On Training in Psychology and Psychotherapy

I have two advanced degrees in the field of mental health. Despite about 12 years of university I learned almost nothing about how to do therapy. It was always hit and miss, never a science. It was “do what you feel comfortable with,” which is a license to do terrible stuff. Since neurotics are comfortable with neurotic goals and neurotic techniques; witness cognitive therapy, intellectuality raised to the level of a principle. Head lucubrations converted to a theory. The training was useless and meaningless and could help no one. Why? Because it was not and never was a science with testable hypotheses that one could suss out and discover things that would enhance our techniques.

I was also trained, a residency, at the Freudian clinic of the west, a sort of Meningers on the west coast. Also useless. I never learned a single scientific principle, nor how to put the therapy to the scientific test. The reason was there was no science and still is not: except, primal therapy. When I do training all of my advance therapists know the minute a mistake is made; it is that precise. And we do training in science as well so that we are all aware of the scientific method. Our training never stops. It goes on for years because there is so much to learn. We have done several double blind studies in Europe on our patients; and what did I discover? No one cares. It is the syndrome, “I won’t believe it even if you prove it.”

Is this sour grapes? Maybe, but when trying for research funds we are always turned away as unscientific.

Our patients are always our scientific subjects. We do vital signs before and after each session. I have written earlier on my blog about their importance. We have studied the immune system, the brain function, the inhibitory/serotonin system, and on and on (see Primal Healing for a discussion of all this). But for those shrinks who are left brain the greatest voyage they are ever going to make is to the right brain, and alas, they cannot do it. No one can do it voluntarily. We need to open the gates between the hemispheres and that takes time and serious scientific therapy.

We try to make sure that our therapy coincides with current physiology and neurology; you will see that I write a lot about that. Because we cannot concoct a psychotherapy that flies in the face of how the brain works; for example, believing that ideas change feelings, when it is just the opposite that is true. We have spent something like one million dollars in scientific pursuits, often using outsiders who have no idea what we do. But I am convinced that you cannot “prove” our therapy but these facts alone. It has to hit you in the gut. And who does it hit there? Those who suffer. Those who are close to feelings. Those who cannot make it, who are constantly depressed and anxious. They understand my theory right away and come from 26 countries for the therapy. I am not sure I would read a book by a curly haired shrink and travel 10,000 miles for help. But they do and they get help. They do not care about statistics. They care about their feelings and their misery. We are the therapy of last resort, a therapy of misery where patients can finally let their misery out. Almost every single therapy extant works to push back feelings. Isn’t that strange? Feelings need to be expressed and they push them down. The result is more depression and anxiety, more not getting along with others, more dysfunction and later, more serious disease. And worse, they have the statistics to prove their case because it is all in the definition of what is success. And if they say better social adjustment and self-described feeling better, then you cannot beat that. Because nothing is as infinite as self-deception.

More on Psychosis

How do you know when someone is crazy? Not easy because we can all go crazy in different ways. If that is so then how can we possibly define it. And, as I often say, someone can go crazy to keep from being insane. This is not just a joke but a truism. Let me explain. What psychosis is about generally is when the first line (in my lingo) moves into the third line. When deep pain and remote trauma occupy the thinking, present day frontal cortex. When the inhibitory gates are so leaky that traumas in the womb, at birth and in the first year cannot remain repressed but instead move higher in the brain and interfere with present-day functioning. Those events are so shattering that sometimes they cause aberrant ideation, paranoia, and bizarre beliefs. But those ideas and beliefs are relating to the traumas; that is, they arise out of them, so that these beliefs have been formed out of the sequestered pains, however remote.

Psychosis and neurosis are not different diseases, psychosis is the more heavily loaded pain affliction causing exaggerated beliefs and reactions: pounding a door shut with nails to keep the devil’s rays from penetrating the brain. What happens is that the heavy-valence early traumas are the kind of events we cannot see yet are the predominant factor in later psychosis. It is the result of preverbal events that provide a shaky couche upon which later events are compounded. They are so severe, near-death experiences that the gating system is weakened; and by that I mean that among other things, they put such a drain on the inhibitory chemicals in the brain that we are chronically deficient in them; hence leaky gates. It doesn’t take much neglect or loss of love later on to overwhelm the gating system completely leading to psychosis . And when a stressor such as adolescence occur there is apt to be a frank outbreak of psychosis because the body, already in turmoil due to hormones, is weakened again by raging hormones.

Because the early imprints are most often of near-death experiences when they provoke paranoid ideation it is nearly always to do with death; someone is after me and is trying to kill me. Or they are shooting rays into my head. Or they are poisoning my coffee. There is an immediate threat which forces the person to wear aluminum foil on his head to ward off rays from the helicopter above. Logic is out the door as the cortex strives mightily to concoct a rationale for the upcoming pain. In the person’s mind that rationale makes sense since the feeling he is dealing with seems very real to him. “They are trying to hurt me,” is the leitmotif from perhaps a birth experience so terribly painful and hurtful that thinking someone wants to hurt us makes sense. It is the first terrible experience occurring to the baby who has been comfortable in the womb. He is suddenly plunged into a pain that is excruciating but for which he has no scenes or explanation since he had no words nor capacity to produce scenes at the time. So of course it is bizarre since it is an event that never had words nor understanding.

So the paranoid has to compile a complex reason for what he is undergoing. Sounds crazy and it is. He is going crazy to keep from being insane. That is, he is keeping much of his cortex intact with a set of compartmentalized, cohesive ideas but so he can function. If the early pain is catastrophic it might completely overwhelm the neo-cortex and we get a babbling idiot who cannot function at all. In this sense psychosis is a defensive measure against complete mental collapse; meaning the kind of person who enters a school house and kills fourteen people. His past became his present. There was nothing left in his brain to inform him of the different between past and present.

In a sense, neurosis/psychosis is the difference between a dream and a nightmare. Dreams weave acceptable stories that are ego-syntonic. Psychosis produces stories that are ego-dystonic. Still they both attempt to ease, filter and defend against the pain. The source of the pain and its force may be the critical difference.

So how do we know that this is true? When those who had horrific birth, gestational and infantile life approach those imprints in my therapy they can undergo transient psychotic episodes. When they approach not-so-devastating events they do not go crazy. But we have to be careful because putting a fragile person into very early horrific imprints can be dangerous; and it can be lasting if the therapist does not know what she is doing.

A paranoid belief is at least a structure that keeps the psyche from fragmenting into pieces so that a person can function and repair bicycles during the day. I had one patient who was a knife sharpener; completely delusional, and yet housewives would let him in their living rooms and kitchens to sharpen knives.

The stuff of psychosis is the same material from which our brains make nightmares. They are the intrusion of very early womb/life events into the top level brain that produces ideas and some scenes to go with them. One classic one: I am in a washing machine whirling around and drowning and I am going under and cannot stop myself or the machine. His primal was of being the womb, thrashed about, drowning and feeling powerless against it.

We all go crazy or become neurotic in different ways. It depends on so many factors: where we grew up, in institutions or foster care, during war time or not, how anxious or depressed was the carrying mother, etc. These are all influences but the amount of pain and how early it started largely determines psychosis or neurosis. There is in my opinion nothing more psychotic-making than incest. I have rarely seen an incest victim who was not pre-psychotic. It depends on how early it started but when the person who is supposed to protect you becomes the danger it is crazy-making.

So what does the anti-psychotic medication do? It is largely a first-line blocker. It holds down the pain of those very early traumatic imprints. And when effective there is much less paranoia and bizarre behavior. All this means is that someone with heavy early pain needs massive painkillers to keep it all in check because those same imprints depleted the inhibitory, repressed chemicals that we produce ourselves. The levels were permanently suppressed. When early pains occur they affect the production of serotonin (think Prozac). Later that is exactly what needs to be added to the mix to keep the pain down. Ideas do help produce those chemicals, as well; so in a way, delusions are pressed into service to help secrete pain killing chemicals. The system is always trying to right itself; to normalize. Most of what we do and what our bodies do is a constant attempt to achieve normalcy. That is, to function, protect ourselves and our loved ones. Normal means survival in every way. Our physiology when normal lets us live a longer life. We do not fall so easily into disease. And in my books I have quoted study after study that shows how early trauma leads to later cancer and heart disease.