Arthur Janov's Blog, page 28

On Suffering and Pain. What Does it Matter So Long As We Hurt?

It turns out it matters a lot, and the difference is essential. Because pain is curable and suffering is not. I had better explain. To be clear we must first turn suffering into pain for there to be cure. In brief, suffering is not healing; feeling pain is because pain is more specific, less diffuse and has an origin, while suffering is diffused throughout the system and is vague. We suffer when we cannot reach the cause. And that often means that the cause is so deeply buried as to be unknowable. And that can mean one of two things;
1. The pain is so great that it must remain repressed.
2. The pain is so deep and remote that it is very very difficult to reach.

When those two elements exist we have generalized suffering as the agony portion bursts through but not the origin. The imprint is still there behind it all but for now it is unattainable. Pain means connection; that is why patients hurt when they do connect—my mother never loved me. What we do to produce cure is to turn suffering into pain and then into feeling: mama, please love me.

Suffering and pain are mutually exclusive; one (pain) eliminates the other (suffering). I am not discussion chronic suffering from physical causes such as infection.

Why isn’t suffering curative? Because it remains in our head and does not reach all of us. It means that it is not connected. We are constantly miserable and never know why. Because it is in our head it stay alienated from deep causes. Once we feel deeply, over months, we can read ultimate causes. The more we try to understand our suffering the less we succeed. This is why cognitive therapy cannot succeed. It means ensconced in the intellect when what we need for cure is a deep imprint. We need the opposite: letting go of intellectual pursuits and allowing oneself to drift downward to the remote past. That is not easy and most often cannot be done without professional help. Too often, we conflate pain and suffering and that prevents us from ever finding cure. Where is cure? On a lower level of consciousness. If it were on top we could say, “Oh deal I cut myself..”

To recap: suffering happens when pain/imprint is on the rise but is still repressed and hidden. Cognitive cannot achieve cure so long as it suppresses agony without focusing on deeper imprints. They give pills, which further sequesters causes, the causes that gave rise to the suffering. They get results but it cannot last. They claim it is effective; within narrow confines it can be but it won’t endure.

Suffering and pain should not be conflated, as that assures no cure. They are not interchangeable, allowing them to be treated through ideas and insights. This amounts to thinking our way to health; that believing makes it so. Once we know that deep pain lies far below the neocortex we can focus on real causes and of course, cure.

Philip Seymour Hoffman is dead

He died from an overdose of painkillers; e.g. heroin. He had been in plenty of rehab yet it didn’t seem to solve his problem. It wasn’t the drugs that did him in; it was the pain. He was simply the carrier. Since he was the carrier, killing the pain meant ultimately killing himself.

And what was he carrying? Here lies the rub. Because he was carrying around a load of pain from his earliest months; something invisible, not obvious and very well hidden inside. Yet this is the epoch to be treated as well as later pains, and it is precisely the epoch avoided in all rehabs and therapies. Why? Because it is not obvious and cannot be easily ferreted out. These pains from birth and gestation lay down a basic strata of pain upon which it becomes compounded throughout our lives, a due lack of love and harm continues. We can see the lack of love, the neglect and avoidance, which can be treated; but the greatest force of the pain is neglected. It is here during the beginnings of our neuronal development and adversity that our nervous system becomes rerouted and deep agony is embedded. It changes the whole system and installs serious pain, which can last a lifetime. So when he reverses and goes back to drugs it cannot be a surprise. The pain remains and is engraved. He carries it around all of the time, whether he is aware of it or not. And it drives him to seek relief no matter his efforts at rehab.

It is not he who has failed therapy. It is the therapy and rehab that has failed him, all the while going through the motions of getting well, yet never touching the basic cause of his pain. I am writing about first-line, brainstem imprints, which we have seen and studied for over forty years. When we see patients reliving lack of oxygen, the inability to exit the womb and dozens of our pains we know what is being laid down. These are far too powerful to be left in the hands of do-gooders with the best of intentions. It is science that we need; including the recent work of Moshe Szyf who notes that these early pains leave a trace, a marker that carries them forth inside of us. And what we hope to do through reliving is attack the trace at the source, relive the pain of it and reverse the imprint through demethylation. Take away the trace with its load of agony and its memory. In short, remove key aspects of the trace that spell constant, ineluctable hurt. Take the pain away, not the pain of later life, which needs to be dealt with, but the lower strata that produces the exacerbation of the agony.

What does it mean that he did rehab? I have visited rehab centers where they really care about the addict, provide the best food possible, swimming pools, a whole new environment. And it lasts as long as the stay. Yes, it can last longer as the exhortation and new ideology implanted can carry him along for a time. But the demon imprint never, never leaves. It is not more concerted effort he needs; it is science.

I have treated actors and I have found that the greater they are the more pain they carry. They can be anything to feel loved. “I will be anything or anyone you want so long as you love me, “ said one actress in therapy. And why are they so great? The emotions are breaking through at all times as they suffer damaged defenses. They cannot control their pain/emotions, which makes them great and in pain, a pain close to the top at all times. If they get away from it, they are lesser actors, an unavoidable law. So whether it is Brando or Hoffman, it is the same dynamic; I will be someone else so effectively that I will be praised for the performance. And why are the defenses so weak? Because they were damaged so early in life as to be defective for a lifetime. The defense system can only hold on for so long and then the biochemicals of repression such as serotonin give way. And what do we prescribe for those in pain? Serotonin, exactly what was depleted in the fight against monstrous early imprints. It is the weakening that makes defenses ineffective. And when there is later compounded pain on higher brain levels, the defenses suffer again. And the result? Addiction. The constant battle to put down the pain from early on, and the added neglect, lack of touch and love in childhood. You may get “love” from an audience but it is not the same as being hugged and loved very early on. But actors are willing to settle.

So let us remember; when we kill pain we are literally killing ourselves.

Another Look at Reliving

Let’s go over this again so we can make sure that reliving is important in the therapy for all kinds of neuroses. Neurosis means that there is an early traumatic input that alters function and behavior; not one or the other but both. That is, there is pain and denial of need that overwhelms normal functioning and causes a diversion. We are no longer normal; things go wrong neurologically, biochemically and behaviorally. And of course to cure we need to normalize the whole system, not just behavior or biochemistry.

That in a tiny nutshell is the story of neurosis. We are no longer ourselves; we are re-routed in function. To get back to ourselves we have to re-establish function in every aspect. Not just behavior.

And when we are diverted and rerouted, there are marks that leave their traces; epigenetic marks. For example, if we are loved and hugged and touched a lot there are changes in the brain where methylation patterns are changed. The function of the gene is changed and how we then behave is diverted. The brain has “borrowed” part of the methyl group and produced alterations in how genes are expressed or repressed; shut down or opened up. And this changes us in profound ways. Our personality becomes different; we can be more open or closed off; more depressed or anxious depending on what genes do what. But it is not genetic; it is epigenetic, how life impacts us. How experienced changes us. It is not just in the genes; it is in experience. Don’t go looking at the genes alone; it is not there. They are the result of experience.

Now those marks or traces are embedded and can follow us throughout life. They form the substrate on how further experience impacts us. So with lots of love we have a different system than a deficit amount of love. And a different brain. And a different focus and attention span. All this right after birth. And it can spell a chronically aggressive or passive baby and child. The difference between a heavily allergic child who spends her life in emergency rooms, and a normal child. Above all, it sets the stage for a child who does well in school and another who fails. You mean all this from events in life before birth? Exactly. Love means altering those immune cells and making them stronger. No love means the opposite.

OK so now we have those marks, methylation which foretells of a life to come and how it will be lived. How do we change all that? We need to revisit those early experiences, those without words, go back and redo them. Change history and their traces. We need to undo the damage and that means slowly demethylizing. One experience at a time; or one experience over many times. We need to find how the system was detoured and put it back on track, literally. This happened because pain installed itself and forced change. A mother who was on coffee or who was constantly on tranquilizers changes the baby’s system. He cannot slow down because the anxious carrying mother has caused a more speedy system in her offspring. And this can be measured; the amount of methylation can be observed and changed. That is meaningful progress. It informs us about altering neuroses. And when allergies disappear we have supporting data. And when sexual deviation goes away we have even more key data. And above all, when the telomeres lengthen and we live longer that is critical information. Neurosis, in short, is a global affair, not just one behavior or one symptom.

But isn’t this what medicine today is about? Lowering blood pressure, giving allergy medication. Restructuring behavior. It is called “whack-a-mole.” Every time a symptom shows up just whack it back.
And don’t ask where it all came from? It is obviously a “brain disease.” Experience takes a back seat as we slither down into the depths and minutia of the brain seeking answers that do not exist there and never will.

But we are the dealers in experience because we have seen what experience does to us, especially very early pre-verbal experience. If one sees one Primal one knows for all time how crucial experience is in the scheme of things. It is rarely a brain disease; that is concocted by those who fiddle around in neurons and synapses and do not see the brain reacting to experience. If we leave out experience we are bereft of what can give us answers. We see only the end result and miss half of the puzzle. It is like looking at diabetics and never know what they eat. If we leave out the first three years in an orphanage can you wonder that we can never know what the matter is. Thinking it is a brain disease is the result of another more serious disease: solipsism.

How Do You Harm a Fetus?

 You harm anyone, no matter the age, by depriving them of their biologic needs. So you abuse a fetus by not recognizing her needs. And what are they? We can tell because we have seen those needs in action in therapy sessions, and the screaming and agony when they go unfulfilled. We do not have to theorize about them. If we do not know them then there will be deprivation and harm. We see the terrible impact when the baby is left alone after birth, and is not held, caressed or touched. We see the pain and the result. Further, in later reliving, we see its lifelong effects: the inability to be alone, the nagging emptiness of not being with someone, the need to constantly connect either personally or on the phone. All to keep that basic aloneness away.

 We can see how the pains pile up and accumulate reaching inordinate heights, and the symptoms that issue from that; aching stomach, migraines and high blood pressure. Further, we see in the reliving that once that terrible aloneness and isolation has been felt, so much changes both psychologically and biologically. And we also know that we don't get to those imprints until months into the therapy.  The earlier the pain the more time it takes to reach, as it should be since the more remote the event the more painful it will be. And from what I have seen, the imprints from just after conception cannot be seen or often even imagine but they set down their seeds in the earliest formation of cells. And those are the most difficult to find and the most difficult to conceptualize and treat, but they may be behind schizophrenia, Alzheimer’s and some cancers. These may be the deepest imbeds, the most remote and ineffable memories engraved in the primitive developing cells. We look at them after decades of agitation and try to decipher their causes and how to deal with them.  But we are long after the fact, and that is the problem. The fetus is deprived, first of all, through irresponsible diet by the mother, and then most importantly, the mother is chronically anxious and revs up the baby unrelentingly. It is this chronic input, un-contained and un-circumscribed that does its damage. It never lets up, and the baby's resources can no longer cope. This is the harbinger of later disease. It is not one fixed event in time that does the damage; it is the unrelenting adversity that does it.

 But when we get the perfect trifecta: fetal damage, birth damage and infancy harm, there is little doubt that we have a child whose life will be cut short. Depriving parents tend to be that way all along the child's development. One way we can predict how long that child's life will be is by the length of her telomeres, the longer the better for longevity. The mother's stress level shortens her telomeres and, I assume, that of the fetus as well. Your projected lifespan is already set inside the womb. That is where the great early harm takes place; a fetus who has not way to escape the harm but sets there and takes it, day after day. Children who grow up in orphanages have very short telomeres. And that tendency goes on into adult life. It does not have to be in institution; a divorcing mother can suffer continuously and over stimulate the baby. And we know that the higher the stress hormone level, cortisol, the shorter the telomeres. Worse, those who had shorter telomeres in childhood could often count on diseases such as cancer in adulthood. Three times more likely to develop pancreatic cancer. And this, I believe, begins during womb life and sets the stage of arcane and recondite illness later on. So telomere length is a good index of disease later on. Those with chronic shorter telomeres were far more likely to end up Alzheimer’s. The point is that those mothers who were heavily stressed during pregnancy had shorter telomeres, which finally affected the offspring.

Thus the remote life endangering events are the very imprints that become life endangering in adult life. It is a memory of near death that again can put you near-death later on, so long as that memory is not relived and extirpate from the system. Stress, or deprivation of need, which is the same thing, imprints a molecular mark that trails us for life. That is the culprit we must deal with.
And that is the culprit that is so evasive because it is of such early provenance. Few of us can imagine that time-span. Few of us can investigate and see the fetal imprint, yet it is there before our eyes if we know how to look at it.

So we ask patients about their childhood, and usually go not further. We leave out real basic causes and content ourselves with what may be obvious. It is the non-obvious that is the killer.

The New Science of Mind

There is a piece in the New York Times Science section, (September 8, 2013, by the Nobel Prize winner Eric Kandel)(See http://www.nytimes.com/2013/09/08/opinion/sunday/the-new-science-of-mind.html). He is discussing the advances being made in the science of the mind, and in particular, psychotherapy. What he means by advances or progress is a deeper understanding of brain function. Here he states, “Consider the biology of depression. (We can) discern the outlines of a complex neural circuit that becomes disordered in depressive illness.” So here we have it; it is all about brain structure and function. No discussion of the human being that carries around that brain or her experiences. The brain and the mind are identical for him. He seems to think that brain scans are the wave of the future so that we can ferret out the nerve circuits involved in mental illness. He cites the work of Helen Mayberg of Emory University who gave two types of treatment to subjects: cognitive therapy where they train people to develop a more positive attitude to life and its adversities, or anti- depressant medication. She could tell by examining the function of the insula who would respond and who would not. Those who started with a low baseline did well with cognitive therapy. Those who had above baseline insula activity did better with medication.

What’s wrong with this picture? Are those the two key approaches in the treatment of depression? Is there any room for feelings? Either we medicate or change the subjects’ minds about life? It is no small thing that he is friends with a leader in the cognitive approach—Aaron Beck. What he believes is that they have discovered biologic markers for depression. And once we do that, what?

I have an idea. Why don’t we try to figure out what psychological factors change brain function? Why don’t we bring the emotional and mental into the equation? Otherwise, we are forced into a reductionist approach to consider it all within the brain; a form of pure solipsism. Like there is a brain but no person with experience. Or if there is a person with experience what are the experiences? And how do they change the brain? That is the real domain of psychotherapy. The brain and mind are not identical; otherwise how can the mind change the activity of the brain? For example, when we say this drill won’t hurt your teeth and it doesn’t. Or how hypnosis can change brain function. There are levels of reality; the chemical, the neurological and the psychological. They are different and cannot be equated to one another. Otherwise we get into the bind of saying that anorexia is due to too much or too little dopamine or serotonin. And we will never find out what makes for more or less of these chemicals floating around in our brains. So instead of minutely examining neural circuits or biochemistry let’s be psychologists and psychiatrists and examine the mind. If I read Kandel properly there is really no mind to deal with.


Of course there are changes on all levels due to experience but they are not necessarily causes; rather, they are accompaniments. They are responses, by and large, to experience. So what are those experiences? Look at migraine headaches. We have looked into this affliction and discovered that very early experience, anoxia at birth, is a major cause; the vascular system shuts down in an attempt to conserve oxygen. It is experience that counts here, and a specific kind of experience. If we examine the brain for 100 years we will come no closer to understanding migraine. Of course neural circuits change as most neuro-biologic functions change in reaction to trauma. This anoxic condition will certainly change the cortisol levels and the output of serotonin. But they are not causes? Does the function of the insula respond to severe input along with other limbic structures? Certainly. They are the result, not the cause of the symptom. Scientists removed from their feelings do not consider feelings in either causes or treatments. It is all cerebral, they assume. It is very much like assuming that those low in dopamine will not have a exaggerated reaction to coffee while those already agitated will have a greater reaction to coffee.

Kandel maintains that psychotherapy is a “biological treatment. A brain therapy”. And therefore there is no real place for psychotherapy. And then he goes on, “Any discussion of the biologic basis of psychiatric disorders must include genetics.” Not epigenetics where all the late research points, but inheritance. Again no place for life experience. It is either inherited or the problem is in the brain. He says it: Individual biology and genetics” make up the contribution to such things as depression. That is why it is a small step to operating on the brain to try to change depression. Again, when we get on the wrong train every stop we make is wrong. Let’s get on the right one.

Is Addiction Incurable?

A piece in the N.Y. Times , June 9, 2013 discusses Dr. Drew Pinsky, a television personality and doctor who treats addicts and helps in rehab. (See http://www.nytimes.com/2013/06/09/fashion/dr-drew-pinsky-physician-and-media-star.html) Here is what he says: addiction is not a curable condition. It is one of those endearing syllogisms that say, since I cannot cure it, it must be incurable. Therefore I don’t have to try. I just control it as best I can. And of course he has had some suicides among his rehab group. He says he wishes he could blame himself but alas it is not true. He is not to blame. He did his best. Sadly, that best is not good enough and derives from the notion that it is all in our heads, and if we can change our attitudes we can conquer it. Not cure it, mind you, just conquer it.

Of course he had suicides. His therapy was incomplete and ignored the crucial few months of life where deep depression gets its start. And therefore, yes, addiction can be cured…if we take away its generating sources. If we go deep into the brain and the unconscious. That is what cure means, tying symptoms to origins. Otherwise, we can never speak of cure. So long as we ignore the deep-lying causes there is no cure, and that is the inadvertent crime of Dr. Pinsky. No origins,6 never a cure. What are we curing? The causes. No more, no less. Otherwise, no matter what the therapeutic approach they are never curing.

It is strange to see in print that something cannot be cured; that means that they have the last word in theory and technique and it cannot be improved upon. He does not say, maybe there is someone around who knows how to cure but I don’t. For that he needs to survey the literature. We don’t keep our therapy hidden. It is published in books and scientific papers. He has to take the time and interest to search for answers. He does not say, maybe one day we can cure it. No. It cannot be cured.

The problem is that he and others who mean well have a slight arrogance about them to indicate that they know it cannot be cured. What a disservice to addicts in the country who need help and need to know there is a cure. Can he put himself and his therapy in question? Can he have a bit of self-doubt? Can he imagine anyone in the world doing something better than him? Evidently not. Is that arrogance? I think so. It is an arrogance that leaves those who suffer no way out. This is what rehab centers do, as well. No science, just a potpourri of unproved approaches with a hope for the best. But isn’t that arrogance on our part to think we know better? I don’t think so since I did put myself and my therapy in question years ago and decided to change. Also we do get down to origins and we do cure and we never make statements about not curing anyone.

Clearly, we don’t cure everyone but I believe that our therapy provides the platform for cure, something we have been honing for many decades with thousands of patients. Dr. Pinsky says he hopes he could take responsibility for the suicide of his rehab patients. I can help you doctor. You are responsible. Your lack of searching, even by inadvertence makes you able to claim responsibility. And you should because that is the first step toward cure-----toward finding a cure for yourself and your patients.

On Psychological Medicine

Here is what I think is proper medicine in psychotherapy:  it must be always a collaboration between patient and doctor.  It is not something done to the patient as if she were only a research subject. It means that her input has to be considered as a leg of the diagnostic procedure; and that is what seems to be missing in so much psychotherapy today.  The patient is “done to.”  There is a certain set of procedures, which is fixedly applied to the patient without her input whatsoever.  Therefore, a critical leg of the diagnostic procedure is missing and the diagnosis is faulty.  It has to be since a critical input is not there.


The problem is that there is a certain set of assumptions that are decided before the patient ever enters the room, which are then a priori draped over him, and the therapy begins. I use the word, “draped,” because these assumptions then sequester the real patient before them, and she can no longer be seen.  All they see is the image decided on helter-skelter.  And the patient must fit into this image, rather than vice versa…getting all the facts and seeing how they lead to a diagnosis.  How the theory fits the patient; how the diagnosis emanates from those facts and data.  There is rarely a diagnosis that can be changed to fit the new information.  So she is squeezed into a diagnostic category to make it all fit.

So here we have, “got the tools to be applied and don’t let the facts interfere with their use.“  Well don’t we do that, as well?  We try to change our hypothesis when necessary but our hypotheses and theory derived from decades of research and observation.  It wasn’t a decided on procedure irrespective of the facts.  In brief, the facts led to an ever-changing diagnostic approach.  Not so loose as to be a sieve but rather something with a key structure that leaves room for change.  It is a fine line.

How does that work in practice?  One simple point:  I originally never believed in birth primals at the start and told patients it was ridiculous.  I took my lead from a university neurology department who advised me how impossible it was.  So I eliminated the idea and took it out of my diagnostic armamentarium.  But the facts kept piling up; patients who came from many different countries did in fact relive birth, and then we did research on it, testing brainwaves and biochemistry. Reliving birth was filmed and measured, and the results were inescapable.  It not only was possible but major biologic change resulted from the reliving.  We never shut down the idea totally; we waited and studied it to see what it was and what it did.  And it did exactly what the patients insisted what it did.  It changed them; lowered their blood pressure and body temperature.  It was a collaborative process, which included the patient’s input. I cannot imagine it being done without that input.

Reliving stopped anxiety attacks. Then we needed to know why. And we were off and yet another study of panic and anxiety attacks.  What were they and where did they come from?  The result of our work is found in the World Congress of Psychiatry (Spring 2013).  Our work evolves exactly because we leave room for the new.

Now let us turn back, (and I do mean “back”), to the “rebirthers”. They saw something dramatic in it and decided world-wide to practice it randomly. They saw a cure-all, done in an afternoon, some done in swimming pools, other done without the water.  And what did that “I have the tools and will find patients to fit in,” idea accomplish? Many patients completely broken down and coming to us for help to re-establish their sanity.  It is now a predictable result because these patients were victims of the “tool box.”  No studies or research, no seeing if patients can go deep with impunity.  And they cannot.

In fact, I have yet to see, among all those mock practitioners any serious research to accompany their work.  They found a name, Primal, and a technique, Rebirthing, and off they went, using well-researched ideas as their own. Who suffered?  Patients.  Even Steve Jobs was fooled into thinking he was going to a legitimate primal center. There are those who see the title “doctor,” and cannot imagine that a “doctor” would engage in chicanery.  Alas, they can and do.  Few want to put in the years of study again to learn a new approach, so they make off with the name and voila! They are primal therapists.

The hypocrisy goes on:  there is a man in Sweden who has spend decades denigrating primal therapy, all the while practicing it in secret,  Tomas Videgard.  Here is a letter in part from one of his “patients“: “It is difficult to know what he did to me.  Pressed me down to a painful trauma and refused to take me out of it. He told me that he was chosen by you to become a primal therapist.  But he skipped the whole thing (the training).  It was a nightmare.”

I cannot vouch for the letter’s accuracy but it sounds a lot like other reports I have received.  And it highlights the danger of those using the term Primal to practice a so-called primal therapy.  I am often asked, “Why don’t they use some other name?”  The answer is that with the name goes years of research and practice, which they take as their own, giving them a cachet they have not earned. And worse, it allows them to damage patients in our name.  Since there are literally hundreds of so-called primal therapists advertising the therapy, it is not surprising that those who are hurting and need help can be fooled.

The Inheritance of Acquired Characteristics

Oh dear, that used to be such a dirty word.  The idea of it was roundly rejected for a hundred years, and then, lo and behold it is now pure science. What happened? For one thing, the scientific method, slow as it is.  For another, consciousness has developed, stripping us of old canards.

Anent this point, made in several journals and written about in New Scientist (7 Dec. 2013) (See http://www.newscientist.com/article/m...), there is mounting evidence that parental effects dip down into the newborn impregnating her with parental history. So when we ask, “Why is she that way?” We have a better idea.  She is that way due to genetics and above all, what life experience has done to those genes.   For example, “Why does she eat so much?”  We know that it is not current culture that is the sole cause; it could also be because the mother was indulgent and ate compulsively.  It turns out that babies learn some food preferences while living in the womb.  And some of it is pretty well set before the age of two.   While in the womb the baby is learning about his world and what to expect from it; hence lots of food is to be expected from a mother who indulges.

There is evidence now that diet can alter gene expression.  If you love sweets and cannot resist, it could be due to womb-life.   In other words, the mother’s compulsion becomes your destiny.  This can explain a good percentage of obesity in children.  Bad eating habits begin in the womb as do so many other compulsions.  More evidence is piling up to show how this early start can predict the early onset of disease and a shortened lifespan.  (See the work of Keith Godfrey, Univ. Of Southampton (See http://www.southampton.ac.uk/medicine...). And also New Scientist, 7 December, 2013).   The fetus is not only aware of certain tastes and smells in the mother while she is carrying, but those memories can last a lifetime, and can affect so much of our interests later on.  Mothers ingesting carrot juice during pregnancy had children who preferred it.

It is not just diet, that is the obvious one, but think about fear; it can be passed down, as well.   So are we born fearful? Could be.  We can be jumpy, nervous and erratic, all due to epigenetics.  Mice who associated a certain smell with an electric jolt became fearful in the presence of that smell.  It seems so early as to be genetic, but it is more likely to be epigenetic, the condition of the mother (and father) while carrying.  This should teach us something about memory; for memories while being carried can last decades and drive and/or channel behavior.  We do not simply “grow out of it.”

In fact, premature babies who were hugged and caressed a lot went home earlier than those babies not touched as much. Those early kisses count a lot and help shape personality, a loving and warm person versus a stand-offish one.  A nervous mother leaves a predisposition to fear in the offspring, just as a depressed mother leaves a base of depression in her baby.   Whether it becomes overt depends on later events and traumas.   I personally believe that lots of love and healthy living in the very young child can abate these deleterious effects.   This is especially true for those babies who were taken from institutions.  They are greatly in need of love and reassurance early on.   If they don’t get it, it can be somewhat irreversible; that is, there may be a point where love can no longer make a great difference. The damage is done and it is pretty well fixed.  This is the research we will embark on in the near future.  Is there a point in time when love cannot reverse previous damage?   When is that point?

The evidence is becoming clear, ever since I posited early life trauma, even in the womb, almost fifty years ago.  At that time, I had to be convinced of it through the experience of my patients. It became irrefutable.   But I understood how hard it was to convince others of its importance, especially those in psychology and psychiatry.

I know that I had a tendency to be fearful since gestation and birth so that a harsh tone from my father just withered me and forced me to obey without question.   I became obedient to demands, gave in so that the anger will stop.  I had a “couche” of terror below due to a psychotic mother. It was all compounded into an unaggressive child.  Add that to almost never having any needs filled and you get the picture of a child who knows nothing of his needs or his feelings, just drifting along in life, complaisant and undemanding.  That is no way to be, believe me.

The Mystery Known as Depression, Part 12/12

12. ON RELIVING: DEFEATING THE FEELING OF DEFEAT

There is scarcely a professional among us who believes in the absolute necessity of reliving old events and altering their imprints; yet it is that very process that is curative. It is curative because it deals uniquely with history and memory. This is not to be confused with recall. Recall is cerebral, neo-cortical. Reliving the imprint is neuro-physiologic, and is remembered in that way. While imprints are usually not in the therapist’s lexicon, I believe it will be the sine qua non for the future of psychotherapy.

There are now hundreds of studies in the scientific literature documenting the effects of pre-birth and birth traumas on later symptoms and behavior (and this is discussed in detail in Primal Healing.) There are research case studi es we did to verify my point. I have written about the UCLA experiment in my book (Janov, 1996) but I want to sum up the importance of it. This is research we did together with Dr. Donald Tashkin, former director of the Pulmonary Laboratory in 1992. Two patients were wired to many instruments while we helped them into a reliving session, a primal. Neither patient observed the other so we had a rather pure experience on the part of both men. They both relived severe oxygen deprivation during a birth trauma, something we had not planned at all. After being immersed in a memory of oxygen deprivation they began what I term "locomotive breathing," because that is what it sounds like and seems to emanate in part from the brainstem, in particular the medulla. This deep, raspy, rapid, compulsive breathing went on for over twenty minutes.

The heavy breathing was an attempt to compensate for the lack of oxygen they experienced during the memory event. This is never a voluntary effort. It seems “forced” on the person from low in the brain. It is as though the patient is making up for the deprivation event by gasping for air. Once begun it is very hard to stop until it has run its course.
Heavy breathing can go on for many minutes and it may take many sessions for the cause to be comprehensible. Though this heavy breathing goes on for up to twenty minutes there never is any hyperventilation. After the reliving, we did another experiment where each patient mimicked the primal in every way (same movements and heavy breathing) except for not being in the past. That is, it happens out of a deliberate action by the patient living in the present. Both got dizzy and almost fainted after 3 or 4 minutes in what was clearly a hyperventilation syndrome (clawed hands).

It happens systematically to those who attempt to go back to the past without being totally in the memory. In fact it is one of our controls on the veracity of the feeling. If they run out of air right away it is simple abreaction, and unconnected and not integrated event. The reason is rather simple; the subjects were breathing voluntarily, not automatically out of the memory. They were breathing from “on top,” not from the bottom. The memory offers us the truth of the experience.

What the researchers from the pulmonary laboratory found was that when the patient was back in the old feeling and its context of anoxia at birth the body needed oxygen; the patient was “back there” in every way, not the least of which was physiologically. They go back in a complete biologic state. What we found at UCLA was that despite the heavy prolonged breathing the acid-alkaline balance did not change. The conclusion of the UCLA investigators, who were not associated with Primal Therapy in any way, was that no other factor other than memory could account for the results. In short, the life-and-death memory was real. It was imprinted. Despite the fact that the oxygen was normal in the room the brain was sending signals of a great lack of oxygen, and the heavy breathing ensued. There was no hyperventilation syndrome because the whole system was back in history re-experiencing a key trauma and urgent need of oxygen. They were reliving not just in their heads or their thoughts but with every part of them. Patients are indeed in their past. They are living in their history, living in their personal past; and, I might add, living inside a brain from antiquity. Their lives are revolving around history with only a dim awareness of the present when they are reliving in a primal.

These experiments are the best supporting information for primal therapy , as the experience cannot be faked. The fact that his imprint endures and is immutable means that it constantly affects so much of our feelings, moods and behavior. It means that there is a profound origin for depression which began its life before we began life on the planet. In the case of one of our patients trying to get born against massive anesthetic the feeling was, "I just can't try any more. I have to give up. It is hopeless." Here was the deep preverbal forerunner for depression; the physiology of depression.

Once we establish that we are propelled by imprints embedded in an ancient brain we see that it has everything to do with our current behavior and symptoms, then we must acknowledge that the primitive brain affects not only our breathing but also most of our current life, our moods, values and attitudes. Those imprints must be considered when we want to understand depression. It is not just breathing that is affected but most of the brainstem functions; digestion, elimination and many mid-line events. We go to doctor after doctor to try to solve a stomach problem when the memory will give it all up as soon as we can access it. It will tell us all because it was there at the scene “of the crime.” It will tell us of the carrying mother’s anguish, her use of drugs and alcohol or her own depression. Therein lies the answer – history. It divulges all of its secrets when we descend to meet it. It won’t come up to confess its history verbally; we need to meet it half way. Then it may say in its own nonverbal way, my stomach aches, as we plunge into history; my stomach is not working well. Later on there is colic that speaks more of what is wrong. And still later a drug addiction. The point is that when life is not going well and one is unhappy for unknown reasons we need to look at generating sources. It is never a matter of thinking healthy thoughts; it is a matter of knowing what underlies unhealthy thoughts.

This is significant because it can open up a universe to us about the depths of man’s unconscious. It confirms that very early experience is impressed into us, not just as a memory but as a wound that needs healing. The corollary to this is that the early need for love endures, and does not change throughout our lifetime. We seek symbolic, substitute fulfillment but it is never fulfilling and compels us to go on seeking more and more, always in vain, because it is symbolic. The critical time when need must be fulfilled has passed. And we have found that we can only heal where we are wounded. This means a return to relive events deep imprints where breathing is organized. Thus, if the “wound”/trauma affected breathing at birth, due to a heavy dose of anesthesia, then it must be revisited and relived; a return to generating sources. This usually normalizes many functions, from cortisol levels to natural killer cells as well as blood pressure and body temperature. With reliving the system is allowed to function normally.

The marks that originally appeared during the birth trauma may again appear in a later session. (We have photographed these marks; they can be found in my books). The baby-cries during a session can never be repeated by the patient after it. It is clearly not a simulation. In other words, the past and its neurobiology remains encapsulated inside of us. This may account for a number of lingering diseases in adult life. What is remarkable is that it is impervious to later experience; no matter how much approval an actor gets he always needs more. It is why I maintain that only re-experiencing in the context of an old traumatic memory can be curative. Consider, in the session, despite the adequate oxygen in the room the brain is signaling a serious lack of it and the body responds accordingly-- gasping for air, living for the moment in the past. Engulfed by memory.

One would think that we learn from experience but those with heavy pain keep having the same experience over and over. That is why those who have one auto accident are likely to have another.

We have to ask the question, what is about reliving that is so important? Why is consciousness so critical? It means acknowledging the evolution of the brain. Although that seems evident, many current therapies treat the patient ahistorically, as if he/she had no history and there was no personal evolution. It is creationism in the guise of science. The universe was not created magically in seven days, and mental illness does not suddenly appear in people one day, without regard to their individual evolution. History must be the primary goal in psychotherapy if we want to get better. After all, what does it mean to “get better?” I believe it means getting our selves back, the self that hurts and feels. We must get our feelings back to become fully human.

Why relive? Because without access the agony portion of the memory has never been completely experienced. We carry that painful residue continuously inside of us. In Primal Therapy, we now react fully to the prototype. We no longer hold pain in storage where it has done its damage.

Depression is a terrible state. It feels devastating and never-ending, but fortunately, it no longer has to be. There is a way out; and that way out is the way in. But we have to have a map of the way; otherwise we are lost. The reason so many therapists believe it is untreatable except by drugs is that heretofore they have had no way to probe the inner depths of their patients. And that is where the problem lies. Depression seems like it is in the present, but actually, the person is walking around engulfed and ruminating in his/her past. In Primal Therapy, we help put the past back into history and thus bring the person into the present, now unencumbered. We cannot leave our past behind by any great amount of will or effort. In fact, trying to do so with will power only insures failure. We need to let go of that strong will and submerge ourselves into our feelings. In therapy, we provide access to ourselves, no more no less. But that is a lot, for it means an end to depression.

I use the terms radical and revolutionary for my therapy with caution; yet I believe it is. It is revolutionary, in form and content. Primal Therapy is a radical departure from the face-a- face, insight-besotted discussion between two unequal partners; one with a worldly knowledge and an unerring moral stance, the other a willing neophyte genuflecting psychologically to learn what the worldly one dispenses, acquiescing to the outside instead of the inside. I speak from experience, having practiced insight therapy for many years. The majesty of it all is intoxicating for the therapist. The power of directing someone else’s life is seductive – and wrong!

Sadly, in the name of progress and being modern we have moved away from the past into a more present approach. There is an apotheosis of the present, of the here-and-now, and a move away from the one thing that is curative--history. More sadly, for one hundred years we have been talking to the wrong brain! It is that brain – the intellectual, unfeeling brain – that prevents any hope of a cure for emotional illness. Talking to the brain that talks was fine a century ago but now we know so much more about the brain and what it contains; we can speak to the brain that feels in its own language.

We need to learn a new language – that of the unconscious – a language without words that could help us make profound change in patients. After all, we call it “mental illness.” Yet, words often are the defense against feeling. Our goal is to produce feeling human beings, not mental giants. When one feels the prototypic trauma, one is on one's way to a solution for depression. That, plus feeling all of the harshness, the excessive discipline, the indifference and the lack of caring in one's family; and expressing all of the feelings and needs held back for those years. Expressing all that with the original feelings involved – that is why it is so forceful and terribly sad. The crucial, curative difference is that our therapy is not about the adult shedding a few tears – the adult crying about the past – but it is about becoming the baby and child with wrenching sobs and agonizing screams. "Be nice to me! Hold me! Cherish me. I'm your son! Let me be me. I'm your flesh and blood. Show that you want me. Let me express how I feel!" Those are the needs. When all that is physiologically re- experienced as what occurs during a Primal re-living, depression is no longer a mystery. And only when it is all felt, over months of reliving plus the birth trauma when appropriate, will the depression be resolved permanently. So the more one feels what caused the closure of the system, the more it becomes safe for the system to become open.
Finally, love can get in.


For References, see the full text at: http://www.activitas.org/index.php/nervosa/article/view/157/186

More on the Meaning of the Act-Out

I have written about how we, most of us, act out our unfulfilled needs and feelings. We act out because those needs remain active throughout our lives., and we still seek fulfillment even if we are not conscious of what we are doing. The act-out, in short, is as unconscious as the need/feeling. Since we cannot beg mother to love us when we are forty we try to get it in other ways, and those ways are known as act-outs. We can all choose our poison (how we do it), but too many of us never know we act out. But there is a hidden force in there that most of us do not understand. The drive, the compulsion has a biologic side; there is a churning of physiologic forces that wear down our organs because the act-out is, alas, unrequited and requires unrelenting effort for a lifetime. So it is not just behavior, it is what is going on inside of us, at the same time. That means tension, as all of us, is working overtime. And part of that work is dealing with the pain of unfulfilled need, which means repression.

The act-out is not benign. One might say, what does it matter that one has to keep active and unable to relax? It matters because the system is always on the alert to seek fulfillment. We become attached to authority figures tying to get approval, or attached to an aggressive man trying to feel protected. Or we gamble to try to feel like a winner. It seems so common that we think it is normal. But when the system breaks down later on it becomes the price we pay.

We need fulfillment early on. There is a critical period for fulfillment and it is rather short-lived and limited; it ends rather quickly. Any time after that our actions are symbolic; we can no longer be fulfilled; the critical period has passed. It is too late; sadly, it can never be made up for. So why is someone hooked on heavy drugs? Because he is not fulfilling old lacks that still need fulfilling. The drug is calming, perhaps, events during womb-life or at birth. But is never fulfilling. And here lies the enigma. For parents may be decent and loving, but they cannot make up for terrible lacks and traumas in the first few months of life. If love could do it then the problem could be solved, but it can’t. No matter how much a parent wants to, he cannot love neurosis away. Love cannot penetrate the barrier of the gates, which are busy blocking- out input from inside and out.

I used to think that it was the act-out that would be the death of us; but I now believe it is the underlying feeling that keeps the system activated and forces the act-out. The daredevil is constantly doing something death-defying. He is facing death and conquering it, a replay of his early life. But the imprint of approaching death is still imprinted and forces him to do it again and again. A counselor can insist that you stop this negative behavior but she doesn’t see the force below that drives it. Need forces unrelenting behavior. It is out of control because it is already controlled by unconscious forces, which are stronger than any act of will.