The Worst Comparitive Psychotherapy Study Ever Published

by Bruce Wilson

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

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

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

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

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

Wrong.

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

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

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

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

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

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

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

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

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

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

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

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The Passing of a Genius

Art & Bruce

by Bruce Wilson

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

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

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

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

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

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

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

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

Avec le temps, va, tout s’en va

On oublie le visage et l’on oublie la voix

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

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

– Léo Férré

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The Truth About Janov’s Primal Therapy

by Peter Prontzos

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

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

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

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

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

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

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

Dr. Janov is the best writer today on what makes us human – he shows us how the mind works, how it goes wrong, and how to put it right. – Dr. Paul Thompson, Professor of Neurology, UCLA School of Medicine

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

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

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

And finally, referring to Janov’s later work:

Without an accurate developmental history of troubled minds, coordinated with a recognition of the primal emotional powers of the lowest ancestral regions of the human brain, therapists will be lost in their attempt to restore psychological balance.  – Dr. Jaak Panksepp, author of, “Affective Neuroscience: The Foundations of Human and Animal Emotions”

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

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

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

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

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

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