Arthur Janov's Blog, page 42

Another Look at Electroshock Therapy

Years ago my team and I watched something we had never seen before. Someone reliving something that looked like a birth primal and yet quite different. We let him go through it for about a half hour and then asked him what it was. He wasn’t sure. We then found that he’d had ten shock therapies in England for depression. He was reliving the shock, in the same way that another patient, also from England, was reliving her shock therapy (which we filmed). It looked to me like shock therapy and when I put a pencil between her teeth, her back arched and she went into what looked like an epileptic seizure. She knew when she came out of it what it was. It seems clear to me that what goes in has to come out; it is a shock just like any other shock we go through in our lives. It overwhelms the system and shuts down large parts of it. Patients need to relive electroshock therapy without a specific event in the same way as reliving the shock of seeing their parents die in a car crash. The system is overwhelmed in both cases. Part of memory is shutdown in both situations. The doctors find shock therapy helpful since it hides away past memory, keeps the person unconscious; but, as I have said before, “You cannot get well unconsciously.” It’s no different than hypnosis.

The authors of a recent study on shock therapy noted that over 10-20% of depressed persons unaffected by psychotherapy go on to shock therapy. This also seems to be true for tranquilizers, which often cannot touch depression. The doctors conclude that the only option left is to blast the patient’s brain with electrical energy. And again, there is no asking “why?” Why is depression there in the first place? Or even, what is depression anyhow? There is no thought that perhaps we need a therapy that goes deep enough to effect deep, suicidal depression.

The template here seems to be that a first-line imprint from gestation or birth leaves the prototype of hopelessness (or terror or rage, etc.), impressed into the system. Until that original imprint is addressed and relived there will always be a tendency to deep depression. Yes, it will help to discuss one’s feelings with another person, a therapist, but that still leaves the template intact. Still, talking it out eases the load a bit, even temporarily, and is a good thing.

It is not that depression is refractory to psychotherapy. It is that psychotherapy is refractory to depression. It is that current psychotherapy is too superficial to change anything profoundly. It is the fault of the therapy, not the patient. Once we know what it is and have the proper tools it is no longer untreatable. Cognitive therapy only worsens matters by remaining in the realm of cognition instead of feelings. Thinking “positive thoughts” will never change the feelings that are at the heart of depression. It isn’t that depression cannot be touched by therapy because it is such a serious affliction; it is that conventional therapy is not designed to probe the depths of the unconscious where generating sources lie. And today it seems that the only way conventional shrinks can get to those deep-lying imprints is through jolts of electricity.

Doesn’t it seem bizarre that when we are at a loss we start to blast the brain with electricity? But the shock doctors, they don’t see it as a loss. Of course there is memory loss in shock therapy; it is meant to happen. We are programmed to forget. In a way, our therapy is shock therapy in reverse. In reliving we are feeling shocked again but we can integrate that shock and so be done with it. We become superconscious, hyperaware of what went on. We don’t blast away the imprint; we approach it and finally welcome it. We don’t make it an alien force; we make it become part of us. Until that happens we must take measures to put down the force—pills, shots, shocks, endless discussion, cheerleading, jogging and exhortations to get going. And in cognitive therapy, the advice by doctors, “You see there is no reason for you to be depressed; your kids are healthy, your wife loves you…blah blah blah.”

The force is that ancient engraved imprint. The doctor is sitting behind his desk and cannot see an event that is forty years in the past. He therefore can draw no other conclusion: he (the patient) needs to get over it. For the cognition/technician it is all in the present, and seems to be irrational. They try to make it all rational without noting that the symptom has antecedents far back in history. And for such antecedents there are consequences—depression. It is all a logical extension, reacting to something specific in the past; once we get to the past it becomes eminently rational. To be bereft of the past makes it all seem irrational. We cannot make sense of any of this without referring to history. It is not just some bad thing we must blast away but specific feelings that need to be felt.

What is being blasted away? Often it is hopelessness and helplessness, the bedrock of most suicidal depressions. Those feelings are trying to make it up to the top for release, but alas, pills and then shock therapy keep it down. So the one thing that can cure is seen as the enemy, something to be avoided. What a strange paradox!

In shock, as in both that form of therapy and life, there seems to be a fundamental disconnection from feeling centers to the top level comprehension areas. A sort of functional lobotomy. The brain is saying, “I can’t take any more input so I will just shut down.” And with that shutdown come hidden forces that constantly render the person uncomfortable, like he is carrying a heavy load that he cannot get rid of (which he is—of feelings). His movements therefore are slow and labored; he has trouble breathing; it all seems like such an effort. There is no energy left to do anything in life, even eat. Repression is at an extreme, and it weighs the whole system down. All energy is being used in the service of gating/repression.

The current rationale for depression seems to be that it comes out of nowhere (some textbooks state it thusly—“endogenous depression”), like some phantom to haunt us. And if we do not understand the imprint we are forced to call in the phantoms. We need to know that suicidal depression is something knowable and genuinely treatable. We don’t need to insert something like a shock machine into someone. All we are doing there is ensuring that would-be liberating memories are more hidden and inaccessible. There are treatments that are much easier, safer, and quicker; and a way to truly get rid of depression.

On the Mystery of the Unconscious Part 2/2

We have seen in my past blog how we go in and out of consciousness in ordered fashion. In therapy we start at the end and move to the start, evolution in reverse. We start in the present and move to the past, to the origin of the nervous system. The thrust of the therapy is to begin with the end product in our evolution, the neocortex and move slowly downward. And this order is unshakeable in every way. An approach that defies this order is doomed to failure. The brain is an orderly entity that brooks no insurrection. So we begin on the third line (present) move to the second line (childhood) and finally the first line (after conception to months after birth). When we are anchored in the present it then allows us to dip into feelings, and those feelings become the vehicle for a deeper descent in the brain. Words are not the primary vehicle, feelings are because their origin is lower down. It is like a mine elevator that takes us ever so slowly into the lower depths. Words cannot be the primary vehicle because they exist on the top level. We descend in therapy to where feelings lie, where they begin their organization; those feelings begin their and our liberation. Evolution dictates how our therapy works; for if we want to provide connection to feelings we need to be cognizant of where feelings lie. And obviously, we cannot produce connection only on the cortical top level of the brain; we are connecting lower level imprints to higher level understanding. We need to learn how to descend to lower levels of consciousness where our pain lies. Our job is the opposite of most other approaches who cover over the pain. We let it rise in ordered fashion. Perhaps more accurately, we descend to meet them.

When deep levels rise faster and higher than higher levels, as in rebirthing, we're in trouble. This defies the natural order of the brain. That is why hallucinogens are so dangerous; unleashing deep levels prematurely. They are too powerful to allow connection so they produce only abreaction, or they rise to produce strange ideas, sometimes psychotic ideas. These are never connected but simply the effluvia of too many and too strong feelings. All because the doctor has decided to skip evolutionary steps and produce what looks like super dramatic results; too dramatic to be of any therapeutic use. What I am describing is a neurologic dictatorship; it allows no disobedience and demands absolute loyalty. It is merciless, permitting no second chances, no opportunities to take a different route. Follow the prescribed evolutionary route or suffer. Evolution, as I have said, is pitiless. If we want to get along with it we must learn its rules. So of we want to take a fast route to the depths of the unconscious and use drugs we will pay a heavy price. We can't trick mother nature.

We know more about how drugs work now based on the neurologic hierarchy; how we react to them, how we come out of them, how we suppress different brain levels with different kinds of drugs. And because of this evolution we never want insights, ideas, to precede feelings; that is not how it happened in our history. We didn't speak before we had feelings. Why should we speak our insights now in therapy before we get to feelings? Evolution! We were first all brainstem, then limbic, finally neocortex. Each brain has its secrets, and it is our job to find them out.

Each new level absorbs part of the previous level, which is why as we descend down the hierarchy of consciousness and feel on one level we are also feeling part of the previous deeper level; we feel about our childhood but it may incorporate without our knowing it, aspects of the birth trauma, as well. When the previous level is too strong it may well interrupt the feeling. So we feel on the level of childhood and suddenly there is gagging and choking as the deeper level of the birth trauma is surging forth. It does this because our gating system between levels is impaired. It is impaired due to the heavy load of pain which has weakened it.

Only when we follow evolution do we have a chance to get well. We need to know how to read the instructions; they are there and are obvious to the attentive. When we try to outsmart those instructions we get in trouble. And those who want to outsmart it are those usually in their heads: the intellectuals who believe they know better. They think that way because they are bereft of access to their feelings; they do know more and would inform them of evolution. There is nothing like access to feeling to keep us straight. We can think straight when those ideas come fluidly out of our feelings. When we don't feel, our ideas are not anchored, become detached, and can be anything. That is why when doctors concoct a theory from their heads it may have nothing to do with us humans, and their therapy goes off track and cannot be curative. The reason is that it is all intellectual and ignores the human body and physiologic system. Theory must evolve out of the human experience, and not out of the head of the doctor. So intellectuals become therapists and superimpose their beliefs on to how we do therapy. (I am not against intellect, only intellectuals). They superimpose their beliefs onto feelings, and what that does is suppress feelings and make it look like the therapy is a success because the patient can no longer feel her pain. But it won't last and she will keep on having to do it. Because feelings will surge their head again and again upwards, searching for neocortical connection. Connection means final relief. No connection, no relief, no matter what anyone believes. Well yes, a bit of relief for a short time but nothing definitive. When I discuss connection it means taking a lower level feeling towards the neocortex. We need to access feelings to do that.

Scientific American just published a piece called, Decoding the Body Watcher. (4-5-12) They ask the question, what is the difference being attentive to the outside world as opposed the inner one? They explain that while the top level cortex can attend to the outside, the older more buried parts (Insula and posterior cingulate cortex) specialize in our inner world. If we want to appeal to the inner world we need to go there, and we cannot do it by an act of will or conscious deliberation. "Will" is a top level event that has no roots. We need to go to the unconscious. If we remain on the level of ideas we cannot get there from here. We go there via the lower structures but need the higher levels to start us on the track. Descent can never be an act of will (top level); it is an act of total submission as we leave the neo-cortex behind. When we usually say "Pay attention" we mean using the top level cortex to focus. Abandoning the top level and sinking into feelings is the proper way to get feeling's attention.

When we stay on unanchored cortical level the lower levels can dominate perception so that we mistake someone's intention or their interest in us? Those lower levels can make us suspicious and untrusting. What the university of Toronto researchers found was is that we become victims of our feelings and have little control over them. Segal and Anderson found that feeling perceptions rely on deeper level brain processes, lower level consciousness—older brain systems.
So here is the key: we cannot rely on newer brain systems to access the older ones, especially the very old ones that lie deep in the brainstem. We mistakenly think that we can resolve our emotional problems from the top down; using the new brain to figure out the old one, the one that is millions of years away from the present. They suggest that we need to bypass the cortical area to get lower to feelings tapping directly into body areas. That describes what we do completely. When you do that you eliminate what Freud used to call the superego; you bypass critical judgment and let the feeling rise. You are not endlessly ruminating about what you are thinking or believing.

Imagine now going to a shrink who makes a mystery of the unconscious and presumes to tell us what is in our unconscious; something millions of years away in neurologic time. He will need something more powerful than the Hubble telescope to do that. It is impossible yet many therapies are based on that; thinking our way to health. Too often, we seek out doctors who will tell us what is wrong with us. They tell us what to do to improve when, as I repeat ad nauseam, only we can do that in a proper environment where we can access deeper levels. In our case, a quiet padded room with softened light. And unlimited time for the session.

Too often shrinks tell us what and how to think; to think positive and deny what our body is importuning all of the time. When doctors have little access to feeling, they can manufacture a therapy that offers us little access, as well. When we ignore access, all the other ways of therapy become alleviating, palliatives, quick-fixes, and don't last. That doesn't stop millions from trying it. They seem to want to learn how to stuff back those naughty feelings. Yet it is so much easier and freer to let it all out. But all of these old conventional theories come out of ancient times when feelings were an anathema. Feelings became equated with nuttiness; true to this day. You know, "John is so emotional. We need to be careful around him. " Or, "so and so can't think straight because he is so emotional. " What this usually meant was that his feelings overwhelmed his rational mind. So long as his feelings meld with understanding he is rational.

It seems to be true that the only way we are willing to go deep into ourself in therapy is if we are already suffering; which means that the pain has risen into conscious/awareness. Otherwise, we seem to look for a little touch-up, a bit of suppression so that we can go on with our neurosis. We don't seem to want change; we want to make our neurosis work.. I believe that in doing that we are surely shortening our life. The pain doesn't leave; it stays and agitates and eventually will get at our heart or brain. There is no escape, just evasion.

On the Mystery of the Unconscious Part 1/2

There are two new and very important research studies that I will discuss that helps clarify what our consciousness is all about; and more, what access to deeper levels of consciousness mean. This is part one. Tomorrow part 2.

There is a scientific piece by a group of Finnish scientists on how consciousness emerges. Here is what they did: they took twenty healthy volunteers and gave them drugs that made them unconscious. Drugs similar to what Michael Jackson got(Propofol). Then they measured them with brain measurements (PET scans), and watched what brains were active as they woke up and came out of unconsciousness. You would think it would be the higher level (consciously/aware)neocortex (1). But no. What seemed to happen is that we come out of unconsciousness as the brain evolved. Deep brain, brainstem, then limbic system, then top level cortical areas. These brain structures. Brainstem, (1)thalamus and hypothalamus (2) were activated first. We start with the most ancient phylogenetic structures first, then limbic second; no different, by the way, from how we come into and out of primals. We call it, the 1,2,3 hierarchy; and coming in—the 3,2,1 hierarchy. The point is that there is a neuro-biologic schedule for going in and out of consciousness, and it must not be abrogated for convenience. And that is how we know we are getting proper primal therapy. There is specific hierarchy for feelings and they follow evolution, of course. They follow how we became feeling then thinking human beings millions of years ago in evolution. And that structure dictates life and above all, dictates how psychotherapy works. There is an order to how we become unconscious and conscious; an order to how we descend into the deep reaches of the brain in therapy and how we ascend back up to the top. So when someone tells you, as in EMDR, that you can access feelings through thoughts and ideas, with a current focus, they defy human evolution; when they say we can access the limbic areas without ceding top level consciousness they misread science. You cannot be on the top level and in lower level feelings at the same time. They are two different universes; two different brain regions; two different brain tissues.

On the contrary, when we plunge patients into deep brain structures with LSD or rebirthing we get overload and often delusions—"cosmic consciousness, at one with the world," etc. We have defied evolution and we arrive at mental illness. No mystery, the top level is overloaded by the lower levels and it is all too much. It can well be a description of psychosis. When we first wake up in the morning we are briefly in touch with our deep brain (brainstem). And we briefly feel what is there; a stab of anxiety or depression or hopelessness. We are in touch with our beginnings; but before we can feel it we get ready for the day, get busy and ignore it. We move out of the lower level into the higher levels (the precise order in which we wake up). But if we lay back and allow that stab of anxiety to overtake us it would help make us free. It is that deeply imprinted feeling we have touched.

There are drugs that suppress the first line, brainstem and leaves the emotional level intact. There are drugs that suppress emotions and leave the top level neo-cortex intact, and there are drugs that suppress top level cortical cells that block inhibition and give us some access to feelings. That top-level suppression inhibits some of our inhibition and makes us feel somewhat freer for a time. Think of hypnosis. It blocks some of our top level critical faculties. It begins as something psychologic--suggestion, which then becomes chemical-- enhancing unconsciousness). But it allows us to descend to our past. The problem is that there is no final connection that would really free us. We need conscious/awareness for that. And again, when we defy evolution we fail. But it does show us our unconscious and how memories reside on lower levels. Hypnosis allows us to travel back to old memories. But as I noted, there can be no long-lasting cure there. There is no organic connection.

What we have done is set aside the top level for a moment, allowing lower level imprints surge forth. The imprinted memories were not suddenly manufactured; they reside continuously below higher levels of consciousness. They are active all of the time below the level of conscious/awareness. And they agitate us all of the time; hence we cannot sit still and relax. We are unable to relax, because in ordeer to relax we cannot be hyper-vigilant. We are hyper vigilant because down deep there is danger---of the imprints and their force. It is a vicious circle. When we let go of vigilance we get anxious because the feelings are right there. So we still can't relax. Visiting them for a moment in hypnosis versus experiencing them are two different universes of discourse. It looks magical that hypnosis but it cannot be curative. The laws of evolution won't allow it. But still, many of us want that magic. That is the attraction of EMDR, a magic wand (literally) that passes before our eyes and makes us well. Unbeatable. So even better, we take tranquilizers which take only minutes to work. That is good except it shortens life. Someone says, "yeah but it is only at the end." So ask yourself when considering any therapy—does it follow evolution? It is not a theory; it is a fact.

When we look at evolution we also see confirmation both of the unconscious and the hierarchy of the brain. There are indeed three levels, as I have describing for forty years. Those levels have to do with neurosis, depression and cure. They cannot be ignored or defied if we want to provide a cure; neurobiology leads the way for how to do it. There is are brain processes underlying our actions, thoughts and beliefs; we cannot forget them to produce some psychotherapy that is not based on how our biology functions. What all this means is that a proper therapy must obey strictly to how we evolved.

We can say that ideas are strong and change feelings when science shows that is exactly that opposite. This is the dilemma of the cognitive-behaviorists who do indeed believe that beliefs and ideas are the sine qua non.: change ideas and we change feelings. They develop a therapy based on a falsehood. No one can get well that way; in the mind alone. Ideas only slightly affect feelings but they do not radically alter or transform them. Only experiencing those feelings, back then when they were imprinted, can there be a cure. Feelings are stronger than any ideas; don't forget, ideas and beliefs came along millions of years after feelings. When a theory does not correspond to the reality of how our brains and bodies work there is no way to get well. And neurology teaches us that when feelings get to be too much the neo-cortex whips into action to stop them. Evolution dictates how therapy should go, not some intellectual notion from a therapist. Humility is foremost; and let us not imagine we are smarter than evolution, probably the greatest discovery in history.

Nutiness Apotheosized

Here below is  an example of today's psychotherapy. Look at her honors; a consensus of dunces, a complicity  of intellectual fools bereft of feelings who know  nothing of neurology or any understanding of what is going on in the brain.    And she has inveigled top ranking shrinks and neurologists into her scheme. The  is Booga-booga brought to its asymptote.  She is approved by a body  representing all psychiatrists  in America.  It is all about "taking   control of your life," that is distracting your mind away from reality.  Yes she does genuflect before old memories but then she uses that only to identify what is below current complaints. But if the memory is too powerful or too early or nonverbal, then what?  I have written a very long piece on this in my blog (in 4 parts, here is the first part.  Look it up.   art janov

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(from http://consults.blogs.nytimes.com/2012/02/27/ask-an-expert-about-e-m-d-r/ )

Ask an Expert About E.M.D.R.By TOBY BILANOW



The psychological therapy known as eye movement desensitization and reprocessing, or E.M.D.R., has gained increasing attention in recent years as a treatment for post-traumatic stress disorder among returning war veterans and others suffering from the results of serious trauma. The integrative approach uses rapid eye movements and other procedures to access and process disturbing memories.
Francine Shapiro, Ph.D."Recent research has demonstrated that certain kinds of everyday life experiences can cause symptoms of P.T.S.D. as well," says Francine Shapiro, the originator of E.M.D.R. "Many people feel that something is holding them back in life, causing them to think, feel and behave in ways that don't serve them. E.M.D.R. therapy is used to identify and process the encoded memories of life experiences that underlie people's clinical complaints."The therapy has been recognized as effective by numerous organizations, including the American Psychiatric Association and the Department of Defense, but controversy exists as to how it works.This week, Dr. Shapiro joins the Consults blog to answer readers' questions about E.M.D.R. She is a senior research fellow at the Mental Research Institute in Palo Alto, Calif., director of the EMDR Institute, and founder of the nonprofit EMDR Humanitarian Assistance Programs, which provides pro bono training and treatment to underserved populations worldwide. Her latest book is "Getting Past Your Past: Take Control of Your Life with Self-Help Techniques from EMDR Therapy" (Rodale, 2012).

On Being Non-Functional

ON BEING NON-FUNCTIONAL

We can easily understand when all kinds of things are happening around us and we get confused and don't know what to do first. But suppose all kinds of thing are happening not around us but inside us, things we cannot see or even imagine? And we get all confused, cannot concentrate or focus and stop functioning. Too much input, but from where!? Let's see, hummm, maybe from inside? From all those imprints down low in the neuraxis that are constantly sending messages to the top cortical level, trying to inform us about danger down below. So many strong messages from preverbal imprints, messages with no special content but simply high-level electrical charges to try to enter our conscious-awareness, only to be rebuffed by the gating system.

So now imagine when there is all this current tumult going on that sets off the internal tumult and begins to overwhelm us; we can no longer focus and get immediately overwhelmed by the simplest of tasks to be done. It is all too much. We imagine it is because we are being pressured by domineering bosses but in reality we are being pressured first and foremost from inside, by importuning painful memories hidden away seeking exist and surcease. They are groping for priority, for access to top level processes that will allow for some peace. But they are competing with other external priorities that must be done…..now! Who wins? No one; nothing gets down as we break down and become non-functional.

Primal memories don't just go away; they are as yet not connected, held back by the gates and so are unresolved and non-integrated. And the biologic system "knows" that connection means liberation. So they continually send their message higher up for connection. Alas, it is not to be. But those inchoate messages enter the cortical arena and create chaos because of their inability to connect. They have no specific content to allow them to be relived and be done with. They are preverbal, by and large, and can only be relived and resolved after many higher level imprints are integrated. And then, as we relive lower level, earlier imprints there is a resonance effect, a kind of dredge which raises up the earlier imprints. They now merge with imprints from infancy and earlier childhood providing the energy component to the feeling and making the reaction all the more powerful. Making a rather banal feeling incredibly strong. We may not understand what is going on because we have neglected the resonance factor that makes similar feelings connection or bind with each other, remained stored in memory and tend to rise together when the time is appropriate. So we feel disappointed at age seven but that triggers off the preverbal sensation of deeper aspect of the feeling, which can be many things but often is simple hopelessness. They now rise together and, as the reliving goes on there is a simultaneous reliving of the preverbal, energy part of the feeling, as well.

That same resonance goes on all of the time, higher level deception can trigger off deeper feelings but those feelings do not get resolved and simply create burgeoning chaos and tumult. They do not get resolved because not enough of the less powerful feelings have been integrated as yet. The system is simply not ready yet. And that sometimes can mean pockets of insanity as the system struggles to hold back feelings or perhaps tries to make sense of them, but to no avail. Enough premature breakthroughs and we have frank psychosis, which is when painkillers are necessary. And those same painkillers can, paradoxically, make us functional, as the painful imprints are held down below, out of harm's way. It is when the pain is so strong, so many imprints that tranquilizers can no longer do their job. So we have to titrate the dose to make sure the patient gets enough to hold back the input from inside. After more pain is felt the person will need less and less painkillers.

Those early pains broke open the gating system initially because serotonin supplies could not keep up with the demand. So what is in those tranqs? Serotonin. All the pills are doing is doing what the system could not do at the beginning because it ran out of supplies. And it ran out because those early life endangering events demanded too much of the gating system. Don't be afraid of offering chemical help because the system is demanding—non verbal therapy for non verbal pains. We just need to understand and comply, and above all, to tell our patients what is going on inside them. We are only boosting repression for a time until their system can take over.

On the Difference Between Help and Cure

Most of my readers know about my notion of the three levels of consciousness. That what happens to us in the womb, at birth and infancy is registered low down in the neuraxis and constitutes what I call the"first line." As we grow up we may suffer neglect, trauma and/or lack of love; that will take place on what I call the "second line." And what happens to us in adulthood and in the present is called the "third line." It is possible to relive events that happened on any of those lines, but they have to be in order; feeling the third line first, second on the second and first line last. What is clear is that so long as we leave one level untouched we can get relief from reliving on the various levels but not cure; because the traumas on the first line have not been addressed. Final resolution means reliving on ALL levels, otherwise we have only skimmed the upper levels, leaving the powerhouse first line untouched. That is, to be clear, we can feel real feelings with their real force from the second line, in the first months of therapy but if there has been first line trauma it must be experienced. If it has only been minimal it may not ever have to be addressed. That is rare, indeed. All in all, it is the difference between relief and cure. Lots of relief from second line primals but not cure.

After 45 years of primal therapy we know that what is often behind later strokes, schizophrenia, epilepsy, severe addiction and heart attacks are first line traumas. They are nearly always packed with force and are also most often life-endangering. So one can spend months in therapy and still be prone to a stroke or heart attack because the basic primal imprint, the generating source upon which later traumas are added or compounded is first line. Yes, we can get increasing relief as we go on in our therapy but if we are to discuss cure there must be obligatorily reliving of first line. That has the strongest valence and remains the most dangerous imprint lodged in our system.

The first line left unfelt will always be a danger in later life. We may have take out fifty percent of the emotional force in primals about childhood but gestation trauma can still kill us. That is why it is not a good idea to do this therapy half way. You can say, "I got what I wanted out of the therapy." But the system is insisting, "Not enough! You're life is still in danger." None of us want to say to patients, "You know you must go on with the therapy." It makes us look avaricious, wanting to keep the patient with us. That is not the case. We want to save lives through the integration of feelings, and that cannot happen in a few weeks or several months of therapy. It is indeed dangerous to allow patients to go to first line when starting therapy. That can upset everything and only insure major symptoms from migraines to epilepsy. That means first line events are pressing at the repressive gates; if allowed to erupt too soon, the system cannot integrate it all and the result are symptoms. When a medical patient is given medication that is much too strong the system cannot integrate it and its excess force is flushed out through, perhaps, diarrhea. Nearly all key symptoms are the result of overload. We take pains to make sure it does not happen. The aim is integration and resolution, not feeling as a thing in itself such as crying or screaming out or pounding the walls. That feeling has to become part of us. Until it does it remains alien, an external force treated is an enemy of the system; and when those feelings are strong the person can run a high fever; the system feels it is under attack—danger is imminent. The feeling is pushed away; not accepted as part of us, and of course, not integrated. The feeling must become part of the "family." Not an outsider that has to be shunted aside. Once it is part of us we can grow; we no longer have massive blockages impending our progress. Expressing our feelings can only have meaning after we have been in the feeling; otherwise neurology and evolution is backwards; using the third line intellect to get us to feelings, when it is the third line that must recede in order to permit access to full feelings. If the notion and the decision about where we need to go comes before feeling, the evolution is reversed and we will fail in therapy. Even while we think we are doing marvelously in a so-called feeling therapy. We cannot abrogate evolution and do well in therapy because evolution is how nature acts. It is an iron law of human behavior.

A Bit More on Depression

What exactly brings on the overwhelming feeling of depression, which lasts anywhere from hours to days, I don't know. It seems to be part of the theme of my depression that I can't control when it comes on. It then feels like a big black feeling-less hole I fall into and can not get out of. I feel completely empty, hopeless, and helpless. I feel it is my fault I am in this place and can't get out of it. I blame myself for being there. It's a place that almost seems unreal when I'm not in it, like I am making it up, like I'm lying about it. It's a place that feels very gloomy and doomed. It's a place where I feel suicidal, where I dream a suicidal dream. There used to be times when I couldn't move when got in this place. I feel very different from everybody else, apart, disconnected and removed. My face turns into a mask, the corners of my mouth droop and smiling seems as foreign to me as laughing at a funeral.

Feeling alone and isolated is a big part of my depression. I currently have dropped so deeply into this place that it's hard to write about it. I am pregnant with my first child, who is due to be born in three months, and I am overwhelmed by fear how my depression, loneliness and isolation is going to affect his life. A lot of my pain is rooted in early infancy (separation from mother for 5 weeks after birth) and I am worried about how this early pain is going to affect my mothering abilities. I am very concerned about postpartum depression, because I know that holding my own child in my arms when he is born and welcoming him into this world is going to trigger my pain of not having been held and not having been welcomed into this world. The pain in this is so huge that I can only touch on it in little pieces. I always thought I would have one gigantic Primal that would just magically clear everything away, but this therapy a slow process in my case. The books I read that made me start this therapy talk a lot about feeling "the pain". I think I forgot that feeling pain does hurt and even now thirty years later I can only take so much of it.

Why feel then if it does hurt? I feel closer to myself when I feel the pain. I am hidden in my pain and the only way to uncover me is to uncover my pain.

How has therapy helped me with my depression? First of all, it helped me identify that I am/get depressed. Before, I was walking around not knowing what was going on with me. There is a certain comfort in knowing. The most important thing I discovered for me is that if I can cry the depression lifts, sooner or later depending on how deep I have dropped into it. The way to the tears, though, is not always straightforward and until I can cry there is suffering.

Feeling my pain has made room for new, good feelings, which are as rewarding as the road to them is difficult. An example of that is my thirtieth birthday, which occurred not too long ago. Months before I started to agonize over what to do with that day, feeling more and more alone as the day approached. I ended up not doing anything, being too overwhelmed by the feeling and spent a good deal of my birthday crying in that loneliness. My husband and I agreed that we would go out to dinner, just the two of us. He ended up surprising me with a very, very special evening. The joy, happiness and completeness I felt that evening was nothing I had ever experienced before and I told him that every tear I cried was worth the happiness of evening. His gift to me was a feeling that I had never felt before and I treasure that feeling more than anything. Depression has robbed me of the good things life has to offer. Feeling pain is a way to make room for them.

The other big thing is that I can still feel suicidal but it's not something I would want to act on. The thought of suicide is at the bottom of my depression and used to be a fantasy that would allow me to fill its emptiness. It used to be my dream of a way out. I now know that my way out is through feelings however twisted and difficult they can get sometimes.

The Chemistry of Depression (How Memory Is Inscribed)

The concept of the imprint is being confirmed by new research which demonstrates that extreme, early emotional trauma is inscribed in and locked into our system as a physiological event, with continuing later psycho-physiological effects. It is for this reason that preverbal trauma that occurs before the frontal, thinking area of the brain is mature is critical to our development, and continues to affect our personality, behavior, and health for a lifetime.

James McGaugh, of the University of California, Irvine, points out how under heavy emotion catecholamines (alerting chemicals--the neurojuices of vigilance) are secreted, which tend to seal-in the memory – in effect, inscribe it in the brain. It becomes, in my terms, the imprint. It means that extreme emotional trauma is locked-into our systems as a psycho-physiological event. It is not just psychological or physical, but rather both at once, and it can last a lifetime. So the feeling essence of a trauma, such as "no one wants me," endures because it was too much to feel and integrate at the time of trauma; to do would have killed the living body. The imprint, then, changes our brain and drives our behavior. What Primal Therapy sets out to do is reestablish normal, healthy biologic set points and brain circuits. By experiencing fully the deviated circuits of the brain, we can now normalize neuronal networks.

Researchers have identified both the location of these traumatic imprints in the brain and the mechanisms by which they are stamped in permanently. Imprints during the critical period are engraved in the brain's right hemisphere, particularly in the right limbic system, the "feeling" brain. The right brain develops earlier than the left. At birth, the right amygdala which is one of the key structures of the brain and which is responsible for appraising crude information, is active among the brain's limbic structures, along with the brainstem, which goes on developing from early gestation until the first six months of life. The rest of the limbic system becomes active soon after and the right limbic system is in a period of accelerated growth until the baby's second year. The hippocampus, another limbic structure, which registers what happens to us very early as fact, is mature by age two.

When there is traumatic experience during the critical early years, various brain structures that deal with vigilance such as the locus ceruleus of the brainstem help organize the chemical secretions for the imprinting. The hippocampus helps consolidate the imprinted memory, while the guts of the feeling are supplied by the amygdala. For example, it is the right amygdala and brainstem that will engrave whatever upset state the mother is in. (footnote: Incidentally, this idea of the "guts of the feeling" is my conclusion based on an ensemble of various research studies. It is inductive logic, not an established fact. ) The role of the amygdala may be simply a metaphor but there doesn't seem to be any other structure that could fill the bill. Certainly, feelings are the property of the limbic area, and the amygdala becomes engorged when there is preverbal trauma. It bears the brunt of the trauma and seems to be bursting at the seams.

One also has to ask why the alerting neurochemicals aid in the imprint. Clearly, because great danger needs to be remembered as a guide to the future, of what must be avoided. And when we are in danger later on, the brain scans its history for the key early imprints to use as guideposts.

Jules used to intellectualize and beat around the subject endlessly never getting to any point. In our last group I said to Jules one sentence: "The bottom line, Jules." He hesitated a split second, fell into my arms and shouted, "Help me – I hurt!" And so he took the first step toward health.

The Truth: Where is it?

The simple truth is progressive, and that pertains to psychotherapy. The question is whose truth? Simple. The patient's. Always. You won't find it in the theories of the therapist nor in her techniques. As obvious as it seems, the truth always lies in the patient; that is why he comes to us, because the painful truth is there but he usually doesn't know it and even when he does he does not know where it is or why. But if we never get to his truth there is no progress (progressive) in therapy. We are there to treat him and not our theories. We are not after cleverly designed statistical outcomes but biologic ones. Each treated patient is a kind of test and ultimate support of what we do. We learn from patients; not them from us. We are not the fountains of wisdom but students of the human mind, and we learn at the source. We don't delve into books to find answers to our questions; we observe our patients. All we need to know they hold within. So long as they come to us for answers they force us to look into the wrong places; and the answer remains elusive. It is a mutual delusion. They trust us to have the answer, and we take it as a sacred trust that must be pursued. We are both wrong, deluded by the history of psychotherapy and by the zeitgeist.

Deluded by the pedestal we have been put on, deluded by the desperate need and pain of the patient, deluded by socially institutionalized consensus that we professionals are the holders of secret truths about the unconscious. When I see patients each day I feel like I am going to school, getting my maturity degree in humility, eager to learn what lies in her unconscious. She is the holder of sacred truths; we have only found the way to access them. If our delusions had not fooled us into a false role we all would have found ways for access. How about talking to the patient? Not pontificating which is so seductive. How about following the trail of feeling, probing because we are interested in her, not in our theory. We can't teach interest. Neophytes often make mistakes because they are not truly interested, nor empathic. They want to get ahead—ambition is the enemy of feeling. Remember again, the simple truth is progressive, and it is the secret for progress in psychotherapy. It is a simple thing; the minute we try to get complex and brilliant we fail. The patient is not interested in our discourse; she wants to get well and so does he. And she holds the secret of her cure; and that is what patients have to understand. When they claim, "I am not getting anywhere," and if we answer defensively--yes you are-- all is lost because that is also a feeling……not getting anywhere at birth could have been fatal. Patients need to know that we both go at the speed she can tolerate and no faster. We cannot hurry feelings; besides she dictates the pace, not us.

What a relief not to have to have the answers; what a relief not to be brilliant all of the time. I always ask my patients (not beginners) if I made a mistake because they now know themselves better than I. They sense the mistakes and we must leave the way open to be corrected; that is how we learn. No more the professorial pose, the measured speech and the implied brilliance in our insights. No more acting out being the protective father. Patients need to learn about their needs, not have them fulfilled in the office by the shrink. It is so tiring to be the all knowing, omniscient soul. We all can relax and the therapy will go swimmingly.

Why We Must Relive to Get Well (Part 2/2)

Why can't any therapy help patients with their feelings? One good reason is that they are talking to the wrong brain—the brain that thinks rather than the one that feelings. Unfortunately, the correct brain, the right brain doesn't talk much, doesn't understand English and, as a matter of fact, doesn't understand words. It doesn't understand in the way we think of understanding. The correct brain is one that contains our history, our pain and our feelings; the lower brain that processes our deep feelings that can finally liberate us. It does understand feelings; we need to speak that language—one without words. We have to convince the brain that spouts words and ideas that it is necessary to go back to early life and a world devoid of intellectuality, (kids are not intellectual as yet), and relive—that lack of love—feelings that were too much to feel at the time. We have to convince that thinking brain to let go, let the lower brain systems emerge and breathe the air of freedom. It can be done; cure can be accomplished. But only by stealth not by deliberation. Feelings have to creep up on us, not sought out. It has to be a therapy of nuance, of subtleties, of flexibilities and lack of domination; that is, it cannot be a therapy of experts because the only expert is the patient. The doctor has to let go of any notion of superiority. Even keeping the patient waiting for a session is a sign of superiority, which I do not tolerate in our therapy; it means: "I am more important than you and my time is more valuable". And while you are trying to get back some self-esteem, I the doctor, lowers it by keeping you waiting. It is subtle but there. And above all, we need to get rid of any time constraints that force a crying patient to leave in the midst of her feelings until the next session.
We do not touch the patient when he needs to feel unloved; we touch her when the pain is so excruciating that we need to lower its force so it to be experienced and integrated. It is one means of keeping the patient in the primal/feeling zone. If the therapist cannot feel he cannot distinguish the difference and will touch at the wrong time or in the wrong way. Patients can sense when they are being touched out of the needs of the therapist and not our their own needs. So the therapy can go wrong when the therapist has not resolved a good piece of his own pain. And none of that can be taught; when students take notes all of the time it usually means that they cannot feel what is right and need intellectual signs of what to do. This is a therapy that cannot be done by the numbers. It is a matter of sensing, intuition and instinct…..plus a soupcon of training….a lot of training. When a therapist cannot tolerate the patient's suffering she may touch to ease the pain, and thereby ruin the session because it kept the patient from feeling all of his pain. The therapist may be acting out her own need for touch and caress in her own early life. Watching the patient writhing may bring up great pain in herself, setting off her own feelings, forcing her to stop the patient from feeling.