Toward a True Science of Primal Therapy

by Bruce Wilson

What is science? A simple definition is offered by George Orwell in his essay by that name. He defines science is either: “(a) an exact science, such as chemistry, physics, etc. or (b) a method of thought which obtains verifiable results by reasoning logically from observed fact.”

By this simple definition, primal therapy might be defined as a science. Arthur Janov developed his theory through observed facts by watching his patients descend into deep feelings, gain insights, and get better. He then reasoned logically from those facts and developed a therapy that obtained verifiable results. He then went further to find supportive evidence for his theory from physiology and neurobiology, both exact sciences (or close enough to it). Throughout this process, he developed a theory of mental illness based on early life trauma and a conclusion that primal therapy can be the one and only “cure for neurosis.”

Throughout his work, Janov also tried to follow the scientific method, which is required for any study claiming to be a science. The scientific method is derived from the hypothetico-deductive model of inquiry, which occurs roughly as follows:

1. Make an observation.
2. Develop theory about that observation.
3. From the theory, develop a testable hypothesis.
4. Test the hypothesis and observe the results.
5. Use the results to modify your theory and retest. Continue revising and retesting your theory until it becomes robust. This often requires tossing out the original theory.

Applied to primal therapy, this translates as follows:

1. Make an observation: Janov observed his patients regress into deep feelings. This was not new – Freud, Janet, and others had observed it and called it abreaction, but had abandoned it as untherapeutic. But many of Janov’s patients obtained relief and insights after these regressions so he decided to take a deeper look.

2. Make a theory: Borrowing some ideas from Freud, Janov came up with a new theory about human suffering: If the needs of a child go unmet, the result is overwhelming primal pain which the child cannot feel because is so devastating. Thus, the child represses and stores that pain in the brain where it remains in the unconscious. This became the core tenet of primal theory.

3. From the theory, develop a testable hypothesis: If one were allowed to regress into those early memories, primal pain can be felt in small increments and eventually resolved.

4. Test the hypothesis and observe the results. Primal therapy was the test for the hypothesis. According to Janov, most of his patients have became well by doing primal therapy and continue to remain well today.

5. Modify the theory and retest: Primal theory has been refined for more than forty years, and according to Janov, the core theory has held up to the test. However, fetal and perinatal experiences are now recognized as being far more important in creating neurosis than earlier thought.

But something crucial is missing in this process and that is the attempt to falsify your hypothesis, not just seek evidence that support it. This is the gold standard for any scientific process.  A famous essay by physicist Richard Feyman describes difference between good science, bad science, and pseudoscience. Feynman says that in order to do good science…

Details that could throw doubt on your interpretation must be given, if you know them. You must do the best you can—if you know anything at all wrong, or possibly wrong—to explain it. If you make a theory, for example, and advertise it, or put it out, then you must also put down all the facts that disagree with it, as well as those that agree with it….  In summary, the idea is to try to give all of the information to help others to judge the value of your contribution; not just the information that leads to judgment in one particular direction or another.

In other words, you must report your experimental failures as well as your successes. And you must make sure that your successes are truly explained by your hypothesis and not some other factor. You must not become so in love with your hypothesis–no matter how beautiful it is–that you neglect other explanations or observations that don’t support it. You must never jump to conclusions beyond the data, and you must never cherry-pick data that fits your theory and ignore data that refutes it. You must test, test, and test again, always with the attempt to falsify your theory, rather than prove it. You must invite others to try and prove you wrong.

Feynman described this attidute as…

…a specific, extra type of integrity that is not lying, but bending over backwards to show how you are maybe wrong, that you ought to have when acting as a scientist. And this is our responsibility as scientists, certainly to other scientists, and I think to laymen.

So in my mind, for primal therapy to truly be considered a science, those working in the area need to heed Feynman’s advice and do the science right!

There is evidence that conflicts with Janov’s claims. For example, many people do not respond to the therapy and yet we rarely hear of them. Why do they not respond?

And might there be other explanations as to why people get better in primal therapy? Comparative studies of other psychotherapies have shown no significant benefit of one approach over another. In fact, the skill of the therapist and the strength of the therapeutic relationship between therapist and client were more relevant to outcomes. Also, you cannot ignore the fact that the therapist’s and client’s belief in the therapy can have a big effect on outcomes. Also, significant changes in life circumstances (e.g. getting into a relationship, finding secure, well-paid work you like, financial security, etc.) may be more important to getting well than the actual therapy itself.

To anyone who has access to their deep feelings, or who has read Janov’s books and experienced the primal process, it is obvious that Janov has hit upon a fundamental truth about human suffering and its treatment. To these people, primal pain is real and feeling that pain under the guidance of a skilled therapist can lead to enormous relief and healing. For those of us who have received benefit from primal therapy, it is clear that there can be no deep healing without deep feeling. Everything else is personality adjustment. People who do well in primal therapy don’t need science to know it works; they are convinced by their own experience.

By to gain respect in the scientific community, primal therapy must follow the accepted standards of good science. With all due respect to Janov’s deep insights, he fails to recognize this fact and denigrates it the scientific method as a search for “statistical truth” rather than “biological truth.” He writes in Primal Healing…

“..we should not lose track of the overarching truth—feelings are their own validation. We can quote and cite all day long, but the truth ultimately lies in the experience of human beings. Their feelings explain so much that statistical evidence is irrelevant. Cognitive therapy seeks statistical truths to corroborate their hypotheses and theories; these theories are too often intellectual constructs that do need statistical validation. We are after biological truths beyond mathematical facts.”

On one hand, he is right—one cannot fully understand the inner experiences of human beings through scientific analysis. Science can only observe exteriors, such as changes in behavior and physiology, and not the mind itself. Even reports of “I feel better” is an exterior. If one holds to statistical evidence alone with criteria for getting “well” that lack depth, then you’ve missed the mark.

The many studies on cognitive behavioral therapy fit into this category. Changing thoughts and behavior may make you feel better, but for how long? Evidence suggests that CBT often fails over the long-term because it doesn’t address deeper problems. However, CBT fits well with the market-driven view of the human psyche, which values productivity and consumerism over everything. More on this in future posts.

But following what I wrote earlier, you cannot eschew good methodology in making conclusions, and that usually involves gathering statistical evidence in the form of outcome studies. Statistics alone are not the end-all and be-all of explanation—they do not constitute truth, as Janov says. But they are an indispensable tool in the scientist’s tool kit to determine whether or not the results of your testing are true and not the result of wishful thinking. In other words, biological observations may determine your hypothesis, but statistical studies are still the the standard for confirming or rejecting those biological observations.

As yet, we do not know how many people respond to primal therapy and how many don’t, why people respond or not (is it access to feeling? Skill of the therapist?), or how long the results last. What does it mean to be “cured” of neurosis? Testimonials and reports from responders are not enough.

So in answer to the question, “is primal therapy a science?” I would say…not yet. It is more of a protoscience, which Wikipedia defines as, “a fringe science that has limited acceptance in the mainstream scientific community but is nonetheless rooted in established scientific principles and thus has potential for being more widely accepted.”

It is my belief that primal therapy is rooted in established biological principles, especially with regard to affective neuroscience and I hope someone in the primal community who has the required resources decides to give it the scrutiny it deserves.



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2 Replies to “Toward a True Science of Primal Therapy”

  1. Comment to Bruce Wilson’s article, April 22, 2011.
    Thank you for your article ”Toward a True Science of Primal Therapy”. So far, this is among the best comments about P.T.  that I’ve read. I totally agree that PT is possibly a proto science. Arts and Michael Holden’s ambitions to do research and establish a scientific approach unfortunately never took off. (As a neurologist Michael was of great help to me when I came to L.A. I think his scientific approach could have been of much help to Art. So for example, Michael helped me through my first MIR test at UCLA in 1978 when they just had received the newly developed equipment.) 
    I have in my ”Epileptic Journey” a number of times stated that my great luck was not the fact I went to PT but that I embossed my total confidence in Art as my ”personal” therapist over 30 years. His skill and intuition (with many outstanding examples) as a therapist is what in combination with a deep tissue massage to restore the body’s naturalposture and structural integration (Rolfing) took me through sensational healing experiences and almost totally eliminated serious epileptic seizures and neurotic behavior, even if it took very long time due to circumstances of life.
    However, in a group of >10 hopeful people who joined PT in 1978, I was the only one who eventually survived and was successful. A couple of them took their lives. All others died all to early.

    Regards Jan

  2. Great article Bruce! I think the biggest thing needed is a well done outcomes study. Art Janov has a beautiful theory on how and why primal therapy works but that isn’t enough.
    The problem is how a good outcomes study can be done with so few primal therapists out there.
    I wonder if it would be best to focus on a particular problem or type of client which the therapy handles best. That way it could at least be recommended for that particular issue.
    Those of us having done the therapy know that it ends up addressing all kinds of problems we didn’t know we had. Thats good, but people have specific things bothering them and it needs to be proven that the therapy can address those issues.
    That is not necessarily good science, just proving that something has a benefit.

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