Arthur Janov's Blog, page 31

The Looking Glass is Inside Out

         I have often wondered why there is so much nonsense out there in the treatment of mental illness.  One psychiatrist says most of it is a brain disease and the answer will be found in analyzing the molecules of the brain. This is also the view of the head of the National  Institute on Drug Abuse, Dr. Nora Volkow.  She spends her days in the depths of brain neurons trying to find answers to so many problems. Still others come up with nutty ideas about depression and anxiety that I have cited in numerous articles.  Some want to drill in the brain, others shock it, and most others want to medicate it.  Few if any know what it is they are shocking or medicating. The reason: they all need to guess what “it” is.   And “it” is not a neuron or a molecule or a hormone. “It”  is a memory, an imprinted one that sways genes in one direction or another and alters the trajectory of our lives.

         In other words, they all have  to guess because no one has seen “it;” they all have to look at it from outside, imagining what lies inside. Yet it can be seen and it is palpable. But before we get to “it”, we need to get to the human being who carries the “it.”  He is the ultimate arbiter of what is true.  We need to focus on her or him and not just molecules. Only then can one observe the wrenching body arcs from the pain,and hear the gasping for breath, the screams and tears.  One can observe the relief from the reliving, as the body and face relax, not only from observation but in the indices of vital signs that descend radically, and in an ordered fashion, after a primal reliving.

         Why hasn’t anyone thought about it?  Because Behaviorists rule the roost.  Looking at it all from the outside is "de rigueur", while feelings are anathema – a simple negative influence to be eschewed, set aside and abandoned.  Feelings become pests in the overall scheme of science where precise measurement is the apotheosis.  Yet it is feelings that govern and drive us; feelings when repressed make us sick. We will never notice this so long as we remain outside the realm of feeling and choose to observe it from afar.  How can we know that anoxia at birth may play a part in migraines until we see someone relive the beginning of anoxia and develop a headache?  How can we know what is behind depression until we see deep pain at work with repression rushing to save our sanity and create depression as a consequence?  How can we know what is behind anxiety until patients travel down the chain of pain, descending through levels of consciousness to the most primordial reactions of panic?  How can we ever know what trauma at birth does to us until we see the reliving and discover the lifelong allergies and attendant breathing problems?  Or what it does to blood pressure and heart rate as they rise radically during the reliving, then drop to normal levels after the primal experience.

         So of course some can say it is a brain disease since we can always find neurological accompaniments to anorexia, for example.   None of this exists in a vacuum.  Of course there are changes in serotonin levels accompanying the affliction but they are not necessarily causes.  We will never know that so long as we are “objective observers.”  Once we delve into deep memory and feelings we will find a whole new world, the primal world, if you will.  It will open up a plethora of directions that pain has taken us, but it is not in the chemistry of pain where answers will be found, but in the causes of that pain.  Of course when there is a lack of serotonin in certain anxiety states it helps to add serotonin to the mix, in the form of Prozac.  But that is what I call tinkering or tweaking.  It has little to do with ultimate causes.   We can tweak dopamine or serotonin in depression, and currently they do this by adding “chemical uppers,” that have the effect of activating the neurotransmitters. Or they tinker with the glutamate level allowing more activation with less repression.

         And when they tinker it has to be a daily job because the causes are untouched and create the same old mess over and over again. Witness drug addiction.  The addict’s pain is very deep and requires heavy-duty drugs to calm it—over and over again.  How do we know?  We have treated addicts and see the pain underlying the addiction. We know it is refractory because the level of pain, down deep in the brain is never touched in all those rehab centers.  Worse, they do not know it exists. So what do they do? They calm it chemically and are satisfied with that. Why satisfied?  Because they have never seen the Pain!  Never seen the agony, which allows them to think that it is just a bad habit.   Or to believe that a few words of praise can help it.  Or to think that a good diet will change it.  Or to think that a few lectures or group therapy sessions will change it.  And the pain, hidden and recalcitrant, shouts back at the curers: “Try to find me! I am far below where you are looking, encrusted into the deepest chemistry of the brain,  conjoined with repression so no one can see  how I operate.”

         And on the psychological side, how could any of us know that not being held and caressed right after birth can lead to life-long terror of being alone.  Or that this memory can play an important part in depression when there is no one around us to soothe and calm.  So when we are not busy working and surrounded by people we get depressed.  More important, how can we know that love is primordial in the earliest months and years of our existence until we see what its absence does to us?  Lack of touch and hugs causes pain, more pain than we realize. Or that an anxious carrying mother is speeding up the metabolism of her baby, perhaps for a lifetime.  We cannot know about the imprint that lies engraved into the brain until we observe its reliving.  And reliving over and over with the same vital signs each time.  No one who has not seen primal pain in its full blown agony can know what it does to us and how it drives our behavior and intractable addictions. The imprint is the archive of our remote past that we carry around all the time but never know it because in its repressed state it is unrecognizable. 

         So does nothing help?  Lots of things help – help to tweak and tinker.  But only one thing works to reverse the imprint, resolve the engraved feelings, restore health and relieve suffering – Reliving. Aah!

The Mystery Known as Depression

This article published in the Journal for Neurocognitive Research of the World Psychiatric Association (Activitas Nervosa Superior).Read the full text at: http://www.activitas.org/index.php/nervosa/article/view/157 (available as a pdf).

Here is the abstract:

"This opinion article presents the result of years of observation of depressive patients. It is a report on their treatment while undergoing a feeling therapy that deals with reliving past imprinted trauma in context of new research in neurology and biology. The underlying premise is that early traumatic events, including the time in the womb and at birth, leave an imprint aided by epigenetic methylation that endures and comes to dominate our lives. It later accounts for serious ailments and the imprint plays a role in our behavior, interests and attitudes. Through a feeling psychotherapy that allows patients to relive their traumatic history might be possible to found a way to make profound changes in depression. "

Suicide is Painless (More on Suicide with some additions)

I was discussing the difference between self destructive behavior and suicide with a colleague. They are quite different, although you would think that suicide is destruction of the self, but it is not at all like that. To understand, we must go back to the imprint, as so many of my suicidal patients have done.
In many of these cases, the person has experienced an oxygen deficit, perhaps due to a heavy dose of anesthesia to the mother during labor, or being strangled on the cord during birth. And after an agonizing attempt to get born, death approaches and there is a sense of impending relief. That memory of possible relief is sealed in so that later, in the face utter hopelessness, an impending divorce for instance, death becomes the answer. An attempt at suicide follows. The memory of possible relief becomes stamped in, or engraved, and it endures for a lifetime. It is the last link in the chain of pain, as it were, the logical denouement when current hopelessness can set off the primordial (primal) hopelessness where death lurks and where suicide seems the logical step.

You may wonder: how is it that hopelessness today sets off the same feeling created during birth? It is again the chain of pain, the descending links between levels of consciousness. It is known as resonance, where one feeling, which evolved out of similar feelings at earlier stages, ultimately triggers the earliest related feeling that was originally imprinted at the start of life. I have written that it may be a specific neurological brain frequency that sets off the imprinted counterpart. Each deep feeling, such as hopelessness, matures and evolves onto higher brain levels where there are more advanced levels of consciousness. Thus the deep imprint becomes reflected in the same or similar feelings higher up. Conversely, in our therapy we start at the top, the last stage of the evolutionary chain, and work down the chain of pain to those earliest imprints. Normally the gating system keeps the brain from evoking those deeper levels but when one has undergone years of neglect and lack of love, the gating system falters. Then, a current frustration can set off profound feelings of hopelessness impressed deeper the brain. Here we may see violent act-outs as those more powerful feelings are elicited. It is why, for example, a student’s current fear of failing in class can set off a full-blown anxiety/terror attack. The manifestation of the feeling in the present gets amplified through resonance. Thus, the current feeling sets off the same deeper feelings until the whole system is engulfed in utter hopeless feelings. And worse, there is no scene attached to it, since it is pure feeling, naked and unadorned, the exact same feeling from gestation and infancy, rising again to smother the person and make her suicidal. It is the most profound hopelessness. The current feeling has triggered its progenitor with sensations of approaching death becoming paramount. When that feeling becomes excruciating one may want to kill oneself, just as the fetus/infant had no other options. The accompaniment of this hopelessness is nearly always lower body temperature, the parasympathetic nervous system dominance.

That early hopelessness is later expanded and ramified as the whole system and brain mature. As each new brain system comes on line, it adds its emotional weight to the feeling. But it is the same feeling with increased neuronal development. It is that feeling that is the essence of depression. As I explain in my extensive article on the subject, “The Mystery Known As Depression,”  it is the system’s effort to suppress the feeling that produces depression. So depression is not a feeling; it is what happens as that feeling is blocked from higher level access. And when we unravel depression that is what we find: utter, unarticulated hopelessness. And as it is felt and experienced with all of its pain, the depression begins to leave, at last.

This means that we must not trump evolution and experience the deep feelings too soon in therapy. This happens when gating is leaky or faulty. And it is here that for a time the patient must be given pain blockers to temporarily hold back resonance. We are not blocking higher levels of expression, only that portion of the feeling that might be catastrophic if experienced too early. Inadvertently, I think this is what doctors are trying to do with their drugs; sever the possibility of triggering off deeper pains for a time. They are attempting to block resonance, though they may not even acknowledge that it exists. Yet, painkillers that work on lower levels are targeted precisely for that. We can only feel those deep hurts as the body and brain allow – current hopeless feelings first, then those from childhood and finally infancy, where the deepest feelings always lie. I use the word “compounding,” because these are not different feelings; they are the same feeling compounded. The child just seems unhappy and sullen and no one knows why. And certainly the child has no idea at all, nor do his teachers. He is in the grasp of that early primordial, devastating feeling that no one can say or name. It is literally ineffable – so deep and overwhelming as to defy description.

What has this to do with self-destruction? Let’s take a literal example of destruction, cutting oneself. This is a later ploy, making hurt obvious. It is a plea for help: “Please see my hurt. See that I hurt.” This in lieu of screaming out that hurt. And the cutter is not often aware of what she is doing or why. It was never acknowledged by anyone because perhaps the parents had no idea of that hurt, or even that such emotional hurt existed. There are many aspects of this. For one patient, the feeling was, “I’m trying to let the hurt escape,” even when she had no idea what it was. She just knew it was inside and it had to come out. In therapy, that is exactly what we helped her do – let it out in methodical ways, so she no longer had to cut herself.

Examples of self-destructive behavior are myriad, but all the manifestations come from subdued feelings. There are people who set themselves up for certain failure, who always make sure things turn out bad, who drink themselves into oblivion or who repeatedly get involved with a low-life they know is bad for them. Here the driving forces are nearly always deep-seeded pain. But in the strict sense, a sense not in the psychoanalytic lexicon, these are secondary effects of imprinted hurt.

An example: one patient in graduate school could  not get feedback from his professors for a paper he turned in.  After weeks of “trying to get through” he sent a most nasty letter to the instructor.  For that, he was delayed in getting his degree. So he shot himself in the foot (self-destructive) because he could  never get through to his father and also because he literally couldn’t get through in being born. Being blocked from getting what he  wanted and needed had set off a rage in him, and as we know rage is first line,  brainstem originated.  It is the seat of the most atavistic anger possible.  He was helpless before this surge of fury.   Resonance reached down and dredged it all up, surging beyond control.   He knew when he  sent the letter it was wrong; this is what used to be called “emotional.”  His emotions got the best of him.  They weren’t irrational; they were real but buried deeply.

In the news, there is story of a man who went on another mass killing spree, this time at a supposedly secure Navy Yard in Washington, D.C. The shooter walked through the facility with a shotgun and calmly fired at defenseless people, killing twelve. Somewhere he might have known that it was suicidal but that was a faint force against his feelings. A month before the rampage, the killer had told police that he was being followed by three people who were talking to him through the walls and ceilings of his hotel room and sending microwave vibrations into his body to deprive him of sleep. In this case, we see clearly that the killer’s feelings are so deep and so remote as to seem like a machine controlling his brain. Otherwise he would know it derives from deep in the  brain.  It has been discovered that when such disturbed people hear voices, they really do. And what those voices really say is,  “I hate.”

Here is the important point. This man did not suffer a “thought disorder.”  If it were a simple thought disorder then it might be treated with more healthier thoughts; i.e., cognitive therapy. But to believe it is a thought disorder means  to ignore the evolution of the brain, to deny that there are lower levels with their own characteristics and functions.  To believe this means that the thinking cortex arrived de novo with no antecedents, and that it was not  anchored anywhere in the brain. It  is considered by cognitivists as an entity unto itself. These are the deniers of evolution, the “creationists of the brain.” They might not agree  to this characterization but there can be no other. It is feelings that drive thoughts, in the here and now and in the history of the brain.  The killer  suffers from a feeling disorder.  Until we acknowledge that we will go on treating the wrong thing  in the wrong way.  Feelings have that great power in history, and when it comes to the brainstem,  unleashed,  it  can lead to murder. Ideas, remember, are the last vestige of brain tissue that we can resort to.  Feelings slop over boundaries and surge into the ideational brain where we manufacture ideas to match them. The most bizarre come from the earliest imprints where they provide a terrible neuronal force that the cortex has to deal with.  When ideas no longer do their duty, a stroke cannot be far off.

  How can we be so sure? We see this in our therapy: as deep feelings rise they can sometimes provoke strange ideas. When we give patients medication that addresses mainly the lower feeling centers, the paranoid ideas may disappear for a time. We would not think of attacking the ideas head-on.  We address the underlying feelings, but again, only when they can be safely integrated. Indeed, when a patient is on the verge of a deep, heavy feeling, she may get paranoid transiently: “They are trying to suffocate me.” We know immediately where it comes from and can treat it post-haste.  Once our patients begin to relive deep brain imprint those paranoid ideas disappear.

So what are the self-destructive people among us doing?  What and who a re they destroying? The feeling self, the one with all the pain, but they are not destroying it, they are keeping it from destroying them. Drinking into oblivion seems self destructive but it is the person’s means of keep pain under control.

Suicide and self-destructive behavior, then, are indeed two different things. Even though suicide attempts to destroy the self it is not, oddly, self destructive. Suicide means one final act. It is not anything in the present that causes it; it is the result of a deep memory. And yes, if one could, then screaming it out could help temporarily, since it would relieve the pressure. There are some acts of suicide that are a cry for help; taking a certain amount of sleeping pills, for example. And there are others that say, I really don’t want to live anymore; that is a jump off a bridge. That is final, no call for help. It all seems so helpless and hopeless; they want to die for relief. No more pain; that’s enough. That’s why the theme song from the television series “M*A*S*H” rings with a profound kernel of truth: “Suicide is painless.” Killing oneself is not meant to be self-destructive, per se; it’s meant to kill the pain, which has come to subsume the self.

In Primal Therapy, we get patients gradually down to those deep feelings that are so disturbing. It takes time, but when they get there, they discover real relief, the kind that lasts and lets them live.

On the Imprint: Its Role in Psychotherapy

It seems that by now in Science, we have a good idea of what the imprint is about. Something I did not know about 50 years ago when I first posited the concept. The reason it is so important is that it determines personality, illness, whether we are constipated or not and many other facets of our lives. It is now an established fact in human development. I will explain but let me first say that once we understand the nature of the imprint we understand that no basic change in personality can take place in therapy without altering the imprint.

So what is the imprint? It is a memory, an ensemble of all the circumstances surrounding a key adverse event; a memory of an early trauma encapsulated. It is not just a “memory” in the usual sense of recall or actively going back to consciously retrieve something forgotten in the past. It is an event sealed-in biochemically forevermore and it affects us forevermore. It drives our behavior and the kind of sickness we will suffer from, will be get Alzheimers disease or cancer? The imprint may be able to answer those questions. And you cannot get there from here; you cannot willfully try to retrieve the memory because “willful” is the opposite of what is needed. One needs to let go of high level cortical processes and descend down the levels of consciousness where the imprint exists. And there we find that we cannot reach out to it because it is encapsulated, surrounded by aspects of the methyl chemical group, which helps encase it and make it unreachable. In effect, it is methylation that is heavily responsible for the imprint and its enduring affects. To retrieve the memory we need to “live” on the level of its existence for a time, use the right brain to lift it toward conscious/awareness, and bit by small bit integrate parts of the memory into the brain and the entire system. Thus, we need to de-methylate the memory. Until we do that there can be no profound change in anyone despite all claims to the contrary, notwithstanding. Not meditation, not cognitive therapy, not mindfulness or hundreds of other nonsense approaches that ignore neurobiology. And, I might add, that ignore evolution; how the brain evolves and what levels of the brain are holdovers from our animal history. No one can make real change when two-thirds of our brains are unacknowledged. We have the tail and the feet but we still don’t know what it is; how can we treat it?

Yes, one might add but this is just a theory. Yes but a substantial one with much research and therapeutic years behind it. And for over fifty years we have not seen any substantial change in patients until they descend down into the levels where the imprint exists. It is the deep unconscious and it has not been seen or observed in any way because it is out of contact with our intellectual brain. It is the province of the shark and chimp brain; the province of non-verbal behavior.

There are easily several hundred current research studies on methylation, acetylation and phosphorylation that describe how imprinted memory reroutes the brain. How it changes brain circuits. Do we really think that changing our perceptions, rationales and attitudes can alter those basic processes? Research says “No.” There are chemical processes that help open up the memory system and others such as with methyl that closes it down. But once locked-in, it lives on and experience does not change it. The evolution of the genes has been rerouted. Epigenetics reigns. That is crucial; experience cannot change it. That is why we cannot love neurosis away or exhort it to change, or plead and beg for it do something “healthy.” Its ineluctable road is already paved with bumps and crevasses. We are destined to travel them unconsciously. We could say in this sense that our lives our predetermined.

Let me give you an example. We see a patient and we do not know why he is so hyperactive, cannot sit still and cannot concentrate. How do we now what’s wrong? We won’t until we know what events at birth or in the womb transpired to fix this affliction in the system. Was the mother on coke, both kinds? What she very active and nervous throughout her pregnancy, especially since her husband left her. Was there a war going on? Was she depressed or was she given heavy drugs to hurry birth along? Hundreds of questions that need answering. A therapist can say, “I’m not interested in the patient’s past; it is her present that counts. Yes but the present is very dependent on that past. This is too often a rationale to simplify therapy but it is simplistic, at best. How did the pregnancy evolve? We know that bickering parents often produce allergic children. Should we ignore the gestation period? We know that a carrying mother takes drugs it has a profound effect on the later drug taking of the offspring. Should we ignore that too? We will never know the true causes of adult cancer and Alzheimers disease without know the patient’s history. So what on earth does paying your attention to your breathing in mindfulness therapy do to the imprint? What does it do to prevent serious disease? Nada!

So how can we understand mental illness with 2/3rds of the brain missing? It is a practice with one arm tied behind. In my clinic with many hundreds of patients over fifty years of primal I have seen what a carrying mother’s heavy smoking does to create severe mental illness. It happens too often to be a chance affair. Or the mother’s drug taking and how it affects later drug use in the offspring. Karen Nyberg’s research, which I quoted in my other blogs, is instructive. There is a heavy correlation between the two. We must change the imprint and begin to reverse the memory and its impact. Our research will tell us more about this. How on earth can we understand anorexia without knowing about the research (Roberts and others) on early trauma and later eating disorders? The research states that it is largely due to epigenetics. And key epigenetic changes take place very early in our lives that alter fetal programming and the evolution of the fetus/baby. Let us not forget the critical window where those events are engraved for a lifetime. That is where we therapists must go; to that window where trauma was impressed into the brain and whole system. If we do not, then we cannot understand anxiety states in our patients or ADD which shuts down focus and concentration. It is not here and now; it is there and then that must be our focus because there and then determines here and now, to a great extent. If we exclude there and then we will not know that later eating disorders are often caused by the nutrition of the carrying mother. That has been confirmed by numerous studies. Let us take off our blinders and look at the whole brain. And above all, the whole person.

We need to make clear that we need to change consciousness in psycho-therapy, not just awareness. Too many therapists conflate awareness with consciousness. Consciousness encompasses many layers of brain function not just the neo-cortex. It is all levels working fluidly together that form consciousness. Awareness is but one level trying to do the work of all layers.

Adversity in the Womb and How It Affects All of Our Lives

Over the years I have quoted a great number of studies showing how womb-life experience can carry on for a lifetime. What seems to be evident is that the chronic moods of the carrying mother produce the same or similar effects in her offspring. One way we imprint these deleterious experiences is through the process of methylation. We recruit part of the methyl chemical group to enhance or seal-in the repression of the memory. And the importance of our proposed research is to show how remote/early experience changes the neurophysiology of us humans for a lifetime.

I have explained that traumatic imprints change our biology and our neurology; the process of repression of these pains may play into such serious afflictions as cancer and Alzheimers disease. But what we want to show is that we can reverse the imprint or alter it a bit with our therapy. What I have proposed is that in reliving the primal imprint we lessen its effects, and once that is done can we actually short-circuit or demythelize the imprint. Can demythelation abort the advance of a serious disease? I think so. We need to prove it.

But the theory should guide us here; deep repression, heavy methylation is the culprit in many afflictions, not the least of which is depression. Can we intervene in time to avoid the advance of both physical and mental disease? We do attack the key primordial imprints at their source. And since we lessen chronic cortisol (alarm reactions) levels, as well as lowering blood pressure, body temperature and heart rate, we already have evidence of the reversal of key indices of neurosis/imprinted pain. It seems to me that the system functions as a whole, and when we relive and relieve many of the concomitants of the imprinted pain we are affecting the imprint directly. Otherwise why would the stress hormones continue to decrease in many of our patients as the result of our therapy? What I am indicating also is that undoing repression may contribute to a longer lifespan for our patients, something we shall measure through telomere lengths.

Methylation is becoming critically important in current science. What has been found recently is that if a stretch of DNA has a lot of methyl surrounding it the activity of some of the genes is suppressed. And they found in a study of twins where one was healthy and the other had a split spine (New Scientist, 31, Aug. 2013), that the possible cause was a plethora of methyl in the area which down some of the activity of growth; growth was suppressed. Methyl and repression seem to be more and more blood sisters. It’s hard to get one without the other. We are finding that more and more of harm such as pesticides is agented by the methyl group; that is, methylation patterns are altered. And it may also be that prolonged smoking may have impacted methylation as to produce enduring harm.

I have wondered why it is that we see wisdom teeth dropping after the age of forty in some patients, or why there is marked foot growth in their thirties. Methylation may be one answer since, an assumption, what seems to happen is that we do in part is reverse methylation, allowing certain structures to continue their voyage to their proper destination. In other words, methylation blocks or aborts genetic evolution, puts it on hold until it is revisited and then allows it to continue along its genetic arc.

Regarding the twin study, the authors seem to think that even though the twins share the same womb, the methylation for each of them can be different. And this may ultimately affect how each person interacts with others later on; making for marked differences.

What brought this home to me was a recent article in Science News (Also Human Health, Brain and Behavior, Aug. 25, 2013) (see http://www.sciencenews.org/view/generic/id/352184/description/Caffeine_shakes_up_growing_mouse_brains). Mice given caffeine while pregnant changed the brains of the offspring. Also, a set of mice drank water treated with caffeine, (an amount a woman would drink while carrying--about 3 cups of coffee a day). There were direct effects on parts of the limbic system, particularly the hippocampus. There were fewer neurons in these structures that deal with memory in the mice. And more, these caffeinated mice did poorly on tests of memory. These mice did not explore new stimuli and had what I think was aspects of ADD. They were not as curious as normal mice. Their brains seemed rewired. And it is not a big step to see the implications for humans. A mother does not have to have drunk coffee to produce adverse effects; she simply needs to be in a chronic agitated, nervous state. It is exactly as if she drank many cups of coffee. The fetus picks up on this automatically and reacts accordingly. Neurons in the limbic system, then, became hyperactive, as well. And that chronic agitation keeps focus and concentration from happening.

During sessions with in-dwelling thermisters in our patients we can observe changes in blood pressure as the patient relives key imprints. It lowers when primal pains are relived and rise when repression is evident. We see this clearly also with body temperature; depressives come to sessions with low body temp and we see it normalize when they relive early traumas. In other words as key memories are relived the accouterments of the memory do change; from this we may find, as I believe, that these are the indices of changes in the imprint itself. In short, the imprint is an ensemble of reactions, not just the chemical.

Whatever external stimuli are affecting the carrying mother are also affecting her baby. He is not behaving on his genetic legacy so much as his epigenetic inheritance, his life experience. We must understand that we need to be careful about ingesting any foreign substance from alcohol to tranquilizers, while pregnant. And we therefore need to be aware that womb-life effects are impactful and enduring.

Because they endure and continuously stimulate the system there is hope; that we can attack the basic imprint and reverse it. It is not heredity that is irreversible, but epigenetics which is reversible, something we have been doing for almost 50 years. If it has been life experience that has caused changes in the biochemistry and neuronal circuitry it can be altered. It is not a fixed entity. The way this is done is searching out and reliving key imprints. The changes in vital signs are part of the imprint so that when we reverse the by-products (lower blood pressure) it tells us of its effect on the imprint.

On Catatonia and the Freeze Response

We have a patient coming into therapy who has been diagnosed by an English clinic as catatonic. She freezes up and it can last 8 hours where she cannot move or react. She has no feelings during the episode, just numb. She has stayed in the clinic for eight months while they tried everything they could including art therapy and few booga-booga varieties of nonsense. Why am I mad while I am writing this? Because it is criminal what happened to her. They had no idea what was wrong so they tried a potpourri of all the things that the usual addiction clinic tries. And with the same result: nada.

So let’s look at what it really is: first it needs to be triggered. We are not triggering catatonic; what is triggered is first-line terror, and what happens is one of two responses, both originating in the hypothalamus. The first is attack and aggressive; fighting off menace. The second is the freeze, becoming paralyzed with terror where moving is life endangering; the mother on serious drugs or tranquilizers, for example. Here is where using up oxygen becomes life endangering; the whole system has learned that freezing is the first primal response against danger. And in the first instance where danger lurked it worked. The carried baby may have been reacting to heavy drug overdose or drinking. So some of us, depending on the nature of the early trauma and genetic tendencies admixed with epigenetic effects, find the inexplicable reaction of no reaction as effective. We see this so clearly during the trauma at birth where the baby heavily anesthetized has to withhold breathing deeply to conserve oxygen. These are the later breath holders.

I have seen and helped catatonics at the mental hospital where I worked; most suffered from what is known as “waxy flexibility.” We put their arm up in the air and it stays there. We twist their hands in a certain direction and it remains in that position. They cannot manage any voluntary action. At the time no one, including me, knew what it was. Now we know. And I shall explain it.

Let’s go back to our three levels of conscious; the first line is basically brainstem and ancient part of the limbic system—the amygdala. This is our most ancient brain that has its beginnings millions of years ago. It is a mass of impulses but no feelings; here is where the primitive parts of the hypothalamus exert their dominance. And depending on many factors determines whether there will be either anxiety reaction with aggressive responses (the sympath); or whether there will be anxiety responses held in immediate check as bodily reactions freeze (in the parasympath). These response tendencies get stamped in and engraved so that it directs our characteristic reactions thereafter. The parasympathetic nervous system activates the freeze response everywhere in the system, not just in behavior. Think of the frightened reactions of a deer or rabbit. So something in the human triggers off fear, which then may resonate with first line terror which provokes the parasympathetic system into action—freeze. “Freeze” is a reaction to something that really happened, not a chance or whimsical caprice.

An example: some years ago I was napping in the backseat of the car. The driver looked back to make sure I was comfortable. By the time she looked back to the road she was in a culvert heading for a major steel signpost. She froze. I reached over grabbed the steering wheel and guided us back on the road and to safety. The imprinted reaction governs our life forevermore. My basic tendency was sympathetic but with a lot of parasympathetic reactions as well. The “freezer” usually has low blood pressure and low body temp; she is in the constant conservation of energy mode. She is not a self starter and needs constant direction and guidance. One has to “breathe life” in them to get them going. And why? Because something could have happened during womb-life or birth that diminished oxygen to dangerously low levels. They go on acting as if the imprint is now— current. They go on in a passive mode; go on as if they had no more energy to fight.

Freeze and paralysis is a reaction to anxiety and terror, remember. It doesn’t happen without reason. It is the alarm system that signals the response; we must suss out what the danger is that provoked that alarm reaction. Then we can treat it. And what is the danger? Nothing external; something internal…..sensations (of suffocation) or feelings (something closing in). When the patient who is coming into our therapy gets provoked she goes into the freeze—catatonic response first, for an hour or five. Then slowly as the defense weakens and body lets go of its tension/defense she develops an anxiety state. This is what the freeze response is defending against….not enough oxygen, which produces terror. Then after more time, she seems to be flooded with feelings which causes great frustration. But she doesn’t know what is flooding her. It is now a mélange of feelings liberated. So it is literally the freeze response we see where the person cannot move or speak because she is locked into the deep, brainstem imprint where there is no emotion, nor speech. Her nervous system is moving up the chain of pain, up to higher levels of brain function.

Why Is the Unconscious So Mysterious?

I know why. As one blogger put it: the body keeps fighting to tell me what happened in my life but my brain/cortex keeps fighting back and refuses to hear. It is not a willful refusal. The cortex just whips into action when pain levels get too high. And it reaches over and down into the limbic structures to keep them at bay, spritzing chemicals here and there to make sure feelings don’t get out of hand. Sometimes, that doesn’t work; feelings do get out of hand, and what do doctors do? They reach into their pharmacy for more of the very same chemicals (SSRI’s) that are lacking in the person, dosing him up so that feelings are again in control. Never seeing that those feelings, when under proper care, are liberating. All the person knows is that she is anxious; what the doctor and she do not know is that it comes from deep in the brain and needs exit in slow methodical ways. If they both only see anxiety then they are both lost. If they understand what it is, then they are on the track for proper resolution of the problem.

Generally, it is often the troublesome first line brainstem memories/ imprints that fight their way to the top, only to be put down again. And these memories rise with no words to them nor any scenes from childhood. They emerge from the dark depths where no words exist nor ever existed. They are pure forces, amorphous, no recognizable shape or sound, but they want out. They remain mysterious just because there are no verbal accompaniments with them. They need to connect to the prefrontal cortex. They “speak” of what happened to us at the start of our lives, impressions so vivid and strong, so menacing of death and so catastrophic and painful as to be overwhelming. A carrying mother drinking or smoking or going on crazy diets, all endangering the baby’s life.

That is why after a time in therapy when these sensations begin to rise up in therapy they can be severely disturbing to the whole system. And this is how we know how devastating they are, enough to cause serious ailments years later. We can see and measure their force; how it raises amplitude of the brain waves, how it speeds up the heart and raises blood pressure, and how when these sensations threaten to intrude into awareness, the person sometimes feel he is going crazy. And in cults, where they have no idea what is happening, they can go crazy. That terrible confusion is what the fetus feels— disoriented.

Now we have an idea why a person under constant stress can get very sick. The person imprinted with first line trauma can get sick because he has suffered chronic imprinted stress from the start of life that never leaves and never lets go. It is tenacious because it needs connection, to be integrated and be done with; the sensaton/ feelings needs connection so that it no longer stays an alien force. So in their infinite wisdom many shrinks help them stay unconscious by drugging them and repressing the early experiences. They do that because they have no idea that there are such deep forces hidden and barricaded by neuro-chemicals as strong as prison bars. This means that they think there are results with no ultimate cause; that symptoms just come out of the air. Why? Because they cannot see that mysterious deep unconscious.

And it is these aleatory, primal imprints that can cause massive drug addiction; and so we see the heavy use of painkillers to calm the symptom, but not what is driving it. Calm is not cure. And it takes a strong drug to hold down these pains because they are massive; they are nearly always life and death—a pregnant mother taking drugs or seriously depressed. These maternal habits are catastrophic for the baby and often result in equal and opposite catastrophic illnesses down the line. And sadly, they are a mystery in our field. The reason they remain a mystery is that the professionals have no idea of how to approach or get to these early imprints. Worse, they don’t know they exist. Even though the field of epigenetics should tell us something about it. So if I as the doctor spend a life-time repressing my pain, and it happens automatically, then I have no idea that anything is there.


 Of course I don’t put anything in question, I believe that there are only childhood memories and that’s it. This is as if there is no 9 months of gestation and absolutely no experience that affects the fetus during that period. And yet, in our research in many articles in the last few years and in our therapy, those first line imprints are critical.

If we want to change the world we better be aware of gestation and how to manage it, we must be conscious of the first line. Above all, we must change the birth practices. Automatic cesarean by appointment is a no-no. So is cutting the cord prematurely, so is bad diet and drinking. In the NY Times Sunday in the Science Section, for Christ sakes, there is a shrink saying it is OK to drink while pregnant. This counters everything we know. And what if she is wrong? Imagine the damage that can happen. My guess she is exculpating her own drinking while pregnant. How on earth can a major newspaper cite such nonsense. It is one thing to be fair but quite another to run pieces that can be dangerous.

We cannot see first line unless we are in a therapy that aims for it. We do see the results. Do we go on ad nauseam beating down the symptoms to make them disappear and then pretend they do not exist? What does cure in these cases mean? Certainly not beating the symptoms down. It means getting at the generating sources—the imprints. It is that simple and that complicated. Otherwise, it is whack-a-mole all over again. The symptom pops up again, and we smash it again with drugs and surgery and shock. Or the weakest of all—talk it to death.

In our field the first order of business is to help professionals be aware of the deep unconscious. They need to learn how we get there. It can be a protracted trip but it is a sure one.

What I Don't Understand

You may wonder why I  don’t understand this, but I really don’t: why, out of 200,000 shrinks in America very few reach into science to prop up their theories.  Why is it that every time we read about a new theory, such as mindfulness,  it is concocted out of whole cloth by the therapist?

I was thinking about that today in reading about research  starting in Science 1997 about stress hormones, which activate  us.  And what makes their rise?  Lack of love in animals, lack of licking and grooming.  In humans not enough kissing and hugging.  I  will take a simplistic notion here—cortisol.  It is a complex matter but one thing we do know is that lack of warmth in humans raises those levels; that is why my beginning patients are uniformly high in cortisol levels.  And after they feel deeply unloved their levels lower radically…..because they feel, and  feelings lower levels.

But here is the point; lack of love activates us and that means faster metabolism, more brain activity, faster heart rate and higher blood pressure.  We go to a doctor and he cannot see the “lack of licking,” so he prescribes drugs to stop the activation.  Usually the drugs that slow down the neural message from one synapse to another. Meanwhile the child is now eight years old and he is diagnosed as ADD. He cannot concentrate or sit still in school.  He is activated, and if therapists know their science they would look right away at what is causing that activation.  They need only look at animal  studies to find the answer. Everything is souped up when we are not loved enough and we are activated to find it where we can.  There  are myriad of other factors but this alone should help us understand an overactive brain.

What the Science journal was emphasizing was the long term effects of deprivation.  And how is  this done?  By methylation.  Now, just this fact and no more than that should inform those treating ADD sufferers about why children are so activated.  And that in turn should tailor a therapy toward dealing with this activation.  Up to now that has mean medication to slow down neural impulses so the message of pain cannot  reach higher brain levels.  But surely we can do more; we can go back and find the imprint and the origins of methylation and stop the activation in its tracks, which is what we have done.  Doesn’t that seem logical, an overly active child  is revved up due to a cause.  We don’t just look at the end product, the excitation, but the generating source.  Lo and Behold!  We find the answer.  And it never is about pushing back the activation/pain

All I am trying to point out is that there is simple science out there that can give us so many answers.  We can learn from neurologic science and we can change our treatment based on their findings. Alas, too often the research remains left brain and cannot inform the right of how to apply it to therapy.  So what the therapists know cannot be applied to their work.  The patient gets more of the same-- repression and repressive drugs to hide the source.  Is that therapy?

More on Suicide

I was discussing the difference between self destructive behavior and suicide with a colleague.  They are quite different, although you would think that suicide is destruction of the self, but it is not at all like that.  Let’s go back to the imprint as so many of my suicide attempts have done.   In most of these situations, there is an oxygen deficit, perhaps a heavy dose of anesthesia to the mother or being strangled on the cord. And after an agonizing attempt to get born, death approaches and there is a sense of impending relief.  That memory of possible relief is sealed in so that later in the face utter hopelessness, an impending divorce for instance,  death becomes the answer.  And attempt at suicide follows.  It is a memory of possible relief, stamped in, engraved that endures for a lifetime.   It is the end of the chain of pain, as it were, the logical denouement when current hopelessness can set off the primal, primordial hopelessness and death lurks.

You may wonder, how is it that hopelessness today sets off the same feeling during birth?  It is again the chain of pain, the links between levels of consciousness.  One way we see that link is through resonance; the current feeling sets off the same  deeper feelings until the whole system is engulfed in utter hopeless feelings; and worse, there is no scene attached to it as it is pure feeling, naked and unadorned, the exact same  feeling rising again to smother the person and make her suicidal. It is the most profound hopelessness. The current feeling, in short, has triggered off its progenitor with sensations of approaching death becoming paramount.

Let’s put it differently for clarity.  That early hopelessness is later expanded and ramified as the whole system and brain mature.  As each new brain system comes on line, it adds its emotional weight to the feeling.  But it is the same feeling with increased maturity and neuronal development.   It is that feeling that is the essence of depression; it  is the system’s effort to suppress the feeling that  produces depression.  So depression is not a feeling; it is what happens as that feeling is blocked from higher level  access. And when we unravel depression that is what we find: utter, unarticulated hopelessness. And  as it is felt and experienced with all of its pain, the depression begins to leave, at last. This is not done in a day because it is very deep, the end point of the birth agony, a cord around the neck, for example. This means that we must not trump evolution and feel it soon in therapy. We can only feel it as the body and brain allow, current hopeless feelings first, then the childhood compounding  and finally, the first line, brainstem component where the deepest  feelings always lies.  I use the word “compounding,” because these are not different feelings; they are the same feeling compounded.  The child just seems unhappy and sullen and no one knows  why. And certainly the child has no idea at all, nor do his teachers.  He is in the grasp of that early primordial, devastating feeling that no one can say or name.  It is literally “ineffable.”

What has this to do with self-destruction?  Let’s take literal destruction, cutting oneself.  This  is  a later ploy, making  hurt obvious.  It is a plea for help; “Please see my hurt. See that I hurt.” This in lieu of screaming out that hurt. And the cutter is not often aware of what she is doing or why.  It was never acknowledged by anyone because perhaps the parents had no idea of that hurt or even that such emotional hurt existed.  There are many aspects of this.   Her feeling was, “I’m trying to let the hurt escape,” even when she had no idea what is was.   She just knew  it was inside and it had to come out. She found out that it was exactly what we do; letting  it out in methodical  ways, so she no longer had to  cut herself.

Suicide, then, is a  deeper, earlier sensation/feeling with no behavioral possibilities.  And the hurt that some act out may have many different feelings involved.  They are, indeed, two different things.  Even though suicide attempts to destroy  the self it is not, oddly, self destructive like burning or cutting oneself.  And of course, it ramifies so that the destructive behavior takes on many forms.  Deliberate failure is one part.  Getting involved with crazy and violent people is another.  But it is not as direct as suicide.  Suicide means one final act.  It is not anything in the present that causes it; it is the result of a deep memory.    And yes,  if one could  then screaming it out could help temporarily; it would relieve the pressure.

There are some acts of suicide that are a cry for help; taking a certain amount of sleeping pills, for example.  And there are others that say, I really don’t want to live anymore; that is a jump off a bridge.  That is final, no call for help.  It all seems so helpless  and hopeless; they want to die for relief.  No more pain; that’s enough.

What we do is get patients, over time, down to those deep feelings that are so disturbing.  It takes time but when we get there it is pure relief, and it lasts.

Anthony Wiener and His Sexual Compulsion

 The recent chapter in the Anthony Weiner sexting scandal brings to mind the old adage, “The spirit is willing but the flesh is weak.” I think Weiner’s disgraceful downfall shows that we, as psychologists seeking to explain sexual compulsions, need to turn that saying on its head: The mind is weak when the flesh is willing.

By now, most of us have heard of the sad and sordid escapade that threatens once again to torpedo the political career of this once rising star of the Democratic Party. It came as a shock two years ago when the married congressman from New York was forced to resign after being publicly exposed, quite literally, for texting photos of his private parts to a woman he had never met. We would think that after a world-wide embarrassment he would have learned his lesson. But another surprise came this week when it was revealed that he continued to carry on internet liaisons even after his remorseful resignation, his apologies to his wife and constituents and, most importantly from my perspective, his promise to change his ways and stop his incredibly risky behavior. Now, after his wife and the public forgave him the first time, Weiner is under pressure to drop out of the race for mayor of New York City. Still, he is standing firm, no pun intended. He appeared at a press conference with his wife in tow and vowed to stay in the race. She admitted that it took a “whole lot of work before I could forgive Anthony.” Given his compulsion, she may have to forgive him over and over again.

 A year ago, I commented on Weiner’s resignation in my blog, ending with a line that turned out to be prescient: “He went away, but his needs didn’t.” On the surface it may sound like a simple thought, but the idea of being driven by insatiable yet unconscious needs is key to understanding why smart men do such dumb things.

 I will not get into the politics of it all, whether he should quit or not. My question is: What makes someone take such risks, with his marriage and career in the balance? What force is so strong that a public figure with such a formidable intellect – and so much to lose – cannot stop himself, especially with the whole country watching? Why doesn’t his intelligence kick in and stop him? Why can’t he reason himself away from this behavior?

 In his press conference Mr. Weiner admitted that he and his wife are in analysis to figure out what is wrong. But he’s kidding himself if he thinks he’ll ever get to the bottom of what’s driving him through conventional talk therapy. If you don’t believe me, just ask Woody Allen. Psychoanalysis simply bolsters the cortical intellect which has failed him so miserably so far. That part of the brain – and the psyche – remains completely out of touch with the deep impulses that are driving his serial sexual act-outs. “Figuring out” is, I am sure, what he has been trying to do for years. The more he tries the more distant and out of touch he becomes from those impulses he needs to control. He is battling forces that will not recognize nor submit to intellect.

Clearly a therapy must address the lower brain where those impulses reside if it is to be successful in cases of obsession. Any therapy that ignores two thirds of the brain cannot possibly succeed.

 To understand this seemingly unfathomable dynamic of destructive compulsions and obsessions, I must explain my hypothesis of the three levels of consciousness. The human brain is really three brains in one: the primitive brainstem, the limbic system, and the neo-cortex, or thinking part of the brain. It is constructed in layers that correspond to the way our brain develops from infancy, and also how it evolved in stages over millennia, from shark to chimp and to human brain, respectively.

These neurologic stages of brain growth correspond to three distinct levels of consciousness: the earliest, pre-verbal stage of infancy, followed by childhood and finally present-day awareness. At each level of brain development, we have specific needs that must be fulfilled uniquely. The earlier the needs the more lasting the consequences when they are not fulfilled, and the more grave the imprint on the person’s nervous system and personality. We are discussing the instincts for survival so that when there is a trauma the in infancy, we have a need to be touched and nurtured tenderly, the need can be thwarted or diverted but never erased. It lives on as an imprint. It is engraved forevermore and drives later symptoms and behavior. The disconnect between that deep imprint and a knowledge of it is great, so great that this makes the thinking brain unable to suppress its force, which again, I remind you, had survival value early on. On the second level, we seek fulfillment of emotional needs: to be listened to, to feel secure and supported, to get an empathetic response to our hurts and fears. And the third level involves intellectual stimulation, communication and understanding by the parents. Fulfillment on this level can lead to clear and logical thinking, and an accuracy of perceptions. Problems arise when those needs at any level are not met.

The pain from that deprivation creates an imprint in the brain that remains hidden from awareness but continues to drive behavior years later. That is how a person like Weiner can act out in destructive ways and have no clue what is driving him to do it. The real cause is hidden in his past, but stored in the lower levels of his brain, and his consciousness. There is no rationality there. The brain has to wait millions of years in evolution and decades in personal maturity before one can properly use the cortex to figure things out. He is acting out a need and a feeling that were left over from early in life. It is so early that it remains unconscious all of the time. It cannot be remembered in the conventional sense of the term. But it is a concrete memory that altered so much of him without his knowing it. At a press conference given by the offending congressman during the original scandal, someone shouted out “pervert!” Was he a pervert? Yes, in the sense that his basic need was perverted or twisted in order to feel loved. Otherwise he would never have lost his control, and he would never have this perverted need, his needs would never have been so direly distorted in the first place. It had to be such a strong past unfulfilled need as to crush his judgment. That need forced him to channel it into bizarre behavior, especially for a well-known politician. It had to be diverted just because it was never fulfilled. He was driven to be well-known, to be seen and appreciated and judged a “man.” Only his parents never saw that.

 The congressman’s unmet needs decimated his critical mind. What was that need? I surely do not know. But I have treated “weeny wavers” (excuse the expression) for years and have seen the motives behind what they do. I often have them do it (act out the exhibitionism) where it is safe in group, and where afterward they fall into the feeling: “Look at me! Pay attention to me. I am important. Please care about me. See me. Want me.” And so on. The penis gets the attention, which is what the person wants. It is often the only way he finds to get that attention. Those are not the only motives but we can be sure that deep unfulfilled need is behind it all. If not, the critical capacity would kick in and stop the act-out. The act-out is always saying the feeling; we only have to pay attention.

 No one is smarter or stronger than his need. Need overwhelms any thought almost every time. Why should that be? Because need and its fulfillment always deal with survival, and always derive from very early in our lives when fulfillment was crucial. It is that which mounts and suffuses our critical capacity; no different from hypnosis where someone can suggest we lose that critical capacity and we do. We become Sinatra because we are told to. Or become Nazis because the pressure is there to become them. We lose our critical capacity.

 The problem is in Weiner’s case that he was both combative and impulse ridden. That forceful combativeness also may signal early infant trauma, meaning brainstem forces at work. That is where not only pure impulses exist, but also rage. What happened to him early on stirred up what I call first-line reactions, brainstem activity that is imprinted and remains as a constant threat. Those impulses took on yet another flavor dimension in his infancy and youth when the constellation of his family life directed them in a specific direction. I do not know what his family was like but I have treated others with similar problems. What might they be? A father who belittles the boy and makes him feel like a “sissy.” A mother who dominated her son; he was close to her but somehow felt “unmanly.” And his father reminds him to stop crying and act like a man. Which is what Mr. Weiner was doing in his act out: acting like a man; proving he was a man. But before we draw any conclusions I remind you that there are a myriad of reasons and I may not have touched on his. The point is that he was driven by powerful, primeval forces that he could not control, nor could he learn from because they were deeply sequestered in the brain. Out of sight but nevertheless omnipresent in driving him.

 So to sum up, here is a very rational and brilliant man, and yet he acts dumb, so dumb as to ruin his life. Why? Because his need drives him toward “symbolic” fulfillment, wherever that leads him. That primitive need is what guides him, not his rational mind which has taken a vacation for a while. He is acting out in the present the needs and feelings from long ago, and that disconnect is what makes him look dumb. Those old childhood needs never disappear. They are inappropriate now, but were appropriate back then. Always think “back then.” One man might act out with his penis — “Be happy to see me” — something his mother never was. The women he flashed or texted never were either, but that never stopped him from trying. He needed a caring mother, but it’s too late. He can’t stop because he’d have to accept that he’s never going to have one.

 It is most interesting that the hapless Weiner used the sobriquet “Carlos Danger” in his emails, acknowledging the danger both to him and from him. He now claims that the behavior is “behind me.” So long as it is below him, imprinted deep in the brain, it will always be a clear and present danger.