Two items crossed my attention this week, both of them related to addiction.

The first was a WSJ article about a study looking at the adolescent brain: “Are Some Teenagers Wired for Addiction?” Using fMRI, the researchers identified a particular pattern of neural activity in teens who had a tendency to become addicted to drugs or alcohol. Specifically, these teens had lower activity in the orbitofrontal cortex (OFC), a region that mediates impulsive behavior. (More on the OFC in a future post.) The implication is that faulty OFC activity causes poor impulse control which in turn causes kids to become easily addicted. A different pattern of faulty networks was found in kids with ADHD, also related to impulse control. In other words, the brain is the problem.

The second item was a segment on CBS’s 60 Minutes about the work of addiction researcher, Nora Volkow. In addition to being the director of the US National Institute on Drug Abuse, Volkow has the dubious distinction of being Leon Trotsky’s great granddaughter and actually grew up in the house where he was assassinated. She describes addiction as a physical disease: “we know that drug addiction is a chronic disease; the drugs physically change the brain…those changes are very long lasting and persist for a long period of time after the person stops taking the drug.” The culprit? Dopamine! In Volkow’s view, addicts are conditioned by triggers that cause a dopamine rush, making them feel, “I want that!” And because of drug tolerance, “I want that!” becomes “I want more and more of that!” Hardened addicts are merely conditioned, like Pavlov’s dog, perhaps by a genetic disposition, the theory goes. But instead of salivating; they crave. Show them a photo of someone hitting up their favourite substance of abuse and dopamine surges through their midbrain, reinforcing more brain dysfunction. Once again, the brain is the problem.

The problem with both of these reports is that the brain is not the problem; it’s what’s deep within the brain that’s the problem – the pain of unmet need. But why don’t these researchers see this?

The answer is that you have to feel it to see it, and they don’t feel it.

Over my twenty-year history working in the medical community, I’ve met precious few scientists who are able to see the wider view of what they are studying. Medical scientists are trained to analyze and seek explanations for living processes in terms of the bits and pieces of life: molecules, biochemistry, pathways, and genes. This works well for genetic diseases such as cystic fibrosis or Huntington disease, but it’s utterly inadequate for mental conditions such as depression, schizophrenia, and…addiction.

As Iain McGilchrist points out in his brilliant work, The Master and His Emissary, analysis is an function of the left hemisphere whereas synthesis and intuition are functions of the right hemisphere. Whereas the left sees only the bits and pieces, the right sees the “big picture.” The best scientists use both processes when trying to explain phenomena but modern behavioral scientists seem to have forgotten that. The very term, “behavioral science” implies that people are stimulus-response units—turn on the stimulus switch and the response follows as behavior. The left-brain scientist tries to explain it all in terms of brain mechanisms. As one cognitive scientist put it, the brain is nothing more than a “computer made of meat.”

Apparently, Volkow gets $1 billion a year to study the biological mechanisms of addiction, delving ever deeper into the neurons, synapses, receptors and cellular biochemisty, searching for the cure for this “brain disease.” The same is true at addiction research centres everywhere.

Meanwhile, the real cause of addiction is ignored, except for those who can see it because they feel it. Art Janov was writing about the primal causes of addiction as early as The Primal Scream. Gabor Maté, no stranger to addiction himself, works with hopelessly addicted patients in Vancouver’s Downtown Eastside, which he tells in his heart-wrenching book, In the Realm of Hungry Ghosts. Every one of Maté’s patients suffers from the pain of terrible childhood abuse, clearly the cause of their addictions. Neuroscientist, Jaak Panksepp, who has spent his career studying the neurology of animal feelings, sees addiction as an attempt to resolve the pain of unresolved separation distress, or in primal terms, a futile effort to get the love one didn’t get as a child. Addictive substances not only stimulate brain dopamine, they stimulate endogenous opioids as well – the body’s own pain killers.

No doubt, brain function is deeply altered by addiction; levels of neurotransmitters are altered; receptors are changed. But to conclude that these aberrations constitute a disease process that appears out of nowhere or is influenced by brain biology or genes is scientific reductionism at its worst. What about the personal history? The family history? What about the social determinants of addiction? What about poverty, stress, and the hopelessness of your life situation in a world beset with government austerity measures and dominated by financial elites?

None of this counts in mainstream addiction research – the biological cause must be identified and a chemical cure must be found! So an army of left-brain analytical scientists continues to spend more effort and more money to find what will never be found, the medical “cure” for addiction. Volkow—who goes for a seven-mile run each morning to get her own addictive hit of dopamine (perhaps to help keep the big picture at bay)—envisions a vaccine that will banish addiction once and for all, as though it were a virus. But the real virus seems to be the one preventing scientists from recognizing addiction’s true cause and we already have a treatment for that – feeling.

This a modified review that first appeared in the Vancouver Sun:

“A paradigm shift is happening” in the way that we understand the importance of our life in the womb. That was the assessment of Dr. Marti Glenn at a recent Congress of The Association for Prenatal and Perinatal Psychology & Health (APPPAH).

She pointed out that, “researchers are beginning to discover…that the events and environment surrounding pre-conception, pregnancy, birth, and early infancy set the template out of which we live our lives.”

While this paradigm shift is new to most people, it is a view that was put forth decades ago by Dr. Arthur Janov, whose new book, Life Before Birth, explains just how fragile we are while in our first home. He believes that many – perhaps most – children have been damaged at a much earlier age than has been traditionally acknowledged.

Janov has also stressed that we are especially fragile at birth, and infancy and childhood as well.  All of these areas are readdressed in Life Before Birth.

The main focus of the book is threefold: early development, including in the womb; adult mental illness and disease; and the nature of a feeling therapy.

One of the central themes in this book is that we are most vulnerable in the earliest stages of our development. In fact, our experiences in utero and infancy literally sculpt our brains and central nervous system. Janov explains that “imprinting” may take place when the fetus reacts “to the womb environment by readjusting its vital signs, hormones, and neurotransmitters to adapt to a new reality; he is getting ready for life in the outer world.”

In other words, early experiences teach a fetus or infant what the world is like and what to expect. The child’s brain and body then make adjustments to be ready for the future. If its experiences are healthy, it will grow in a normal manner.

But if they are threatening (a stressed mother, an abusive father, or environmental toxins, for example), then the child’s body takes defensive measures at the expense of healthy growth and development. Survival comes first.

These changes can reach so deeply down into a child’s cells that they may actually determine if its genes are switched on or off.  This new science, epigenetics, explores how a person can be deeply affected by, for instance, a traumatic birth or emotional abuse, and how such damage may be passed on to their own children.

Stress ages our cells and is associated with increased risk for a host of diseases of aging, including cancer, heart disease, and stroke. Elissa Epel, an associate professor in the UCSF Department of Psychiatry, has shown that the way people respond to a stressful event “impacts their neurobiology and cellular health.”

Epel adds that damage to a cell’s telomeres can occur in “the prenatal environment” due perhaps to “poor maternal nutrition” and that it is correlated with low birth-weight.

That’s why Janov writes that loving a child is not just a feeling, but that it also “means fulfilling the needs of the baby”, such as a providing a healthy environment in the womb, lots of cuddles for infants, and a gentle, natural birth.  The latter can be crucial.  He cites a study in the British Medical Journal which found that, “individuals who committed suicide violently were more often exposed to complications during birth.”

Janov’s clinical focus is healing past trauma through his Primal Therapy (which, contrary to a common misperception, has nothing to do with screaming).  Rather, the focus is on re-connecting one’s consciousness with trauma buried in the lower parts of the brain.  Again, early pain was repressed in order for the child to survive, but at the cost of healthy development.

For Janov, it is this re-connection that is truly healing, and why relatively superficial approaches, such as cognitive behavioural therapy (CBT) might be able to address symptoms, but it ignore the source of one’s pain – emotional and/or physical trauma.

Despite his focus on therapy, Janov stresses that the most important task that society faces is to prevent the children from being hurt in the first place. While he places a great responsibility on parents to be loving towards their children, he does not engage in parent-bashing.  For one thing, parents themselves are the product of THEIR upbringing, for better or worse.

For another, it is clear that, for most children, the primary factors that affect their emotional and physical development are the social determinants of health, such as access to education, levels of pollution, inequality, and poverty. One study found that children from “low socioeconomic environments showed a lower response to the unexpected novel stimuli in the prefrontal cortex that was similar…to the response of people who have had a portion of their frontal lobe destroyed by a stroke.”

The study’s co-author W. Thomas Boyce, now at UBC, emphasizes that, “We are certainly not blaming lower socioeconomic families” for problems that they did not create.

Here in B.C., the non-partisan children’s rights organization First Call emphasizes that our province has the worst child poverty rate in Canada for the eighth year in a row. It rose to 12 per cent in 2009, coming in higher than all other provincial and territorial rates as well as the national average of 9.5 per cent. As long as these conditions exist, the cost to children, families, and society as a whole, will increase.

Life Before Birth raises issues of the utmost importance for all of us, children and former children alike. Unfortunately, the book could have used a better editor, especially to make sure that the sometimes complex ideas were expressed more clearly.

Nevertheless, Janov has again taken a leading role in illuminating what science is showing discovering about raising healthy children. His book deserves a wide readership.

In my last post, I described the history of abreaction and why it was abandoned in mainstream psychotherapy. But modern therapists who model their treatment on primal therapy often facilitate abreaction without even knowing it. They may encourage an anything-goes approach to feeling, allowing the client to go wherever they will without intervention.

The result can be an undetected slide into abreaction because it’s often easier to feel something out of context rather than face the original feeling that was triggered in the session. I asked France Janov of The Arthur Janov Primal Center to describe abreaction and how it differs from a connected feeling. She explains it as follows:

Abreaction is an emotional release that looks like a feeling, sometime sounds like a feeling, but isn’t a feeling. It is the discharge of a  feeling, disconnected from its source, making it in fact a defense or reinforcing a defense.  It can be the release of a feeling from one level of consciousness into another level of consciousness – for example, first line into third line, or first line disconnected from any other level, taking on a life of its own to the exclusion of any other levels.

To those unfamiliar with primal theory, levels or “lines” of consciousness refers to the three levels of feeling we can reach in therapy, which correspond to three levels of the brain in Paul McLean’s triune brain theory. First line is the primitive, reptilian complex consisting of the basal ganglia and brain stem; second line is the mammalian brain consisting of the limbic system and cingulate cortex; and third line is the cerebral cortex. Although McLean’s theory is obsolete, it still provides a good working model to explain the levels of feeling experienced in primal therapy.

As France states, abreaction is a defense against feeling and an insidious one at that because it gives the illusion that one is having primals when one is just bleeding off energy. Worse, one can become grooved into abreacting, after which attaining connected feelings becomes extremely difficult. France explains,

Abreaction can become a groove, like a royal way to nowhere. It is feeling inside our defenses, promoting no insights, no resolution, not  getting better. The therapeutic difference between real primal feelings and abreaction is that abreaction isn’t curative or even helpful. The patient doesn’t get better and in fact,  long term abreaction can induce recurrent behaviors and lead to worsening of symptoms, such as prepsychosis or psychosis.

Because of their immense power and demand to be felt, first-line feelings can quickly lead to abreaction if allowed to occur without connection to the present. The person can get sucked into having endless birth primals; perhaps feeling temporary relief but without real resolution. So the feeling occurs over and over again, sometimes for years. Taken to the extreme, these abreactions can lead to bizarre “connections” that aren’t real, such as the “memory” of being in a past life, experiencing conception as a sperm or egg cell, or suffering infantile abuse by Satanic cults. In France’s words:

Abreaction is repetitive as it doesn’t “empty” the pain. It just creates a closed circuit, a loop, travelled over and over again whenever part of it is triggered. And every trigger, however different it might be, will bring up the same abreactive feeling: “I want to die. I am in too much pain (indeed!), I want to die.” It will not be attached to anything specific at any time and will remain as a litany or series of sensations repeated endlessly.

Patients who abreact  become very entrenched in their “primal” style and very resistant to admitting that what they are doing isn’t “the right way” and of course they aren’t open to changing it.

If the abreaction goes on for years, as in the case of people who self-primal for a long time, it may not be reversible; the groove is too strong and it becomes a neurological defense in itself.

If there is a sine qua non of abreaction, it is in the lack life changes made by the person abreacting. Abreaction keeps you “stuck” –  no ventures are made, no risks are taken, no changes in jobs or career, no “going for it” in a real, healthy, meaningful way. Instead, one remains a prisoner of their pain, always reacting to circumstances, always triggered, always needing to “go down” to feel every few days, and always acting out. Primal therapy becomes an end rather than a means. I recently received a call from a self-primaler asking me to sit for him on the phone. He had lost his phone buddy and needed to feel every day, sometimes twice a day. When he told me he had been in this situation for well over a decade, I knew instinctively he was abreacting because needing to feel every day for years is a clear sign that nothing is being resolved. I declined his request and recommended he find a good therapist.

Another sign of abreaction is the “fake cry.” After reading one of Janov’s books, some therapists tell their clients to emulate feeling by making vocal sounds or screams, hoping it will lead them to primal feelings. Self-primalers can fall into this trap easily. They may get into this pattern of acting out deep feelings without actually feeling them.  France gives an example:

I remember the  case of a woman who had been self-primaling for about 20 years somewhere in a very remote part of the world. Her style was a persistent screaming. That is what she thought the “Primal Scream” was all about. She could go on screaming for hours at the top of her lungs in a piercing voice. It was devoid of all real feeling, content, context, and  resolution. She didn’t know why or about what she was screaming; she had no memories attached to it. She “felt” like screaming because “she was in so much pain.” It was very hard to listen to, and totally unmoving, and of course she never had any insights and wasn’t getting better. Reversing that groove proved to be very difficult.

In contrast, real feelings don’t need to be felt forever, there is an end to them. In Primal, past a certain amount of feelings that had to be done over and over for a while – depending on how much pain was attached to them, the need to feel  decreases  with each felt feeling until, at some point, we hardly ever have to “feel” old pain.

So how does one know if you’re abreacting? Again, the surest way to know is whether or not your life is changing. Even if you’ve been feeling deeply on all three levels, you are probably abreacting if there’ve been no life changes for years, or if you are repeatedly thrown into pain whenever you try to move forward in life. That’s when you need to find a good primal therapist to break the pattern.

Looking at the state of psychotherapy today, one might be forgiven for thinking that it’s always been about talking, analysis, and cognition. Psychoanalysis is focused on…well…analysis—examination, interpretation, and explanation with words upon words upon words, but it wasn’t always that way.

Before there was psychoanalysis, there was “cathartic therapy.” Freud and Breuer experimented with catharsis after being influenced by German philosopher, Jakob Bernays, who advocated Aristotelian catharsis in medical treatment. They called it  abreaction — “to react away or to react off…. the act of giving vent in speech and action to repressed experiences, and thereby disburdening one’s self of their unconscious influences.”

Even in those early years, one can see the bias towards talk therapy rather than connected feelings. In Studies on Hysteria, Freud and Breuer write, “language serves as a substitute for action; by its help, an affect can be ‘abreacted’ almost as effectively.” Eventually, psychoanalysis abandoned catharsis. The expression of feelings was never a central theme in analysis; at most, it was considered as a tool to loosen “strangulated affect” and facilitate analysis and it was usually done under hypnosis.

The “discharge” theme is also evident in the work of French psychiatrist, Pierre Janet (1859-1947), who used the colourful name of “mental liquidation” for abreaction. Janet regarded neurosis somewhat like an electrical capacitor—traumatic memories were stored as “mental energy” or “psychological tension” and abreaction was the means to release it. Several other European physicians used catharsis in the late 19^th and early 20^th centuries, either with or without hypnosis, and some achieved significant success. Dutch physician, Andries Hoek (1807-1885) reports the use of catharsis on a psychotic patient who was terribly tramatized by repeated childhood abuse, including rape, and by the death of her ex-fiancé, who killed himself after she broke off the engagment. Over an 11-month period of daily sessions, his patient achieved sanity. Most remarkable was that Hoek allowed his patient to take an active role in treatment and guide its course. This in itself may have been the reason why his patient got better. Having a sympathetic witness can do wonders to help someone heal, although it is not enough.

Abreaction was used by several 20^th Century psychologists, especially for traumatized soldiers in the two World Wars, however, the purgation aspect increasingly came to dominate. Although the emphasis had originally been on reliving the traumatic memory, as we see in primal therapy, therapists encouraged emotional venting as a way to clear the decks for what they regarded as the real work: talk therapy. The focus shifted toward controlling emotions rather than finding resolution through their expression. Ernst Simmel, a German medical officer in WWII, regarded catharsis as an opportunity for the soldier to “master his emotions intellectually.”

After the war, emotional expression in psychotherapy became more mechanized and increasingly detached from the patient’s inner being. Psychodrama treated feelings as a sort of stage play that one could act out. (Don’t neurotics have enough acting out?) Reich had his patients access “simulated” feelings through a bizarre process he called vegetotherapy, in which:

…the analyst [asks] the patient to physically simulate the bodily effects of strong emotions. The principal technique is asking the patient to remove outer clothing, lie down on a sheet-covered bed in the doctor’s office, and breathe deeply and rhythmically. An additional technique is to palpate or tickle areas of muscular tension (“body armor”). This activity and stimulation eventually causes the patient to experience the simulated emotions, thus (theoretically) releasing emotions pent up inside both the body and the psyche…. Screaming usually occurs, and vomiting can occur in some patients.

Reich later developed this process into orgone therapy. The intent was to free up orgone energy and make it available for more useful purposes, such as orgasm. Alexander Lowen refined Reich’s therapy into Bioenergetics which again focused on body “energy” rather than integrated feeling. One sees this focus on the body in Pat Ogden’s Sensorimotor therapy, in which traumatic memories and feelings have been reduced to mere physical sensations. (I’ve viewed videos of Ogden’s approach and they are excruciating to watch. So close to feeling and yet so far!)

Fritz Perls’s Gestalt Therapy utilized emotional expression but the patient was kept firmly in the present. One of the more bizarre uses of abreaction was in Danriel Casriel’s New Identity Process, which utilized screaming as an “an emotional exercise that frees the individual from symptomatic pain and leads to the deeper feelings he has disguised.” His aim was to “re-educate” the patient’s emotions, behaviors, and attitudes. His book, “A Scream Away from Happiness” says it all.

This short history reveals clearly why abreaction was abandoned and especially why it’s regarded with such disdain today. Despite the promising beginnings of the deep feeling approach, psychoanalysis was never able to get a handle on feelings as feelings. The psychoanalyst lives in the left hemisphere and even though there may be deep intellectual understanding of how the right hemisphere processes feelings, it’s not the same as knowing it from the inside. Allan Schore comes to mind. Despite his brilliant work on early life attachment, emotional dysregulation,  and the role of the right brain, his work exudes the dry, detached intellectuality of all psychoanalysts. His therapeutic approach remains firmly embedded in psychoanalysis with the therapist in full control.

Without the understanding of how deep feelings actually work, without knowing them from the inside, one is led into a desert of ideas about feeling, some of which are quite bizarre. Abreaction, that is venting, purging, screaming, expunging, or mere expression of feelings without connection and integration is not only nontherapeutic, it is dangerous. This is undoubtedly why most psychologists reject deep feeling approaches on the grounds that they are “retraumatizing.” Dredging up feelings without a clear understanding of what’s going on is a recipe for disaster.

In my next post, I’ll discuss the difference between abreaction and primal therapy.

In civilized societies, perhaps the most despised person is the one who preys on children. Even in jail, child molesters are often segregated from other prisoners for their own safety.

Human beings have a natural tendency to love their children and most will do anything to protect them from harm. Noted primatologist Frans de Waal has made a convincing case that love originated from the evolutionary need to protect our young, who are uniquely vulnerable in their early years.

It is difficult, then, to understand why we — especially those of us who are parents — tolerate the kinds of attacks that are taking place on our children.

But as Joel Bakan describes in Childhood Under Siege, they are being assaulted in ways that are often extremely subtle, but also extremely profitable.

From junk food to video games to toxic chemicals to prescription drugs, the danger to children’s health is being deliberately increased — all to improve the bottom line.

Bakan provides numerous horror stories regarding children’s games, some of which can be extremely violent. He describes, for instance, an online game called, Whack Your Soul Mate, in which a player can choose how to kill his or her “love.” In one manifestation, “the man hands the woman a heart-shaped box of chocolates, and watches as she opens the box and a spring-loaded cleaver pops out and cuts her head off, blood gushing everywhere …”

What wholesome fun.

Shifting to other threats, the author details how pharmaceutical companies manipulate research as well as reports in medical journals to hide the fact that many of the drugs that are prescribed for children are actually ineffective, dangerous, or both.

The book also provides horror stories of children over-dosing on drugs, or killing themselves while under the influence.

Big pharma spends huge sums of money to entice doctors to prescribe these drugs, with tactics ranging from dinners and vacations to visits by what has been termed, “Pharma babes” — often former cheerleaders who may offer “sexual favours” and other gifts to their clients.

Not surprisingly, the increasing amounts of artificial chemicals in our foods and environment take a huge toll on children. Babies are most vulnerable when they are developing, and nowhere are they more at risk than in the womb, (as documented in Arthur Janov’s new book, Life Before Birth).

And Scientific American recently reported that, “fetuses are particularly vulnerable to … even extremely low levels of some environmental contaminants.”

This work provides some grim examples of this threat, such as the diseases and deaths associated with the tar ponds of Sydney, N.S., and the dangers from Bisphenol A (BPA), “a key ingredient in food and drink containers [including baby bottles], plastic wraps and the lining of cans.”

Bakan, who teaches law at UBC (and who wrote The Corporation), also describes how British Columbia has, “the most astonishingly neglectful child labour laws in North America … [where] a child at 12 years old can go to work, in just about any job, hazardous or not.”

This particular law was introduced by the Liberal government of Gordon Campbell to make B.C. more “economically competitive,” (according to a government statement). Bakan explains that corporations “tend to favour permissive labour laws” since they can pay children less than adults, and because children are less likely to resist harsh or unfair working conditions.

Bakan stresses that “science” can be misused by corporations in their drive to increase profits. As Harvard geneticist Richard Lewontin explained in a Massey Lecture, science “is a human productive activity that takes time and money, and so is guided by and directed by those forces in the world that have control over money and time.”

I had two primary emotions when reading this book. One was sadness in hearing about so much needless suffering inflicted upon young and innocent lives. The pain that their parents felt is hard to imagine.

The other feeling was, frankly, outrage, at what we allow big business to do to our children.

I believe that parenting is not only the most important job in the world, it is also the most difficult. By what right do corporations have to make this vital and demanding work even harder?

Society needs to help parents to ensure the well-being of their children, and Bakan explains that for roughly 100 years, Canada and many other countries gradually strengthened the laws to protect children.

Beginning around the 1980s, however, child protection was significantly reducedas corporate-friendly neo-liberal policies — including privatization and de-regulation — spread around the world. (Such policies allowed Wall Street speculators to make the toxic investments which triggered the global recession).

Reversing this dangerous trend is the goal of Childhood Under Siege.

By informing parents (and others who care about children) of the dangers that we face, Bakan hopes that an informed public will demand that our governments live up to their prime responsibility: to protect its citizens — especially its children — from harm.

This review was originally published on Nov. 3, 2011 in the Vancouver Sun

One of my favorite movie scenes occurs in Star Trek V: The Final Frontier. On a voyage to rescue hostages, the crew of the starship Enterprise encounters Spock’s half-brother, Sybok, who has the power to heal a person’s innermost pain through telepathy. Embracing emotion rather than logic, Sybok is obsessed with finding God who, he claims, lives in a mythical land called Sha Ra Kee at the center of the galaxy, beyond the Great Barrier. No probe that has gone beyond the barrier has ever returned. In an effort to hijack the Enterprise to carry him to the center of the galaxy, Sybok gains the cooperation of Spock and McCoy by healing their pain—or at least making them believe he had. But Kirk will have nothing to do with it.

To me, Sybok represents every religious guru and huckster who promises relief from suffering for eternal bliss and happiness. It’s the Maharishi, it’s Meher Baba (“don’t worry, be happy”), it’s Osho, the “sex guru” with his 93 Rolls Royces; it’s Jim Jones, it’s Adi Da, who lived on Fiji, surrounded by followers who treated him like a god; it’s a thousand other spiritual leaders who promise nirvana if only…if only… you “give up” your pain and follow them.

And Kirk? He’s the realist who asks, “What does God need with a starship?” He’s the hard-headed skeptic who tells McCoy that “pain and guilt can’t be taken away with the wave of a magic wand.” He’s the guy grounded in reality who knows that our pain is an essential part of us: “They’re the things we carry with us, the things that make us who we are. If we lose them, we lose ourselves.” He shouts at Sybok, “I don’t want my pain taken away! I need my pain!”

I too need my pain, just as I need love, hope and reality. And having the access to feel one’s pain deeply and fully, is what paridoxically opens the door to the latter. No need for cosmic debris. As John Lennon sang in his tenderest song, “love is real, real is love; love is feeling, feeling love.”

If you follow Art Janov’s blog, you may have read his scathing essay on mindfulness therapy. While I agree with his basic argument—that mindfulness therapy is too often a form of mindLESSness therapy—I’d like to provide a broader perspective. In short, mindfulness is not all that bad if you use it to be mindful of feelings, rather than detach from them.

Mindfulness meditation is the current zeitgeist in psychotherapy. Not surprisingly, it fits hand-in-hand with the other dominant therapeutic modality: cognitive behavioral therapy. In fact, there is now a hybrid of the two called MBCT – mindfulness-based cognitive therapy. Both techniques are based on the same mechanism—detachment from feelings and thoughts. The “how” of mindfulness meditation can be summed up simply: sit still for 30 or 40 minutes, keep your eyes slightly open, follow your breath, and pay attention to whatever is going on in your mind and body but don’t do anything about it. Just sit there. When you catch your thoughts drifting, get back to the breath. There are variations on this theme, such as walking meditation and meditation while doing yoga or manual work. In a word, meditation is about paying attention. Be here now! Nothing more, nothing less.

Buddhist meditation, such as that practiced in Zen, strives for a combination of concentration (such as counting the breaths) and open awareness (listening to sounds, noticing things in your environment, etc) The goal is the same—to be attentive to whatever is going on within you and without you, as the Beatles song goes. Vedic forms of meditation usually include a mantra or phrase that is to be repeated over and over while keeping the eyes closed. The intent is to create a state of bliss, which some people call transcendence but I call spacing out. TM, à la the Maharishi, is a form of Vedic meditation.

Today’s popularity of mindfulness in psychology stems from the work of Jon Kabat-Zinn, famous for his stress reduction clinic, established in 1979 at the University of Massachusetts Medical School. You could say that Kabat-Zinn made Zen Buddhism scientifically respectable by stripping it of its religious trappings and subjecting it to clinical research. Over the past 30 years, mindfulness meditation has swept throughout the medical world and is used to treat patients suffering from cardiac disease, schizophrenia, cancer, chronic pain, rheumatoid arthritis, and a host of other conditions. Indeed, the research shows that mindfulness meditation can bring a lot of benefit. Practiced diligently, it can reduce the stress response, lower blood pressure, improve immunity, ease depression and anxiety, and even thicken areas of the cortex involved in the regulation of emotions.

So if meditation is so good for you, what’s the problem? The problem, as Janov states, is that it is based on suppression of feelings, or rather, dissociation from them. Meditation is often not calming at all; in its more intense forms, it is practically guaranteed to bring up feelings. Humans are just not made to sit still for hours or days at a time like a sessile creature on the bottom of the sea. We are born to move and to feel, and when feelings do come up in meditation, they can be intense. Serious meditators often experience extreme anxiety or depression—even panic—but rather go into those feelings to find out where they originate, as one does in primal therapy, the meditator is told to “sit through it” and observe them as one might observe clouds floating across the sky. Feelings are neither here nor there. They are to be regarded merely as sensations that arise from nowhere and go back to nowhere—ahistoric, meaningless, even delusory. Over time, the capacity to feel is attenuated as one’s consciousness becomes increasingly rooted in the moment. Here and now. Here and now. Here and now….

Truly dedicated meditators—those who meditate for hours a day and attend frequent retreats—often get to a point where they feel disembodied. Their sense of self diminishes as they advance toward the ultimate goal of enlightenment, where one transcends space, time, and life and death itself to become one with the universe.

Beyond Life and Death? How Real is That?

Admittedly, meditation can make you calmer, more focused, resistant to stress, and more functional, but it must be done daily. In a sense, meditation is like an addiction that requires its regular fix. Stop doing it and your feelings come rushing back. Meditators often report feeling more peaceful—even joyful—after years of practice, but at what cost? Where did the trauma go? What access to feeling has been sacrificed? I’ve met meditators who seem more like animated pieces of wood than feeling human beings. Others may smile beatifically, but exude an aura of passive aggression under the peaceful exterior. Despite the dozens of studies reporting positive results, despite the brain scans showing thicker cortices and lower vital signs, one is led to wonder what happened to the pain. Does it just vanish? Is it true that mindfulness can heal trauma, as its proponents say? Or has the pain just been driven deeper into the body, leaving an appearance of being healed?

My hypothesis is that mindfulness meditation encapsulates those painful feelings and keeps them dissociated from awareness, much as an oyster encapsulates an irritating grain of sand within a pearl. And one must keep them encapsulated with daily meditation for the rest of one’s life. Therapists who specialize in treating PTSD say that mindfulness can help someone examine their traumatic feelings – look at them from afar so to speak – so they can be “reprocessed.” Reprocessing usually means “reappraisal” – i.e. rethinking your feelings rather than taking them at face value. Once again, it is an attempt to control feeling with cognition, in direct contradiction to the affective neuroscience principle that feeling (affect) always trumps cognition.

I have a love-hate relationship with meditation. I’ve found mindfulness to be quite effective for dealing with present-day stress. It can and does provide resilience during those times when you need to keep things together and function at a high level, but I’ve never mistaken it for healing. It is only an adjunct; a tool to help with difficult feelings and situations until one can resolve them through action in the present or through feeling what needs to be felt, whatever is appropriate to the situation. Without attention to feelings, mindfulness meditation is little more than a virtual lobotomy.

I’ve often told Arthur Janov that primal therapy needs good evidence from well-designed outcome studies before the psychological community will accept it as a valid therapy. I tell him this is the only way his colleagues will come to believe that the therapy works. His response is usually something like, “they won’t believe it even if you prove it to them. With scientists, the distance from the left brain to the right cannot be crossed.”

In a way, he’s correct. To those of us who have allowed ourselves to let go and drop deeply into feelings without inhibition or control, the concept of “feeling” takes on a whole new meaning. From that point forward, the common notion of feeling held by most psychologists is revealed as a pale facsimile of the real thing. Rather, it is only the tip of the iceberg, the bare beginning of what’s needed to connect with our deepest selves and reclaim our birthright as fully feeling human beings. And as Janov repeatedly reminds us, this process must be done slowly and carefully, with a constant focus on insight and connection, otherwise we can get easily get lost in empty catharsis with few insights or bizarre ideation. Janov calls this “abreaction.”

To psychologists who haven’t gone deeply into their own feelings, this is terra incognita. Most consider deep feeling as dangerous – something to avoid lest it “retraumatize” the client. Even the most well-meaning of therapists who say their approach is “all about feelings” miss the point. The loss of control needed to descend to the level at which the trauma occurred cannot be avoided. Without it, you remain at a distance, apart from the trauma. You must go into the center of the pain to resolve it, and when done properly, the pain dissolves into feeling and the insights flow. Left brain and right brain connect to create a wholly functional, feeling being.

But in today’s trauma therapy, the client is usually led part-way into the pain whereupon the therapist intervenes with advice on how to “appraise” the feeling. The cognitive brain stays firmly in control while the feeling is observed from afar, as though on a stage. A variation of this is EMDR – eye movement desensitization therapy – where the client witnesses the trauma from afar, as though in hypnosis, and then talks about it. She remains detached from her pain because to go deeper into it risks retraumatization.

And herein lies the difficulty in encouraging the scientific community to consider primal therapy seriously: unless you’ve been there and dropped to that level yourself, the concept of primal feeling is foreign and usually confused with loud screaming, crying, venting, flailing or flopping about, or some other display of extreme emotion, but with no understanding of what is happening on the inside. More often than not, deep feeling is avoided because most if not all psychologists have some degree of past trauma they are defending against. They may have touched on it in talk therapy, cried about it even, but very few have let themselves go to the depths because after all, it is painful, and most talk therapy situations don’t allow full expression of feelings, lest it disturb their professional neighbours. Also, later trauma often connects to earlier trauma underneath, a phenomenon Janov refers to as the chain of pain. There is a general fear of losing control, despite the fact that primal therapy has mapped this territory well over its forty plus years of development.

This is why the science of primal therapy must be done by researchers who have gone through the primal process, preferably all the way through therapist training. Otherwise, there will always be the question, “just what are primal feelings?” And as Louis Armstrong said when someone asked him what jazz was, “if you have to ask, you’ll never know.”

This post contains a portion of the talk that I gave last month at the 16th International Conference of the Association of Psychology and Psychiatry for Adults and Children in Athens. While I began with a short discussion of primal theory, I also wanted to stress how social and economic factors create the basis for much of the pain in our lives.

Research has now clearly established that economic, and social variables – more than individual or family behavior – are the most salient factors overall in determining a child’s well-being.

Epigenetics, for instance, explores how the social and economic experiences of one’s parents and even grandparents are transmitted to a fetus by influencing whether genes are turned on or off.

And psychologist Monique Robinson points out that:

Regardless of exposure to stress in the womb, a nurturing environment after birth can provide the child with enormous potential to change their course of development. This is known as “developmental plasticity,” which means that the brain can adapt and change as the child grows with a positive environment.

The important message here is in how we as a community support pregnant women.  Stressful lives are most often linked with socioeconomic disadvantage. This research shows we should be targeting these women with support programs to ensure the stress does not negatively affect the unborn child.

Not surprisingly, poverty can do significant harm to children, including brain damage.  Researchers at UBC and UC Berkeley found that US children from low socioeconomic environments displayed a response in the prefrontal cortex that was similar “to the response of people who have had a portion of their frontal lobe destroyed by a stroke.”

Providing optimal conditions for pregnant women, such as nutrition and prenatal care, would prevent children from suffering from a host of cognitive, emotional, and physical illnesses.

Nobel prize-winning economist James Heckman argues that every dollar invested “in the very young” not only saves lives and prevents illness, but it will also save from $4-17 dollars in future social costs.  For instance, toxic chemicals and air pollutants, which result in such outcomes as lead poisoning, ADHD, and autism, cost the United States $77 billion annually.

Almost 350,000 women die each year in childbirth – most of whom could be saved for the cost of – six fighter jets.

The most horrific figure is this: over 22,000 children under the age of 5 die every day from hunger and preventable diseases – almost 9 million every year.

The crime is that the world has more than enough wealth and knowledge to eliminate most of this suffering.

Consider that governments give approximately $400-500 billion dollars every year to wealthy corporations whose activities are destroying the environment.

This year’s US military budget is around $800 billion, and the world spends twice that: $1.6 trillion. Perhaps the simplest (and most rational) change would be to redirect wasteful military spending – one-fifth of which, according to the United Nations, would end the worst elements of global poverty by providing basic levels of health care, sanitation, food, housing and education.

The wars in Afghanistan and Iraq alone will cost over $3 trillion.

Literally trillions of dollars were spent bailing out Wall Street when their dubious investments collapsed, and yet the 25 top hedge fund managers in 2009 “earned” an average of more than a billion dollars each – “more than 24,000 times that of the average American.” Millions lost their jobs and houses, but it’s OK because, in the view of the CEO of Goldman Sachs, they were “doing God’s work” (McQuaig and Brooks, The Trouble with Billionaires, Penguin, Toronto, 2010).

And in 2009, the combined net worth of the world’s 1,011 billionaires increased to $3.6 trillion, up $1.2 trillion in just one year. Just one-quarter of this new wealth could end global poverty.

The single greatest negative influence on the health of children is extreme social and economic inequality (both relative and absolute).  This is just as true for wealthy countries as it is for poor ones, since “high levels of inequality have a negative impact on population health in both rich and poor nations alike.”

It is obvious that trying to “live” on $2/day or less is hardly optimal for one’s physical or emotional health, but almost half the world’s population is trapped in this predicament.  Even a rich country like Canada is nowhere near as healthy as it could be:

The primary factors that shape the health of Canadians are not medical treatments or lifestyle choices, but rather the living conditions they experience…how income and wealth is distributed, whether or not we are employed, and if so, by the working conditions we experience (“Canadians’ health is mostly shaped by social determinants”, CCPA Monitor, June 2010).

Almost everything that is vital to a healthy community, from life expectancy to levels of depression to educational performance to crime rates, is affected by how unequal a society is.  This is true in both rich and poor countries.  Infants and children are the ones most vulnerable to negative social and economic inequalities (The Spirit Level: Why Equality is Better for Everyone, Wilkinson and Pickett).

Perhaps the most important point to remember is that none of the social, economic, and environmental problems are necessary. All scarcities are, as Murray Bookchin pointed out over 40 years ago, artificial. We possess both the knowledge and the wealth to eliminate the worst of these afflictions. Why aren’t we doing so?

The Dalai Lama is often held up as an example of what human beings can be: kind, loving, compassionate, even in the face of adversity. One of the reasons he is so healthy is because he had a loving mother.