Sunday, January 5, 2014
On Psychological Medicine
Here is what I think is proper medicine in psychotherapy: it must be always a collaboration between patient and doctor. It is not something done to the patient as if she were only a research subject. It means that her input has to be considered as a leg of the diagnostic procedure; and that is what seems to be missing in so much psychotherapy today. The patient is “done to.” There is a certain set of procedures, which is fixedly applied to the patient without her input whatsoever. Therefore, a critical leg of the diagnostic procedure is missing and the diagnosis is faulty. It has to be since a critical input is not there.
The problem is that there is a certain set of assumptions that are decided before the patient ever enters the room, which are then a priori draped over him, and the therapy begins. I use the word, “draped,” because these assumptions then sequester the real patient before them, and she can no longer be seen. All they see is the image decided on helter-skelter. And the patient must fit into this image, rather than vice versa…getting all the facts and seeing how they lead to a diagnosis. How the theory fits the patient; how the diagnosis emanates from those facts and data. There is rarely a diagnosis that can be changed to fit the new information. So she is squeezed into a diagnostic category to make it all fit.
So here we have, “got the tools to be applied and don’t let the facts interfere with their use.“ Well don’t we do that, as well? We try to change our hypothesis when necessary but our hypotheses and theory derived from decades of research and observation. It wasn’t a decided on procedure irrespective of the facts. In brief, the facts led to an ever-changing diagnostic approach. Not so loose as to be a sieve but rather something with a key structure that leaves room for change. It is a fine line.
How does that work in practice? One simple point: I originally never believed in birth primals at the start and told patients it was ridiculous. I took my lead from a university neurology department who advised me how impossible it was. So I eliminated the idea and took it out of my diagnostic armamentarium. But the facts kept piling up; patients who came from many different countries did in fact relive birth, and then we did research on it, testing brainwaves and biochemistry. Reliving birth was filmed and measured, and the results were inescapable. It not only was possible but major biologic change resulted from the reliving. We never shut down the idea totally; we waited and studied it to see what it was and what it did. And it did exactly what the patients insisted what it did. It changed them; lowered their blood pressure and body temperature. It was a collaborative process, which included the patient’s input. I cannot imagine it being done without that input.
Reliving stopped anxiety attacks. Then we needed to know why. And we were off and yet another study of panic and anxiety attacks. What were they and where did they come from? The result of our work is found in the World Congress of Psychiatry (Spring 2013). Our work evolves exactly because we leave room for the new.
Now let us turn back, (and I do mean “back”), to the “rebirthers”. They saw something dramatic in it and decided world-wide to practice it randomly. They saw a cure-all, done in an afternoon, some done in swimming pools, other done without the water. And what did that “I have the tools and will find patients to fit in,” idea accomplish? Many patients completely broken down and coming to us for help to re-establish their sanity. It is now a predictable result because these patients were victims of the “tool box.” No studies or research, no seeing if patients can go deep with impunity. And they cannot.
In fact, I have yet to see, among all those mock practitioners any serious research to accompany their work. They found a name, Primal, and a technique, Rebirthing, and off they went, using well-researched ideas as their own. Who suffered? Patients. Even Steve Jobs was fooled into thinking he was going to a legitimate primal center. There are those who see the title “doctor,” and cannot imagine that a “doctor” would engage in chicanery. Alas, they can and do. Few want to put in the years of study again to learn a new approach, so they make off with the name and voila! They are primal therapists.
The hypocrisy goes on: there is a man in Sweden who has spend decades denigrating primal therapy, all the while practicing it in secret, Tomas Videgard. Here is a letter in part from one of his “patients“: “It is difficult to know what he did to me. Pressed me down to a painful trauma and refused to take me out of it. He told me that he was chosen by you to become a primal therapist. But he skipped the whole thing (the training). It was a nightmare.”
I cannot vouch for the letter’s accuracy but it sounds a lot like other reports I have received. And it highlights the danger of those using the term Primal to practice a so-called primal therapy. I am often asked, “Why don’t they use some other name?” The answer is that with the name goes years of research and practice, which they take as their own, giving them a cachet they have not earned. And worse, it allows them to damage patients in our name. Since there are literally hundreds of so-called primal therapists advertising the therapy, it is not surprising that those who are hurting and need help can be fooled.
Quotes for "Life Before Birth"
“Life Before Birth is a thrilling journey of discovery, a real joy to read. Janov writes like no one else on the human mind—engaging, brilliant, passionate, and honest.
He is the best writer today on what makes us human—he shows us how the mind works, how it goes wrong, and how to put it right . . . He presents a brand-new approach to dealing with depression, emotional pain, anxiety, and addiction.”
Paul Thompson, PhD, Professor of Neurology, UCLA School of Medicine
Art Janov, one of the pioneers of fetal and early infant experiences and future mental health issues, offers a robust vision of how the earliest traumas of life can percolate through the brains, minds and lives of individuals. He focuses on both the shifting tides of brain emotional systems and the life-long consequences that can result, as well as the novel interventions, and clinical understanding, that need to be implemented in order to bring about the brain-mind changes that can restore affective equanimity. The transitions from feelings of persistent affective turmoil to psychological wholeness, requires both an understanding of the brain changes and a therapist that can work with the affective mind at primary-process levels. Life Before Birth, is a manifesto that provides a robust argument for increasing attention to the neuro-mental lives of fetuses and infants, and the widespread ramifications on mental health if we do not. Without an accurate developmental history of troubled minds, coordinated with a recognition of the primal emotional powers of the lowest ancestral regions of the human brain, therapists will be lost in their attempt to restore psychological balance.
Jaak Panksepp, Ph.D.
Bailey Endowed Chair of Animal Well Being Science
Washington State University
Dr. Janov’s essential insight—that our earliest experiences strongly influence later well being—is no longer in doubt. Thanks to advances in neuroscience, immunology, and epigenetics, we can now see some of the mechanisms of action at the heart of these developmental processes. His long-held belief that the brain, human development, and psychological well being need to studied in the context of evolution—from the brainstem up—now lies at the heart of the integration of neuroscience and psychotherapy.
Grounded in these two principles, Dr. Janov continues to explore the lifelong impact of prenatal, birth, and early experiences on our brains and minds. Simultaneously “old school” and revolutionary, he synthesizes traditional psychodynamic theories with cutting-edge science while consistently highlighting the limitations of a strict, “top-down” talking cure. Whether or not you agree with his philosophical assumptions, therapeutic practices, or theoretical conclusions, I promise you an interesting and thought-provoking journey.
Lou Cozolino, PsyD, Professor of Psychology, Pepperdine University
In Life Before Birth Dr. Arthur Janov illuminates the sources of much that happens during life after birth. Lucidly, the pioneer of primal therapy provides the scientific rationale for treatments that take us through our original, non-verbal memories—to essential depths of experience that the superficial cognitive-behavioral modalities currently in fashion cannot possibly touch, let alone transform.
Gabor Maté MD, author of In The Realm of Hungry Ghosts: Close Encounters With Addiction
An expansive analysis! This book attempts to explain the impact of critical developmental windows in the past, implores us to improve the lives of pregnant women in the present, and has implications for understanding our children, ourselves, and our collective future. I’m not sure whether primal therapy works or not, but it certainly deserves systematic testing in well-designed, assessor-blinded, randomized controlled clinical trials.
K.J.S. Anand, MBBS, D. Phil, FAACP, FCCM, FRCPCH, Professor of Pediatrics, Anesthesiology, Anatomy & Neurobiology, Senior Scholar, Center for Excellence in Faith and Health, Methodist Le Bonheur Healthcare System
A baby's brain grows more while in the womb than at any time in a child's life. Life Before Birth: The Hidden Script That Rules Our Lives is a valuable guide to creating healthier babies and offers insight into healing our early primal wounds. Dr. Janov integrates the most recent scientific research about prenatal development with the psychobiological reality that these early experiences do cast a long shadow over our entire lifespan. With a wealth of experience and a history of successful psychotherapeutic treatment, Dr. Janov is well positioned to speak with clarity and precision on a topic that remains critically important.
Paula Thomson, PsyD, Associate Professor, California State University, Northridge & Professor Emeritus, York University
"I am enthralled.
Dr. Janov has crafted a compelling and prophetic opus that could rightly dictate
PhD thesis topics for decades to come. Devoid of any "New Age" pseudoscience,
this work never strays from scientific orthodoxy and yet is perfectly accessible and
downright fascinating to any lay person interested in the mysteries of the human psyche."
Dr. Bernard Park, MD, MPH
His new book “Life Before Birth: The Hidden Script that Rules Our Lives” shows that primal therapy, the lower-brain therapeutic method popularized in the 1970’s international bestseller “Primal Scream” and his early work with John Lennon, may help alleviate depression and anxiety disorders, normalize blood pressure and serotonin levels, and improve the functioning of the immune system.
One of the book’s most intriguing theories is that fetal imprinting, an evolutionary strategy to prepare children to cope with life, establishes a permanent set-point in a child's physiology. Baby's born to mothers highly anxious during pregnancy, whether from war, natural disasters, failed marriages, or other stressful life conditions, may thus be prone to mental illness and brain dysfunction later in life. Early traumatic events such as low oxygen at birth, painkillers and antidepressants administered to the mother during pregnancy, poor maternal nutrition, and a lack of parental affection in the first years of life may compound the effect.
In making the case for a brand-new, unified field theory of psychotherapy, Dr. Janov weaves together the evolutionary theories of Jean Baptiste Larmarck, the fetal development studies of Vivette Glover and K.J.S. Anand, and fascinating new research by the psychiatrist Elissa Epel suggesting that telomeres—a region of repetitive DNA critical in predicting life expectancy—may be significantly altered during pregnancy.
After explaining how hormonal and neurologic processes in the womb provide a blueprint for later mental illness and disease, Dr. Janov charts a revolutionary new course for psychotherapy. He provides a sharp critique of cognitive behavioral therapy, psychoanalysis, and other popular “talk therapy” models for treating addiction and mental illness, which he argues do not reach the limbic system and brainstem, where the effects of early trauma are registered in the nervous system.
“Life Before Birth: The Hidden Script that Rules Our Lives” is scheduled to be published by NTI Upstream in October 2011, and has tremendous implications for the future of modern psychology, pediatrics, pregnancy, and women’s health.