primal therapy

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Primal therapy is a trauma-based psychotherapy created by Arthur Janov, who argues that neurosis is caused by the repressed pain of childhood trauma. Janov believes the repressed pain can be brought to conscious awareness and resolved through re-experiencing the incident and fully expressing the resulting pain during therapy. Primal therapy was developed as a means of eliciting the repressed pain; the term "Pain" is capitalized in discussions of primal therapy when referring to any repressed emotional distress and its purported long-lasting psychological effects. Janov takes issue with the "talking therapies" as they deal primarily with the cerebral cortex and higher reasoning areas, and do not access the source of Pain within the more basic parts of the central nervous system.

Primal therapy became very influential during a brief period in the early 1970s, after the publication of Janov's first book, The Primal Scream. It inspired hundreds of spin-off clinics worldwide, and served as an inspiration for many popular cultural icons like John Lennon and Tears for Fears.^{[citation needed]}

Since that time, primal therapy has declined in popularity, in part because Janov has not produced the outcomes studies necessary to convince research-oriented psychotherapists of its effectiveness. Despite this decline, Janov and others continue to advocate and practice the therapy or various developments of it.

Concept

Janov states that neurosis is the result of suppressed pain which is the result of trauma, usually trauma of childhood origin. According to Janov, the only way to reverse neurosis is for the neurotic to confront his trauma in a therapeutic setting. Janov contends that by confronting his trauma, the neurotic can "re-live" the original traumatic incident and can express the emotions that occurred at that time, thereby resolving the trauma.

Janov believes that there is only one source of mental illness (besides genetic defects)—imprinted pain. He argues that this unitary source of neurosis implies that there can be only one effective cure—re-experiencing.

Needs

Janov felt that much of the pain of childhood is the result of needs going unmet. Drawing from earlier psychologists, he described his take on the basic needs in his books. "Our first needs are solely physical ones for nourishment, safety and comfort. Later we have emotional needs for affection, understanding and respect for our feelings. Finally, intellectual needs to know and to understand emerge."^[1]

"Need is a total state of the human being - and at birth we are almost nothing but need."^[2] Janov argues that for the helpless newborn, survival is at stake in nearly every second of existence.^[2]

Janov asserts that when needs go unfilled for too long, pain is the result (he capitalized Primal Pain in his early work, although in later works he dropped the capitalization).

Pain

In primal theory, "Primal Pain is deprivation or injury which threatens the developing child. A parent's warning is not necessarily a Primal Pain for the child. Utter humiliation is...An infant left to cry it out in the crib is in Pain...It is not hurt as such which defines Primal Pain but rather the context of the hurt or its meaning to the impressionable developing consciousness of the child." ^[3]

Janov describes Pain as the pain that doesn't hurt because, as soon as the person goes into it, it becomes simply feeling. Most of the suffering component is in the blockage or repression.^[4]

Consciousness and repression

In primal theory, consciousness is not simply awareness but refers to a state of the entire organism including the brain in which there is "fluid access" between the parts.^[5] Using the triune brain work by Paul D. MacLean, and adapting it to Primal Theory, three levels of consciousness are recognized in Primal Theory.^[6][7][8]

The following table summarizes some of the fundamental ideas and terms Janov (J) has used as well as conventional terms used in general and scientific papers.

• Janov describes defenses as the agents of repression that consume energy while protecting the system from the catastrophic Pain of unfulfilled need. When referring to Pain or defense the word "line" is used instead of "level"; e.g. first line Pain = early trauma imprinted in the brainstem usually involving physical injury, third line defense = intellectual defense.
• The brainstem has also often been referred to as the reptilian brain as it is the structure which mammals have in common with reptiles.
• 1st line imprints occur before intellectual abilities such as the use of verbal language have developed. They are at the level of pure sensation and visceral (or gut) reaction. The brainstem is capable of processing the most primitive emotions of rage and terror and these can be experienced very early in life.

According to Janov, Primal Pains are imprinted in the lower brain first then later the limbic system and still later intellectual defenses are formed by the cortex simply because this is the sequence of neurological development. The therapy therefore occurs in the reverse sequence: 'There is no way to go deep without first going shallow.'^[9] In primal therapy medication is prescribed for some "overloaded" patients so they don't overshoot into 1st line pains that they are not ready to feel, thereby allowing them to feel the more recent pains first.^[10]

Origins of neurosis

Primal theory contends that many or most people suffer from some degree of neurosis. This neurosis begins very early in life (especially in the "critical period"—birth plus the first three years)^[11] as a result of needs not being met. There may be one or more isolated traumatic events but more often it's a case of daily neglect or abuse.

Neurosis therefore may begin to develop at birth, or even before, with "first line" Pains. Subsequent Pain is thought to be added on top of previous pain in what is called "compounding" the Pain.^[12]

Throughout childhood more elaborate "defenses" develop as the early unmet needs keep pressing for satisfaction in symbolic and therefore inevitably unsatisfying ways.

Format and process

The overall strategy of primal therapy has hardly changed from the early days. The therapy begins with an intensive three weeks of fifteen open-ended sessions with one therapist. After this the patient joins group meetings with other patients and therapists once or twice a week for as long as is needed. Private sessions are still available, though not every day. The length of time needed in formal therapy varies from person to person.

Connected feeling

A connected feeling, according to Janov, is a "conscious" experience which connects the present to the past and connects emotion to meaning - there may also be a connection to sensations in the case of a physically traumatic experience such as physical or sexual abuse or painful birth.^[13]

Primal

As a noun or a verb, the word "primal" denotes the reliving of an early painful feeling. A complete primal has been found, according to Janov and Holden,^[14] to be marked by a "pre-primal" rise in vital signs such as pulse, core body temperature, and blood pressure leading up to the feeling experience and then a falling off of those vital signs to a more normal level than where they began. After the primal ("post-primal"), Janov claims the patient will be flooded with his own insights.

Based on Janov's own in-house studies, Janov and Holden^[14] concluded that the pre-primal rise in vital signs indicates the person's neurotic defenses are being stretched by the ascending Pain to the point of producing an "acute anxiety attack" (the conventional description), and the fall to more normal levels than pre-primal levels indicates a degree of resolution of the Pain.

Janov distinguishes the "primal" from emotional catharsis or abreaction. A primal may be referred to as a "connected feeling" but a complete connected feeling will usually take months or even years to feel, in many primals.^[13] It should be noted that "abreaction" or "catharsis" as used by other psychologists does not mean a false or unconnected feeling.

Duration

Janov writes that after a year to a year and a half, patients are able to continue therapy on their own, with only sporadic follow up necessary.^[15] However, this duration is exceeded by many primal patients in practice.

Janov's warnings

Arthur Janov has printed warnings for many years in all of his books, stating that people could check the credentials of any therapist claiming to be a trained primal therapist, by contacting The Primal Institute or The Primal Foundation in Los Angeles.^[16]

Since his first book, Janov has often written about primal therapists who are not associated with his practice, whom he has referred to as "mock primal therapists" or simply "mock therapists" or "would-be practitioners."^[16]

Reports

Over the decades since Janov's first book on the subject, there have been several reports and critiques relating to primal therapy in books and peer-reviewed journals.

Arthur Janov wrote that primal therapy is an experiential psychotherapy and that:

"Although there are scientific references and citations throughout this work, we should not lose track of the overarching truth--feelings are their own validation. We can quote and cite all day long, but the truth ultimately lies in the experience of human beings. Their feelings explain so much that statistical evidence is irrelevant."^[17]

Tomas Videgård's The Success and Failure of Primal Therapy

In an early account of the results of primal therapy (published in book form, only in Sweden in English), Tomas Videgård^[18] reported on a study of a sample of 32 patients who entered therapy at The Primal Institute in 1975 and 1976.

The outcome evaluation for the patients was 4 Very Good, 9 Good, 8 Medium, 6 Bad (including one suicide), 5 Unavailable for post-testing. Patients who did not finish the therapy were excluded. (See Duration above.) Patients in the sample had been in therapy for between 15 and 32 months.

Videgård himself went through the therapy. The evaluation was based on patients' answers to questions and some projective tests that require interpretation by the tester (Videgård himself). There was no control group.

Videgård concluded that therapy at The Primal Institute was marginally better than the Tavistock Clinic and markedly better than the Menninger Foundation--the two psychotherapy clinics which he used for comparison.

Peer-reviewed journal reports

• Zander E (June 1975). "Janov's primal scream therapy" (in German). Nervenarzt 46 (6): 328–31. PMID 1196453. 
• Shectman F (March 1977). "Conventional and contemporary approaches to psychotherapy. Freud meets Skinner, Janov, and others". Am Psychol 32 (3): 197–204. doi:10.1037/0003-066X.32.3.197. PMID 848784. 
• Davisson B (1978). "Primal therapy : yesterday and today." (in French). Sante Ment Que 3 (2): 111–7. PMID 17093674. http://id.erudit.org/iderudit/030043ar. 
• Yassky AD (January 1979). "Critique on primal therapy". Am J Psychother 33 (1): 119–27. PMID 464162. 
• Ehebald U, Werthmann HV (1982). "Primal therapy—a clinically confirmed procedure?" (in German). Z Psychosom Med Psychoanal 28 (4): 407–21. PMID 7180218. 
• Dahl AA, Waal H (1983). "An outcome study of primal therapy". Psychother Psychosom 39 (3): 154–64. doi:10.1159/000007926. PMID 6622628. 
• Sprengler M (1984). "Wilhelm Reich—Arthur Janov—a comparison of their work" (in German). Z Klin Psychol Psychopathol Psychother 32 (3): 234–47. PMID 6523964. 

Papers by Arthur Janov in peer-reviewed journals

• Janov A (1977). "Towards a new consciousness". J Psychosom Res 21 (4): 333–9. doi:10.1016/0022-3999(77)90016-2. PMID 592223. 

Books by Primal patients about their therapy

• Facing the Wolf: Inside the Process of Deep Feeling Therapy by Theresa Sheppard Alexander (1997), Plume. ISBN 0452275210 ISBN 9780452275218.
• Healing Fits: The Cure of an Epileptic by Robert Reese (1988) Big Sky Press ISBN 0944-59200-7

Criticism

This article's Criticism or Controversy section(s) may mean the article does not present a neutral point of view of the subject. It may be better to integrate the material in those sections into the article as a whole. (November 2009)

Primal therapy has not achieved broad acceptance in mainstream psychology.^[19][20] It has been frequently criticized as lacking outcome studies to substantiate its effectiveness.^{[21][22][23][24][25][26][27][28]} It is regarded as one of the least creditable forms of psychotherapy.^[19]

Primal therapy has sometimes been dismissed as shallow, glib, simplistic, or trendy.^{[29][30][31][32][33]} It has also been criticized for not paying sufficient attention to transference.^[34][35] Some researchers have suggested that Primal Therapy's contention that adults can recall infantile experiences is empirically refuted.^[36] Primal Therapy has also been rejected as dogmatic or overly reductionist.^[30][37]

In the book Let's Talk About Me, Dr. Anthony Clare criticizes primal therapy in several ways. He claims that Janov sees confirming evidence everywhere: "Everything is taken as evidence of [the truth of Janov's Pain Theory]." And he claims that Janov has "no evidence" that childhood traumas cause adult neurosis, except for the "frenzied memories" of his patients.^[30]

In a 1982 paper published in the journal Zeitschrift für Psychosomatische Medizin und Psychoanalyse, Ehebald and Werthmann report that, following a review of the scientific literature, they found "no on-going reports of primal therapy's therapeutic results, no statistical studies and no follow-up studies". Concluding that primal therapy is not a valid therapeutic technique, they stated that most psychotherapists in the Federal Republic of Germany believe it to be questionable in theory and dangerous in practice.^[19]

Alice Miller initially endorsed primal therapy. Later, however, she wrote a communication to her readers in which she expressed some reservations about it. In that communication, she stated that primal therapy could be dangerous when conducted by therapists who are not properly trained. She also stated that there was "too much faith" in cathartic discharge, claiming that the relief was sometimes temporary. She also voiced criticisms about the structure of the initial 3-week intensive phase, claiming that it could provide opportunities for unscrupulous therapists. And she warned of the dangers of developing an "addictive dependency" to pain. ^[38]

In 1996, authors Starker and Pankratz published in Psychological reports a study of 300 randomly-sampled psychologists. Participants were asked for their views about the soundness of methods of mental health treatment. Primal therapy was identified as one of the approaches "most in question as to soundness".^[20]

The 1996 book "Crazy" Therapies ^[39][40] discusses Janov's claim to have discovered the one cure for neurosis:

"Evidence that expressing angry, violent behaviour does not drain it away but increases the chances of its recurrence has been presented in the scientific psychology literature for years " (page 128).

In the 1998 book Insane Therapy sociologist Marybeth F. Ayella says that "what Frank (1974:424-25) describes as healing cults more closely resembles what I think occurs in Primal Therapy than does Janov's description". ^[41]

Primal therapy is cited in the book The Death of Psychotherapy: From Freud to Alien Abductions. The author claims that all schools of psychotherapy, including primal therapy, cognitive behavioral therapy, and others, have no scientific evidence of effectiveness beyond placebo. ^[42]

In the Gale Encyclopedia of Psychology, Timothy Moore wrote: "Truth be known, primal therapy cannot be defended on scientifically established principles. This is not surprising considering its questionable theoretical rationale." ^[43]

Martin Gardner wrote a critical article called "Primal Therapy: A Persistent New Age Therapy." in the Skeptical Inquirer. Gardner discussed some of what he sees as the problems with primal therapy, and also details a protest over the publication of the book The Biology of Love. (Janov, 2000) ^[44]

The National Council Against Health Fraud (NCAHF) Newsletter listed primal therapy, among other treatments, in the article "Dubious Mental Health."^[45]

In popular culture

The musician John Lennon, and his wife, Yoko Ono, both went through Primal Therapy in 1970. Shortly afterward Lennon produced his album, John Lennon/Plastic Ono Band. (Ono recorded a parallel album, Yoko Ono/Plastic Ono Band from her experiences; both albums were released on the same day on the Apple record label.) Lennon's album featured a number of songs which were directly affected by his experience in therapy, including "Remember", "I Found Out", "Isolation", "God", "Mother", "My Mummy's Dead", and "Working Class Hero". Lennon ended his therapy sessions before completing a full course of therapy. Lennon did not recommend primal therapy after that time. For more on this subject, see the webpage, "John Lennon - Primal therapy," which includes excerpts of interviews of John Lennon, Arthur Janov and Vivian Janov, along with an account of one of John's therapy sessions written by Pauline Lennon.

The therapy and Janov are the subjects of the Mötley Crüe song "Primal Scream" from their 1991 album Decade of Decadence.

Apple Inc. founder Steve Jobs purportedly practiced primal therapy and is referenced in the biopic Pirates of Silicon Valley.

British rock band Tears for Fears reference Janov's therapy in both their moniker and song lyrics to their debut album, The Hurting.

See also

• Attachment theory
• Center for Feeling Therapy
• Pre- and perinatal psychology
• Primal integration

References

Bibliography

• Ayella, Marybeth F. (1998). Insane Therapy, Portrait of a Psychotherapy cult. Philadelphia: Temple University Press. ISBN 1-56639-601-8. 
• Eisner, Donald A. (2000). The death of psychotherapy: from Freud to alien abductions. New York: Praeger. ISBN 0-275-96413-2. 
• Holden, E. Michael; Janov, Arthur (1975). Primal man: the new consciousness. New York: Crowell. ISBN 0-690-01015-X. 
• Janov, Arthur (1970). The Primal Scream (A Delta Book). Dell Publishing Company. ISBN 0-349-11829-9. 
• Janov, Arthur (1974). The anatomy of mental illness. New York: Berkley. ISBN 0-425-02494-6. 
• Janov, Arthur (1980). Prisoners of pain: unlocking the power of the mind to end suffering. New York: Anchor Press/Doubleday. ISBN 0-385-15791-6. 
• Janov, Arthur (2000). The Biology of Love. Buffalo, N.Y: Prometheus Books. ISBN 1-57392-829-1. 
• Janov, Arthur (1991). The new primal scream: primal therapy 20 years on. [Wilmington, Del.]: Enterprise Pub. ISBN 0-942103-23-8. 
• Janov, Arthur (2006). Primal Healing: Access the Incredible Power of Feelings to Improve Your Health. Franklin Lakes, NJ: New Page Books. ISBN 1-56414-916-1. 
• Carol Lynn Mithers (1994). Therapy gone mad: the true story of hundreds of patients and a generation betrayed. Boston: Addison-Wesley. ISBN 0-201-57071-8. 
• Reese, Robert T. (1988). Healing fits: the cure of an epileptic. Los Angeles: Big Sky Press. ISBN 0-944592-00-7. 
• Rosen, Richard (1978). Psychobabble: fast talk and quick cure in the era of feeling. New York: Atheneum. ISBN 0-689-10775-7. 
• Rossman, Michael (1979). New age blues: on the politics of consciousness. New York: Dutton. ISBN 0-525-47532-X. 
• Videgård, Tomas (1984). The success and failure of primal therapy: 32 patients treated at the Primal Institute (Janov) viewed in the perspective of object relations theory. Stockholm: Almqvist & Wiksell International. ISBN 91-22-00698-2. 
• Complete list of books by Arthur Janov

External links

Wikiquote has a collection of quotations related to: Primal therapy

• Dr. Arthur Janov's Primal Center home page
• The Primal center "Primalrevivre" in Geneva in Europe of Ansermot Myriam
• The Primal Institute directed by Vivian Janov
• The Primal Psychotherapy Page - A Resource For Those With Interests In the Regressive Deep-Feeling Psychotherapies