Arthur Janov's Blog, page 9

On the Difference Between Abreaction and Feeling (Part 13/15)

How Good Primal Therapy Should Work

 Now, let us look at how a Primal Therapy session is supposed to work.

 A patient comes in for his session feeling anxious and not knowing why. “What does it feel like?” we ask. He doesn’t know. It is all agitated and “jumpy” and cannot sit still. And here we do not make any effort to get him into a feeling. We spend a lot of time just on understanding the feeling: when it is worse, how it affects work and sleep, etc. What it feels like. He cries a bit and we let it happen; he is overwrought. We embed the current feelings solidly before we travel back in time and deeper in the brain. The present becomes the platform from which we work. We want to establish as much as we can in the present and embed the feeling in the present. No going back right away unless the patient leads us there. But we want to take easy steps with the feeling going back to childhood later on, and in each stage settle the feeling deeper. The patient begins to feel more deeply; this can go on for many months and then, after a year or more the feelings will take him down to first line if there is a traumatic first line, and if the feelings are very disturbing. It is not always necessary. Then the patient may alternate first- and second- line events for reliving which get deeper and more powerful over time. We keep the pace even and not too overwhelming; otherwise we get abreaction due to overload. It is an ordered process as much as that is possible. We help keep him on track when he diverts from the beginning feeling so he doesn’t get grooved into a new channel of feeling. That is our skill, knowing when and how to keep patients on track. We follow evolution in reverse at all times.

 Remember, each level of consciousness is an entity unto itself. If someone is reliving something emotional and then begins birth movements, it means to us that there is intrusion from another level; it may be that it is a defense against too strong emotions. And of course, if any words leak out we know it is not a preverbal imprint we are working with, another sign of abreaction. Similarly, if the patient doesn’t have her feet and arms in a specific position during a first-line Primal, we know it is abreaction. Defenses are tricky and we need a long training to pick them up correctly. In Primal Therapy we make it safe not to block pain. Since each higher brain level elaborates the same sensation/feeling/need differently, we can ride the top level down and it will eventually take us to the bottom—to origins. Once down there, the system on its own will move upward toward connection automatically, following the paths of evolution for connection. That is, we then move back up toward the right orbitofrontal cortex, around the orbits of the eyes, and then to the left prefrontal cortex for final connection.

 How do we go back in time? Good question and the answer is simple. We don’t deliberately decide to go back and visit our early lives; that is a recipe for abreaction. We cannot engage the higher- level cortex; we must disengage from it. Cede to feelings. And that is our scientific mission: to provide access to feelings and let the whole organism proceed in an ordered, slow descent into the deep unconscious. As odd as that seems, feelings are the vehicle that take us where we need to go. Deep feeling has little restraint and flows effortlessly. There is no such thing as trying to have a deep feeling; it flows and pours like the well-known salt.

 Again, it is not for the therapist to determine what the patient should feel. Our system has a biologic sensor that knows not only where we have to go in the past, but also how far, and above all, when. During therapy, when the body temp reaches a low of 96 degrees it often means that there is a first-line component. The patient has touched on the brainstem part of the feeling and therefore it drops inordinately. So the patient feels depressed and his vital signs indicate that he is close to the original imprint. Otherwise, we would not get such low readings early in therapy. This physiological reaction gives us a clue about the beginnings of depression. Some life-and-death threat during womb-life forced the system to a last- ditch defense to conserve energy. All systems slowed down and went into energy conservation mode. Worse, that mode gets stamped in. Then we spend a lifetime depressed and have no idea why. To end depression – notice, I did not say “to treat” depression – we must address those origins fully. It means going back a long way. In our therapy, we have patients reliving remote deep pains, those with no words nor tears, and we see it over decades.

 In Primal Therapy, we seek access to those deep recesses of the brain, where ultimate healing lies. First-line is always more powerful than later imprints; so the insights that flow from first-line feelings are widely encompassing because they are the basis for so much later behavior. There are fewer words in these insights to match the preverbal pains that give rise to the insights. But they have weight and importance. Reliving on the brainstem level means complete connection as the driving force of impulses are experienced at last. We connect, in short, on the level of the trauma and in that context only. Here we are dealing with the shark brain: no shouts, no words and no tears. Evolution has taken over. It means the patient has gone back in time and is living again what went on decades before. Then it was too overwhelming for a naïve and fragile brain to integrate. Now, perhaps, he is ready for it. This is the true meaning of facing yourself and accepting yourself; not in the booga-booga, new- age sense but in the biologic evolutionary meaning of it where the feeling is now integrated into the physical system. It is ego syntonic. (Excuse my use of old Dr. Freud for this contribution he made which expresses exactly what I mean to say.) As the reliving goes on, the feeling is fully integrated and there is a continued drop in vital signs, arriving below baseline. The body temperature lowers to real normal, rather than “average” normal. In this sense, “integration” is a new biologic state where the whole system can re-regulate itself. Blood pressure drops and heart rate slows.

 But a word of warning: vital signs are a symptom, not the problem. Treating the symptom alone is a mistake, one that can make matters worse. So when doctors see someone with very low vital signs, they look around for a good diagnosis. They work on his blood pressure, for example, in a medical effort to “normalize” it without understanding that the patient is already in his normal, life- saving mode. In Primal Therapy, we do nothing to address vital signs directly. We work to change the whole neurobiological system by addressing the repressed pain which vital signs only reflect. The difference is between a temporary effort, which has to be repeated into infinity, versus a basic biologic change which lasts.

The Anthony Weiner Sexting Case:When a Picture Is Really Worth 1,000 Words

Believe it or not, this is the third time I have written about the lurid sex scandal involving disgraced politician Anthony Weiner, a former U.S. representative and New York mayoral candidate. He was caught years ago texting his crotch shots to women. As a result, he lost his reputation and his career, and almost lost his marriage to wife Huma Abedin, a close aide to Hillary Clinton, who had previously decided to stick by her man.
What truly defies belief is that Weiner was caught doing it again. This week, the incorrigible ex-congressman was busted sending sexual images to a busty woman who, this time, reciprocated with pictures of herself.
And so history repeats itself, inexorably. But we should have known it would, as I suggested the last time I wrote about the sad case:

“A year ago, I commented on Congressman Anthony 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 am sure that at some point his wife must have given him an ultimatum, “Never again or I will leave.” Well, she finally had to go trough with her threat. After the latest expose, she announced she was finally leaving. I guess finally it became clear that her husband’s outrageous, unfaithful behavior wasn’t going to stop.

The poor woman, like the public, must still be at a loss to explain how the man could continue to risk the only good thing he has left, his family life with his wife and young son. So my point bears repeating: Needs don’t just go away.
How can we explain Mr. Weiner’s odd behavior, and especially his choice of sexting as a vehicle for release? Why send pictures electronically when he knows full well they can easily be made public, providing proof of his perversions?

In order to understand Mr. Weiner, the man, we must focus on the child he still has inside. As early as age one, children start learning rudimentary language so they are no longer frustrated and can communicate with the rest of us. They can signal us when hungry, thirsty, annoyed, tired, sleepy, etc.  And the message gets through. The child is relieved because he can deliver his feelings.
Well, Mr. Weiner can do the same.  He can speak in a language with no words that conveys his needs and feelings. And what do they say?  “I am a man, strong, tough,” or whatever his unconscious dictates. Perhaps he is trying to say, “I am worthy of attention and caress and adulation.” Whatever it is, this message has to get out because it represents a deep need/feeling inside of him that he has no idea is there. It is saying what he feels unconsciously. It is saying what his parents deprived him of: A feeling of being loved, worthy, important.  That is what he needed way back when, and he needs it NOW.  The need has never left and never will, until it is felt and made conscious so it no longer has to be acted-out.

Obviously, it can be overwhelming. As long as the need remains unconscious, it is out of his control and will continue to drive his compulsive behavior.  
So when his wife says,  “Next time I leave,” he may want to do the right thing, but he can’t. He is forced to act out again even though it means divorce and being bereft of his young child. There has to be something very strong to defy that and put his marriage in danger.  Having seen the force of Primal pain I do know of its force and pressure; it has to get out.  The only way nearly all of us have for relief is acting out the feeling.
The experience of the one year olds tells us about Anthony. They both speak in symbols, not words, to express their feelings.  They speak on the brain’s second line, the limbic system.  And Weiner is back down in time in the brain speaking with the same language. The force is enormous and demands relief from the pressure it exerts.
The act-out doesn’t have to be sexual. I once had a patient who refused to use her turn signals while driving because, she’d rationalize, “it’s no one’s business where I go.” She realized later, through therapy, that her unsafe driving was driven by defiance of her mother who constantly kept tabs on her as a child, relentlessly asking her where she was going.

It can also happen when a drug addict has found relief.   He falls prey to his buried Primal Pain.   It is all done without words, mind you.  Whether the person shoots up, or he flashes or texts or he takes one more drink. We all understand that alcoholics find it hard to quit drinking. Well, for someone like Weiner, flashing one’s sex is compelling and irresistible as one more drink is to an alcoholic. They both know it’s ruining their lives, but they can’t help themselves. “Knowing” is a weak combatant in the fray. It is a latecomer to the cortical armamentarium and a weaker force than the dinosaur brain spouting out its memories.  When there is deeply buried, embedded pain, it often takes a non-verbal method to combat it.  Like drugs, which are immediate and powerful.
For dear Anthony to put a long-term marriage in danger has to involve an equal and opposite force, something possibly life saving.   I have observed that force in hundreds of patients over fifty years, and it is an ineffable experience. We do see near-death events, the strangling and choking and suffocation that cannot be faked but it is there.

I cannot possibly know what is behind Weiner’s acts act-outs but we know it is there, as we have stopped it in so many other similar cases. That act-out It is
saying something, that act-out, and but only he can decipher the meaning.  There is no expert alive who can do that job.  That is why we need a therapy of deep memory, a therapy of feelings and of embedded and hidden memories.  A therapy of experience, not of insights.  No one alive can bestow that truth on anyone else; except that contained within that act-out lies a secret, symbolic message betraying what it is.  So if you read hieroglyphics you get it; if not, you don’t.
It is the feeling that remains in the memory/feeling system, and it gets transformed into an act later on.  The act can only be approximate, because it if were exact it would be a Primal, and the level of pain would not allow it.  But the feeling drives the act-out, and that involves all kinds of different experiences.  If he finds playing  football early on that may fill the void.   Life circumstance fills the void.  But the act-out has to be close to the feeling and it usually is.
There is no way to know what that need is until he feels it in a Primal but rest assured, it is there, in force. Until then, the act-out relieves the pressure of unfelt feelings.  If it did not, then all manner of afflictions may occur as the person is bottled up with his pain. What the act-out may block is deep depression as one sinks with his load of unfelt feelings, or a different balancing act such as overeating or heavy smoking. There is only one way out, and that is the scientific way in which I believe we now have. Aah.          

Preamble by A. Gurza of my next book: "The Psychology of Every Day Life"

Here is the preamble of my next book, "The Psychology of Everyday Life", by Agustin Gurza.

 Preamble: A Primal Primer


            When Arthur Janov wrote The Primal Scream almost 50 years ago, he revolutionized the field of psychotherapy with a treatment he boldly called the cure for neurosis. Since then, he has written more than a dozen books and countless articles expanding, refining and enriching his theory. However, the fundamental principles he laid out in the original book remain unchanged. The clinical practice of Primal Therapy has evolved over time. But the basic discovery – about why people get sick and how they can get well – has yielded a set of truths that have proven as immutable as the laws of nature.
        Yet, Primal Therapy is not just a treatment modality for people with private problems. It is a unified worldview, a Weltanschauung, if you will, that helps explain so many of the ills afflicting man and mankind. It is a theoretical framework that helps us understand not only the psychology of the individual but also the dynamics of what was once referred to as our “sick society.” Just as Primal Therapy helps unravel the mysteries of our personal neuroses, it also sheds light on those monstrous forces that frequently shock the public and repeatedly cry out for explanation.
        It is this primal perspective that informs the essays Dr. Janov has written in this collection. Behind every commentary and critique lies this deep understanding of how the human mind works, and how it can be twisted and distorted through physical abuse and emotional deprivation in childhood. For those who have followed Dr. Janov’s work through the years, the primal context for these essays will be taken for granted. You might say that we speak the same primal language.
        To some degree, these essays stand-alone. Readers will find the topics provocative and the language accessible. Dr. Janov observes the world with a wonder and awe that we all can share, in a language that eschews dense academic jargon, which tends to obfuscate rather than clarify. However, a basic understanding of primal principles can surely enhance the reader’s appreciation of this work, since Dr. Janov’s observations arise out of primal thinking.
 With that in mind, this preamble is offered to help explain some of the ideas that form the pillars of Primal Therapy. It’s not intended as a crash course in the theory or therapy. It’s only meant as background for those readers unfamiliar with the basic tenants of the therapy. The only caveat is that the following summary strips the theory down to its most elemental form. For a full understanding, readers should still consult the source.
        Here is Primal Theory, in a nutshell.
        

 We Are All Creatures of Need

        The first and most fundamental primal principle was stated in the short but powerful opening line of The Primal Scream: “We are all creatures of need.” Truer words were never spoken. Any understanding of mental illness has to start with that premise. All human beings have needs, from the primordial (“feed me”) to the psychological (“praise me”). And when those needs are not met, the human organism goes awry. Why? Because it hurts when needs go unmet. We seem to understand this so clearly when it comes to plant life: flowers need a certain amount of sun and water and a certain type of soil, or they wither and die from the lack of life’s essentials. The same is true for our pets on both a physical and emotional level: we respond instinctively when they crave affection and attention.
        Yet, it seems we are not as attuned to our own human needs, which are so much more layered and complex, like our brains. The consequences of ignoring needs are also complex. We suffer from the deprivation, we struggle to absorb the pain, we find a way internally to suppress it and overcome it and move on, but at a great cost. 
        The price of unmet needs is neurosis.
        The entire theoretical structure of Primal Therapy is built on that basic understanding of human need. Those needs evolve over time, in successive stages. As the brain grows, so do our needs. As infants, our needs are few, but they are critical. We need to be fed, to be touched, to be soothed, to be cuddled, to be kept warm, safe and comfortable. The needs are simple but for a helpless baby they hold a life-and-death urgency. Of course, babies can’t feed themselves or cover themselves when they’re cold. So instinctively they know they will die without food or perish if left alone. That’s why when babies start wailing to signal their needs, their cries sound so alarming. To them, the danger feels imminent because they don’t have the intellectual capacity to reassure themselves that help could be on the way shortly. In fact, they have no way to measure time, except by the satisfaction of their needs. If their needs are promptly met, they feel loved and can continue to grow and flourish. If not, they are plunged into pain that they must now overcome. The crisis posed to the infant organism is commensurate with the urgency of the need. For adults, it is sometimes hard to grasp the intensity of the pain a neglected or traumatized baby can feel. That is why some parents still believe it is harmless to let their babies cry themselves to sleep, inventing a rationale called self-soothing, which is an oxymoron at that age. These are fragile human beings at their most helpless and vulnerable, with brains that are not developed enough to help them understand what is happening, much less resolve it with some sort of mental process that soothes their own fears. This is where feelings of terror, despair and hopelessness begin. This is where the seeds of neurosis are planted.
        In childhood, our needs become more complex. Our brain is growing; we are acquiring language and a sense of self. We still have basic needs for shelter and food, though we can now keep ourselves warm and get milk from the fridge. We now also have a need for approval and encouragement as we learn new skills and try new things. We need to feel comforted when we fail, and appreciated when we succeed. We need our parents to calm our fears and support our first steps toward independence. Most importantly, we need to be given the freedom to express our feelings, be it hurt or anger or fear. When our needs are met at this level, when our feelings are accepted, we feel loved. We feel strong enough to grow and take our first steps out into the world. This is how we acquire self-esteem, something that cannot be taught or acquired later on. If instead, the child faces neglect and disapproval, the pain is compounded and added to the stored pain and need from infancy. By adolescence, the child can already be a full-blown neurotic, in primal terms. We’ve all seen teenagers who are angry with their parents and starved for love and approval from their peers. The psychic/emotional system has already gone haywire, and parents throw up their arms not knowing how to handle their tempestuous teenagers. They ask: Where did we go wrong?
        Our needs continue into adulthood. We have a need to find mature love, to succeed in our work, to have fulfilling friendships, to eat healthy and get enough sleep. If however, we carry the old baggage of unmet needs, we might find it difficult to become a successful, happy adult. As we shall see, we cannot escape the unmet needs of our past.
            
 Repression and the Three Levels of Consciousness

        The notion of the subconscious is crucial to Primal Therapy. It is not a mysterious subconscious in the Freudian sense, a dark and violent depth that is to be avoided. The primal subconscious is filled with the pain from all that unfulfilled need, all those unfelt feelings from childhood. And this leads to another main pillar of primal theory: repression. We are all familiar with the way the brain represses awareness of traumatic events in adulthood, such as severe car crashes or violent sexual assaults. Victims often say they remember everything up to the moment of the catastrophic event, but not the event itself. Clearly, the mind is capable of blocking awareness of extremely painful experiences to protect the organism. The same is true for traumatic events from childhood. The human brain is capable of burying painful memories, along with all the feelings attached to those memories, as a way of protecting the individual from an unbearable realization. And for vulnerable children exposed to abuse or neglect, that realization represents a threat to the system: “I am not loved.” Repression, then, is a survival mechanism that allows the child to encapsulate and bury the awareness of traumatic experiences when they are too painful to take, at that stage of growth.
        There is much new scientific research that illuminates the neurological way this happens, including methylation. For our purposes, we just need to understand that traumatic memories and feelings are blocked from awareness at the time they take place. Thus, repressed memories are laid down and layered over time, creating levels of consciousness corresponding to each stage of an individual’s development. In Primal Therapy, there are three levels of consciousness, all inter-connected via memories and their feelings.
        The first level of consciousness we call the first line. It is the earliest level corresponding to the pre-verbal experiences of infancy, including birth.
        The second level, or second line, encompasses the experiences of childhood that include all the emotional responses arising from the evolving interaction with our parents.
        The third level of consciousness, the third line, represents our current experience as adults, which includes our relationships with our loved ones, our endeavors at work, etc. This is the level of our awareness in the present that, barring one of those catastrophic events, is not unconscious. The normal neurotic is generally aware of feelings and reactions on this level, though they may not understand why they feel a certain way in given situations. In extreme cases, however, even the awareness of feeling may be blocked in the third line, although the subconscious levels are still driving behavior in the present. This is the case with psychopathic killers who feel nothing while committing horrible deeds, which is why witnesses often describe mass murderers as acting calmly with blank looks, or even a smile. The lower level rage that drives these murderous impulses is so buried from consciousness that some killers later confess they don’t know why they did it.
        There is an important corollary to the theory of three levels of conscious, and that is the notion of resonance. This is the idea that similar feelings are connected to each other across the levels of consciousness, from the present to the past and back to the present. Resonance is crucial in clinical settings, because it provides the vehicle by which patients can follow a feeling from the present and be led back to similar, inter-connected feelings in the past.
        Neurologically speaking, the three levels of consciousness correspond to the structure of our triune brain, which, broadly speaking, evolves in three stages. Thus, first-line feelings are registered in the earliest, most primitive parts of the brain; second line involves the mid-level, feeling centers; and third-line engages the higher and last-developing part of the brain, the neo-cortex. This brief summary does not do the science justice, but suffice it to say that Primal Theory is in sync with the way the brain is built, and the way it evolves and grows.
        For our purposes, it’s important to know that these primal fundamentals – pain, repression and levels of consciousness – help us understand many of the mysteries of human behavior. It all comes clear with one kernel of primal truth: Humans hold repressed memories and feelings from the past that drive our actions, thoughts and emotions in the present, without our even knowing it.

 The Act-out and the Divided Self

        Repressed memories and painful feelings are not simply buried from consciousness and forgotten. They remain as a powerful force within the individual, constantly pushing for resolution. Repression produces a divided self, the conscious versus the unconscious. The split creates a constant state of conflict and tension that can only be resolved by making the self whole, which means bringing the unconscious into full awareness. That, in brief, is the goal of Primal Therapy, to unite the self and make the person whole again by systematically retrieving buried memories and finally experiencing the pain and need that had been kept at bay for so long. The cure lies in the reliving and integration of those traumatic experiences.
        Without that resolution, the force of those old, buried feelings continues to impact a person’s personality and take a toll on their health. While repression might keep a neurotic comfortably unaware of the demons inside, the pressure on the system can eventually lead to cancer, heart disease, and dementia. The body breaks down, so to speak, under the stress of holding so much back all the time.
        In order to work effectively, repression requires defenses. Some defenses are built into the system naturally through bio-chemicals produced by the body itself.  These help create a gating system that keeps the traumatic memories unconscious, allowing people to become functional adults. In some cases, however, the pain is so great that it damages or weakens these natural gates, bringing the pain closer to the surface and thus making the person suffer. These are often the people who come to Primal Therapy, because their pain is breaking through and they desperately need a way to resolve it. Others may turn to drugs or alcohol to soothe the suffering, risking a lifetime of addiction since unresolved pain will always be there, requiring more and more drugs to keep it down.
        Our behavior can also constitute a line of defense. We keep our old feelings away through act-outs that can take many forms: Chasing women, acquiring wealth, keeping busy, seeking more and more diplomas and professional recognition. Drug use is also an act-out, but one which directly quells the system though chemical intervention. Behavioral act-outs work symbolically. We try to satisfy our old needs by creating current symbols for what we were missing in the past. So if a person lacked the warm touch of a mother or loving hugs of a father, he or she may constantly seek human touch through sex. Or if a child was constantly put down and never praised, they may become performers always seeking applause.
        Dr. Janov puts it this way: 
        
            “We keep busy and doing things to keep from feeling there is nothing I can do. We keep having new projects to give us hope to keep from feeling there is no hope. We keep controlling things to keep from feeling I am helpless. We keep making phone calls to keep from feeling I am all alone.
            Now why would we do that? Because the feeling “I am all alone” isn’t just something from yesterday or today; it is the primal aloneness in the first minutes or weeks of life when mother, who was sick at childbirth, abandoned her baby. It became a life and death matter. It is a devastating aloneness that can be triggered off in the present whenever we are left alone for a time.
            We are acting-out against the pain, so that the act-out is unconscious; we do not know what drives us and we usually don’t even know that we are driven. It is all automatic. We keep from sitting still by much travel all to keep from feeling confined at birth, stuck in the canal, then later stuck in a tense and depressed household which was again “suffocating.” So we drag along our past but never know it is there weighing us down. One reason we know the pain is there is by the act-out, obsessive, continuous behavior that seems irrational. We are acting-out the feeling/pain, trying to get over the feeling but never knowing what it is or how to get rid of it.
            I used to think that it was the act-out that would be the death of us; but I now believe it is the underlying feeling that keeps the system activated and forces the act-out. The daredevil is constantly doing something death-defying. He is facing death and conquering it, a replay of his early life. But the imprint of approaching death is still imprinted and forces him to do it again and again.
            A counselor can insist that you stop this negative behavior but she doesn’t see the force below that drives it. Need forces unrelenting behavior. It is out of control because it is already controlled by unconscious forces, which are stronger than any act of will.
            Check your act-out and you will get a good idea of what your pain is. Now the tough part: feeling it.” 

 Insights and Essays

        In therapy, the final stage of a primal is the moment at which the patient emerges from an old feeling and realizes the impact it has had on his life all along. This stage is called the insight. Finally, the repressed feelings are made conscious, and with that comes an often astonishing new understanding of why we have done, or failed to do, certain things all our lives. The therapist never provides the insight for the patient. The insight arises from reliving the old pains, or rather, experiencing them consciously for the first time. Making the connection to the old feeling in its original context is what brings relief, and healing. Once the old pain is felt, it no longer exerts its subterranean force, and we can stop trying to symbolically satisfy the old need that created the pain in the first place, and kept us crazy all our lives.

        Dr. Janov wrote the essays in this book using this primal insight into how human behavior works. You might say he is using the insights achieved by hundreds of patients to help explain the inexplicable: Why mass killers kill, why successful celebrities commit suicide, why people feel the need to travel all the time, why so many kids suffer from ADD, and why it’s so hard to find true, fulfilling love. Primal theory provides the powerful lens that allows him to probe beneath the surface of this array of befuddling, frustrating, shocking and mystifying human behavior. Like a primal, the analysis is often illuminating.

On the Difference Between Abreaction and Feeling (Part 12/15)

 Awareness is not healing; consciousness is. True conscious- awareness means feelings, and therefore humanity. The conscious person does not have to be told about his secret motivations. He feels them and they are no longer secret. Consciousness means thinking what we feel and feeling what we think; the end of a split, hypocritical existence. Awareness cannot do that because awareness has to change each and every time there is a new situation. That is why conventional cognitive/insight therapy is so complex. It has to follow each turn in the road. It has to battle the need for drugs and then battle the inability to hold down a job and then try to understand why relationships are falling apart. This also explains why conventional therapy takes so long; each avenue must be traversed independently. Consciousness is global; it applies to all situations, encompasses all those problems at once. The true power of consciousness is to lead a conscious life with all that that means: not being subject to uncontrolled behavior, being able to concentrate and learn, able to sit still and relax, being able to make choices that are healthy ones, to choose partners that are the healthy ones, and above all, to be able to love.

 A therapy of awareness versus one of consciousness has an important difference in terms of global impact. In science we are after the universal so that we can apply our knowledge to other patients. A therapy of needs can apply to many individuals, since we all have similar needs. A therapy of ideas usually can only apply to a specific patient. When we try to convince the patient of different ideas (e.g., “People actually do like you”), we generate no universal laws. It is all idiosyncratic. But if we address the feelings underneath, we can generate propositions that apply generally: for instance, pain when unleashed can produce paranoid ideas or compulsions. Or, the frontal cortex can change simple needs and feelings into complex unrealities, changing them into their opposites.

 One cannot be aware without an intact prefrontal cortex. By contrast, there is no seat of consciousness. As banal as it may seem, consciousness reflects our whole system – the whole brain as it interacts with the body.

 When there is awareness without connection during a session, that is what we call abreaction. Again, the vital signs rise and fall in sporadic fashion, rarely below baseline. We cannot make progress on the third-line cognitive level alone. We can become aware of why we act the way we do but nothing changes biologically; it is like being aware of a virus and expecting the awareness alone to kill it. Our biology has been left out of the therapeutic equation. What is missing is that we cannot produce feeling, empathic human beings from the top of the brain. Somehow feelings got the sobriquet of bad, out of control, negative, anti-thinking, unreflective and impulsive. All of which is true for suppressed feelings, which inject themselves without warning into our daily life and make us act irrationally. Not true if they are just part of a feeling person who lives his feelings and does not abreact.

On the Difference Between Abreaction and Feeling (Part 11/15)

 Awareness V. Consciousness

 The leitmotif of every intellectual therapy is that awareness helps us make progress. I’ll grant that awareness helps; but being conscious cures. Unless we are able to achieve consciousness in psychotherapy, the most we can do is tread water, having the illusion of progress without its essence. When it comes to measuring progress in psychotherapy, it matters whether one measures the whole system or only aspects of brain function. Awareness fits the latter. It has a specific seat in the brain.

 Psychotherapy has been in the business of awareness for too long. Since the days of Freud, we have apotheosized insights. We are so used to appealing to the almighty frontal cortex, the structure that has made us the advanced human beings that we are, that we forgot our precious ancestors, their instincts and feelings. Thus, when the patient is uncomfortable during a conventional, talk-therapy session, therapists typically take the position that, “More insight is what we need; the patient is not aware enough.” Yet, what lies on low levels of brain function is impervious to the realm of any ideas, where insights lie. That is why we can be anxious and aware, but not anxious and conscious. Consciousness is the end of anxiety.

 Consciousness means connection to what is driving us – our disconnected feelings. Awareness means dealing with only the last evolutionary neuronal development: the pre-frontal cortex. It is the difference between separation on the top cerebral level versus the confluence of all three levels, which is consciousness. Once we are conscious, we have words to explain our feelings, but words do not eradicate them; they explain and elucidate. We are deeply wounded long before words make their appearance in our brains. Words are neither the problem nor the solution. They are the last evolutionary step in processing the feeling or sensation. They are the companions of feelings.

 We need a therapy of consciousness, not awareness. If we believe that we have an id stewing inside of us, there is no proper treatment because the cause is an apparition – a phantom that doesn’t exist. Or worse, it is a genetic force that is immutable and therefore cannot be treated. In any case, we are the losers. There is no powerlessness like being unconscious; running around in a quandary about what to do about this or that, about sexual problems, high blood pressure, depression, and temper outbursts. It all seems like such a mystery. The aware person, or he who seeks awareness, has to be told everything. He listens, obeys – and suffers. Awareness doesn’t make us sensitive, empathic, or loving. It makes us aware of why we can’t be. It’s like being aware of a virus. It’s good to know what the problem is, but nothing changes. The best awareness can do is create ideas that negate need and pain.

On What Help Us Love

There is the obvious: being loved from the start.
There is the less obvious, abstracting the chemical elements that are part of the ability to give and receive love; i.,e; oxytocin.  Being loved is the natural way; paradoxically, another way is to feel the lack of love, which seems to normalize so many biochemicals.  I have seen so many patients who were unloved by their parents and who cannot sustain a loving relationship.

This inability to love is now being recognized in the field  and doctors are prescribing a spray that enhances oxytocin. I have another idea; let them feel their agony over not being loved, in Primal Therapy. What we find is an increase in loving in patients who have relived their pain over the lack of love.  It is an odd dialectic that crying out not being loved can help you love, as one turns into the other. To be determined to love one’s wife or kids will help, but it does not add the feeling element to the process.  And it is the feeling element that is missing, at the start. And can happen despite our best intentions.  The will power needs to be driven by passion and feelings.  Otherwise it remains a cerebral desire, bereft of feeling.

Those who take pain killers also suppress passion.  But,  suppose we are on pain-killers permanently; when there is great early pain there is an equal and opposite reaction to hold down feelings… repression which is constant and obdurate to hold down great agony.  Then we cannot love completely.  And that can begin before we begin in this world.  Clearly, when we remove deeply embedded pain we enhance the ability to love.  We reopen the feeling channels.

Remember, feeling unloved means feeling; repressing it means no feeling.

Let us not look only at oxytocin because what we have found is that normalizing the patient elevates so many biochemicals to normal levels, as we have measured over the years.

We do not dissect the patient into his parts, a kidney, a heart or a liver,  We try to approach the human being as a totality and expect changes as a totality, as well.  That is the trouble with Rolfing and Bioenergetics where muscle groups are targeted and worked on to the exclusion of the brain and mind.  Which means all that does not come from the central nervous system but the organs themselves.  Which is how we go awry studying the organ apart from the human being.  And we get changes in the muscle groups and not an organic change.  Relaxing tense muscles is not the same as relaxing the whole person.  The tension usually arrives from experiences in life and those sculpt the human being.  I treated one person who had chronic arm muscle tension.  He felt in therapy he was chronically holding back hitting back his father who beat him incessantly. Beware of the facile, easy answers.  We are not an arm, a liver or blood pressure.  We are humans, and therapy must be of experience, not “psycho.” There are some lessons here:  we can repress feelings when imprinted pain gets immense, or we can repress pain with drugs that mimic what takes place when we ingest the same drugs that we should secrete when pain gets to intense….serotonin…..in the form of Zoloft and Prozac.  We need to revisit our inner pharmacy to help out with pain killers when repression is not sufficient.

On the Difference Between Abreaction and Feeling (Part 10/15)

By definition, abreaction lacks connection, which is the sine qua non of Primal Therapy. Without connection there is neither healing nor cure. So, clearly it is crucial. If there is no connection to solidify the feeling there is no progress. So what is connection, after all? It means that while the patient is feeling and reliving she is connecting to the pain/fear/terror. Bit by bit as she relives and feels she is making a connection to something buried away for perhaps years. Connection means feeling something in context, comprising each different level or aspect of the feeling until the patient arrives where it all began. That is eventually where patients need to go. But a random scream or cry will not take you there. At each level, the feeling must connect with its context, which is different as we descend down the chain of pain. Each brain level contributes its specialty: ideas, feelings or instincts.

 On the other hand, abreaction is just a release of the energy of feeling without meaning and out of context. There is a great gap between reliving and relieving, and this is the mistake so-called mock therapists make all of the time. The mistake is easy to make because, again, abreaction looks like feeling but it is not. It should be noted that the patient is not deliberately faking a feeling. Abreaction can be a real feeling, but it is out of sequence, and therefore it is not curative because it does not allow for proper connection across all three levels in a natural, orderly way. The patient is pushed into the tributary feeling because the pain of the main feeling is too great. This heavy painful feeling does in therapy what it does in everyday life; it keeps us from focus and concentration. It pushes us away from the central feeling. So abreaction is going through the motions of feeling without its depth and history. And it requires that the person perform the sidetrack feeling over and over again—relieving not reliving.

 So again, connection means liberation of feelings in context. There are those who scream and writhe and cry out of context, as in an exercise. They make no profound change, but when the patient slowly descends to deep levels over time and reacts to the stimuli and events on that level with the neurological capabilities of that era, there is progress.

 The goal of our therapy is to retrieve memory, not only of the scene or the place but also of the feelings belonging to them; that is what has been repressed and held in storage, the pain and terror. When we primal, we are reaching deep down physiologically to a part of our history that has been sequestered for decades and will not give up its secrets easily. Sometimes, the patient is not yet ready for the experience so it remains a mystery, until the time is right. When patients finally experience those feelings in their totality, including physiological aspects, they become integrated. The neurotic split is healed and the person is no longer at war with himself. Now we can use the term “holistic.” The patient has become whole in every sense of the word. His feelings are integrated into awareness and into his neurophysiology.

On the Difference Between Abreaction and Feeling (Part 9/15)

 The idea is to remain in the feeling zone, the only zone where connection can take place. Outside of the Primal Zone, no integration is possible. This is why it helps for the therapist to have at least a modicum of brain science at his disposal. In some cases, for example, we know that the use of tranquilizers can help get the patient into the zone for a time. This is not in lieu of therapy but as an aid to it.

 Now why is the wrong feeling addressed? Because when a therapist has unresolved feelings of her own she will tend to drive the patient where she needs to go.(2) Or worse, she will avoid feelings of the patient that she is not ready for. As for example, anger. If the therapist is terrified of hostility, she will shut it down in the patient.

 She won’t let the patient go near it, and the feeling will remain unresolved. If the therapist cannot be criticized, she will dodge any blame and try to make any error the patient’s fault instead of hers. This is the most widespread of problems with therapists. Above all, we want to avoid confining the patient to his ideational cortex to the neglect of feeling. In other words, we want to avoid precisely the predominant therapeutic approach in contemporary psychotherapy, which is Cognitive Behavioral. The cognitivists really do believe it’s all in your head, that changing thoughts can change behavior. To me, Ideas signify something “disembodied.” When a therapist lives in the world of ideas there won’t be much feeling there; one reason is that feelings seem secondary to them. Ideas, they agree, are paramount and have value.

 By contrast, a full, feeling experience in the Primal sense means that that we are not confined to the neocortical level where ideas and intellect live. What we are after is to hook up the primitive, lower levels of the brain with higher levels so that there is a proper connection. This means that the historical need/feeling/pain has been fully experienced with all of our being.

 And how do we know when a real feeling has taken place? We can verify it, physiologically. Before and after every session, we systematically measure vital signs of each patient. During a real Primal, we expect to the vital signs move pretty much together – up at the start and back down towards the end of a session. Over months there is a constant normalization of vital signs so that the blood pressure, heart rate and body temp get reset to the normal range after some months of therapy. Over time, there is also a significant drop in cortisol levels and enhanced natural killer cells. (See my book “Primal Healing” for further discussion.) Measurable metabolic changes also include a permanent one-degree lowering of body temperature; since body temperature is a key factor in our longevity and the work of our bodies, it is an important index. In addition, our research found that after one year of our therapy there were systematic changes in brain function toward a more harmonized cerebral system. It all means that we are getting to the pain and undoing repression.

 That is not the case with abreaction. In a feeling without context, which is an abreaction, there is never this kind of organized, coordinated movement of vital functions. Instead, a random discharge of energy from the feeling/pain will produce a sporadic, disorganized movement of vital signs. There is no harmony to the system. Thus, when vital signs do not reflect integration, we can be sure that connection never took place. By these measures, “thinking” that we feel and actually having a real feeling are neurologic worlds apart.

 2 Excuse me for jumping between the masculine and feminine pronouns, using “him and he” interchangeable with “her and she.” I get very tired of trying to balance he and she, so be aware that my heart and mind are in the right place.

On the Difference Between Abreaction and Feeling (Part 8/15)

Feeling is healing. No feeling, no healing. Connection is the Key.

 So how do we guard against abreaction and produce genuine feelings? There are two important factors at play. First, the patient must arrive at a particular feeling/pain/need untrammeled by other feelings, which are often compounded by a history of unrelenting pain from childhood trauma and neglect. That is, the therapist must be acutely aware of the leitmotif in the session – which feelings are critical and which are peripheral. It takes much experience to know how to do it because often, there is a tendency to conflate feelings and go off on the wrong tangent. If the wrong feeling is addressed, we get abreaction. For example, if a patient is in a feeling and suddenly starts gagging and coughing as a result of first-line intrusion, the therapist should steer him back to the original feeling because the intrusion is a diversion, and that diversion itself is the abreaction. Or if the patient comes in bitching about his wife – “she is just suffocating me with her demands” – and then he begins gagging, we know that the origin of his complaints is deep in the brain, likely the part of the brainstem concerned with breathing. We do not push the patient into the birth trauma unless he is far along in therapy and ready for such an experience. Otherwise, he is steered back into the original feeling, to explore why he feels suffocated. It is indeed a thin line to know which level the patient is on and what level he can access without unbearable pain.

 The same is true of a patient who comes in crying on the third line and never goes beneath it, to older pains. That too is abreaction. He is discharging deeper feelings on a higher level of brain function, unable or unwilling to take it back further and deeper. The result is not a full feeling; rather it becomes a chronic discharge of the energy of the feeling with no final resolution. For example, a patient may come in and cry only about a film he just saw, but never connect it to his own life and his past experience. He is stuck on the third line, and abreacting. Screaming and yelling in and of itself always remains a simple discharge. Feeling ultimately means an experience in context. The problem is that yelling, crying and screaming with no context still feels good and can form a groove of relief.

 This is where it gets tricky because there are levels of contexts: the ideas (top level), the emotional experiences (limbic system) and the infantile (brainstem) level. The contexts deepen as the patient is able to go deeper in his therapy. A complete primal experience means encompassing all three levels of brain function involved in a single feeling. That comes later in therapy when access allows the patient to travel to the beginnings of experience and of life. He is then allowed to complete the cycle of feeling and obtain resolution. In this kind of primal the patient feels the entire crucible of his behavior and symptoms. It is no longer a mystery, so long as we allow evolution to do its job. It is too tempting sometimes for a therapist to push the patient into something very dramatic so as to show his so-called skill.

 So we need to know on what line or level the patient is operating on, so that we help him and us to focus. This avoids a mélange of levels that also prevents proper connection. We see this with patients who wander over several feelings and disparate subjects during a single, scattershot session. Nearly always, the patient’s wandering over many subjects means there is a mélange of great underlying pain pushing him from one place to another. Needless to say, this is the patient who often suffers attention deficit for the same reason: too strong a primal force, preventing focus.

 Feelings must be felt on all levels but in an orderly sequence, not all at once. The therapist must get the patient back on track so the natural feeling can be allowed to unfold in tune with the natural resonance that links the levels of feeling together neurologically. Once the patient is on the right track, resonance will take its course, leading the patient naturally deeper and more remote over time. In abreaction, it’s often the therapist that is leading the patient in the wrong direction, creating all manner of bad outcomes.

On the Difference Between Abreaction and Feeling (Part 7/15)

This is exactly what happens with mock primal therapy. The correct roots have been evaded while driving the patient into false byways. The result? Abreaction. A false root can mean leading the patient into first line, brainstem level where highly charged imprints await. So what does the doctor see as the first line intrudes? Gagging, shortness of breath, squirming, coughing. And what does he do? He encourages the patient to go into it when he is not nearly ready for such a deep experience. What does he get? Abreaction – temporary release plus a residue of feelings that could not be experienced, which push against defenses to make the patient feel bad. More often such great reactions produce fear in the therapist and he avoids dealing with it at all. It is left hanging and unresolved.

 But beware: there is also danger when the therapist is too passive. Those who do not recognize first line on the rise will keep the feeling down and only let it come up for experience when it is far too late. It is too late due to the lack of experience of the therapist who has no idea how to handle pretty strenuous feelings on the rise. So what happens? Abreaction again: feeling different memories from the ones at hand. Again a groove is formed and instead of deep resolving feelings, there are little by-ways that are not resolving. For this timid and reluctant therapist, Freud’s dictum about the unconscious still holds true: don’t go too deep. Freud decided almost one hundred years ago that digging deep into the unconscious was dangerous for the patient and would disturb his equilibrium irrevocably. We have seen the unconscious at work and it is simply not true.

 We therapists need to abjure being omniscient. We don’t know enough, and I cannot even guess how it happened that we became experts in the human condition. Whenever a therapist tells the patient what to feel we know he is already on the wrong path. We must sense feelings and follow the patient, not lead him. We take him by the hand and follow where he leads, not vice versa. We doctors must avoid the temptation to act smart. We spent years in college learning to be smart, and now we must elude it. How ironic! Yet the history of psychotherapy was intellectual and provided a therapy of the intellect, exactly what we don’t need. We don’t let the patient act “smart;” we allow her to act intelligent, to recognize her feelings and how they drive her and cause her to act out. When she tries to act smart we help her get to the feeling; of how to please momma or father. Finally it is a great relief just to be yourself and not have to act this way or that to get love.

 It seems banal and harmless that a therapist supplies insights for the patient, but it is far from that because the patient is given a guess about his feeling from the professional which may be accurate but most often is not because it does not emanate from the patient’s feelings, but from someone else’s. It is a subtle way of channeling the patient into a groove because the therapist is insecure and wants to make sure that the patient is really feeling. And a facile groove is what most people suffer from in abreaction; they find a release to direct their feeling and it becomes comfortable to stay in it. It becomes embedded until they cannot get out of it and they don’t even know they are in it. The force of the feeling, the actual content, finds its groove, and it takes months of proper therapy to help patients out of it. Abreaction has compounded the neurosis rather than eliminating it. Worse, the person is convinced he is better, and he is not. Much worse, the doctor is convinced that all is right, yet nothing is right. The whole process has become a charade; a delusion of wellness. It feels good for the patient because he can release the pressure of the upcoming feeling and that feels like progress: ergo he is getting better.


 When we try to insert ourselves into the feeling process we get a reflection of ourselves, not the patient. And that reflection relies on a host of theories concocted by doctors to explain that which needs no explanation. The mistakes in theory are as myriad as the unconscious of the doctor. He may see a need for power or of meaning or of sex and on and on. He often sees what is not there and refuses to see what is right there. His vision is limited by his openness. And that depends on how much he has felt and experienced of his own pain. You cannot be more open than your repression. That blocks so much: vision, insight, empathy compassion and understanding. If you live in your head you will never consider plunging to the depths of feeling; it is then all about explaining feelings, discussing them or writing about them. There is a form of therapy today where patients believe they can get well by keeping a journal about their feelings. Again, it is too obvious for comment but it is the top level that is embraced when we need to push far below it. The same is true for mindfulness therapy, which enhances attention and asks the patient to concentrate on details such as rate of breathing. This keeps that top level super-attentive when it should lie quietly. In these therapeutic schemes, there is no way to go deeper when every move that is made in therapy militates against feeling. They cannot go deeper because they are locked into kind of abreaction themselves. There is no larger, encompassing frame of reference that can guide them. They are as diverted from feelings as the patient who abreacts.

 These cognitive theories are based on a basic distrust of feelings in favor of intellect; the opposite of one needs to produce a feeling cure. When a doctor defines his therapy as cognitive, he has already lost. It means he will deal with half the brain to the neglect of the other parts; above all the feeling parts; those parts that are healing.