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Primal therapy is a trauma-based psychotherapy created by Arthur Janov, Ph.D.

Arthur Janov claims that neurosis is caused by repressed pain which is the result of childhood trauma. Janov claims that repressed pain can be brought to consciousness and resolved, by re-experiencing the traumatic childhood incident and by fully expressing the resultant pain in a therapeutic setting. Janov claims that by re-experiencing traumas and expressing long-buried painful feelings, permanent resolution of neurotic symptoms will be achieved.

Janov created primal therapy as the means of eliciting repressed pain and trauma. Janov claims that in primal therapy, patients would find their real needs and feelings in the process of experiencing all their Pain. The capitalized term "Pain" refers in primal theory to any general emotional distress and its purported long-lasting psychological effects.

Arthur Janov claims that therapeutic progress can only be made through direct emotional experience, which allows access to the source of psychological pain in the lower brain and nervous system. In this view, psychological therapies which involve only talking about the problem (referred to as "Talking Therapies") are of limited effectiveness because the cortex, or higher reasoning area of the brain, Janov claims has no ability to affect the real source of psychological pain in other areas of the brain. This is emphasized throughout Janov's writings.

Janov's first book, The Primal Scream, was published in 1970. Primal therapy received public attention after ex-Beatle John Lennon sought treatment from Arthur and Vivian Janov. Janov later trademarked the term "Primal Therapy", then lost a court case over it, and eventually the trademark was withdrawn by the patent office only about five years after The Primal Scream appeared. [How to reference and link to summary or text]

The absence of independent peer-reviewed outcome studies (or experimental clinical trials) to substantiate these claims led to the therapy falling out of favor in academic and psychotherapeutic circles. Primal Therapy is listed at the Discredited psychological treatments and tests psychological poll [1]. Janov and his associates have continued practicing the therapy at his Center[2] in Santa Monica, California.

Concept

Janov claims that neurosis is the result of suppressed pain which is the result of trauma, usually trauma of childhood origin. Janov claims that the only way to reverse neurosis is for the neurotic to confront his trauma in a therapeutic setting. Janov claims 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. And Janov believes 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, Janov 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."[2]

"Need is a total state of the human being - and at birth we are almost nothing but need."[3] Janov argued that for the helpless newborn, survival is at stake in nearly every second of existence.[3]

Janov claimed 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." [4]

Arthur Janov described Pain as the pain that doesn't hurt because, as soon as they go into it, it becomes simply feeling. Most of the suffering component is in the blockage or repression.[5]

Consciousness and repression

In primal theory, Janov claimed that 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.[6] Using the triune brain work by Paul D. MacLean, and adapting it to Primal Theory, three levels of consciousness are recognized in Primal Theory[7][8][9]

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.

Level/Line (J) Technical name Functions mediated Brain structures involved Incorporates (J)
Third cognitive cognition and intellectual faculties neocortex thinking mind
Second affective emotional responses limbic system feeling mind
First somatosensory sensation and visceral responses brainstem survival mind
  • Janov described defenses as the agents of repression and 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.
  • Janov claimed that 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.

Janov claims that 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. Janov claims that therapy occurs in the reverse sequence: 'There is no way to go deep without first going shallow.'[10] 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.[11]

Origins of neurosis

Primal theory claims that many or most people suffer from some degree of neurosis. This begins very early in life (especially in the "critical period" - the gestation period plus the first three years)[12] 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.

Janov claimed that neurosis may begin to develop at birth, or even before, with "first line" Pains. He also claimed it could be reversed by reliving these pains in sequence, all the way back to birth trauma. Subsequent Pain is thought to be added on top of previous pain in what is called "compounding" the Pain.[13]

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.[14]

Primal

As a noun or a verb, this word denotes the reliving of an early painful feeling. A complete primal has been found, according to Janov and Holden,[15] 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[15] claimed 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 claims that the "primal" is different 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.[14] It should be noted that "abreaction" or "catharsis" as used by other psychologists does not mean a false or unconnected feeling.

Duration

Janov claims 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.[16] 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.[17]

Since 1989, Arthur Janov with his present wife, France, has had his own center separate from The Primal Institute, which is still directed by his former wife Vivian Janov [How to reference and link to summary or text].

Since his first book, Janov has often written about primal therapists who are not associated to his practice, whom he has referred to as "mock primal therapists" or simply "mock therapists" or "would-be practitioners." [17]

Spin-off: The Center for Feeling Therapy

Main article: Center for Feeling Therapy

The Center for Feeling Therapy was a psychotherapy group founded in 1971 in Los Angeles. It was founded by two defectors from primal therapy, Joe Hart and Richard "Riggs" Corrier, who had been in the therapist training program at Janov's Primal Institute[18], along with seven other people, two of whom had been certified as primal therapists[19]. Richard Corriere, one of the original founders, had contributed to a scientific study reprinted in Janov's second book.[20]

Joe and Riggs confronted Arthur Janov with their misgivings about primal therapy, claiming it should focus more on patients' present lives. Janov denied that, claiming that Joe and Riggs were really only interested in power, and were 'abreactors' - people who had emotional outbursts without really feeling anything - and were about to be fired anyway.[21]

The Center for Feeling Threapy started as an offshoot of primal therapy, but quickly abandoned primal therapy and subsequently went through many theoretical shifts, eventually focusing on a concept called 'Psychological Fitness'.[22]

Over time, the Center became cult-like and extremely abusive to its members. The abuse consisted of physical assault, sexual humiliation, verbal assault, financial abuse, excessive demands for ritual, inadequate rest, and enforced physical labor. The enforced physical labor was so severe that some members were permanently injured by it.[23]

After nine years, the members rebelled, and the Center was shut down.[24] Eventually, some of the former members sued the founding therapists in what was the largest psychology malpractice suit in California.

Reports

There have been several reports relating to primal therapy in books and peer-reviewed journals, many negative, over the decades since Janov's first book on the subject.

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."[25]

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[26] 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.

There is a paper by Stephen Khamsi Ph.D. about this study: The Success and Failure of Primal Therapy: A Critical Review.

Peer-reviewed journal reports

Papers by Arthur Janov in peer-reviewed journals

Books by Primal patients about their therapy

Criticism of Primal Therapy

Primal therapy is not accepted by mainstream Psychology.[27] [28] It is regarded as a fringe psychotherapy by most Psychologists, and is not considered to be scientifically validated.[29] [30][31] [32] It has been frequently criticized as lacking outcome studies to prove its effectiveness.[33] [34] [35] [36] [37] [38] [39] [40] It is regarded as one of the least creditable forms of psychotherapy.[41]

Primal therapy has sometimes been criticized as shallow, glib, simplistic, or trendy.[42] [43] [44] [45] [46] It has also been criticized for not paying sufficient attention to transference.[47] [48] It has also been criticized for its claim that adults can recall infantile experiences, which some researchers believe is impossible.[49] It has also been criticized as being dogmatic or overly reductionist. [50] [51]

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.[52]

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. [53]

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. [54]

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". [55]

The 1996 book "Crazy" Therapies [56][57] 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". [58]

Primal therapy is cited in the book The Death of Psychotherapy: From Freud to Alien Abductions. Author wrote: "Since there is no relevant research, Primal Therapy could simply be chalked up as a placebo and the excessive demand characteristics of the extreme rituals and procedures as well as group pressures." [59]

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." [60]

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) [61]

The National Council Against Health Fraud (NCAHF) Newsletter primal therapy as one type of treatment listed in the article "Dubious Mental Health."[62]

John Lennon as patient

The musician John Lennon, and his wife, Yoko Ono, both went through Primal Therapy in 1970, and shortly afterward Lennon produced his raw, emotional 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.

See also

References

  1. Norcross, Koocher, & Garofalo (2006). Discredited psychological treatments and tests: A Delphi poll. Professional Psychology: Research and Practice, 37(5), 515-522.
  2. Janov, A., The New Primal Scream page 5
  3. 3.0 3.1 Janov, A., Prisoners of Pain page 3
  4. Janov, A., Prisoners of Pain page 9
  5. Janov, A., Primal Healing page 199
  6. Janov, A. & Holden, e. M., Primal Man pages 1-4
  7. Janov, A. & Holden, e. M., Primal Man pages 56-111
  8. Janov, A., The New Primal Scream pages 54-55
  9. Janov, A., The Biology of Love, 106-137
  10. Janov, A., Primal Healing pages 182
  11. Janov, A., The Biology of Love, page 133
  12. Janov, A., Primal Healing pages 42-48
  13. Janov, A., Primal Healing page 94
  14. 14.0 14.1 Janov, A., The New Primal Scream, page 362
  15. 15.0 15.1 Janov, A. & Holden, e. M., Primal Man pages 137-146
  16. Janov, A., The New Primal Scream, page 360
  17. 17.0 17.1 Janov, A. The New Primal Scream, page 386
  18. Mithers, C.L. Therapy Gone Mad, page 55
  19. Mithers, C.L. Therapy Gone Mad, page 60
  20. Janov, A. The Anatomy of Mental Illness, pages 198-210
  21. Mithers, C.L. Therapy Gone Mad, page 57
  22. Mithers, C.L. Therapy Gone Mad, pages 199-202
  23. Mithers, C.L. Therapy Gone Mad, page 352
  24. Mithers, C.L., Therapy Gone Mad, pages 325-326
  25. Janov, A., Primal Healing page 15
  26. Videgård, T., The Success and Failure of Primal Therapy
  27. Z Psychosom Med Psychoanal. 1982;28(4):407-21
  28. http://www.ncbi.nlm.nih.gov/pubmed/8839319
  29. Z Psychosom Med Psychoanal. 1982;28(4):407-21
  30. http://www.ncbi.nlm.nih.gov/pubmed/8839319
  31. http://www.selfhelpfraud.com/uploads/3__Fringe_Psychotherapy.pdf
  32. http://www.encyclopedia.com/doc/1G1-74523978.html
  33. Singer, Lalich, Crazy Therapies : What Are They? Do They Work?, pp 128
  34. Abrall, Soul Snatchers: The Mechanics of Cults
  35. Eisner, The Death of Psychotherapy: From Freud to Alien Abductions, pp 51
  36. Moore, Gale Encyclopedia of Psychology
  37. Psychoanalytic Psychology (20:717-726, 2003)
  38. Cordon, Popular Psychology - An Encyclopedia, pp 133
  39. http://discovermagazine.com/2007/may/whatever-happened-to-primal-therapy
  40. http://www.counselormagazine.com/content/view/338/1/
  41. Z Psychosom Med Psychoanal. 1982;28(4):407-21
  42. Rosen, Psychobabble
  43. Clare, Let's talk about me, pp 121
  44. http://tanadineen.com/media/NatPostMilstone.html
  45. http://www.guardian.co.uk/music/2000/dec/21/thebeatles.johnlennon
  46. New Age Blues (1979, ISBN 0-525-47532-X), Page 28
  47. http://www.primals.org/articles/weiner.html
  48. Ayella, Insane Therapy
  49. http://www.selfhelpfraud.com/uploads/3__Fringe_Psychotherapy.pdf
  50. Clare, Let's Talk About Me, pp 121
  51. Kirsch, Los Angeles Times, March 27, 1970
  52. Let's Talk About Me (1981), BBC, ISBN 0 563 17887 6, Page 121
  53. Primal therapy - a clinically confirmed procedure?
  54. Alice Miller´s communication to her readers
  55. [1]
  56. Skepdic entry about "Crazy Therapies"
  57. Review of "Crazy" Therapies, 1997
  58. Insane Therapy ISBN 1-56639-601-8 ,page 39
  59. The Death of Psychotherapy: From Freud to Alien Abductions. Donald A. Eisner ISBN 0275964132 , 2000, Pages 51-52
  60. Primal Therapy section from the Gale Encyclopedia of Psychology, 2nd ed. Gale Group, 2001, author Timothy Moore
  61. "Primal Therapy: A Persistent New Age Therapy." in the Skeptical Inquirer, May 1 2001.
  62. "Dubious Mental Health."

Bibliography

Complete list of books by Arthur Janov

External links

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