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The Worst Comparitive Psychotherapy Study Ever Published

by Bruce Wilson

While reading through several newspaper obituaries on Arthur Janov, one name kept coming up over and over: John C. Norcross, professor of psychology at the University of Scranton in Pennsylvania. According to Norcross, primal therapy is little more than a trendy psychotherapy that arose in the fevered sixties, and Janov was “a classic instance of being the right charismatic therapist at the right time.” And to further demonstrate his ignorance, Dr. Norcross says in the New York Times, “There is no evidence that screaming and catharsis bring long-term emotional relief.”

This comment is repeated again and again in obit after obit, merely parroting the NYT review. But the review also states:

Much of the psychotherapeutic establishment now regards the therapy as marginal. A 2006 article by Dr. Norcross and colleagues in the journal Professional Psychology: Research and Practice reported that their survey of more than 100 “leading mental health professionals” had found primal therapy to be “certainly discredited” — together with treatments including angel therapy, crystal healing, past-lives therapy, future-lives therapy and post-alien-abduction therapy.

“It’s both a discredited theory and treatment in mental health,” Dr. Norcross said. “Today, I look back at it as an unfortunate but understandable product of its time: believing that pure emotional release would prove therapeutic.”

Those are pretty strong words. After all, if you deem something to be “discredited” you should have extensive evidence to back it up, right?

Wrong.

This survey enrolled 101 so-called mental health experts to assess 59 treatments by questionnaire. “Experts” were decided by criteria such as doctorate-level education, fellows of the American Psychological Association (APA) or American Psychological Society (APS), current and former editors of scholarly journals in mental health, members of the APA Presidential Task Force on Evidence-Based Practice, and chairs or editors of the Diagnostic and Statistical Manual of Mental Disorders (DSM). In other words, no one who had ever practiced primal therapy was included. Overall, 66% of respondents were supporters of cognitive behavioral therapy (CBT) or “eclectic/integrative” therapy. In other words, these “experts” represented the dominant wing of the psychological establishment, which has always been critical of primal therapy and the notion of repressed memory.

The term “discredited” was based on the following criteria:

We operationally define discredited as those unable to consistently generate treatment outcomes (treatments)…beyond that obtained by the passage of time alone, expectancy, base rates, or credible placebo. Discredited subsumes ineffective and detrimental interventions but forms a broader and more inclusive characterization. We are interested in identifying disproven practices.

The criteria for making the discredited ratings were left to the respondents on the basis of “several types of evidence: peer-reviewed controlled research, clinical practice, and/or professional consensus.”

On a scale where 1 =not at all discredited, 2=unlikely discredited, 3=possibly discredited, 4=probably discredited, and 5=certainly discredited, “primal scream therapy” was rated as 4.51, i.e. “probably discredited” and halfway to “certainly discredited.” Primal was regarded as less credible than “standard prefrontal lobotomy for treatment of mental/behavioral disorders (4.44),” “Erhard Seminar Training for treatment of mental/behavioral disorders (4.29),” and “Psychotherapy for the treatment of penis envy (3.60).”

Therapies deemed as “unlikely discredited” included “eye movement and desensization processing (EMDR) (2.88)”, “laughter or humor therapy for treatment of depression (2.83)” (I kid you not!), “psychosocial (nonbehavioral) therapies for ADHD (2.85),” and thought-stopping procedures for ruminations/intrusive worry (2.25).” The only therapy regarded as not at all discredited, by a narrow margin, was “behavior therapy for sex offenders (1.97).”

Echoing the NYT obit, the authors concluded, “experts considered as certainly discredited 14 psychological treatments: angel therapy, use of pyramid structures, orgone therapy, crystal healing, past lives therapy, future lives therapy, treatments for post-traumatic stress disorder (PTSD) caused by alien abduction, rebirthing therapies, color therapy, primal scream, chiropractic manipulation, thought field therapy, standard prefrontal lobotomy, and aroma therapy.”

Stunning ignorance, I know. But take a deep breath.

In all the therapies listed, except the cognitively based therapies, cognitive behavioral therapists were more likely to rate them as discredited. Not only that, but most of these “experts” were not even familiar with many of the treatments. And yet they felt competent to judge them. With regard to “primal scream therapy,” 6% were not familiar with the therapy. Actually, I would say zero percent were familiar with the therapy because it is not called primal scream therapy!

Nowhere is the “evidence” mentioned that substantiates these “expert’” decisions. I assume they just cherry picked whatever papers fit their therapeutic orientation, or perhaps they just gathered around their virtual water cooler and made up that “professional consensus.” As for “primal scream therapy” they had obviously done no research to find out that primal therapy has nothing to do with screaming.

So this is the sort of misinformation about primal therapy that is circulating around the psychological community and the mainstream press. Decades ago, Art Janov decided to distance himself from the mental health establishment for this very reason. Despite his many efforts to convince his colleagues that his therapy worked, he was met with ridicule and outright defamation. Since then, primal therapy has existed on its own, quietly advancing as the decades have passed, and some respected psychologists, physicians, and neuroscientists have come to appreciate its effectiveness: Louis Cozolino, Justin Feinstein, Jaak Panksepp, Paul Thompson, and Gabor Maté, to name a few. And although the therapy still needs to be researched, it will be done without the participation of these “expert” clowns.

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The Passing of a Genius

Art & Bruce

by Bruce Wilson

Three days ago, the world lost one of the greatest psychologists of the past century, Dr. Arthur Janov, originator of primal therapy and Director of the Janov Primal Center in Santa Monica, California.

I first “met” Janov on the front cover of his groundbreaking book, The Primal Scream (1970). I was 21 and deeply troubled and there he was with his dark eyes, handsome face, and curly hair, looking totally relaxed, promising hope. I had heard he had treated John Lennon and Yoko, and Lennon’s primal album was one of the most gut wrenching pieces of music that I had ever heard. There was no doubt when I read Janov’s book that primal therapy was exactly the treatment I needed to get better. In 1974, I entered into therapy at the Denver Primal Center and have never regretted it. Today, I am having another round of treatment at Janov’s centre in Santa Monica, all to good effect. I will be blogging more on this in coming weeks.

In recent years, I became closer to Art (the name he preferred among his friends), offering to help him advance his therapy in the scientific community. He took up the offer wholeheartedly but he was pretty skeptical of anything coming of it. After all, he had gone through decades of ridicule and abuse in both the psychological and psychiatric communities. My best memory during this period was introducing Art to Jaak Panksepp, another giant in the field of affective neuroscience. Panksepp immediately recognized the logic of primal therapy – that early life trauma can have lifelong consequences – as he had observed himself in his animal studies. Although the two never went on to collaborate (sadly), Panksepp was profoundly affected by primal and went on to talk about it in conferences and in his books. After being ignored by almost every scientist Art reached out to, this was a real bonus for him. Art and Panksepp stayed in touch over the years, right up to the Panksepp’s untimely death earlier this year (April 18).

Several years ago, Art attended a conference in LA on the cause of trauma and its treatment. He was keen to collaborate with a neuroimaging scientist which unfortunately didn’t come to pass. But I will never forget him walking out during a presentation by a “sensorimotor therapist” who professed to have discovered a means whereby traumatized patients could relive their traumas without becoming “retraumatized.” It consisted of little more than minor body movements coupled with a few tears. Art would have nothing to do with it, as he wouldn’t with dozens other treatments offered up by professional psychotherapists. He spent a good part of his writing career criticizing these therapies (see “Grand Delusions” on his website.) His term for many of these treatments was “booga booga”, a polite name for bullshit. Art was adamant (and I believe rightly so) that these treatments were non-curative and a waste of money and time. From the beginning, he held to the tenet that in order to resolve a particular trauma or psychic insult, to get rid of troublesome symptoms such as depression, anxiety, compulsions, etc. it was necessary to feel the pain beneath and not cover it over with a new set of defense mechanisms. No amount of talking, massage, meditation, fake screaming, eye movements (which Art called ‘voodoo’), psychedelics, shock treatments, drugs, etc. could effect a cure. The dialectic of primal therapy is that one must do the opposite of what your defenses want you to do, i.e. go into the pain rather than away from it. As he wrote in Grand Delusions,

The only hope for cohesion, and lasting help for patients, is to address the generating sources of neurosis or mental illness. What and where are these sources? I believe that the conflict between the imprinted Pain of early trauma and its repression is the central contradiction that generates neurotic reactions both internally (physiologically) and externally in the form of behavior. Repression, or the loss of access to feelings and sensations, is an evolved function that allows us to survive unmitigated pain early in life. The pain, however, stays in the body, unavoidably – as unavoidable as the experiences that originally caused the pain. And the pain will perpetually fuel a dislocation of mental and physical functioning to keep itself unfelt, for as long as it remains unfelt.

Throughout his career, Art held fast to these principles, reiterated time and again in fifteen books, plus a large number of blog posts. Today, primal therapy is exact and measured, a far cry from the primal of early days. Patients are followed closely from the beginning with physiological measurements (heart rate, blood pressure, body temperature), and many of the patients at the center (including me) are taught to “regroove” their feeling style so that later, higher level feelings are fully felt and integrated before lower, earlier “first line” feelings are allowed to surge forth. Art was always adamant that primal therapy should proceed in an orderly and coherent manner, with later feelings going first and earlier feelings following. I now see the wisdom in this, as it helps one to connect and integrate feelings and prevents first line overload.

The last time I saw Art was at his second home in Palm Springs, Calif. We were gathered with several of his therapists and two scientists who were interested in his work. That was three years ago. Perhaps prophetically, Art was telling all of us that it was up to us to carry on the therapy. He never referred to “after I’m gone.” At one point, he looked me in the eye and said, “Kid, you have to do this therapy. It’s really important. Really important. This is your life, the only life you’ll have.”

And so I have done so. Dear Art, rest in peace my friend. You have done more for me than you can imagine, and continue to do so through your books and blog. Thank you.

Avec le temps, va, tout s’en va

On oublie le visage et l’on oublie la voix

Le coeur, quand ça bat plus, c’est pas la peine d’aller

Chercher plus loin, faut laisser faire et c’est très bien

– Léo Férré

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The Truth About Janov’s Primal Therapy

by Peter Prontzos

There has always been a lot of misunderstandings about Primal Therapy, as developed by the late Dr. Arthur Janov.

Probably the biggest misconception is that it’s all about screaming. That likely derives from the dramatic – but misleading – title of Janov’s first book, “The Primal Scream.” It is a catchy title, but it is not what his therapy is about.

Simply, Primal Therapy is a form of psychodynamic therapy which emphasizes the need for a person to connect with, feel, and release the pain of earlier traumas. Some of these traumas can go as far back as a person’s birth.

It is client-centered, that is, the role of the therapist is NOT to analyze, offer insights, and decide what a person’s real feelings are. Only the client knows – consciously or not – their own history, and they must make their own connection to their past if they are to heal.

The other part of the problem is that many people who know nothing of the true nature of Primal Therapy think that they can judge it, and condemn it. Such is the case in the obituary of Dr. Janov that ran in the N.Y. Times. Specifically, they cite a study which charges that there is little evidence to support Janov’s claims and that the therapy has been “discredited.”

That is a false and ignorant accusation. But you don’t have to take my word for it. Here are just a few samples of scientists, researchers, and therapists who have a much more accurate understanding of the claims of Primal Therapy:

Dr. Janov provides the scientific rationale for treatments that take us through our original, non-verbal memories – to essential depth of experience that the superficial cognitive-behavioral modalities currently in fashion cannot possibly touch, let alone transform.   – Dr. Gabor Mate

Dr. Janov 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. – Dr. Paul Thompson, Professor of Neurology, UCLA School of Medicine

Forty years of neuroscience research convince me that Janov has discovered a way to rewire neurons in your brain. – Dr. David Goodman, Newport Neuroscience Center

 Dr. Janov’s works are, a valuable guide to creating healthier babies… – Paula Thompson, Professor Emeritus, York University

Dr. Janov’s essential insight – that our earliest experiences strongly influence later well-being – is no longer in doubt…His long-held belief…lies at the heart of the integration of neuroscience and psychotherapy. – Lou Cozolino, Professor of Psychology, Pepperdine University

And finally, referring to Janov’s later work:

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.  – Dr. Jaak Panksepp, author of, “Affective Neuroscience: The Foundations of Human and Animal Emotions”

I will conclude with an anecdote regarding Jaak and Dr. Janov. I first met Jaak at a conference at UCLA, where I was told by Dr. Norman Doidge (“The Brain That Changes Itself”) that – in his opinion – Jaak was the most important scientist in the world. Jaak’s specialty was the similar processes found in the brains of humans and other mammals.

Bruce was already aware of Jaak’s ground-breaking research, and arranged for us to all get together for dinner and discussion at Janov’s house. Art showed Jaak a video of a Primal patient re-living an agonizing birth.

The next day, in his presentation to the Interpersonal Neurobiology Conference at UCLA, Jaak said to the audience that the evening before he had seen a video of a person re-experiencing their birth, “that could not be faked.”

So – while there is still a need for more scientific research on the process and the effectiveness of Primal Therapy – the slanders aimed at the process, and at Dr. Janov, are seriously flawed.

Hopefully, this problem will be remedied by future research; not so much to be fair to Art, but in order to more fully develop effective therapy, and especially to use this knowledge to prevent babies and children from being hurt in the first place.

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Review of “Life Before Birth” by Arthur Janov

by Peter Prontzos

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.

Continue reading “Review of “Life Before Birth” by Arthur Janov”

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Abreaction Part 2: Abreaction vs Connected Feeling – What’s the Difference?

by Bruce Wilson

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.

Continue reading “Abreaction Part 2: Abreaction vs Connected Feeling – What’s the Difference?”

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Abreaction Part I: What it is and why it was abandoned in psychotherapy

by Bruce Wilson

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.”

Continue reading “Abreaction Part I: What it is and why it was abandoned in psychotherapy”

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“I’ll have a cup of enlightenment, please.” “Will that be with or without feelings, sir?”

by Bruce

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.

Continue reading ““I’ll have a cup of enlightenment, please.” “Will that be with or without feelings, sir?””

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If you have to ask, you’ll never know.

by Bruce Wilson

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.”

 

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Why Past Life Therapy is Not Primal Therapy

by Bruce Wilson

On a previous post, I was asked why I neglect “past lives” in my discussions of primal therapy. The short answer is that I am not convinced that past lives or past life memories are real. If someone were to produce convincing evidence for this, I might change my tune, but the evidence would have to be extremely powerful and incontrovertible.

In scientific terms, the claim for past lives is extraordinary, and as Carl Sagan said, extraordinary claims require extraordinary evidence. I’m not saying I am certain that past lives don’t exist, only that the current evidence doesn’t support the idea. In fact, psychiatrists highly dedicated to the scientific method have produced suggestive evidence to support past life phenomena, but its relevance to psychotherapy is questionable. I explain why below. Continue reading “Why Past Life Therapy is Not Primal Therapy”

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Primal Therapy and the Limits of Science

by Bruce Wilson

A comment I hear frequently is that primal therapy can never be proven by science. As Phil states in his comment to my last post:

“…the actual practice of primal therapy can never really be scientific, in my opinion. How could it be when it is based on feelings? Adding blood pressure measurements and brain wave readings might help a little, but not much. What is critical is what the therapist says and does, and has the patient say or do. That can’t be scientific, I am afraid. It is based on feelings and intuitions on what will work or not work, based on experience and the degree to which a therapist has done his or her own feeling work.” Continue reading “Primal Therapy and the Limits of Science”

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