Friday, March 6, 2015

Is Drug Addiction a Disease?



No, but we often treated as a disease.  So what’s the disease?  The changes in our neurobiology that cry out for the disease.   What?  Addiction is not the disease; what it really is something we use to calm the disease;  a little help from our chemical friends.   Enter pain killers, alcohol,  sweets and on and on.  They step in to help the brain suppress the pain, the need and the agony.  And since we go on treating the wrong thing as The Disease, we never find a solution.  So Heroin use is not an addiction?  Of course it is, but addiction is not to be conflated with disease.  It is the poor man’s attempt at a solution; doing what he possibly can to soothe and calm.

What is the disease?  Thwarting of need, leaving it unfulfilled, to hang there gnawing away at so many of our systems, doing damage.  The system cannot develop properly with many biologic systems unfulfilled and so it accommodates, and alternates, and deviates until  we may have too much or too little cortisol, serotonin,  immune cells, etc.  There is where the disease lodgers itself well hidden and out of the way.   So what do we do?  We treat the symptoms of the disease and it is an endless task because so long as the real disease is untouched there will always be symptoms.   Unless, the “therapy” is successful, and the drugs the doctor give us drive down the symptom and make it disappear.   Herein lies the key difference between a symptom of disease and its origin.  Why do we keep on treating the wrong thing, year after year, hoping and praying for a different outcome?.....a cure.  And why is it so elusive?  We are chasing the wrong dog.   And that is why all those helpful ploys offered by so many experts give therapies that make us come back over again.  Out of sight out of mind?   No.  Out of sight held captive by the mind.

I read many scientific journals and recent one is about addiction, (Science News, March 2014.  The Addiction Paradox).  They state that drug addiction has 2 faces;  chronic disease, and a temporary failure to cope.   Bruce Bower, the author, claims that addiction is a “solvable coping problem rather than a chronic, recurring disease.   Really?  So I take heroin because the boss is putting pressure on me or my wife wants to go out dancing more often?   All this is put forth by those who have never see the pain below addiction, who have not seen how long it lasts and the damage it does.   Yes, we can take a drink or a few Prozac when we have a deadline for a paper to write but that is not the addiction we therapists treat.  We treat a deranged neuro-biologic system forcing us  to find solutions while the experts try to find ways to stop us.  When we break a leg they might give us a few pills because they can see the damage. But what about the damage that happened before we had verbal memory?   The damage that lies in less oxytocin or serotonin?   That cannot be seen; therefore it must not be important.   And what happens when we treat rats and pigds and humans with touch and kindness and warmth?  All have their oxytocin levels rise significantly.   Does that means they were lacking something?  And when we offer pain killers to those deprived animals and they take to it with alacrity what does that mean?   It means that they need it; they hurt!  Is that so difficult to understand? Why is there this war against drugs?  Yes drugs do damage but they are an attempt at damage control.
Of course the other choice for the scientists is to call addiction a brain disease.  And then we spend years examining the minutia of the brain to find answers.   We need to see how experience affects the brain; that is what we need.  Then if we fail we can call it a brain disease.   But I have seen hundreds of addicts mainly travel back and down to the first months of life, continuing on to their infancy, and there we see the terrible hurt those individuals have suffered.    If there is no access to those deep-lying biologic memories then there is no choice but to think it is because of a defective brain.  When my patients overcome addiction they have no brain damage, unless, unless years of use, even of seemingly benign drugs, finally disrupt function.

The author agrees that addicts never really get rid of addiction?  Why is that?  Because they never get rid of the need which still lingers in its neural cave forcing the tendency to use soothing devices.  Warmth and caring in the present does help; witness the good the 12-step program does.   The problem is that you have to recognize that there is a higher power than you and you must accede to it.  Wait a minute; we are the higher power, and we have control given the right circumstances.    As long as need lives on in encapsulated form we will require weekly visits for reassurance and help.  But when basic primal need is extirpated, we don’t need a surplus any more of constant human reassurance.  .  I am writing about deep early need but that also encompasses early childhood where love means so much;  guidance, protection and warmth.    These count but they build on a structure already partly in place.   But believe me they count a lot.

In a self satisfied piece, one expert on addiction assures us not to worry because many addicts  mature out of addiction by their thirties.   Do they also mature out of their pain or is it better hidden?    This is an  age-old saying told us by our doctors in the forties and fifties; don’t worry your child will grow out of it.  By some magic?  We never grow out of need.  It is in place to stay. It must be experienced for us to grow and mature.   And its pain is a warning system that says, pay attention, there is something lacking.  Do not push it away except at your peril because it will always, always, come back to bite you.

And there are others, many others in the Behavioral Cognitive School, who think addiction is a decision, a choice both in and out of it.  Make a good decision and voila, all is well. Only people who live in their head could think that.  They have not seem the great pain addicts are dealing it.  Yes, we can make a decision to stop, and suffer thereafter.  Is that what we want?  More pain? The problem is, how can I get strong enough to make a decision to make a decision?

All experts agree that the addict cannot go it alone; cannot be cured without continuous psychotherapy.  I suggest that they cannot get well so long as they are in therapy because the doctor is now the calming influence.  He cares.  He has warmth.  He guides, and above all  he is totally interested in you.  Who can disagree with that?  As long as we keep going we have exchanged one addiction for another; both designed to ease our pain, insecurity and low self esteem, especially when the doctor approves of us, is happy to see us and hopes to see us again and again for years……..for our fix.

After the war I was a mess, so I looked up some shrinks for help.   They all wanted me to pay in order to be better motivated.  I just got out of the navy and was already well motivated, so I call the Veterans Administration for help.  I got an Analyst who spent msot of our time analyzing my dreams.   We never went into why I was such a mess.  I learned something there; beware the ides of March.

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Tuesday, March 3, 2015

When the Unconscious and Conscious Become One


I had a Primal in my sleep last night.  I will tell you about it because it lays bare what is going on in the unconscious.  And I will try to answer the question, “Why in your sleep?”

Is was about my mother, whom I rarely have feelings about because she was emotionally absent and never really “there.”

There is an old saying that if you raise your kids right they leave you as children and come back as your friend.

But what if you were not reared (the correct word) right?  They stay your children forever looking for the fulfillment the parents should have given you.

Once you have all a good part of your need and can begin to see them as people, a lot changes. Your need no longer clouds your perception of them and that leads me to my Primal.  In my sleep I was crying deeply and saying, “I’m so sorry. So, so sorry.”  I was not nice because my mother was pre-psychotic, I treated her later on as “crazy Annie.”  I could never see her limits, yet within those limits she and my father, two lost souls from Russia, did the best they could.  They never heard about, nor knew anything about love.  They never even knew that parents were supposed to talk to children.  Their parent left for America for years to find work, leaving them on their own.  They abandoned me for years in other places because they were left, and that is the way life is.

For me, everything was a mystery.  I never knew their history except what I learned from my aunt.  I knew nothing about their lives, their finances… nothing.  They never knew about touching, softness or caress.  It was a daily struggle to make a living.  We were working class and my sympathies have always been working class.

So in my primal I began to feel how unfair they were to me but also how unfair I had been to them.  I wanted and desperately needed, what they could never give.  So long as my need was strong I could not see beyond the need. No one is smarter or stronger than their need and no one can see beyond it.

Why in my sleep? I think it is because at this late date my unconscious and consciousness are merging.  They are become almost one.  So what should happen on the top level happens during the lower level.  Why?  Because having felt for years the gates are now pliable and allow feelings to rise almost at will.  They rise when I and my brain are ready for feelings.
How do I know? I don’t, except that my body temp remains very low which is usually a sign of far less work the body is doing to maintain its equilibrium and the work it constantly does in the service of constant repression.  That is a great effort.  It used to be higher.  I no longer have nightmares nor do I think my unconscious drives me because that unconscious is now mostly conscious.  I control it, not the case at all when I was younger.  Back then, compulsions and obsessions abounded.  I will  spare you the details but I was run by the unconscious as so many of us are who have not felt.  And that unconscious , more than any bad diet, will shorten your lifespan as it gnaws away at the heart, liver, kidneys and other organ systems.  Of course proper diet is critical, but not as critical as the force of the unconscious.  That maims and kills.  That sends too many prematurely to the great beyond.

What happens in sleep?  Some of the childhood pains reside there, and like all Primal Pains they need liberation. Not everyone has to have merging levels of consciousness but it is critical to reduce the pressure that lower levels exert all of the time.  When they drag the system down into depression or speed it up due to anxiety, they need to know that there is a way to dredge up and eliminate those forces forever.  After all, those forces are only you and your feelings.  Nothing else.  So how bad could it be?  It is now part of my life; not part of a psychotherapy but a state called living.  We laugh and we cry; that is also known as sanity.  It is not that we are so emotional.    We have eliminated all that extraneous force so that emotions are commensurate with reality.  Not a monster driving entity.
When we are not emotional it is a problem; because we means repression and suppression and the emotions are hardly being contained as they whiz around the brain creating havoc.  If are made to laugh we are also made to cry. It is natural, biologic, not an aberration.  And because we often suppress this biologic tendency we suffer.  We have denied our biology.  We cannot do that and be healthy.

We often believe that we can think our way to health and sanity.  Nope.  We think our way to denial, to neurosis, to a false consciousness but not to health.  For health and healing we need feeling; that is what makes us human; feeling human beings.
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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