Friday, July 31, 2015

On the Difference Between Abreaction and Feeling (Part 3/9)


 A Syndrome of Failure 


 When abreaction becomes an embedded groove, it’s like a hellish path to nowhere. It is a defense disguised as a feeling, so it creates no insights and produces no resolution. Instead, abreaction promotes recurrent act-outs that can get reinforced by repetition. When powerful first line is present it doesn't generate genuine insights. In fact it can give birth to fake or far-out "insights." That is the danger of so-called rebirthing therapy, which deliberately plunges patients into first-line pain out of sequence, when they are not ready for it. The technique overwhelms the integrating capacity of the brain and the patient is flooded with strange ideas and bizarre notions. Suddenly, he is “at one with the Universe,” or perhaps “merged with the Almighty.” And if the therapist is mystical, he may not find all this so strange. I have seen people who have gone to rebirthing centers and come to us pre-psychotic. (More on the dangers of rebirthing therapy in a moment.) In these cases, the sequence or order of feeling has been interrupted. The result is serious; we simply cannot order evolution around but rather, we must obey its dictates. Clinically, that means knowing how to identify the right feeling track for the patient and keeping the session on that track, a skill that is trickier than it sounds.


 Since abreaction is not curative, patients are trapped in a forever need “to feel.” Nothing is ever resolved so the pain is never felt or emptied out. Thus, in a very sinister way, abreaction can induce a recurrent neurotic behavior that mimics primalling. The pain is forever present, so people are more likely to be triggered. In fact, it is more present than before the abreactive process set in, because all these triggered feelings are called up into consciousness without ever being resolved. They are 'there" all the time, ready to be triggered again with very little provocation.


 Abreaction creates a closed circuit of pain, an endless loop travelled over and over whenever part of it is triggered. And every trigger – however different it might be – will bring up the same abreactive feeling: "I want to die. I am in too much pain. I want to die." It will not be attached to anything specific at any time and will remain a litany, or a series of sensations repeated forever. Like a starved monster, abreaction will swallow all these different triggers and feelings to incorporate them into the same loop of physical sensations and/or disconnected feelings. They are all processed by the same defense system. It is truly amazing to contemplate the brilliance of a defense system that can reroute painful feelings into abreaction in order for them – the feelings – to remain unconscious.


 Patients who abreact become very entrenched in their "primal” style and very resistant to admitting that what they are doing isn’t "the right way." And of course, they aren't open to change it. Why? First, because it means to them that they aren't doing their therapy right, a reaction associated with feelings of "I am wrong/bad." Secondly, it is hard for them to accept that all the time, effort and money spent for "feeling" was actually a waste. It is hard to accept that what they were doing was not good therapy and, in fact, might have harmed them.


 Another element that also makes the patients resistant to change is that abreaction can make them feel better temporarily. Indeed they have released some tension. However, they could run a few miles and have the same result, a false sense of relief. If the abreaction goes on for years, like in the case of people who self- primal for a long time, it may not be reversible: the grooves are too strong as they have become a neurological defense in and of themselves. Most of the time, this abreactive groove is powerful, persistent and deeply entrenched.


 I remember the case of a woman who had been self-primalling for about 20 years somewhere deep in a very remote part of the world.  Her style was a persistent screaming. That is what she thought the therapy – "The Primal Scream" – was all about. She could go on screaming for hours in a very piercing voice, at the top of her lungs. It was, of course, devoid of all real feeling, content, context, and resolution. She didn't know why or about what she was screaming; she had no memories attached to it. She did "feel" like screaming because "she was in so much pain." It was very hard to listen to, and totally unmoving. As we might expect, she never had any insights and wasn't getting better. Reversing that groove proved to be very difficult.


 Trying to stop a patient from abreacting and switch to a whole new way of "really feeling" the pain is usually a long and difficult conversion. That is because the defenses have been reinforced by the abreaction. So trying to get to these real feelings, with all their pent-up force, immediately summons the abreactive defenses created precisely to keep them at bay. The patient is pulled into the abreactive neurological groove, where they feel comfortable. Trying to reverse the pattern can be even more painful than in the regular process of tearing down defenses in therapy. Some patients have never been able to finally annihilate the abreactive trend, so sadly they never get better.


 Ultimately, the clinical outcome of abreaction is a syndrome of failure. No insights, no resolution, no getting better. Same act outs, same symptoms, sometimes getting worse. Mostly the tragedy in abreaction is that the patient is going through all this agony forever and with no pay off.


 In contrast, real feelings don't need to be felt forever, there is an end to them. In Primal, beyond a certain amount of feelings that had to be experienced over and over for a while – depending on how much pain was attached to them – the need to feel decreases with each felt feeling until, at some point, we hardly ever have to "feel" the old pain again.

Wednesday, July 29, 2015

The Sensory Window Has Closed


I feel that I have to bang on about the sensory window because it has only a brief lifespan.   That is why Marilyn Monroe was always headed for disaster.  All the adoration in the world was not enough; the expanse of her deprivation equaled her massive need for so-called love. And it could never be fulfilled because the sensory window had close years before.   So without knowing it she settled for applause, adoration, interest in her by world leaders and publicity without end.  And still she took painkillers by the truckload.   You can never love neurosis away. And all those substitutes for what looks like love are just that: substitutes.  They are symbolic and never fulfilling except for the moment, which is why there needs to be more and more.  And it can never be enough because the exigencies of the need, its asymptote, have faded away, buried with gates shut.

What we can do is offer enough caring and support to keep the pain at bay and well hidden.

So what does this mean in human terms?  That the open sensory window when need can be fulfilled has a brief short-life. That once it closes, the symptoms will go on and on.  For example, high blood pressure or migraines.  When they are of first-line brainstem origin, once the gates are locked we cannot cure the affliction; we can only ameliorate the expression of the symptoms.  There is no cure because nothing can penetrate to make a difference.   That is why addiction to heavy drugs is so unyielding and obdurate.  Once the imprint is locked-in there can be be no change;  the gating system makes no exceptions and has no mercy.   It is indifferent to other than its key task: to keep pain subdued.  Here biology dictates.  It keeps pain down so we can go on living and producing.  It makes life bearable.  And this is why all of the so-called rehab centers fail.  They dance around the expression of the pain without ever delving deep down into it.  They make the patient feel safe and protected for the moment, but that is the problem. It is momentary.

Until we recognize and accept the powerful force of the gating system we go on trying to do the impossible. Marilyn had the adulation of tens of thousands but when she came off stage she swallowed dozens of painkillers. Clearly symbolic love was and is evanescent.  There was the perfect example that we cannot touch emotional deprivation once the gates are closed.   She could say a thousand times, “I want to get off painkillers” but ideas and desires are cerebral and are no match for deep imprints.  This is assuming that she knew that she was in pain and that she knew where the pain came from.   It is never so obvious.   And even a therapy such as Primal is no match against the imprint unless the therapy takes place in-house where the patient can be watched and controlled.

That is why an addict needs a nonverbal approach, pills, and sadly, electroshock therapy.   We somehow need to get below the top verbal level into the strictly biologic.  I am not sure the exact length of the open sensory window but it matches the time when the need is at its height.  A mother who falls ill during the birth process cannot come back six months later and love the child daily and expect everything to be fine. There will be a residue of pain.  And to make clear, the deprivation of basic need produces unimaginable pain.   Of course her love will make an important difference but it may not eliminate the residue of suffering left inside the baby while the mother was away at a hospital. And this is what is diabolic about the human condition.  Parents can be loving but due to no fault of their own they have left a grain of pain that lingers.
The mother cannot nurse due to a whole host of reasons or she cannot be attentive because, alone, she has to go to work to help feed her baby.  The reasons are infinite but they still spell pure pain.   And that pain is a warning that there is unfinished business to be dealt with.  And wonderfully, it gives us the means to undo aspects of the imprint and allows us to have the means toward normalcy. It says, “deal with this and maybe you can be normal again and get rid of your addictions and compulsions.”  It is not a false promise; it is the promise  kept alive by our biology.

It does not give us a potpourri of choices, however.  It says we must return to the sender; the sender of pain by the imprint.  It is a narrow promise but one of great hope for our stability in life.  It says, pay attention, there is real hope. And one day as our research into deep imprints continues we may find that this is true of serious diseases such as cancer and diabetes, of dementia and Alzheimer’s disease.   The reason these diseases have been so recalcitrant is that we have focused on the wrong thing; the symptoms the diseases gives out, and ignoring solidified imprint.
Why?  Until now we could not see it.  Now we can and as a therapist who has been there, I can deliver the key notes from the underground the accompanying maps, that may pave the way for cures.


 

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