Monday, March 19, 2018

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.

Monday, March 5, 2018

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.

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.