Thursday, November 28, 2013

The Mystery Known as Depression, Part 6/12


It seems that new research provides critical evidence on epigenetics, and how imprints through methylation can be passed down from one generation to another (Booij et al., 2013). A key could be repressed memory that endures and persists throughout our lives; it drives behavior, symptoms and aggravated depression. It turns out that imprints can be passed down from parents to baby and from grandparents to baby. Some genes which should be turned on are not, while those that should be off remain on. Critical in this process is methylation, which is a chemical reaction where a methyl group is transferred from a donor molecule (S-adenosylmethyonine) to the cytosine on DNA or a histone. The reaction is catalyzed by DNA methlytransferase (DNMT). A certain amount of methylation occurs naturally but trauma, such as maternal neglect in infancy, can cause excess methylation of key genes involved with the stress response. (Weaver et al, 2004) Methylation depends on the work of the chemical methyl group which is recruited when there is a traumatic event, and helps embed that memory. It seems that when there is a surge of methylation, part of it, the element 621-13, attaches or adheres to the gene. It is now part of the DNA and turns on or off certain hormones and other neuro-chemical processes. Once that happens and methyl is recruited, the genetic unfolding is thereafter altered.
In short, methylation can be an agent of (transcription) repression, or more exactly, a marker for it. In this context, repression is a systemic event that involves the whole body. If you reverse the methylation chemically (perhaps with new drugs they are developing), one can still have repression. But remove the repression through therapy and you may see demethylation. Until the studies are done, it's unclear how closely the two are linked, and in what tissues. A study at Duke University showed that when female mice were fed a diet rich in methyl it completed altered the fur pigment of the offspring. (Dolinoy, 2008) In other words, it acted like a genetic inheritance when it was not. It was the result of experience which is the linchpin of our theory--epigenetics.

In this context, traumatic events in very early childhood, (and I assume, including the period of gestation), leave a mark or tag on a gene that affects us possibly for life. They found that even grandparents affected the imprints of the grandchildren, which we will get to in a moment. But suffice to say that the experiences of our forebearers can endure and be passed down the genetic chain, the inheritance of acquired characteristics. This is something science thought impossible decades ago.

It is what we all know; that early love makes us stronger and less anxious. But it turns out that if the rat mothers were licked and groomed early on in their lives, that experience could be passed on to their offspring. The genes could be modified by the methyl group (and also other chemicals) in a beneficent way. In humans, that implies a good history in the mother means a good childhood for the children. And more loving by the mother, the less methylation in the child. And with less chronic stress hormone production there may be less chance of serious diseases later on, such as Alzheimer Disease.

To make sure that these changes in the rat pups resulted from experience and not hereditary, they let normally stable rat pups be raised by neurotic negligent mothers. And the result was still the same, unstressed babies. These babies had mothers who had normal amounts of methyl in their systems. Thus rats raised by loving mothers could pass it onto offspring even when the adopted mother was not loving. The genes for stress hormone output had minimal methylation. In other words love was passed down the genetic chain. So normal babies raised by negligent and inattentive mothers still had low methyl levels in their hippocampus. The babies started life one leg up, a good start in life despite a bad childhood. I believe that changes in the genes, methylation and acetylation, must occur very early as the whole neuronal system is evolving. So before we can state what causes depression or anxiety, we need to observe the early epigenetics at work. Again, pups born to unloving mothers were handed over to loving mothers, and those born to bad mothers reared by loving mothers still seemed to be normal and relatively unmethylated. Let us remember that methyl exists throughout the system but it is not the general amount of it but rather how much is found in specific genes (Weaver et al, 2004).

Another reason this research is important: they found that unloving mothers of rodents causes methylation of the estrogen receptors in female offspring. Then when they had offspring of their own the offspring were deficient in estrogen which made them less attentive and loving to their own babies. We as yet do not know how many key chemical processes can be affected by lack of early love. And more, we have no idea how many hormones are changed in neurotic mothers (heavily methylated) and how that affects myriad adult behaviors. Is depression inherited? There may be precursors for it which is never manifested if there were plenty of love later in childhood. Is some of the tendency to methylation inherited or epigenetically passed on? And does that form the basis for depression? It seems from the research just cited that that neurotic mothers (methylated), are ineluctably forced to be unloving, thus laying the groundwork for depression in the offspring later on (Weaver et al, 2004).

And what other hormones are depleted by this scenario? Are we born with a tendency to anxiety? Possibly, but then the imprint is not methyl so much as acetyl, in this case. With acetylation there are more faults in the repressive system. Acetylation (recruiting acetyl) pretty much produces the opposite of methylation, a tendency to open rather than close, toward expression rather than repression. The role of acetylation is inexact for now and requires further exploration.

Taken together these data suggest that trauma produced heavy methylation in those children who grew up in orphanages. And that process then affected much more in terms of brain and neuronal development. So when we find a mother who is not loving we need to know that she may being driven by her epigenes; she is a victim of those changes. Her cortisol/stress hormone level militates against maternal instincts. Methylation shuts down a number of “natural” behaviors. In neurosis we cannot be natural and appreciate nature because we are disconnected and alienated from our own nature, from our biography, history and feelings. We cannot rely on our feelings to guide us because they have effectively been shut down. Literally, the feelings are aliens. We have found in most patients but pronounced in depression, that patients on the verge of these feelings in sessions often run a fever. The body treats the feelings as a menace, a danger and something to be avoided; yet it is also what can liberate us.
Can we reverse or undo methylation? The research informs us that with rats who had been damaged, and raised by unloving mothers, when they were infused with trichostatin they did not show evident damage. As though the trauma never occurred. This drug removes methyl from the system. This is not exactly the same as demethylation. However, it did undo history (Weaver et al, 2004). This is what I think may be happening during the reliving and focusing on the imprint. There might be a change in methylation so as to reverse history; this is what we shall study in our future research projects. It seems to me the natural way provides far less possibility for collateral damage to the system. Since we already have found that chronically high cortisol levels have been reversed in our therapy, it would perhaps follow that methylation could also be reversed. In a way, the levels of methylation can be a marker for having been loved early on or not having been loved. We could tell more than the statements by the person who claims he was loved in his childhood if he were indeed not loved. How much denial is there?

Neurochemistry may be better relied on because biochemistry has no reason to lie and is not motivated by denial. It can be a marker for post traumatic stress. The more abuse as a child in these cases the more methylation produced. When we add this to our future research on telomeres and cortisol we will begin to have precise measures of the pain in us. And we will know when a drug is too dangerous for us, particularly the drugs like marijuana that tend to open us to ourselves; to our feelings and pain. Finally we will have a marker for the efficacy of certain psychotherapies. Does the therapy undo the past? Does it help relieve repression and therefore depression? Is there great first line pain in anxiety states? What seems to be the case is that love obviates methylation and produces normal beings.

K. J. S. Anand and associates state that in a number of suicides by violent means “the significant risk factors were those perinatal events that were likely to cause pain in the newborn.” (Anand & Scalzo, 2000) (More on the link between suicide and perinatal trauma below.) They also point out the carrying mothers who smoke heavily had babies more prone to criminality later on. And mothers who took drugs while pregnant had children far more prone to drug use, both serious opiates (morphine) and speed (amphetamine).

There are literally hundreds of studies now to bolster the hypothesis about early imprints, how they last and alter our systems. Some twenty years ago, most of this research had not been thought of. (Again, this is discussed in detail in Primal Healing. (Janov, 2006) In another revealing study carried out in Canada in 1998, David P. Laplante and Michael L. Meaney of Montreal’s McGill University looked at women who were pregnant during a severe ice-storm to assess the long-term effects of stress on their offspring. (Laplante, et al., 2004) The researchers write: “We suspect that high levels of prenatal stress exposure particularly in early in pregnancy, may negatively affect the brain development of the fetus... Imprinting at birth may predispose individuals to certain patterns of behavior that remain masked throughout most of adult life.”

Wednesday, November 27, 2013

An article on Mindfulness

Here is the abstract of an article from the Clinical Psychology Review journal (2011 Apr;31(3):449-64). (see

I would like your opinion on it.

Does mindfulness training improve cognitive abilities? A systematic review of neuropsychological findings.

Mindfulness meditation practices (MMPs) are a subgroup of meditation practices which are receiving growing attention. The present paper reviews current evidence about the effects of MMPs on objective measures of cognitive functions. Five databases were searched. Twenty three studies providing measures of attention, memory, executive functions and further miscellaneous measures of cognition were included. Fifteen were controlled or randomized controlled studies and 8 were case-control studies. Overall, reviewed studies suggested that early phases of mindfulness training, which are more concerned with the development of focused attention, could be associated with significant improvements in selective and executive attention whereas the following phases, which are characterized by an open monitoring of internal and external stimuli, could be mainly associated with improved unfocused sustained attention abilities. Additionally, MMPs could enhance working memory capacity and some executive functions. However, many of the included studies show methodological limitations and negative results have been reported as well, plausibly reflecting differences in study design, study duration and patients' populations. Accordingly, even though findings here reviewed provided preliminary evidence suggesting that MMPs could enhance cognitive functions, available evidence should be considered with caution and further high quality studies investigating more standardized mindfulness meditation programs are needed.

Saturday, November 23, 2013

The Mystery Known as Depression, Part 5/12


Although genetics may be partly responsible for depression in rare cases, by and large it is early life experience (including experience in the womb and birth trauma), that is the root cause. What we see at work is epigenetics, the altering of gene function without changes in the underlying DNA sequence (Booij et al., 2013). Those alterations, or deviations, if you will, often involve a biochemical process known as methylation. And it is through methylation that psychological trauma is imprinted. Thus the trauma – which can be as simple as a lack of caring and love by the mother – becomes “fixed” in the system and endures. It is the imprint, the linchpin of depression. The biochemistry, and ultimately the brain have been rerouted, sealing in depressive tendencies. It is this imprint that ultimately must be addressed and resolved.

What the scientific evidence shows more and more is that gestation and birth events are critical for later disease. In a 2010 study conducted at the Hannover Medical School in Germany,researchers concluded that “epigenetics is of considerable interest for the understanding of early life stress in depression.” The study, published in the journal Current Opinion in Psychiatry, found, among many other things, that unloved and untouched children had a predisposition to depression. (Schroeder, Krebs, Bleich, & Frieling, 2010). Recent work by a team of Canadian researchers also pointed to the critical role played by epigenetics. (Booij et al., 2013) 

The following passage is from their article:
“The functioning of the hypothalamic–pituitary–adrenal (HPA) axis and serotonergic (5-HT) system are known to be intertwined with mood. Alterations in these systems are often associated with depression. However, neither (is) sufficient to cause depression in and of themselves. It is now becoming increasingly clear that the environment plays a crucial role, particularly, the perinatal environment. In this review, we posit that early environmental stress triggers a series of epigenetic mechanisms that adapt the genome and program the HPA axis and 5-HT system for survival in a harsh environment. We focus on DNA methylation as it is the most stable epigenetic mark. Given that DNA methylation patterns are in large part set within the perinatal period, long- term gene expression programming by DNA methylation is especially vulnerable to environmental insults during this period. We discuss specific examples of genes in the 5-HT system (serotonin transporter) and HPA axis (glucocorticoid receptor and arginine vasopressin enhancer) whose DNA methylation state is associated with early life experience and may potentially lead to depression vulnerability. We conclude with a discussion on the relevance of studying epigenetic mechanisms in peripheral tissue as a proxy for those occurring in the human brain and suggest avenues for future research.”
It seems that the fastest changes in methylation occur early in our lives, at the very least in the neonatal period, though this thesis is subject to further study. What is important now is that certain genes which should not be silenced, are. Thus, certain means of expression are suppressed, which is often the case in depression. None of this means that methylation “causes” the affliction but rather, there are adverse events very early in life that increase its production.

Though the Canadian researchers emphasize the perinatal period, we have found the imprint to lie earlier, as well. If the neonate is especially sensitive to environment insults, it surely is possible that those insults can occur earlier and form the primordial imprint that later gives rise to depression. Methylation, in brief, offers the primordial event that sets the prototype for later inhibition and repression; thus, high methylation may be a predictor for later depression. It means that certain key genes which should find expression are silenced, especially due to modification of the genes promoter region. The tendencies for no or difficult expression are imprinted.

My opinion is that some of these changes in physiology occur during our life in the womb, when the set-points of so many hormones are being established, including thyroid hormone. Indeed if we give a small does of thyroid medication to depressive patients there is a transient improvement. One may think that such deficiencies are genetic but there are events that can cause them that are not always obvious. They are only obvious when the patient in therapy descends down to the far reaches of the unconscious where the crucial explanation of one’s depression lies. One again relives the birth experience, the suffocation, strangulation, the hopeless battle to get out – the unutterable and ineffable despair. Of course, it is not given a name until years later but the feeling is there engraved in the nervous system. We can feel hopeless without giving it a label. In the face of adult adversity, the old imprint – wanting to give up – appears and is now called depression.

We give it that name because we have not seen the generating sources of deep imprinted despair, something we have observed many times. We name it depression because we do not know the hopelessness inside that makes us miserable. We give depression the name of the defense instead of its cause – pain.

Thursday, November 21, 2013

What is Primal Therapy?

I decided to write this because recently there has been an influx of patients from so-called primal therapists, and without exception they have been damaged. Patients have gone to professionals with all the credentials who have advertised primal and claim to know how to do it. Since it takes years to learn, they just borrow the term Primal and use it to deceive prospective patients. Sometimes it is former patients who think they know enough. Most often it is strangers who read the Primal Scream and decided to go into practice. In any case, we have spent some 47 years refining the theory and therapy, joining it with biochemistry and neurology to make it as scientific and efficient as possible. It is at least a complex matter that embodies science as its base.

There is a case this week that set my hair on fire. There are several primal centers in Europe who claim to be doing Primal Therapy. One Center took a woman who was feeling somewhat hopeless, plunged her into first line abruptly and drove her straight into parasympathetic overload and then deep depression. She left their place in pieces and no one there had any idea what was going on and or what to do about it. Then they say, “there is nothing more we can do for you.”

 It happens a lot that they open up the person to far too much pain, flood them and inundate them and then do not know what to do. There all manner of deviations possible and there all manner of unscrupulous individuals who use our term, Primal, to deceive others who are suffering. The proof lies before us every day in the wrecks who come to us from so-called primal therapists.

I know that is often more convenient to go to someone nearby especially if they are in a foreign country but it is your life you are compromising. I have never known any one of these mock therapists to do research, to follow up on their work or to do vital sign research on patients. So here is what to watch out for.

  1. The whole reason for Primal Therapy was to counter the 50 minute hour and let patients stay as long as the need to. So the first thing the mock therapists is to do one hour sessions. That defeats the whole idea of feelings guiding the therapy. There must be no timetable for it.

  2. The mock therapists eliminate doing group therapy, which are essential to getting patients together, to learn about feelings and interact with others and see what feelings look like. Patients help each other in groups and then learn to buddy and carry on the therapy with each other.

  3.  Because they do not follow evolution they often plunge the patient into deep feelings for which they are not ready. The result is overload and flooding of the brain with too many and too heavy feelings. Or, the patient is ready to go deeper but they are not taken there because the therapist has no idea how to do it.

  4. Mock therapists always guide and control the patient. Telling him or her what to say, how to say it and even force them to speak words when the feelings have no words attached to them. Thus they produce a mélange which confuses the patient all the more.

  5. They tell the patient when to come, how often and how long to stay, which should be the province of the patient not the doctor; oh yes, don’t be fooled many of these therapists can be licensed, are doctors, with all the accouterments of professionals. All they lack is knowledge and a bit of humility. They never know their limits and they figure since we do it why can’t they? The “we” in this case is me and my team who work relentlessly refining what we do.

  6. The mock therapists do not have medical controls so they may treat something neurologic as something psychological; the patient suffers. They need a wide ranging background to sort out what is wrong with the patient before embarking on therapy. I wonder how many of them actually have the knowledge. We had a case recently of brain impairment which was previously treated as something psychological, and left a damaged individual in its wake. The human mind is not for dilettantes. Once derailed the patients may take years to make up for what was done to them.

  7. The ways of detours and derailment is infinite. Often done by well meaning therapists, and just as often done by those who see commercial value in it. It has become the “flavor of the month.” I would very much to be democratic and leave the way open for other therapists but our experience up to now has been disappointing. There may be some who sit for patients and give them a good environment in which to feel but I have not seen it.

  8. The danger lies in those who had a bit of training, left too early and hang out shingles saying, “Janov trained.” True, they had some training but Primal Therapy can be dangerous in those with insufficient training. This is especially true when there is no knowledge for how the brain works or should work. I often say that we cannot love neurosis away. No matter and good intentioned there is a precise science to learn.

  9. To my knowledge, not one of those so-called Primal people write and publish in order to further the science of the therapy. Their interest is not the patient; it is commercial. It has become a business not a mental health approach. We have had several peer reviewed articles recently. One in the World Congress of Psychiatry, and another accepted by them for publication. And there are others. I do write books explaining the therapy (in 26 languages) and the science underlying it. Dr. France Janov is now about to finish legacy program detailing what we do, on disc. It is not a secret. We have no desire to keep it for ourselves but we do know that a high level of training is needed, and we do not want therapists to take short cuts that endangers patients’ lives. They would be taking short cuts on the patients’ health.

  10. Primal Therapy should not be practiced alone. There are feelings in all of us that when they come up can derail judgment. We need others around to make sure we do not commit systematic errors on patients. Therapists control one another. There are constant staff meetings to make sure every patient is attended to. And training sessions where we advance the therapy and the theory. The whole focus is on bettering what we do for the benefit of the patient.

Monday, November 18, 2013

The Mystery Known as Depression, Part 4/12

Throughout the ages, writers and thinkers have come up with poetic sobriquets to describe depression. Hippocrates called it the "black bile." Susan Sontag famously dubbed it "melancholy minus its charms." For Flaubert, it was simply “the eternal ‘what’s the use?’ ” And in his book The Noonday Demon, Andrew Solomon says “depression is grief out of proportion to circumstance.” (Solomon, 2002) Today, this ancient malady is poised to become the second leading cause of disability through the remainder of this decade, according to a report from the World Health Organization titled “The Global Burden of Disease.” (World Health Organization, 2004) By any name, depression has clearly become a plague among us. From a public health standpoint alone, it behooves us to understand precisely what it is and how to treat it humanely.

People often say they “feel” depressed, but depression is not a feeling. It is a defense against feeling,– against an accumulation of imprinted pain. As such, it is a protective device to keep us unconscious, or rather, to keep the unconscious from becoming conscious. It holds down, via its handmaiden repression, all of the catastrophic feelings and sensations from womb-life, infancy and childhood that, if unleashed from their safe, subconscious stronghold, would threaten the integrity of our conscious awareness. It is the ultimate survival strategy.

Depression is a system-wide state of repression that blankets many feelings. It is the history of the body’s traumatic experience exerting its force. And ultimately, it is the state of repression elevated to a higher level. For this reason, the depressive is chronically awash in suffering because he/she cannot feel those specific, early feelings. The organism seems to say, "Better to feel numb than feel what lies below and go crazy." Thus, the labored movements, feeling flat and unemotional, the lack of energy, and so on; all the feelings adumbrated by my patients at the beginning of my discussion. Any expression – anger, for example – can temporarily ease depression because it lifts repression a bit. But depression is certainly not, as Freud believed, anger turned inward. (Freud, 2005)

A normal person is rarely depressed; he has no backlog of feelings lying unresolved inside. He is open to feel and does not repress unpleasantness. He will be sad when it is appropriate. But sadness is a “now” event, a real feeling related to real situations. Depression is a “then” feeling, unrelated to now. If the young child could feel each and every original imprint, he would not be depressed in his life. The depressive, on the other hand, is stuck in time. He is stuck back in his past whether he is conscious of it or not, so that everything he does is a symbolic portrayal of that past. This means that we are all open to sadness when our defenses give way. To suddenly be out of work, left alone or excluded by one’s friends is most distressing, but depression is quite another matter. We should feel distressed, despairing, unhappy, sad; these are normal reactions. Not so with depression, which has as its kernel a deep hopelessness and helplessness. This is a basic imprint from long ago that can be triggered when one of those adversities occur. This imprint is often set down either during gestation or at birth when there was no escape from the traumatic input, such as a massive dose of anesthetics given to the mother during delivery which, as we shall see, effectively shuts down the baby as well. It is often this hopelessness that is triggered when seemingly not-so-serious events happen and depression occurs.

Feeling down and discouraged in response to losing a job, or breaking up with a mate, or after the death of a loved one, is different from a chronic, interminable depression. The former may be what is commonly known as "grieving" or "bereavement" which lasts for some weeks or a few months. The person has a normal response: gloominess, sadness, crying, feeling terrible, which stops after a time. What happens is that the person is reacting with real feelings. "Sad," for example, is a feeling; depression is not. Depression happens when you don't feel the real feelings. Those feelings agitate the deep brain levels and activate the imprint. The depressive feels all that; the imprint on the move toward conscious/awareness. It never makes it, however, as repression intercedes. But a deep despair and resignation set in, and a feeling of defeat and wanting to give up; and above all, that gloom and doom that is the hallmark of so many depressions. That is the original, precise, imprinted feeling that is trying to push its way into consciousness; it colors and dominates the present. We see the depths of the imprint in a syndrome known as endogenous depression, something that appears without apparent warning, leaving us helplessly deep into its maw. It has been labeled endogenous because until now we did not know where it came from or why. It is so deep that it seems to come from nowhere, but that nowhere/somewhere is deep in the brain.
When external defenses fail or are under attack, what the depressive experiences is the repression, not the feelings themselves. He feels the pressure against those feelings pushing down into his system. That pressure produces effortful speech and movement and total exhaustion so that the depressive has little energy and moves about in slow motion; “my feet are stuck in cement,” as one patient put it. In short he feels the weight of the repression, the ineffable force of keeping feelings down. He does not feel the feelings themselves. Once he does, the depression can begin to lift.

In depression there is the feeling of "heaviness," a lack of energy, which can be so great that even getting out of bed seems like a monumental chore. It makes everything a Herculean job, so that normal tasks such as talking or raising one's arm can become a great effort, even chewing on solid food. There is little or no energy left for enjoyment, pleasure, sexual drive, or any drive, for that matter, other than the wish to find a way to end the suffering.

So the depressive goes to a therapist for help; he/she usually has to be coaxed into it. What he/she gets is encouragement and hope that the therapist will make it all better – someone who will perform magic. He/she wants to be “pulled out” of her state; a symbolic feeling that was there when the original event – birth trauma – was taking place. Someone literally pulling his/her out, breathing life into him/her. The patient’s passivity requires an active, assertive therapist. The therapist becomes his/ her “friend” because he/she has rarely ventured out to make friends. And he/she will willingly take orders and obey his directions. But he/she has to offer hope and encouragement to combat that loss of hope deep down.

Give a depressive a new outlet – a new job, a party or a chance to go shopping – and all of the inner-directed pressure now pours out in manic activity. He will literally “throw himself” into his work. He will be “happy” for those moments when his work will make him happy. What has really happened is that he has found an outlet to release the primal force. Here we see the basis for bipolar or manic-depression. Not a different disease but a different kind of template – hopeless depths followed by manic energy. When repression fails, manic activity sets in. The imprint reflects the same cyclic event that occurred at birth. The person was stuck in what I call the trough and was blocked, then with great effort made it out. The template – down and then up – is played out in the cycle of giving up and trying manically to finish. It is the same energy source but a different way of handling it. So we can see that some of us shut down early in life and, lacking outlets, we become “dead,” globally and emotionally shut down. Others shut down and “act” alive. If being the “happy clown” pleases one’s parents, then the act will continue. Among the professional comedians I have treated this was never truer. I am treating a depressive now whose mother was chronically ill; he became funny to try to cheer her up. Though it never worked for long, it became a habitual pattern. His need? A happy mother who could love him. Take away the chances to please and the lurking sadness will begin to ascend. If one was disliked, suppressed, and rejected at every turn, then deadness and depression will be reinforced. How we develop depends on later life circumstance: Were the parents loving? Were they not tyrannical? Could they allow free expression? If there were free expression and lots of touch, then the imprint will be kept at bay because it was not compounded, but it will never go away until relived and connected.

Wednesday, November 13, 2013

The Mystery Known as Depression, Part 3/12


To understand how it is possible to trace the causes of a lifelong illness – and its cure – to the very beginning of a person’s life, I must explain my view of the three levels of consciousness.
We basically have three brains in one as MacLean (1985, 1990) already proposed in 1960s: the brainstem, the limbic system, and the neocortex, each representing different stages of evolution, from shark, chimp to human brain, respectively. These neurologic stages of brain growth correspond to three distinct levels of consciousness: the earliest, pre-verbal stage of infancy, followed by childhood and finally present-day awareness. At each level of brain development, we have specific needs that must be fulfilled uniquely. The earlier the needs the more lasting the consequences when they are not fulfilled, and the more grave the imprint. In infancy, we have a need to be touched and nurtured tenderly. On the second line, we seek fulfillment of emotional needs: to be listened to, to feel secure and supported, to get an empathetic response to our hurts and fears. And the third level involves intellectual stimulation, communication and understanding by the parents. Fulfillment on this level can lead to clear and logical thinking; to an accuracy of perceptions.

3.1. First Line – The Brainstem
The first level, the brainstem, is a primitive or reptilian brain, which is our oldest brain system (MacLean, 1990). The brainstem was the first to evolve, and the first part of the central nervous system to develop in human evolution. It seems that we never lost that part. We just added new brain tissue on top of it. The brainstem deals with instincts, basic needs, survival functions, sleep, and basic processes that keep us alive such as body temperature, blood pressure, heart rate and very deep breathing. At this level, we can store a carrying mother’s depression, anxiety, stress, drug-taking, smoking, or drinking. Mother can also communicate, through her changing hormones, her unconscious rejection of her coming baby, which then becomes stored in the baby’s brainstem. Such experience is not stored as ideas, obviously, since we don’t yet have a neocortex, the thinking, intellectual, comprehending mind. But what is important is that the imprints in this storehouse will later motivate certain thoughts and aberrations of thinking. The brainstem imprints the deepest levels of pain because it is developed during gestation and handles life-and-death matters before we see the light of day.

3.2. Second Line: The Limbic/Feeling System
The second level of consciousness is basically the limbic system of the brain (and its affiliates), which is responsible for feelings and their memory (MacLean, 1990). It provides images and artistic output, processes certain aspects of sexuality, and is partly responsible for anger and fear. The limbic system possesses some key structures which affect brain function. They are the hypothalamus and thalamus; the hippocampus, which is the guardian of emotional memory; and the amygdala.
The hippocampus contains the archives of early experience, particularly trauma, and also puts a damper on amygdala activation so that our reactions themselves do not become a danger; after all, continually high blood pressure and heart rate will threaten our existence. The hippocampus has a high density of stress hormone receptors and is therefore quite sensitive to stress. The context of a feeling is predominantly organized by the hippocampus. It gives us an anchor for our feelings—a time and place—and allows us to connect to our feelings.

The amygdala is one of the most ancient structures of the brain and the oldest structure of the limbic system. It is the hub of the emotional system; the gateway to feelings. It gives us the sensation behind feeling, while the later developing hippocampus registers those feelings as facts. Early traumatic memory is consolidated by the amygdala. Luckily, when the going gets rough, it can help manufacture its own opium to hold back pain. In this way it helps us remain unconscious. It is truly a wonder that this small brain structure “knows” when to stop pain and can release a poppy derivative to help. More, it tells other brain structures about how much to release and when to stop.

The hypothalamus works with the lower structure, the pituitary, to govern the release of key hormones, not the least of which are the stress hormones. When we have strong emotions, it is the hypothalamus that organizes our response. (Within the hypothalamus lie two different kinds of nervous systems, the sympathetic and parasympathetic, which are key to understanding depression and are discussed in detail below.)

The thalamus is the central switchboard of the brain, relaying certain aspects of feeling to the frontal cortex. It can decide a feeling is too powerful to be felt and orders that the message not be relayed, and thus kept from awareness. The thalamus talks straight neurochemical talk, a language that expresses itself wordlessly. Yet it can translate painful messages into something understandable by the frontal cortex. If the pain is too much, the message that arrives is garbled. If it is acceptable, the gates open and the message is clearly understood – we know what we feel.

3.3. The Third Line: The Neocortex
The third line is the neocortex, the part of our brain that was the last to evolve and the one responsible for intellectual functioning, generating ideas and thinking (MacLean, 1990). The left pre-frontal area deals with the external world, helps us repress and, when able, to integrate feelings. It comes online at about the third year of life. The frontal cortex is part of the feeling system to the degree that it gives meaning and understanding to our physiologic- emotional reactions. The neocortex serves as a portal for entry into the suffering component of memory, a portal that cannot operate by itself. It’s the first door we walk through toward retracing our history and understanding our pain.

We can be fulfilled or deprived on any of these levels; when deprivation occurs so does pain, as the lack of fulfillment means that the integrity of the system is threatened. And pain is most often accompanied by its counterpart, repression. Fulfillment is more serious and urgent as we descend down the neuraxis on what I call the chain-of-pain. Indeed our biology dictates that deep pain elicits strong repression, to keep the pain at manageable levels. Heavy repression on the first line can mean a deadness of affect, a lack of good interconnection to bodily function so that sex is problematic and appetite is dulled; there is a lack of energy and passion. Symptoms on the first line include ulcers, colitis, and breathing problems. Symptoms on higher levels have different manifestations; the inability to make a decision, to be independent and forthright and to be aggressive.

This is simply a brief overview of the three levels in order to better understand the origins of depression and its therapy. If we consider that those ancient brains are still active in our head, the nature of the problem becomes clearer. All three brains should work in harmony throughout our lives. How they all get along is paramount. We need clear channels among the levels; otherwise there is distortion. Early trauma, however, creates a lifelong disharmony and disconnection among brain levels, resulting in many forms of mental illness. Essentially, neurosis is driven by lower brain centers that are trying to communicate to higher ones but are unable because a disconnection has occurred, a disconnection caused by the imprint of an early lack of love that spells hopelessness and helplessness. The goal of therapy is to restore that harmony, neurologically and psychologically, because consciousness (not to be confused with awareness) means all three levels working fluidly.

Saturday, November 9, 2013

How Womb Life Shapes Us

 There is a recent experiment that throws light on this subject. Babies can learn a musical melody while still in the womb.  They recognize it after they are born.  They took two groups of babies, testing them at birth and again at four months.  The tests were of brain responses. They were greater in those who recognized the tune.  And it was equally true at four months of age.  One key conclusion by the authors was that, “ a baby can be relaxed and soothed by melodies it hears before birth.” Obvious.  But the neurotic mother’s metabolism also plays a tune, a fast or erratic one.  And that baby is not longer soothed; rather, she is galvanized.  Or confused, or dazed. And this state is imprinted in the same way that she is soothed with nursery rhymes.  (twinkle twinkle little star).  (see Eino Partanen, University of Helsinki,  Finland).

Here is what makes early life so important; experiences can be engraved for life.  They stick and they guide behavior thereafter. They make us open as individuals or closed as personality traits.

 The point is that we start learning long before we think we start learning.  Yes, it is a nursery rhyme, but any key experience affects us for a very long time.  Long before we can say, “Oh yes, I remember when my daddy came home drunk and beat us!”  These are things of instincts, primordial memories that have no words, yet shape us ineluctably as any later trauma; more-so, because very early experience is stamped in with a force that is often powerful because it is stamped in to a vulnerable, naïve soul that has little previous experience to fall back on.  There is no reservoir of perceptions that help establish a frame of reference to make sense of things.

The experience joins in the a-perceptive mass which helps form an orientation to life that ultimately shapes one’s attitudes, interests and perceptions.  Later when we are asked what made you think that,? there are childhood experiences we can evoke but also many pre-birth experiences of which we are unaware.  These join into the ensemble of experience that form us. And these are the experiences that psychotherapy ignores systematically.  How can we know what drives us when we ignore life in the womb there the mother is severely depressed or takes heavy duty painkillers?  How can we know about terror and anxiety in a patient when we ignore a father who left home when the fetus was seven months? Or neglect to take into account a severe auto accident where the mother was pinned against the seat and the baby petrified?  We ignore this because we do not know about the imprint of experience and how it endures perhaps for lifetime.  We do not “grow out” of experience; we grow into them.

If we do not understand our malleability early on or how the brain changes all along the nine months of pregnancy we can’t hope to figure out endogenous depression at age thirty.  Those early experiences are still part of us and guide behavior.  So when a therapist says “I focus on behavior and try to make the patient take a healthier more wholesome attitude,” we know she is missing out.  She is missing out on causative factors that are alive and well inside of us.  And when we address the imprint we make real profound changes in the patient as he relives those central imprints.  It is supporting evidence that the traumatic event lives on. Otherwise, obviously there would be no change.

Now we see why some of us suffer endogenous depression.  Children whose mothers were depressed while carrying are more likely to have depressed offspring. (major work done at Bristol University, England who studied 8000 depressed mothers. Also see the work and comments of prof. Carmine Pariante of King’s College, London Institute of Psychiatry, Published in JAMA Psychiatry 2013,).
These studies are part of current science that should affect our practices.  We need to investigate birth weight in our patients because recent studies point to birth weight as affecting how long we live and the rapidity of aging.  (International J. of Epidemiology. 2013).

I don’t want to drown the fish but I do want to underline what we as therapists must do to be effective and help patients:  read the scientific literature.  That is our key responsibility.    We don’t want to rely on the writings of Freud or Jung from one hundred years ago. There is a new science out that we must adhere to.

What is uplifting about this research is that those nursery rhymes can still play in our minds as we mature.  We carry around that relaxation as an imprinted memory, maybe for all of our lives.

Friday, November 8, 2013

The Mystery Known as Depression, Part 2/12


Let me begin by proffering my definition of depression, and how it is understood within the paradigm of Primal Therapy. One caveat before proceeding: Our understanding of depression arises from an observational, not statistical, perspective. Ours is basically an empirical science; wanting to know rather than knowing what we want. What I describe has been seen in hundreds of our patients over 45 years. It is a new paradigm, a departure from the conventional notions of depression. If we try to understand it within the old frame of reference we will fail. Depression has its roots in the earliest moments of a patient’s life, during gestation and birth. Since first espousing these theories more than four decades ago, advancements in brain research have offered mounting evidence to support our theory about the role of early trauma in causing mental illness. What is still difficult to accept by some is our assertion that reliving those traumatic experiences, including birth, is the way to reverse depression. In this sense, exploring the mind has been a little like exploring the world to prove it is round; it often can’t be believed until somebody actually makes the journey. In the development of our therapy, we have made no a priori assumptions in our observations. From the beginning, we have always let ourselves be guided by one unassailable truth – the experience of our patients.
Not long ago, a group of my depressive patients met to discuss their problems and the overwhelming pain that surrounds them. As they talked it became apparent that there were numerous things they had in common. Looking back at the experience of their lives, they identified certain symptoms and tendencies in their feelings and behavior, including:

. A feeling of constant suffering
· Difficulty concentrating
· Extreme fatigue
· Immobilized and paralyzed
· Feeling helpless to change a situation
· An inability to talk
· Lack of energy
· Can’t move, enclosed, stuck in a dark abyss
· Not being able to find anything to live for
· A monotonous, inner deadness
· Feeling that nothing is going to change
· Something wants out
· An inability to feel pleasure.
· Unable to make a decision, or make something stop
· Numbness and ponderous, labored movements
· Recurrence of a wish to die
· Sense of isolation
· Falling into a black hole
· Not getting anywhere
· An overall heaviness or deadness
· An effort to breathe or even lift an arm
· Not interested in anything
. No sexual interest
· Despair, resignation and wanting to give up
· What’s the use of living? Don’t want to go onlike this

This group of “symptoms” is based on my experience with my depressives describing their own general condition. But in addition, what these patients have come to realize, however, is that they were describing the sensations of a birth trauma, the common denominator of their communal experience. No one suggested this in any way because we would not have known what to suggest.
If we were to overlay a transparency illustrating the characteristics of depression over one showing the effects of the birth trauma, we would find that they match perfectly. Everything a person felt during the birth trauma back then is reflected in the description of her current depression. Clear examples are contained in the list of depressive symptoms enumerated by my group of patients; they are expressing exactly what they felt as infants being born. The traumas set down in the womb, at birth and during infancy are coded, registered and stored in the nervous system. They become a template for what happens later.

Tuesday, November 5, 2013

Stress in the Womb and How it Lasts Forever

There is current research so important that all I can do is bow down and genuflect before it. It is research that supports my theories developed over forty years ago; but there is more. There are two studies , one from Germany (Hans Berger, Clinic for Neurology at the University Hospital), and the other is from the Netherlands, (Tiburg University).

In the Berger study; it was done on sheep because their pregnancy development is very close to humans. The parent animals were injected with a stress hormone, an analogue of cortisol. In premature fetuses it offers a better chance at life, helping the development of the lungs. This also increased the development of the brain, as well. One offshoot of this research was the finding that this alone, stress, alters sleep patterns perhaps for a lifetime. So if we want to know why we cannot sleep we need to look to the gestation period, but let us not look to shots of cortisol given to the mother; let’s look to the stress the carrying mother undergoes that operates just as if she were given a shot of cortisol. So if we have trouble sleeping now because the mother was stressed while pregnant. And by the way, if she drank many cokes, or coffee, or if she injected or snorted cocaine we have the same result; her system acts if stressed.

The researchers called this fragmentation of sleep patterns which also occurs in depression; and no surprise, there are serious sleep disturbances in depression. In other words, during gestation the mother may stamp in tendencies to depression in the offspring. This can last a lifetime.

In an unpublished but reported study it was found that in research on 40 eight year old children who were given cortisol-like medication during womb-life, they did much worse on key indices of behavior than normals. Their IQ was lower and so was their concentration and attention span. Again, when we look at ADD in children we must look at this research. Attention Deficit is above all, a distraction in brain processes that may come from major input very early in life. That input from a hyper, revved up mother, is far too much for the baby who is over-activated. The hyper-activation is impressed in the brain of the offspring, and so keeps the baby’s brain over-stimulated. He can no longer easily focus on one thing when so much is going on in his brain. Those early experiences form an indelible imprint for life. That imprint is never inert. It activates and re-activates and keeps us unable to relax, which was the case with the children. Investigators say they were programmed in the womb to release more stress hormones throughout their lives.

In the Tilburg Study they found that maternal stress between the 12th and 22nd week affected the later emotional and cognitive functions for twenty years later. So to reiterate, as if it needed reiterating, womb-life is critical for all later life, not the least of which is the advent of depression. They go on to say, “increased levels of stress hormones in the baby in the womb …play a larger role in the (later) development of disease than previously thought.”

It is not only about obvious physical afflictions but also about serious emotional problems, depression and anxiety. This again adds support to what I have written about. These scientists found the residue of stress hormones in the brains of the unborn. These means: 1. They could be under stress during womb-life, and 2. That the stress endures for a very long time. 3. This stress foretells of impaired functioning later on and possibly the beginnings of mental illness. 4. The damage can be permanent so that high blood pressure, heart disease, and in my opinion, Alzheimer’s disease can result.

It took a while for this research to appear, but how nice to see it.

Sunday, November 3, 2013

The Mystery Known as Depression, Part 1/12

This is the first of a series of articles I wrote on Depression. The whole article has been published by ANS: The Journal for NeuroCognitive Research in October 2013. To see the full text:

Depression has been considered a mysterious ‘monster,’ even in professional circles where it is still deemed an enigmatic illness.
The condition has proven so resistant to treatment that one therapeutic approach, based on cognitive-behavioral principles, calls itself “Taming the BEAST,” an anagram for “treatment modules” in Biology, Emotions, Activity, Situations and Thoughts. (Gilson & Freeman, 1999) Today, however, the most common treatment strategy is also the simplest. It involves the use of antidepressants, now the third most widely prescribed type of drug in the country, often administered by general practitioners untrained in psychology. (Mojtabai & Olfson, 2011) When neither drugs nor therapy are effective, some psychiatrists resort to that holdover from horror movies, electro-shock therapy, which is gaining renewed acceptance under a different moniker, electroconvulsive therapy (ECT).

Until recently, ECT was considered the last resort in the battle against the beast; it was used when psychiatrists concluded that the only option left was to blast the patient’s brain with electrical energy. Now, psychiatrists have gone beyond applying shocks from outside the skull and have opted for an even more radical alternative – brain surgery. (Mayberg et al., 2005) To say the least, it is a most drastic attempt at a solution. The procedure – known as deep brain stimulation (DBS) – involves drilling four holes in the brain with screws inserted into the skull. Surgeons then plant electrodes near the center of the brain in a region called Area 25, part of the subcallosal cingulate gyrus which has been identified as a having a key role in major depression. Activated by a pacemaker in the chest, the devices emit a steady stream of electric pulses to stimulate the area, thereby easing the otherwise entrenched symptoms.
Suppose, however, that we could access deep brain centers without any physical or chemical intervention and make alterations in the circuit – perhaps even rewire it – in a natural way. I submit that Primal Therapy does just that. It is possible to found a natural, non-invasive way to access the same deep brain structures that are affected by surgery and/or tranquilizers. And my opinion is that it is possible to successfully treat many deep depressions, and measure results through brainwaves and biochemistry. (For a detailed discussion, please see my book, Why You Get Sick and How You Get Well: The Healing Power of Feelings. [Janov, 1996]) By finding this psychotherapeutic avenue to the affected brain areas, we can avoid many misdirected approaches, especially the risky use of surgery and heavy drugs. Certainly, natural feeling methods are to be chosen over a serious brain surgery.

It is not that depression is refractory to psychotherapy. It is that psychotherapy is refractory to depression. In its current state, psychotherapy in many of its approaches is too superficial to change anything profoundly. It isn’t that depression cannot be touched by therapy because it is such a serious and unfathomable affliction; it is that conventional therapy is not designed to probe the depths of the unconscious where generating sources lie. And today it seems that the only way conventional therapists can get to those deep-lying imprints is through surgery or jolts of electricity. (The crucial concept of the imprint and its corollary, resonance, the gateway to deep brain levels, is explored in detail below.)

The reason we, as a profession, have had to resort to such drastic and dangerous measures is because most treatments thus far have addressed the neocortex; actually, the front left tip of the neo-cortex, the prefrontal area. Since clinical approaches such as talk therapy and behavior modification concentrate on the cognitive part of the brain, they may neglect the source and the site of the real problem. The success of the surgery itself, with some 80 percent of patients reporting their depression lifted, should tell psychotherapists that the site of the problem may lie deeper. The most serious cases are rightly referred to as “deep” depressions because the problem often emanates from the antipodes of the brain. To be clear, my opinion is that a psychotherapy for depression that fails to probe the depths of the brain, the depths of the unconscious, cannot be successful. The generating source remains untouched.
Diagnosis in psychotherapy too often is a matter of nomenclature, one that may not accord with neurology and the body that houses it.Conventional diagnosis is often symptom-based, focused on external signs – labored movements, lack of interest, and a bewildering array of other symptoms detailed below – while ignoring root causes. I propose a diagnosis, however, that encompasses the system as a whole – neurobiology, behavior and psychology as an ensemble, an integrated view.

Some leaders in the field acknowledge that psychology as a profession is in need of a radical overhaul. The debate about the confounding state of psychotherapy seems to escalate with every new edition of the Diagnostic and Statistical Manual of Mental Disorders (D.S.M.), considered the bible of mental illness and treatment. This year, on the eve of the publication of the D.S.M.-5, the first revision in almost 20 years, the calls for a whole new way of thinking in psychology seem more urgent than ever. On both sides of the Atlantic, there have been recent calls for a complete paradigm shift in the way we understand and treat mental illness.
In a prepared statement on the eve of the D.S.M.-5’s release, the British Psychological Association stated it was unhelpful to see mental health issues as illnesses with biological causes. "On the contrary, there is now overwhelming evidence that people break down as a result of a complex mix of social and psychological circumstances – bereavement and loss, poverty and discrimination, trauma and abuse," stated Dr. Lucy Johnstone, a clinical psychologist who helped draft the association’s provocative statement. (Doward, 2013) Meanwhile in the U.S., Dr. Thomas Insel, director of the National Institute of Mental Health, based near Washington, D.C., states that there can be no progress in the field so long as we continue to use the D.S.M. as our guidebook. He claims it leaves out the complexities of neuroscience, biology and genetics. The manual is even counterproductive, he argues, because it is used to deny funding to researchers looking for the real causes behind afflictions such as psychosis and depression, simply because their research proposals cut across the D.S.M.’s outdated categories. “Dr. Insel is one of a growing number of scientists who think that the field needs an entirely new paradigm for understanding mental disorders,” concludes a recent New York Times article about the controversial manual, “though neither he nor anyone else knows exactly what it will look like.” (Belluck & Carey, 2013)

According to my view the last part of that statement is fully true, the paradigm already exists. I am not a lone voice in the wilderness, but my opinion based on my experience and four decades of work is that for example “Primal Therapy”, that was in focus of my work and experience is one of them that offers precisely the new paradigm that is needed in modern psychology. But as with all new revolutionary theories in science, the status quo is slow to recognize fundamental changes in any field, and loathe to adopt them. (See the article by Agustin Gurza on Primal Therapy and scientific revolutions, originally published in the Journal of Primal Therapy (Gurza, 1976) and more recently posted online as an appendix to my book, “Grand Delusions.”(Gurza, 2005) What this paper seeks to address is precisely that paradigm shift, probing for causes and generating sources that have been neglected in our work. I agree that we need to reorient our field and provide a new understanding of mental illness, which I take as my task. What I am proposing is a total paradigm shift not only in our view of this affliction but also its treatment. We need to reframe our thinking about it, and recognize that what is missing is the "why?" We need to ask: What is depression, and where does it come from? Why is the patient depressed?

Since I first published The Primal Scream: The Cure for Neurosis in 1970, the subtitle became the lightening rod for criticism because we used the term “cure.” Nobody dares speak of curing mental illness. Yet the issue seems to be a double-bind. We utilize therapies that cannot cure, and then look askance at those who claim to have found one. “Cure” is not an opprobrious term. What is opprobrious is that we have given up on proper therapy and made it an unacceptable word. “Cure” is not a term to be avoided in the interest of pure science; it is a state to be sought after assiduously. We owe it to the millions who suffer from depression with no real hope of finding their way out of the darkness.

Depression has been a mystery for a long time because we have ignored the connection between a patient’s current mental and physical health and long-ago imprinted traumas experienced in childhood but also in the womb and at birth. That left us with a narrow range of choices: either drug the patient or operate on him. Preferably, we need to help him plunge deep into that unconscious. We need to help the patient find the nexus between his current state of depression and its deep-lying sources. Only the patient can make that connection inside himself; our task is to help him gain access to those deeper levels of brain function.
History will provide us with the answer; history is the cause and history is the savior.

Review of "Beyond Belief"

This thought-provoking and important book shows how people are drawn toward dangerous beliefs.
“Belief can manifest itself in world-changing ways—and did, in some of history’s ugliest moments, from the rise of Adolf Hitler to the Jonestown mass suicide in 1979. Arthur Janov, a renowned psychologist who penned The Primal Scream, fearlessly tackles the subject of why and how strong believers willingly embrace even the most deranged leaders.
Beyond Belief begins with a lucid explanation of belief systems that, writes Janov, “are maps, something to help us navigate through life more effectively.” While belief systems are not presented as inherently bad, the author concentrates not just on why people adopt belief systems, but why “alienated individuals” in particular seek out “belief systems on the fringes.” The result is a book that is both illuminating and sobering. It explores, for example, how a strongly-held belief can lead radical Islamist jihadists to murder others in suicide acts. Janov writes, “I believe if people had more love in this life, they would not be so anxious to end it in favor of some imaginary existence.”
One of the most compelling aspects of Beyond Belief is the author’s liberal use of case studies, most of which are related in the first person by individuals whose lives were dramatically affected by their involvement in cults. These stories offer an exceptional perspective on the manner in which belief systems can take hold and shape one’s experiences. Joan’s tale, for instance, both engaging and disturbing, describes what it was like to join the Hare Krishnas. Even though she left the sect, observing that participants “are stunted in spiritual awareness,” Joan considers returning someday because “there’s a certain protection there.”
Janov’s great insight into cultish leaders is particularly interesting; he believes such people have had childhoods in which they were “rejected and unloved,” because “only unloved people want to become the wise man or woman (although it is usually male) imparting words of wisdom to others.” This is just one reason why Beyond Belief is such a thought-provoking, important book.”
Barry Silverstein, Freelance Writer

Quotes for "Life Before Birth"

“Life Before Birth is a thrilling journey of discovery, a real joy to read. Janov writes like no one else on the human mind—engaging, brilliant, passionate, and honest.
He 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 . . . He presents a brand-new approach to dealing with depression, emotional pain, anxiety, and addiction.”
Paul Thompson, PhD, Professor of Neurology, UCLA School of Medicine

Art Janov, one of the pioneers of fetal and early infant experiences and future mental health issues, offers a robust vision of how the earliest traumas of life can percolate through the brains, minds and lives of individuals. He focuses on both the shifting tides of brain emotional systems and the life-long consequences that can result, as well as the novel interventions, and clinical understanding, that need to be implemented in order to bring about the brain-mind changes that can restore affective equanimity. The transitions from feelings of persistent affective turmoil to psychological wholeness, requires both an understanding of the brain changes and a therapist that can work with the affective mind at primary-process levels. Life Before Birth, is a manifesto that provides a robust argument for increasing attention to the neuro-mental lives of fetuses and infants, and the widespread ramifications on mental health if we do not. 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.
Jaak Panksepp, Ph.D.
Bailey Endowed Chair of Animal Well Being Science
Washington State University

Dr. Janov’s essential insight—that our earliest experiences strongly influence later well being—is no longer in doubt. Thanks to advances in neuroscience, immunology, and epigenetics, we can now see some of the mechanisms of action at the heart of these developmental processes. His long-held belief that the brain, human development, and psychological well being need to studied in the context of evolution—from the brainstem up—now lies at the heart of the integration of neuroscience and psychotherapy.
Grounded in these two principles, Dr. Janov continues to explore the lifelong impact of prenatal, birth, and early experiences on our brains and minds. Simultaneously “old school” and revolutionary, he synthesizes traditional psychodynamic theories with cutting-edge science while consistently highlighting the limitations of a strict, “top-down” talking cure. Whether or not you agree with his philosophical assumptions, therapeutic practices, or theoretical conclusions, I promise you an interesting and thought-provoking journey.
Lou Cozolino, PsyD, Professor of Psychology, Pepperdine University

In Life Before Birth Dr. Arthur Janov illuminates the sources of much that happens during life after birth. Lucidly, the pioneer of primal therapy provides the scientific rationale for treatments that take us through our original, non-verbal memories—to essential depths of experience that the superficial cognitive-behavioral modalities currently in fashion cannot possibly touch, let alone transform.
Gabor Maté MD, author of In The Realm of Hungry Ghosts: Close Encounters With Addiction

An expansive analysis! This book attempts to explain the impact of critical developmental windows in the past, implores us to improve the lives of pregnant women in the present, and has implications for understanding our children, ourselves, and our collective future. I’m not sure whether primal therapy works or not, but it certainly deserves systematic testing in well-designed, assessor-blinded, randomized controlled clinical trials.
K.J.S. Anand, MBBS, D. Phil, FAACP, FCCM, FRCPCH, Professor of Pediatrics, Anesthesiology, Anatomy & Neurobiology, Senior Scholar, Center for Excellence in Faith and Health, Methodist Le Bonheur Healthcare System

A baby's brain grows more while in the womb than at any time in a child's life. Life Before Birth: The Hidden Script That Rules Our Lives is a valuable guide to creating healthier babies and offers insight into healing our early primal wounds. Dr. Janov integrates the most recent scientific research about prenatal development with the psychobiological reality that these early experiences do cast a long shadow over our entire lifespan. With a wealth of experience and a history of successful psychotherapeutic treatment, Dr. Janov is well positioned to speak with clarity and precision on a topic that remains critically important.
Paula Thomson, PsyD, Associate Professor, California State University, Northridge & Professor Emeritus, York University

"I am enthralled.
Dr. Janov has crafted a compelling and prophetic opus that could rightly dictate
PhD thesis topics for decades to come. Devoid of any "New Age" pseudoscience,
this work never strays from scientific orthodoxy and yet is perfectly accessible and
downright fascinating to any lay person interested in the mysteries of the human psyche."
Dr. Bernard Park, MD, MPH

His new book “Life Before Birth: The Hidden Script that Rules Our Lives” shows that primal therapy, the lower-brain therapeutic method popularized in the 1970’s international bestseller “Primal Scream” and his early work with John Lennon, may help alleviate depression and anxiety disorders, normalize blood pressure and serotonin levels, and improve the functioning of the immune system.
One of the book’s most intriguing theories is that fetal imprinting, an evolutionary strategy to prepare children to cope with life, establishes a permanent set-point in a child's physiology. Baby's born to mothers highly anxious during pregnancy, whether from war, natural disasters, failed marriages, or other stressful life conditions, may thus be prone to mental illness and brain dysfunction later in life. Early traumatic events such as low oxygen at birth, painkillers and antidepressants administered to the mother during pregnancy, poor maternal nutrition, and a lack of parental affection in the first years of life may compound the effect.
In making the case for a brand-new, unified field theory of psychotherapy, Dr. Janov weaves together the evolutionary theories of Jean Baptiste Larmarck, the fetal development studies of Vivette Glover and K.J.S. Anand, and fascinating new research by the psychiatrist Elissa Epel suggesting that telomeres—a region of repetitive DNA critical in predicting life expectancy—may be significantly altered during pregnancy.
After explaining how hormonal and neurologic processes in the womb provide a blueprint for later mental illness and disease, Dr. Janov charts a revolutionary new course for psychotherapy. He provides a sharp critique of cognitive behavioral therapy, psychoanalysis, and other popular “talk therapy” models for treating addiction and mental illness, which he argues do not reach the limbic system and brainstem, where the effects of early trauma are registered in the nervous system.
“Life Before Birth: The Hidden Script that Rules Our Lives” is scheduled to be published by NTI Upstream in October 2011, and has tremendous implications for the future of modern psychology, pediatrics, pregnancy, and women’s health.