Sunday, February 18, 2018

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.

10 comments:

  1. Coinidentally, I´ve been thinking recently about how my entire childhood was one of appearances, and how everyones feelings, or essences, were kind of censored out: forcibly repressed or denied, by my afraid parents.
    They were just little kids totally unable to cope with the mass of their own feelings which would have been triggered by allowing the "essence" of their three children, the truth, to show through. Their need for approval caused them to make us perform (appearances) for their friends and family.
    The performance was a front hiding the truth: their childrens unmet needs and painful feelings. And it hid my fathers chronic and ruthless bullying of my elder sister, with the complicity of my mother, resulting in my sisters admission to a residential psychiatric hospital age 16.
    As I grew up, I wanted desperately to believe in the "appearance" of a fun loving, free and easy family, but my "essence" was so strong that I had become a hollow shell, the "fun" and "laughter" no more than an act, the suffering within immense.
    after 3 years at college, aged 20, I returned "home", in retrospect in a futile attempt to recapture a childhood which, unknown to me, had never existed. Myself, my parents and my brother all continued the "appearance", or the charade, the LIE.
    The truth always shows through, in illness, in moodiness, in some sort of abuse, in violence. In some way. Back at home, my mother would keep showing old slides of when we were children (only a few years previously). I saw the images, yet, even by ag 20, could not FEEL anything. The images were inert, dead.
    When my sister was admitted to "the loony bin", I was just 14. I remember my grandparents coming for the customary sunday lunch soon afterwards, and we all, them, my parents, my brother and myself, all sat in almost total silence around the dining table. That silence was deafening. The "appearance" had become a total charade, close to collapse. Suddenly, I completely broke down and rushed from the table in tears to cry my heart out in the adjoining lounge. I returned a few minutes later to a few comments from the adults such as "I dont know what´s the matter with him". Later that mealtime, my mother did exactly the same. The "essence", the TRUTH, was erupting and smashing the "appearance".
    Looking back, I realize now that my memories are mere images, and there are no feelings attached. The "appearance" is still desperately held onto by my elderly parents and younger brother, all of whom arte pyhsically ill in some way. Myself and my sister have long allowed ourselves to accept the validity of what truth we have been faced with regarding our past. We have allowed ourselves to be depressed, to cry, to feel sad, to act out in ways unacceptable to my parents and brother. And neither of us suffers from any sort of physical illness. Gary

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    1. Hi Gary,

      Your words pretty much reflect my upbringing too. Uncannily similar for many people in UK and other 'apparently' sophisticated and 'well adjusted' societies.

      Paul G.

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    2. Thanks for re posting this amazing piece France.

      Possibly the best essay Art ever wrote, it says it all and it needed to be said like that, just like that.

      Paul G.

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  2. Hi,
    having had time to digest this excellent essay and Gary's very touching response I am now compelled to say something I have become sick of which resonates with all this.
    Once people gain power they more often expect, even demand the loyalty & essence of others, particularly at work, but all they want to see and hear are our appearances. Personality becomes the key. All that is needed from us in this 'unholy contract' is our good behaviour & productive performance. But what cost is there to act out this psychological division to us the actors? We turn up to relate, to do our bit, to be 'essentially there for the other', our boss, our partners or whoever, yet we are ultimately exploited for something cheaper.
    It seems so many work situations and nearly as many relationship situations demand a false response to an essential need.
    Then, far more insidiously, over time that dubious 'reduction' of our essence into the personal gain for someone else (hopefully for us too, but so often not so much for us at all), that reduction becomes the new essence. The truth gets written by a reductionist process and history ends up in no way reflecting real events. Further on down the line of so called history education we discover nothing more than gossip and outright lies. But if the majority of people believe those lies then those lies become the truth. Essence becomes utterly usurped by appearances.
    You may say I am a negative man for speaking this way, maybe I should get a positive attitude on and move into a different job. Of course; and I will, when I am ready.
    I have found that getting in touch with my real feelings has gradually developed in me, an inner being that cannot easily be manipulated anymore, or at least an inner being that tolerates consciously the unconscious ill will & stupidity of others, most of all my own ill will and stupidity. I can see the truth, the lies, my collusion with it and how to extricate myself. All this from touching true feelings, over time. Therefore there is one single human truth, a guiding historical fact in my life: It is that my true feelings, over the years have gradually built bridges across that essence/appearances gap. Those bridges will lead me into relationships with other similarly feeling people and away from those who simply don't care.

    I have Art & France and others on this blog to thank for that.

    Best Regards to all,

    Paul G.

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    1. I understand all this Paul. You write clearly and powerfully.

      Perhaps the fake world of the fashion industry is the most extreme example of appearances elevated to the heights of super importance.

      A point made decades ago by Art was that apparently (there´s that word again) virtuous, upstanding pillars of the community were always found, in Primal therapy, to hide the craziest secrets.



      But I concluded myself that those presenting the most virtuous front in any social milieu, are most likely to be hiding something. I think they need the social approval of others to make them feel better about themselves

      Many people here will have read the harrowing autobiographical books of David Pelzer, whose unspeakably abusive childhood at the hands of a psychotic mother is officially recorded as the worst case of sustained childhood abuse in the history of California

      His mother put on an extremely virtuous front for social workers, teachers and police. In some ways, his descriptions of his childhood and the appearance/essence duality felt disturbingly close to my own....

      And like so many children, I somehow censored out years of sadness, years of abuse, and even at age 31, when I finally read Arts books, I still believed by mother was an angel.

      I repressed the truth, and swallowed the lie

      And so many of us do this, that we continue to be fooled by those in power as adults. And you try to open peoples eyes and they refuse to look because, I guess, the same mechanisms keeping their childhood agony repressed are those keeping them from seeing the pain around them: in children at home and at school, in their partners, in animals.

      And so the leviathan marches on...

      Gary

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  3. Essence and appearance, well...everyone is different; feels differently, thinks differently, physical systems are different. At the time when I was growing up, family events I was in "awe" of (didn't know really what to make of them, didn't know if they made me nervous, feeling awkward, or feeling just passive ...but I didn't show these feelings too much; I just didn't say too much at all ; which was totally accepted, and when I turned 20 , looking back on the family events ; I always tell my parents I was thankful that they brought me to them, because in reality, I did enjoy them and had a good time; always being with Aunts, Uncles, cousins, brother and sister. I would hardly say anything at these events (who knows why....maybe I was waiting for some disaster to happen; which never did). To this day, looking back on these family events; I still always say it was worth my while and I had a great time (maybe I couldn't grasp what was happening at the moment which is why I didn't say too much; but by the time I was 20, I knew they were good times and I loved my family; always enjoy being with them.

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  4. beachcoast7
    I think you were lucky with the family you had if you feel like that about them. There were no appearances with mine, my father, mother and three sisters. I took all their anger and hate for everything that happened as the family scapegoat and they didn't even bother to keep up appearances.I took all the violence from my father almost every day. His misdirected anger towards his mother. Total and extreme neglect from my mother who, even on her deathbed told my older sister that I would always be a problem for the family. None of my three sisters protected me from my father's violent temper though I screamed for help to my mother. Of course this only happened when guests were not in the house. We lived in a pleasant surrey neighbourhood. My best friend used to tell me that she heard my screams all the way down the road where she lived when my father, for no reason lost his temper. Only a whispered word like blast under my breath brought his physical violence on me and he used to pant with his totally out of control anger. My sisters were often sadistic. So it seems I suffered their essence continually and to some extent I still do. I wet the bed as a child and walked in my sleep. In fact I would have been much less scared if they had been a family that put on a polite appearance. but no, my whole childhood and early teenage years were truly terrifying times. But, this is a wonderfully truthful and clever piece of writing from Art. I wish he was still around. Sandie.

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    1. Hi Sandie,

      I just cannot begin to fathom how you survived. As a chronic depression / ptsd sufferer, my heart goes out to you. It's been said that some children fared better with violence (and open violence) because it was better to get some 'stimulation' than none at all; and better that it was open and not hidden. For me my abusers hid their abuse and lied about it. I have tended to become bullied and exploited ever since, believing the lies and persuasion I have encountered from people who want something from me. I have at last realised I keep falling for 'charm & bluster', which is a commonly accepted and acceptable 'appearance', so often concealing something darker. I hope you are recovering. I miss Art too.

      Paul G.

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  5. Without love we can not live... we do not even know we exist. We live in a symbiosis with what we think it is to live. We have nothing else... no reference to anything else. We are like a drawing without its depth of field... flat and squeezed without the opportunity to step out of the picture we have about ourselves. Without love we can not live!

    Frank

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  6. Hallo, Paul
    Just read your comment and thank you very much for it! I think the open violence is perhaps more dangerous because as a child I never knew if he would go the whole hog in one of my father's tempers and actually kill me. Strange but I adored him, despite it all. I was a 'dad's girl'. The love of a child for his or her parents is the most unconditional love of all. I've written a poem about it. My dad became religious, a hell fire Methodist. I was the devil for asking why. I have a deep mistrust of religion. A series on t.v. in England has shown the 1970's Rajneesh Baghwan cult in America. Crazy! He bought 93 Rolls Royces from the money he made out of his cult. How could young people be so gullible. Glad it never happened to you or me. Stay well, Paul! Sandie

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Review of "Beyond Belief"

This thought-provoking and important book shows how people are drawn toward dangerous beliefs.
“Belief can manifest itself in world-changing ways—and did, in some of history’s ugliest moments, from the rise of Adolf Hitler to the Jonestown mass suicide in 1979. Arthur Janov, a renowned psychologist who penned The Primal Scream, fearlessly tackles the subject of why and how strong believers willingly embrace even the most deranged leaders.
Beyond Belief begins with a lucid explanation of belief systems that, writes Janov, “are maps, something to help us navigate through life more effectively.” While belief systems are not presented as inherently bad, the author concentrates not just on why people adopt belief systems, but why “alienated individuals” in particular seek out “belief systems on the fringes.” The result is a book that is both illuminating and sobering. It explores, for example, how a strongly-held belief can lead radical Islamist jihadists to murder others in suicide acts. Janov writes, “I believe if people had more love in this life, they would not be so anxious to end it in favor of some imaginary existence.”
One of the most compelling aspects of Beyond Belief is the author’s liberal use of case studies, most of which are related in the first person by individuals whose lives were dramatically affected by their involvement in cults. These stories offer an exceptional perspective on the manner in which belief systems can take hold and shape one’s experiences. Joan’s tale, for instance, both engaging and disturbing, describes what it was like to join the Hare Krishnas. Even though she left the sect, observing that participants “are stunted in spiritual awareness,” Joan considers returning someday because “there’s a certain protection there.”
Janov’s great insight into cultish leaders is particularly interesting; he believes such people have had childhoods in which they were “rejected and unloved,” because “only unloved people want to become the wise man or woman (although it is usually male) imparting words of wisdom to others.” This is just one reason why Beyond Belief is such a thought-provoking, important book.”
Barry Silverstein, Freelance Writer

Quotes for "Life Before Birth"

“Life Before Birth is a thrilling journey of discovery, a real joy to read. Janov writes like no one else on the human mind—engaging, brilliant, passionate, and honest.
He is the best writer today on what makes us human—he shows us how the mind works, how it goes wrong, and how to put it right . . . He presents a brand-new approach to dealing with depression, emotional pain, anxiety, and addiction.”
Paul Thompson, PhD, Professor of Neurology, UCLA School of Medicine

Art Janov, one of the pioneers of fetal and early infant experiences and future mental health issues, offers a robust vision of how the earliest traumas of life can percolate through the brains, minds and lives of individuals. He focuses on both the shifting tides of brain emotional systems and the life-long consequences that can result, as well as the novel interventions, and clinical understanding, that need to be implemented in order to bring about the brain-mind changes that can restore affective equanimity. The transitions from feelings of persistent affective turmoil to psychological wholeness, requires both an understanding of the brain changes and a therapist that can work with the affective mind at primary-process levels. Life Before Birth, is a manifesto that provides a robust argument for increasing attention to the neuro-mental lives of fetuses and infants, and the widespread ramifications on mental health if we do not. Without an accurate developmental history of troubled minds, coordinated with a recognition of the primal emotional powers of the lowest ancestral regions of the human brain, therapists will be lost in their attempt to restore psychological balance.
Jaak Panksepp, Ph.D.
Bailey Endowed Chair of Animal Well Being Science
Washington State University

Dr. Janov’s essential insight—that our earliest experiences strongly influence later well being—is no longer in doubt. Thanks to advances in neuroscience, immunology, and epigenetics, we can now see some of the mechanisms of action at the heart of these developmental processes. His long-held belief that the brain, human development, and psychological well being need to studied in the context of evolution—from the brainstem up—now lies at the heart of the integration of neuroscience and psychotherapy.
Grounded in these two principles, Dr. Janov continues to explore the lifelong impact of prenatal, birth, and early experiences on our brains and minds. Simultaneously “old school” and revolutionary, he synthesizes traditional psychodynamic theories with cutting-edge science while consistently highlighting the limitations of a strict, “top-down” talking cure. Whether or not you agree with his philosophical assumptions, therapeutic practices, or theoretical conclusions, I promise you an interesting and thought-provoking journey.
Lou Cozolino, PsyD, Professor of Psychology, Pepperdine University


In Life Before Birth Dr. Arthur Janov illuminates the sources of much that happens during life after birth. Lucidly, the pioneer of primal therapy provides the scientific rationale for treatments that take us through our original, non-verbal memories—to essential depths of experience that the superficial cognitive-behavioral modalities currently in fashion cannot possibly touch, let alone transform.
Gabor Maté MD, author of In The Realm of Hungry Ghosts: Close Encounters With Addiction

An expansive analysis! This book attempts to explain the impact of critical developmental windows in the past, implores us to improve the lives of pregnant women in the present, and has implications for understanding our children, ourselves, and our collective future. I’m not sure whether primal therapy works or not, but it certainly deserves systematic testing in well-designed, assessor-blinded, randomized controlled clinical trials.
K.J.S. Anand, MBBS, D. Phil, FAACP, FCCM, FRCPCH, Professor of Pediatrics, Anesthesiology, Anatomy & Neurobiology, Senior Scholar, Center for Excellence in Faith and Health, Methodist Le Bonheur Healthcare System


A baby's brain grows more while in the womb than at any time in a child's life. Life Before Birth: The Hidden Script That Rules Our Lives is a valuable guide to creating healthier babies and offers insight into healing our early primal wounds. Dr. Janov integrates the most recent scientific research about prenatal development with the psychobiological reality that these early experiences do cast a long shadow over our entire lifespan. With a wealth of experience and a history of successful psychotherapeutic treatment, Dr. Janov is well positioned to speak with clarity and precision on a topic that remains critically important.
Paula Thomson, PsyD, Associate Professor, California State University, Northridge & Professor Emeritus, York University

"I am enthralled.
Dr. Janov has crafted a compelling and prophetic opus that could rightly dictate
PhD thesis topics for decades to come. Devoid of any "New Age" pseudoscience,
this work never strays from scientific orthodoxy and yet is perfectly accessible and
downright fascinating to any lay person interested in the mysteries of the human psyche."
Dr. Bernard Park, MD, MPH

His new book “Life Before Birth: The Hidden Script that Rules Our Lives” shows that primal therapy, the lower-brain therapeutic method popularized in the 1970’s international bestseller “Primal Scream” and his early work with John Lennon, may help alleviate depression and anxiety disorders, normalize blood pressure and serotonin levels, and improve the functioning of the immune system.
One of the book’s most intriguing theories is that fetal imprinting, an evolutionary strategy to prepare children to cope with life, establishes a permanent set-point in a child's physiology. Baby's born to mothers highly anxious during pregnancy, whether from war, natural disasters, failed marriages, or other stressful life conditions, may thus be prone to mental illness and brain dysfunction later in life. Early traumatic events such as low oxygen at birth, painkillers and antidepressants administered to the mother during pregnancy, poor maternal nutrition, and a lack of parental affection in the first years of life may compound the effect.
In making the case for a brand-new, unified field theory of psychotherapy, Dr. Janov weaves together the evolutionary theories of Jean Baptiste Larmarck, the fetal development studies of Vivette Glover and K.J.S. Anand, and fascinating new research by the psychiatrist Elissa Epel suggesting that telomeres—a region of repetitive DNA critical in predicting life expectancy—may be significantly altered during pregnancy.
After explaining how hormonal and neurologic processes in the womb provide a blueprint for later mental illness and disease, Dr. Janov charts a revolutionary new course for psychotherapy. He provides a sharp critique of cognitive behavioral therapy, psychoanalysis, and other popular “talk therapy” models for treating addiction and mental illness, which he argues do not reach the limbic system and brainstem, where the effects of early trauma are registered in the nervous system.
“Life Before Birth: The Hidden Script that Rules Our Lives” is scheduled to be published by NTI Upstream in October 2011, and has tremendous implications for the future of modern psychology, pediatrics, pregnancy, and women’s health.
Editor