Overview of Primal Therapy
Repressed pain divides the self in two and each side wars with the other. One is the real self, loaded with needs and pain that are submerged; the other is the unreal self that attempts to deal with the outside world by trying to fulfill unmet needs with neurotic habits or behaviors such as obsessions or addictions. The split of the self is the essence of neurosis and neurosis can kill.
That pain is the result of needs and feelings that have gone unfulfilled in early life. Those early unmet needs create what I call Primal Pain. Coming close to death at birth or feeling unloved as a child are examples of such Pain. The Pain goes unfelt at the time because the body is not equipped to experience it fully and deal with it. When the Pain is too much, it is repressed and stored away. When enough unresolved Pain has occurred, you lose access to your feelings and become neurotic.
Primal Therapy is important in the field of psychology, for it means, ultimately, the end to so much suffering in human beings. Discovering a way to treat Pain means there is a way to stop the misery in which so many of us are mired every day of our lives. After two decades of research, after dealing with thousands of patients with every imaginable psychological and physical affliction, we have arrived at a precise, predictable therapy that reduces the amount of time one spends in treatment and eliminates all the wasted motion. It is a therapy that has been investigated by independent scientists and the findings are consistent. Primal Therapy is able to reduce or eliminate a host of physical and psychic ailments in a relatively short period of time with lasting results.
We have found ways to measure the ongoing presence and chronic effects of early trauma. We have observed time and again that even though it is not felt, the force of the memory remains in the system, reverberating on lower brain levels and moving against the body wherever it happens to be vulnerable. It shapes our interests, values, motivations and ideas. By reliving these traumas, patients can return back to early events and know with certainty how they formed adult behavior and symptoms.
We can see how buried memories constantly activate the system, putting pressure on vital organs and creating disruptions which can eventually result in serious illness. The problem for too many of us is that suddenly we find ourselves with afflictions or obsessions and have no idea how it all happened. We don’t know why we can’t sleep, why we can’t find a mate, why we are obsessed with this idea or that or why we don’t function as we want to, sexually. Primal Therapy can clarify these seeming mysteries.
It sometimes seems that everyone is suffering in their own way and few are aware of it. Television is riddled with ads for ibuprofen, aspirin, sleeping pills and other pain killers, implicitly acknowledging the Pain we are all in but without ever acknowledging it explicitly. Nothing dramatic happens but so many of us have developed this disease or that, from high blood pressure to allergies, colitis, anxiety attacks, asthma, circulation problems and heart palpitations (our history literally becomes palpable). So many ailments that seem inexplicable -- depression and phobias, ulcers and migraines -- may all stem from the same source. So might many of our personality quirks, our habits and behavior patterns, our drives and obsessions. One powerful piece of evidence for the fact of the same kinds of Pains being behind so many different afflictions and behavioral problems is that the same kinds of tranquilizers or pain killers are used to treat all of them.
In the fields of medicine and psychotherapy today doctors deal with symptoms. Just look at the DSM-IV, the psychiatric diagnostic and statistical manual, with page after page of every conceivable variation of neurosis. And in Washington, D.C., they have erected monuments to symptoms, a building for each one — drug abuse, alcoholism, heart disease, cancer and so on. Experts specialize in treating colitis, ulcers, migraines, diabetes, high blood pressure, asthma, anxiety, depression, marital problems, eating disorders, etc.; knowing more and more about narrower and narrower subjects. They add salt, take away salt, add thyroid, remove thyroid, speculate about the reasons for one’s allergies or unhappiness, analyze dreams and nearly always prescribe medication. They are trying to normalize the symptom instead of normalizing the person who has it; trying to normalize the manifestation instead of the system that makes it manifest.
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Delving deep into the unconscious has allowed us to clarify the basis of adult behavior. We have a good idea what lies in the unconscious and it doesn’t seem to be the mystical emporium so often described. We have learned in Primal Therapy that irrespective of whether the Pain is manifest in the body or in the mind, the person is not himself; there is a dislocation of function which is global. Both emotional and physical pain deform cells and cause alterations which show up in measurements of vital signs, brain function and chemistry, the immune system, hormones, peripheral blood flow and in a person’s behavior. Everything is askew. Primal Therapy works in reverse of the normal approach. Instead of working from symptoms to possible causes, we work from causes to symptoms. The focus is always deep. From this approach we have developed a more profound understanding of who we are and what drives us, our basic, hidden, unconscious motivations.
"Some years ago, I heard something that was to change the course of my professional life and the lives of my patients. What I heard may change the nature of psychotherapy as it is now known --an eerie scream welling up from the depths of a young man lying on the floor during a therapy session. I can liken it only to what one might hear from a person about to be murdered. This book is about that scream and what it means in terms of unlocking the secrets of neurosis. The young man who emitted it will be called Danny Wilson, a twenty-two-year-old college student. He was not psychotic, nor was he what is termed hysteric; he was a poor student, withdrawn, sensitive, and quiet.
"During a lull in our group therapy session, he told us a story about a man named Ortiz who was currently doing an act on the London stage in which he paraded around in diapers drinking bottles of milk. Throughout his number, Ortiz is shouting, ‘Mommy! Daddy! Mommy! Daddy!’ at the top of his lungs. At the end of his act he vomits. Plastic bags are passed out, and the audience is requested to follow suit.
"Danny's fascination with the act impelled me to try something elementary, but which previously had escaped my notice. I asked him to call out, "Mommy! Daddy!" Danny refused, saying that he couldn't see the sense in such a childish act, and frankly, neither could I. But I persisted, and finally, he gave in. As he began, he became noticeably upset. Suddenly he was writhing on the floor in agony. His breathing was rapid, spasmodic; "Mommy! Daddy!" came out of his mouth almost involuntarily in loud screeches. He appeared to be in a coma or hypnotic state. The writhing gave way to small convulsions, and finally, he released a piercing, deathlike scream that rattled the walls of my office. The entire episode lasted only a few minutes, and neither Danny nor I had any idea what had happened. All he could say afterward was: "I made it! I don't know what, but I can feel"
"What happened to Danny baffled me for months. I had done standard insight therapy for seventeen years, both as a psychiatric social worker and as a psychologist. I was trained in a Freudian psychiatric clinic, as well as in a not-so-Freudian Veterans Administration department. For several years I had been on the staff of the psychiatric department of the Los Angeles Children's Hospital. At no time during that period had I witnessed anything comparable. Since I had taped the group session that night, I listened to the recording frequently over the next several months in an effort to understand what had happened. But to no avail.
"Before long I had a chance to learn more about it.
"A thirty-year-old man, whom I shall call Gary Hillard, was relating with great feeling how his parents had always criticized him, had never loved him, and had generally messed up his life. I urged him to call out for them; he demurred. He "knew" that they didn't love him, so what was the point? I asked him to indulge my whim. Halfheartedly, he started calling for Mommy and Daddy. Soon I noticed he was breathing faster and deeper. His calling turned into an involuntary act that led to writhing, near-convulsions, and finally to a scream.
"Both of us were shocked. What I had believed was an accident, an idiosyncratic reaction of one patient, had just been repeated in almost identical fashion.
"Afterward, when he quieted down, Gary was flooded with insights. He told me that his whole life seemed to have suddenly fallen into place. This ordinarily unsophisticated man began transforming himself in front of my eyes into what was virtually another human being. He became alert; his sensorium opened up; he seemed to understand himself.
"Because of the similarities of the two reactions, I began listening even more carefully to the tapes I had made of Danny's and Gary's sessions. I tried to analyze what common factors or techniques produced the reactions. Slowly some meaning began to emerge. Over the next months I tried various modifications and approaches in asking the patient to call for his parents. Each time there occurred the same dramatic results.
"I have come to regard that scream as the product of central and universal pains which reside in all neurotics. I call them Primal Pains because they are the original, early hurts upon which all later neurosis is built. It is my contention that these pains exist in every neurotic each minute of his later life, irrespective of the form of his neurosis. These pains often are not consciously felt because they are diffused throughout the entire system where they affect body organs, muscles, the blood and lymph system and, finally, the distorted way we behave.
"Primal Therapy is aimed at eradicating these pains. It is revolutionary because it involves overthrowing the neurotic system by a forceful upheaval. Nothing short of that will eliminate neurosis, in my opinion.
"Primal Theory is an outgrowth of my observations about why specific changes
take place. Theory, I must emphasize, did not precede clinical experience. When
I watched Danny and Gary writhing on the floor in the throes of Primal Pain, I
had no idea what to call it. The theory has been expanded and deepened by the
continuing reports of one patient after another who has been cured of neurosis.
This book is an invitation to explore the revolution they began."
The following paragraphs cover Dr. Janov's theory of neurosis:
We all are creatures of need. We are born needing, and the vast majority of us die after a lifetime of struggle with many of our needs unfulfilled. These needs are not excessive--to be fed, kept warm and dry, to grow and develop at our own pace, to be held and caressed, and to be stimulated. These Primal needs are the central reality of the infant. The neurotic process begins when these needs go unmet for any length of time. A newborn does not know that he should be picked up when he cries or that he should not be weaned too early, but when his needs go unattended, he hurts.
At first the infant will do everything in his power to fulfill his needs. He will reach up to be held, cry when he is hungry, kick his legs, and thrash about to have his needs recognized. If his needs go unfulfilled for a length of time, if he is not held, changed or fed, he will suffer continuous pain either until he can do something to get his parents to satisfy him or until he shuts off the pain by shutting off his need. If his pain is drastic enough, death may intervene, as shown in studies of some institutional babies.
Since the infant cannot himself overcome the sensation of hunger (that is, he cannot go to the refrigerator) or find substitute affection, he must separate his sensations (hunger; wanting to be held) from consciousness.
This separation of oneself from one's needs and feelings is an instinctive maneuver in order to shut off excessive pain. We call it the split. The organism splits in order to protect its continuity. This does not mean that unfulfilled needs disappear, however. On the contrary, they continue throughout life exerting a force, channeling interests, and producing motivation toward the satisfaction of those needs. But because of their pain, the needs have been suppressed in the consciousness, and so the individual must pursue substitute gratifications. He must, in short, pursue the satisfaction of his needs symbolically. Because he was not allowed to express himself, he may be compelled to try to get others to listen and understand him later in life.
Not only are unattended needs that persist to the point of intolerability separated from consciousness, but their sensations become relocated to areas where greater control or relief can be provided. Thus, feelings can be relieved by urination (later by sex) or controlled by the suppression of deep breathing. The unfulfilled infant is learning how to disguise and change his needs into symbolic ones. As an adult he may not feel the need to suck his mother's breast owing to abrupt early weaning but will be an incessant smoker. His need to smoke is a symbolic need, and the essence of neurosis is the pursuit of symbolic satisfactions.
Neurosis is a symbolic behavior in defense against excessive psychobiologic pain. Neurosis is self-perpetuating because symbolic satisfactions cannot fulfill real needs. In order for real needs to be satisfied, they must be felt and experienced. Unfortunately, pain has caused those needs to be buried. When they are buried, the organism goes into a continuous state of emergency alert. That alert state is tension. It propels the infant, and later the adult, toward the satisfaction of need in any way possible. This emergency alert is necessary to ensure the infant's survival; if he were to give up hope of ever having his needs fulfilled, he might die. The organism continues to live at any cost, and that cost is usually neurosis--shutting down unmet bodily needs and feelings because the pain is too great to withstand.
Whatever is natural is a real need--to grow and develop at one's own pace, for example. This means, as a child, not being weaned too soon; not being forced to walk or talk too early; not being forced to catch a ball before one's neurological apparatus can do so comfortably. Neurotic needs are unnatural ones--they develop from the nonsatisfaction of real needs. We are not born in this world needing to hear praise, but when a child's real efforts are denigrated virtually from birth, when he is made to feel that nothing he can do will be good enough for him to be loved by his parents, he may develop a craving for praise. Similarly, the need to express oneself as a child can be suppressed, even by the lack of anyone listening. Such denial may turn into a need to talk incessantly.
A loved child is one whose natural needs are fulfilled. Love takes his pain away. An unloved child is the one who hurts because he is unfulfilled. A loved child has no need for praise because he has not been denigrated. He is valued for what he is, not for what he can do to satisfy his parents' needs. A loved child does not grow up into an adult with an insatiable craving for sex. He has been held and caressed by his parents and does not need to use sex to satisfy that early need. Real needs flow from inside out, not the reverse. The need to be held and caressed is part of the need to be stimulated. The skin is our largest sense organ and requires at least as much stimulation as other sense organs. Disastrous consequences can occur when there is insufficient stimulation early in life. Organ systems may begin to atrophy without stimulation; conversely, as Krech has shown [D. Krech, E. Bennett, M. Diamond, and M. Rosenzweig, "Chemical and Anatomical Plasticity of Brain," Science, Vol. 146 (October 30, 1964), pp. 610-19], with proper stimulation they may develop and grow. There must be constant mental and physical stimulation.
Unfulfilled needs supersede any other activity in the human until they are met. When needs are met, the child can feel. He can experience his body and his environment. When needs are not met, the child experiences only tension, which is feeling disconnected from consciousness. Without that necessary connection, the neurotic does not feel. Neurosis is the pathology of feeling.
Neurosis does not begin at the instant a child suppresses his first feeling, but we might say that the neurotic process does. The child shuts down in stages. Each suppression and denial of need turn the child off a bit more. But one day there occurs a critical shift in which the child is primarily turned off, in which he is more unreal than real, and at that critical point we may judge him to be neurotic. From that time on, he will operate on a system of dual selves; the unreal and real selves. The real self is the real needs and feelings of the organism. The unreal self is the cover of those feelings and becomes the facade required by neurotic parents in order to fulfill needs of their own. A parent who needs to feel respected because he has been humiliated constantly by his parents, may demand obsequious and respecting children who do not sass him or say anything negative. A babyish parent may demand that his child grow up too fast, do all the chores, and in reality become adult long before he is ready--so that the parent may continue to be the cared-for baby.
Demands for the child to be unreal are not often explicit. Nevertheless, parental need becomes the child's implicit command. The child is born into his parents' needs and begins struggling to fulfill them almost from the moment he is alive. He may be pushed to smile (to appear happy), to coo, to wave bye-bye, later to sit up and walk, still later to push himself so that his parents can have an advanced child. As the child develops, the requirements upon him become more complex. He will have to get A's, to be helpful and do his chores, to be quiet and undemanding, not to talk too much, to say bright things, to be athletic. What he will not do is be himself. The thousands of operations that go on between parents and children which deny the natural Primal needs of the child mean that the child will hurt. They mean that he cannot be what he is and be loved. Those deep hurts I call Primal Pains (or Pains). Primal Pains are the needs and feelings which are repressed or denied by consciousness. They hurt because they have not been allowed expression or fulfillment. These Pains all add up to: I am not loved and have no hope of love when I am really myself.
Each time a child is not held when he needs to be, each time he is shushed, ridiculed, ignored, or pushed beyond his limits, more weight will be added to his pool of hurts. This pool I call the Primal Pool. Each addition to his pool makes the child more unreal and neurotic.
As the assaults on the real system mount, they begin to crush the real person. One day an event will take place which, though not necessarily traumatic in itself--giving the child to a baby sitter for the hundredth time � will shift the balance between real and unreal and render the child neurotic. That event I call the major Primal Scene. It is a time in the young child's life when all the past humiliations, negations, and deprivations accumulate into an inchoate realization: "There is no hope of being loved for what I am." It is then that the child defends himself against that catastrophic realization by becoming split from his feelings, and slips quietly into neurosis. The realization is not a conscious one. Rather, the child begins acting around his parents, and then elsewhere, in the manner expected by them. He says their words and does their thing. He acts unreal--i.e., not in accord with the reality of his own needs and desires. In a short time the neurotic behavior becomes automatic.
Neurosis involves being split, disconnected from one's feelings. The more assaults on the child by the parents, the deeper the chasm between real and unreal. He begins to speak and move in prescribed ways, not to touch his body in proscribed areas (not to feel himself literally), not to be exuberant or sad, and so on. The split, however, is necessary in a fragile child. It is the reflexive (i.e., automatic) way the organism maintains its sanity. Neurosis, then, is the defense against catastrophic reality in order to protect the development and psychophysical integrity of the organism.
Neurosis involves being what one is not in order to get what doesn't exist. If love existed, the child would be what he is, for that is love-letting someone be what he or she is. Thus, nothing wildly traumatic need happen in order to produce neurosis. It can stem from forcing a child to punctuate every sentence with "please" and "thank you," to prove how refined the parents are. It can also come from not allowing the child to complain when he is unhappy or to cry. Parents may rush in to quell sobs because of their anxiety. They may not permit anger--"nice girls don't throw tantrums; nice boys don't talk back"--to prove how respected the parents are; neurosis may also arise from making a child perform, such as asking him to recite poems at a party or solve abstract problems. Whatever form it takes, the child gets the idea of what is required of him quite soon. Perform, or else. Be what they want, or else--no love, or what passes for love: approval, a smile, a wink. Eventually the act comes to dominate the child's life, which is passed in performing rituals and mouthing incantations in the service of his parents' requirements.
It is the terrible hopelessness of never being loved that causes the split. The child must deny the realization that his needs will never be filled no matter what he does. He cannot live knowing that he is despised or that no one is really interested in him. It is intolerable for him to know that there is no way to make his father less critical or his mother kind. The only way he has of defending himself is by developing substitute needs, which are neurotic.
Let us take the example of a child who is being continually denigrated by his parents. In the schoolroom he may chatter incessantly (and have the teacher come down hard on him); in the schoolyard he may brag nonstop (and alienate the other children). Later in life he may have an uncontrollable craving for and loudly demand something as patently symbolic (to the onlooker) as the "best table in the house" in an expensive restaurant.
Getting the table cannot undo the "need" he has to feel important. Otherwise, why repeat his performance every time he eats out? Split off from an authentic unconscious need (to be recognized as a worthwhile human being), he derives the "meaning" of his existence from being greeted by name by various maitre d'hotel in fancy restaurants.
Children are born, then, with real biological needs * which, for one reason or another, their parents do not fulfill. It may be that some mothers and fathers simply do not recognize the needs of their child or that those parents, out of a desire not to make any mistakes, follow the advice of some august authority in child rearing and pick up their child by the clock, feed him by a timetable an airline would envy, wean him according to a flow chart, and toilet train him as soon as possible.
Nevertheless, I do not believe that either ignorance or methodological zeal accounts for the bumper crops of neurosis our species has been producing since history began. The major reason I have found that children become neurotic is that their parents are too busy struggling with unmet infantile needs of their own.
Thus a woman may become pregnant in order to be babied-which is what she has actually needed to be all her life. As long as she is the center of attention, she is relatively happy. Once delivered of her child, she may become acutely depressed. Being pregnant would serve her need and have nothing to do with producing a new human being on this earth. The child may even suffer for being born and depriving his mother of the one time in her life when she could make others care. Since she is not ready for motherhood, her milk may dry up, leaving her newborn with the same raft of early deprivations which she herself may have suffered. In this way the sins of the parents are visited on the children in a seemingly never-ending cycle.
The attempt of the child to please his parents I call the struggle. The struggle begins first with parents and later generalizes to the world. It spreads beyond the family because the person carries his deprived needs with him wherever he goes, and those needs must be acted out. He will seek out parent substitutes with whom he will play.
Many parents make the mistake of not picking up their child sufficiently out of fear of "spoiling" him. By ignoring him, this is precisely what they do, and later they will be swamped by the child's insatiable demands for symbolic substitutes--until the day they crack down on him. The consequences of that are both inevitable and dreadful.
Out of his neurotic drama, he will make almost anyone (including his children) into parental figures who will fill his needs. If a father was suppressed verbally and was never allowed to say much, his children are going to be listeners. They, in turn, having to listen so much, will have suppressed needs for someone to hear them; it may well be their own children.
The locus of struggle shifts from real need to neurotic need, from body to mind, because mental needs occur when basic needs are denied. But mental needs are not real needs. Indeed, there are no purely psychological needs. Psychological needs are neurotic needs because they do not serve the real requirements of the organism. The man in the restaurant, for example, who must have the best table in order to feel important is acting on a need which developed because he was unloved, because his real efforts in life were either ignored or suppressed. He may have a need to be recognized by name by the maitre d' because early in life he was referred only to by category-"son." This means he was dehumanized by his parents and is trying to get a human response symbolically through others. Being treated as a unique human being by his parents would obviate this so-called need to feel important. What the neurotic does is put new labels (the need to feel important) on old unconscious needs (to be loved and valued). In time he may come to believe that these labels are real feelings and that their pursuit is necessary.
The fascination of seeing our names in lights or on the printed page is but one indication of the deep deprivation in many of us of individual recognition. Those achievements, no matter how real, serve as a symbolic quest for parental love. Pleasing an audience becomes the struggle.
Struggle is what keeps a child from feeling his hopelessness. It lies in overwork, in slaving for high grades, in being the performer. Struggle is the neurotic's hope of being loved. Instead of being himself, he struggles to become another version of himself. Sooner or later the child comes to believe that this version is the real him. The "act" is no longer voluntary and conscious; it is automatic and unconscious. It is neurotic.