The Elements of Primal Theory

by Peter Prontzos

Isaac Newton, one of the most celebrated scientists of all time, once remarked that he could see far because he was, “standing on the shoulders of giants.” In the same way, Arthur Janov’s ground-breaking approach to psychotherapy, primal therapy, combines some of the most important elements of his predecessors while providing a deeper and more complete theory of the healing process.

This became clear to me as I was reading the second edition of Louis Cozolino’s invaluable book, The Neuroscience of Psychotherapy.

For instance, Cozolino writes that Freud’s psychoanalysis and the psychodynamic forms of therapy that grew out of it,

share theoretical assumptions such as the existence of the unconscious, the power of early childhood experiences, and the existence of defenses that distort reality in order to reduce anxiety and enhance coping.

Janov, who originally trained with Freudians, practiced conventional psychotherapy until his work led him to discover what he termed primal pain. In general, this refers to traumas experienced by babies and children which are so painful that the hurt must be dissociated from consciousness. In the more than three decades that followed, he has refined primal therapy as a way to allow patients to connect with these feelings in order for healing to occur.

However, in contrast to Freud’s psychoanalysis and some modern psychodynamic methods, primal therapists do not interpret or explain to a patient what they think he or she is really feeling. They don’t offer insights or speculate about the source of the trauma, nor would they ask a client to do something artificial, such as exaggerated breathing or play acting.

Instead of such arbitrary practices, Janov maintains that patients must discover their own unique truths for themselves, with the therapist acting as a skilled and empathetic witness. This client-centered approach to therapy was pioneered by Carl Rogers in the 1960s. As Cozolino explains, “Rogers emphasized creating a relationship that maximized the individual’s opportunity for self-discovery.”

In the same vein, a primal therapist does not end a session after 50 minutes or some other preset time limit. The patient has as much time as needed, and a session often lasts two hours or more.

A session usually begins by encouraging the patient to get in touch with whatever they are feeling at the moment. That is the real “royal road to the unconscious.” It may be an emotion, a memory, a dream, a song in one’s head, or perhaps a physical sensation. This bodily focus was first used by Wilhelm Reich, who had studied with Freud and who, as Cozolino notes, understood “that memory is stored not just in the brain but throughout the entire body.”

In short, trusting the client to find their own way (with appropriate suggestions from the therapist) is not only the most reliable approach to access deep feelings, but, not surprisingly, is vital to build trust between the client and therapist – an element that is essential for a healing relationship to develop. While Janov does not agree with the belief that the curative element is the therapeutic relationship itself, he stresses that the patient must feel that they are in a safe, supportive, and understanding relationship.

This empathetic situation is the opposite of that which existed when the damage was done, and it allows the client to safely relive the trauma – this time in small doses to avoid retraumatization.

When all of these elements are in place, the patient has the maximum opportunity to make the healing connection between the conscious self and the repressed pain. When the old pain is felt, there may be crying, fist-pounding, trembling – even curling up in a fetal position when reliving a traumatic birth. (After observing Janov’s video of a patient reexperiencing birth, affective neuroscientist Jaak Panksepp observed that such behavior “could not be faked.”)

Janov’s position is that – most of the time – a therapist must allow the patient to go as deeply as he or she needs to in order to make a full connection, and he believes that too many therapies do not let a patient fully descend into their pain. After a deep connection, patients will have insights into why they felt a certain way or acted out neurotically. It takes many sessions before enough of the pain is released so that one is no longer driven by the old feeling.

Like Cozolino, Janov holds that the “primary focus of psychotherapy appears to be the integration of affect, in all its forms, with conscious awareness and cognition.” Not surprisingly, Janov contends that cognitive behavior therapy only addresses symptoms – ideas – while ignoring the cause – buried emotions. Ideas are one of the most common defenses against feeling one’s pain.

Over time, this integration of affect leads to increased neural integration and information flow, as Daniel Siegel notes. The healing is not merely psychological – neuroplasticity means that there will be physical changes to the architecture of the brain itself.


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The The Elements of Primal Theory by The Primal Mind, unless otherwise expressly stated, is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 2.5 Canada License.

One Reply to “The Elements of Primal Theory”

  1. Peter:
    I enjoyed your article about primal therapy and agree with 99% of it. However, I do question your position about “breathing” therapies when you wrote about primal therapists who don’t use

    “…something artificial, such as exaggerated breathing or play acting.”

    Sure, holotropic breathwork therapies are artificial, but they can work fantastically well. Many years ago a therapist in a “primal-oriented” therapy suggested that I give Stan Grof’s Holotropic Breathwork a try. I did when Grof gave a breathwork week-end in New Orleans. I was amazed at its results and how breathwork speeded up my primal-oriented self-therapy. When the Int. Primal Assn. sponsored a one-day workshop at their convention in New Jersey, again I was happy with the results.

    I was able to feel material that I could not access in my self-therapy or with my intensives in more traditional primal-oriented group intensitive. Birthwork blocks in particular folded as a result. And I don’t mean the transpersonal aspects, although they were remarkable in themselves.

    Great article. Thanks for writing it.

    John A. Speyrer

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