in verbal language terms; we need to see what the body says about improvement. We need to measure the lower brain/physiological language, as well. It speaks in slower heart rate, in more natural killer immune cells and higher levels of serotonin. It speaks from experience; from experience mediated mainly by our non-human ancestors.

Not so oddly, new research is showing that as we search for an emotional memory our brains come to resemble the state it was originally. In other words, we go back to the brain originally involved in laying down the experience. We cannot do that so long as a therapist’s brain along with your brain is engaged in a badinage regarding present day events. We need a therapeutic setting that encourages reflection and introspection.

So what does devolution in therapy entail? It means, first and foremost, not to skip evolutionary steps. It means beginning in therapy with the most recent traumas and letting the vehicle of feeling carry us back in history to related earlier events. It means that in therapy we begin with the late brain neocortex and work back over time to preverbal life. It means not getting to infancy and pre-birth events until far into therapy. There are those who are re-birthers who help patients down into birth traumas long before the system can integrate them. The result is abreaction, going through the emotions of feeling without its full emotional content. It means descending down the chain of pain slowly and in ordered fashion, integrating feelings on each level. It means a basic understanding of neurophysiology so that therapists know what to expect on each level visited by the patient, and do not provoke a patient to verbally express a non-verbal feeling. It means knowing when a patient is ready for the experience of a deep early feeling, and when she is not ready. And above all, it means recognizing what a birth imprint looks like and what reliving it looks like. It means carefully titrating vital signs and seeing how they are affecting the whole organism.Finally it means not pushing patients to go somewhere when they are not ready.Reliving birth trauma and pre-birth trauma is not arrived at until late in therapy. For example, deeply depressed patients usually begin therapy in deep hopelessness and very low body temperature. We need to understand how to normalize that state and what kind of feelings the patient can accept. There is hopelessness on all levels commensurate with different brain systems. We may need to avoid deep level hopelessness until later in therapy.

When we finally arrive at birth events late in therapy we become more and more able to live in the present. That is what is meant by revisiting and reliving the past to insure the present. The deeper we go in history the less it has its grip on our current life—a pure dialectic. Therapies that focus on the present only insure that the past will remain entrenched. That is the meaning of freedom—to be liberated from our history.

On Appearances and Essences

(Originally published September 4, 2008)

Another way of looking at the difference between awareness and consciousness is that of appearances versus essences—of phenotype (appearance) versus genotype (generating sources). An approach of appearances is always individual while that of essences is universal, generating universal laws. Essence is stable while appearances are transient. Essence is historic; appearances are ahistoric. Essences are few; appearances are multitudinous – meaning an endless therapeutic search down the most complex, labyrinthine behaviors. Essences lead to consciousness, the confluence of lower centers with frontal cortical structures. Appearances lead to awareness without consciousness. Essences necessarily mean the understanding of concrete contradictions between the forces of pain and those of repression because that is the essence of the problem of neurosis. Essences mean dealing with quantities of hurt leading to new qualities of being. It means dealing holistically and systemically. Appearances mean fragmentation of the patient, isolation of her symptom from herself; treating the apparent. Progress in psychotherapy is couched in terms of appearances instead of essences; and therein lies the rub.

The reason the Freudians and other insight theorists do not generate universal laws is because they focus on appearances and not essences, on fragments not systems. I should say that sometimes they do posit general hypotheses but invariably they cannot be tested and verified because they have no scientific base. It is very difficult to compose a universal psychologic law from individual, idiosyncratic behavior that applies to one person only, or from an id or dark forces that no one can see or verify. Cognitive approaches seem to superimpose psychologic laws on humans—on (their) nature. By contrast, we believe that through careful observation we can discover the laws of nature and apply them to humans; after all, they derive from humans. Biologic truths are of the essence.

In Primal Therapy, we make every attempt to meld our observations and our own research and current neuro-biologic research. We do this by not having too many preconceived ideas about the patient, and maintaining an empirical attitude. We do not treat each symptom as an isolated entity to be eradicated. Rather, we know that there is an ensemble of symptoms tied together by something that links them. That “something” is what we must get at in therapy; it is of the essence. Thus, we need to see the whole, not fragments of behavior. To see the whole we need to investigate history which is the context for its understanding. We need to look beyond a phobia of elevators and see historic events (put into an incubator at birth, perhaps) that gave rise to it. The minute we are bereft of history we are devoid of generating causes, and therefore essences. We remain in the dark.

The Freudians claim to have a deep dynamic therapy but they stop at plunging the patient into old, infantile brains where solutions lie. They too rely on the here-and-now, on current ideas about the past. Reliving the past and having an idea about the past are not the same thing. One is curative; the other is not. One involves awareness, the other, consciousness. Even tears in psychoanalysis are derivative. There is crying about in their therapy: the adult looking back on her life and crying. But it is not the baby crying as that baby, needing as that baby, something deep that is beyond description that can go on for an hour or more. In “crying about,” there is never the infant cries that we hear so often in our patients—a sign of a different brain at work, a different brain system solving its problems in its own way. The patient in the here-and-now, ego-oriented therapies is walking around in his history while the therapist is focusing on the present. He may be physically present but his emotions are in the past.

What we discover about the cognitive/insight therapists and especially the televangelist psychologists is that they embrace old homilies, morality, and religious ideals that are in the zeitgeist, mix them into some kind of psychological jargon, and deliver them with a folksy air of, “I know what you need.” Too often it all amounts to: Get Over It! And we all shout, Yeah! For we too think others should just get down to business and stop whining. That is the George S. Patton syndrome. Develop a positive attitude and you won’t feel like such a loser. But it’s hard to feel that you are capable and can succeed when you have spent a lifetime with parents who reminded of what a failure you are.

Every insight therapy has the implicit base that awareness causes improvement. It is founded on the notion that once we are aware, we can make necessary changes in our behavior. Awareness can make us aware, and that is a positive step. But it cannot change personality, which is organic, and it can never make us conscious. We can be aware that we are too critical of our spouse. Maybe with effort we can stop that behavior. But if we understand the concept of the imprint, then we know that anything that doesn’t directly attack the imprinted memory cannot make a permanent change. We can be aware that we are working too hard and neglecting our family, but when there is a motor inside driving us relentlessly, that awareness is useless. Ideas are never a match for the strength of the brainstem/limbic forces, which, I remind the reader, have everything to do with survival. There is always a rationale for our behavior: “I have to be gone and work hard to support my family properly.” We have applauded this kind of neurosis in our culture, which adores hard work, ambition, and relentless effort. Being driven is about the most widespread of neurotic forms. If only we knew how to finish the equation: being driven by . . . (Answer: need). Translation: I was not loved in my infancy and I am in pain, which drives me incessantly. And besides, I can’t stop because my imprint at birth was that to stop was to die. I have to keep going to keep from feeling helpless, that there is nothing I can do. Those are the truths we find when we feel our imprints—the truths that when felt will stop our drive and allow us finally to relax.

Why is cognitive therapy so widespread today? To a large extent because it is far easier and quicker (and cheaper) to change an idea than a feeling. Insight and cognitive approaches tend to appeal to those in their “head”; this applies to both patient and therapist. Neither the patient nor the therapist is likely to realize the amount of history we are carrying around and how that affects our thinking. How else could we possibly ignore the horrendous things that happen to our patients in their childhood? Nowhere in the cognitive literature have I seen a discussion of basic need as central to personality development, of why the person cannot put the brakes on impulsive behavior. As I have mentioned, the ascending fibers from down below, starting from the brainstem and the associated limbic networks, alert the cortex to danger; they are more numerous and stronger and faster acting than the descending inhibitory fibers, which as we know come later in evolution. Here in purely neurologic terms do we see how feelings are stronger than ideas.

An early lack of love means that there is an even further degradation of these descending inhibitory systems, not only because of cortical weakness, but also because the limbic-amygdala forces holding the imprint are enormously powerful and are importuning the cortex to accept the message. The engorged amygdala is figuratively bursting at the seams to unleash its load of feeling. The dominant direction it can go is determined by evolution—upward and outward, impacting the frontal cortex. There is only one direction that repression can travel—and that is downward, to hold those feelings back. Ideas can help in that job just as tranquilizers can. I suspect that therapists who practice therapies that deny history, and deny imprints and biology, are drawn to such therapies, ironically, as a function of their own history. So long as the connection is poor and access impaired, the therapist is open to any kind of ideas that appeal to him intellectually. And what appeals to him intellectually is what is dictated by his unconscious. And that means that he might choose a therapy that operates on denial, such as the cognitive, because he operates on denial. He makes therapeutic choices that obey this dictum.

If a therapist, unconsciously, has a need for power, he is apt to dictate to the patient; it may be directions for living, relationships, choices, and, above all, insights. He will impose his ideas, his interpretation of the patient’s behavior. What he says will become the most important in his therapy instead of what the patient feels.

If the therapist has the need to be helpful and get “love” from the patient, he can act this out in therapy. I remember feeling my need to become a therapist and be helpful, trying symbolically to help my mentally ill mother to get well and be a real mother. No one is exempt from symbolic behavior. And it is certainly more comfortable for a patient to act out his needs and get them fulfilled (symbolically) in therapy, and imagine he is getting somewhere, than to feel the pain of lack of fulfillment. It is understandable that the idea of lying on a matted floor crying and screaming doesn’t appeal to some. Pain is not always an enticing prospect. Thus, the cognitive/ insight therapist can be similarly deceived and entangled in the same delusion as his patient: both getting love for being smart. It is a mutually deceptive unconscious pact.

Any time we are not anchored in our feelings we are up for grabs; any idea will do. It is good that the left frontal cortex is malleable, but bad because it is too malleable. It is the difference between having an open mind, and a mind that is so open as to be a sieve. The difference is having a left frontal cortex open to the right brain versus a mind too open to others and their suggestions precisely because it is not open to its better half. That is why a scientist can understand a great deal about neurology but practice a therapy that has nothing to do with the brain, which I have seen time and again—the bifurcation of consciousness. What he or she knows scientifically does not translate to the other side of the head because of disconnection or dissociation. He/she may be utterly aware and utterly unconscious.

In appearances, the therapy remains pretty much the same no matter what is wrong. The Freudians have a certain take on development and pathology. They will follow that irrespective of what is wrong with the patient, and it all adds up to insights and more insights. Other therapies specialize in dream analysis. They go on doing that without any proof of its efficacy other than patient reports. There are no physiological measurements. They neglect the fact that experience is laid down neuro-physiologically, not just as an idea; they neglect essences.

Think of this as magic: Take a tranquilizer and we can sleep better, avoid sleep problems, hold down acting-out, stop feeling anxious, be less aggressive, less depressed, stop bedwetting and premature ejaculation, and stop using alcohol and taking drugs. One specific pain pill can accomplish this universal task. Why? Because the essence, pain, is behind all of those disparate symptoms.

Pain will always remain pain no matter what label we pin on it or how we choose to deny it. Whether we feel ignored or humiliated or unloved, the pain is the same and processed by the same structures. The frontal cortex gives it different labels and we act out differently, but the centers of hurt treat them the same. Isn’t it strange that we use the same tranquilizer to ameliorate depression and children’s bedwetting? Maybe it is all one disease with different manifestations, and when we attack the generating source with drugs, all of the manifestations disappear for a short time. We need to learn from Prozac the most obvious lesson: It blocks all manner of symptoms. Therefore, if we, too, in a feeling therapy attack orchestrating forces, we can block and eradicate all of those different symptoms. Notice also that it is a nonverbal medication that slows down ideational obsessions. It tells us about the relationship of lower centers where there are no ideas to higher level thought processes, which deal with ideas.

In an anti-dialectic approach, which is that of appearances, there is no central motivating force. There is no struggle of opposite forces that move and direct us. It all remains on the surface—static. And because the approach does not contemplate the deep conflicting forces motivating us, there is no reason to delve into the patient’s history. It is all non-dynamic. Treatment based on dialectic principles means that there can be no ego or mystical forces that arise out of the blue, containing a mechanical, hereditary “given.” When the dynamics are left out, the therapy has no alternative but to be mechanical.

Because of an unloving, traumatic early childhood, a person cannot put the brakes on the amygdala or brainstem structures because he hasn’t the neurologic equipment; there is an impaired prefrontal cortex that does that. The cognitivist adds his frontal cortical weight to the patient so that their ideas, welded together, help control underlying forces. “You are strong. You can succeed. I will help you try. You just think you’re a loser but you are not. You are really a good person, not the evil one you think you are.” We see this in an experiment reported in a 2002 journal of Nature where electronic stimulation of the prefrontal cortex prevented rats from freezing up after they had been conditioned to do so at the sound of a tone (the one was paired with an electric shock). (FOOTNOTE: Nature (Nov. 7, 2002) When the therapist and the patient combine their thoughts in an insight session, it is no different from an electronic stimulation of that area. In short, it blocks the experience of terror and pain.

How is that psychologic notion different from the religious? The difference is that psychologists do not use the word evil; they call them negative forces. Shrunk to size, they are the same thing. And of course, the mass of current television psychologists are really televangelists in psychological clothing. They have wide appeal because they combine current religious precepts with psychologese (think Wayne Dyer). It doesn’t challenge anyone; it only confirms their prejudices. It offers cachet to them.

Then there are the drug therapies. Patients are given a variety of drugs for almost any condition. Talking to the patient is secondary. Patients are anxious—one type of drug. They are depressed—another type of drug. And, often the drugs have the same effect on the brain: killing pain. And if the drugs we give to patients do not work, we raise the dose. And if that doesn’t work we change drugs. Meanwhile there is no attempt to find out and address why they are depressed. Though we are trying desperately to find genetic causes, depression is not a necessary part of the human condition. 

A recent newspaper article described a woman who is suing her psychiatrist because her husband was suicidal and his doctor kept changing his medication. She said that it made him worse. The doctors were relying on appearances, not essences, and were possibly misled. She claims that no one talked to him. Here is a case where even a little talking and some sympathy would have helped. There is a place for it. Maybe drugs weren’t the answer. This approach saves the bother of having to deal with the patient’s history and his early life. It saves the troublesome effort of talking to the patient and feeling for his anguish. Just that, feeling something for the patient, can convey empathy and can be therapeutic.

Treatment that primarily involves giving drugs considers the patient as a “case.” There is no personal interaction after a few cursory questions. “Tell me about your symptom but not about your life. Tell me about it, not about you.” I have been in that position as a patient, seeing doctors who treat me as a “case.” It is not comforting. But then there are the economics. Seeing many patients every hour makes it difficult to empathize or to even know much about the patient. After filling out a long questionnaire, we find the doctor entering the treatment room scanning the file, unable to really take in the essentials about us. History is another victim in current therapy, both medical and psychological. Today, psychiatry has become an arm of the pharmaceutical industry. They tell us what drugs work and we use them. The insurance companies won’t pay for us to delve into the patient’s history, to take our time to find out about her. They pay for immediate results. The conclusion: We develop new therapeutic theories to accommodate the idolatry of the here-and-now intellectual, drug approach. We have ceded our integrity for pay. We don’t do it consciously, but we don’t feed our families if we don’t accommodate to the new reality.

Of course, cognitive approaches are ideal. Tell the patient, in essence, “get over it” and “thank you for coming.” In the new zeitgeist, the aim of cognitive therapy is to get the patient over it, not to understand basic dynamics. What is basic in man is his reservoir of pain and how it drives him to behave. Once we neglect basic need, we are thrust into awareness because it is the beginning and end of consciousness. We cannot see the reservoir when we focus solely on awareness. Therefore we cannot see the reason so many people on are drugs, both legal and illegal. We try to stamp out the need with words, but we will lose that war because need is stronger than anyone or anything. It will not remain suppressed. No one is stronger or brighter than her need because need is inextricably intermeshed with survival, and survival reigns. If we want to stop the demand for drugs we must attend to basic childhood needs, starting with the way we perform childbirth.

The Difference Between Awareness And Consciousness

(Originally published September 4, 2008)

The leitmotif of every intellectual therapy is that awareness helps us make progress. I’ll grant that awareness helps; but being conscious cures. Unless we are able to achieve consciousness in psychotherapy, the most we can do is tread water, having the illusion of progress without its essence.

When it comes to measuring progress in psychotherapy, it matters whether one measures the whole system or only aspects of brain function. Awareness fits the latter. It has a specific seat in the brain— Awareness and consciousness are two different animals. “Aware” and feelings lie on different levels. Awareness is what we often use to hide the unconscious; a defense. Awareness without feeling is the enemy of consciousness. What we are after is the awareness of consciousness and the consciousness of awareness. Not the awareness of awareness. When the patient is uncomfortable during a session, therapists typically take the position that “More insights is what we need. She is not aware enough.” But it is not the content of those insights that helps; it is the fact of the insight—a belief system that aids the defense mechanisms to do their job. Yet, what lies on low levels of brain function is immune to any idea. We can be anxious and aware but not anxious and conscious.

Psychotherapy has been in the business of awareness for too long. Since the days of Freud, we have apotheosized insights. We are so used to appealing to the almighty frontal cortex, the structure that has made us the advanced human beings that we are, that we forgot our precious ancestors, their instincts and feelings. We may emphasize how our neocortex is so different from other animal forms while we disregard our mutually shared feeling apparatus. We need a therapy of consciousness, not awareness. If we believe that we have an id stewing inside of us, there is no proper treatment because the cause is an apparition—a phantom that doesn’t exist. Or worse, it is a genetic force that is immutable and therefore cannot be treated. In any case, we are the losers.

There is no powerlessness like being unconscious; running around in a quandary about what to do about this or that, about sexual problems, high blood pressure, depression, and temper outbursts. It all seems like such a mystery. The aware person or he who seeks awareness has to be told everything. He listens, obeys—and suffers. Awareness doesn’t make us sensitive, empathic, or loving. It makes us aware of why we can’t be. It’s like being aware of a virus. It’s good to know what the problem is but nothing changes. The best awareness can do is create ideas that negate need and pain.

Awareness is not healing; consciousness is. True conscious-awareness means feelings, and therefore humanity. The conscious person does not have to be told about his secret motivations. He feels them and they are no longer secret. Consciousness means thinking what we feel and feeling what we think; the end of a split, hypocritical existence. Awareness cannot do that because awareness has to change each and every time there is a new situation. That is why conventional cognitive/insight therapy is so complex. It has to follow each turn in the road. It has to battle the need for drugs and then battle the inability to hold down a job and then try to understand why relationships are falling apart. This also explains why conventional therapy takes so long; each avenue must be traversed independently. Consciousness is global; it applies to all situations, encompasses all those problems at once. The true power of consciousness is to lead a conscious life with all that that means: not being subject to uncontrolled behavior, being able to concentrate and learn, able to sit still and relax, being able to make choices that are healthy ones, to choose partners that are the healthy ones, and above all, to be able to love.

By and large, “awareness” is left brain, but that does not necessarily mean language. Conscious-awareness is right-left brain working in harmony. Incidentally, a study out by two psychologists at UCLA, Eisenberger and Liberman, found that people who experienced less discomfort had more pre-frontal cortex activity. (FOOTNOTE: N.I. Eisenberger and Matthew D. Liberman, “Hurt Feelings,” Los Angeles Times, Oct. 11, 2002, page A16) Again, higher centers are able to suppress and calm the lower ones. They also found both physical pain and emotional pain use the same pathways in the brain. In brief, pain is pain no matter what the source—emotional pain is physical. It is not just in our minds; it is not just psychological and cannot be treated on the psychological level alone.

We know that when there is awareness without connection during a session—it is known as “abreaction.” The vital signs rise and fall in sporadic fashion, rarely below baseline. This is what often happens in the pseudo primal therapies where patients are told what and how to feel. Here the vital signs do not move at all. It is why we measure vital signs before and after each session. We measured a new patient who had mock primal therapy. He went through early feelings that looked real. His vital signs never changed, indicating an energy release but no connection. So long as there is no connection, nor a shift in brain processing from right to left, there will be no commensurate change in physiology.

This is not to be confused with appropriate emotions where a person is expressing anger over an injustice or grief due to the loss of a loved one. Those are appropriate feelings, not neurotic.

The right limbic brain/brainstem is responsible for a great part of our arousal, while the left-frontal brain is the calming agent. When there is hyper-arousal due to brainstem/ limbic unfulfilled needs and memories, the left orbito-frontal cortex can help dampen that arousal and produce a false sense of calm. This is one key element in cognitive therapy. Indeed, as I pointed out, one reason for the development of the left brain was to help in the repressive process; keeping enough pain at bay to allow us to function in everyday life.

It is my experience that the wider the gap between deep feeling and awareness, the greater the unreality of the belief system; the more remote the feeling, the more far-out the belief system, and the more tenacious its hold on us. We had one patient who was fixated on aliens coming from another planet to attack her. After many lesser-strength feelings, she finally felt what those aliens were—her alienated feelings; unknown terrors that she converted into attacking aliens. She needed to justify or rationalize her fears. Because they were so monumental, her beliefs soared into the bizarre area.

Consciousness is the end of anxiety. Consciousness means connection to what is driving us. Disconnected feelings are what drive us constantly to keep busy. Their energy is found in the form of ulcers or irritable bowel, in phobias and the inability to focus and concentrate. They are the ubiquitous danger, shaping a parallel self—a personality of defenses and the avoidance of pain; a self stuck in history forever. In effect, there is a parallel self, the unreal front; and the real self, the one that feels and hurts. Thus, there are parallel universes that make up the human condition; one that feels and suffers, the other that puts on a good front. The latter, the front, is what most psychotherapy deals with: the psychology of appearances versus essences. It is navigating in the wrong universe.

Awareness means dealing with only the last evolutionary neuronal development: the pre-frontal cortex. It is the difference between the top level versus the confluence of all three levels, which is consciousness. Once we are conscious, we have words to explain our feelings, but words do not eradicate them; they explain. We are deeply wounded long before words make their appearance in our brains. Words are neither the problem nor the solution. They are the last evolutionary step in processing the feeling or sensation. They are the companions of feelings.

There are types of awareness that are important for our survival. Being aware of a healthy diet is crucial even in the absence of consciousness. But a therapy of awareness versus one of consciousness has an important difference in terms of global impact. In science we are after the universal so that we can apply our knowledge to other patients. A therapy of needs can apply to many individuals (we all have similar needs); a therapy of ideas usually can only apply to a specific patient. When we try to convince the patient of different ideas (e.g., “People actually do like you”), we generate no universal laws. It is all idiosyncratic. But if we address the feelings underneath, we can generate propositions that apply generally: for instance, pain when unleashed can produce paranoid ideas or compulsions. Or, the frontal cortex can change simple needs and feelings into complex unrealities, changing them into their opposites.

One cannot be aware without an intact prefrontal cortex. By contrast, there is no seat of consciousness. As banal as it may seem, consciousness reflects our whole system—the whole brain as it interacts with the body.