More about the success and failure of primal therapy...

spring picture: bumblebee (humla) - a social insect?!

Have been to the veterinary after lunch (3 hours) with a dog peeing blood... And in the morning I drove mom to the General Practitioner for test-taking. My youngest brother borrowed her car and she didn't want to drive another ones car.

Yesterday when we were to town we took my youngest brother's car, a four-wheel driven Subaru, fairly new (fun to drive :-))... When we parked at the market garden (handelsträdgård) I couldn't pull the key out of the ignition lock!!! There we stood! I had to phone my brother in Stockholm!!! He sounded a bit irritated, as I was the most stupid of the stupid! "Have you pushed?" he asked. "Pushed??" I thought for myself "But one use to pull!??" And he added "I haven't time more!" I got the key out (yes, one should push it first and then pull!!) and we could lock the car and leave it!! Watch this market garden! Or this! Both in Stockholm.

I am a bit tired after everything! The worries for the cute dog...

I was tipped about this article, thought it was interesting, “The Success and Failure of Primal Therapy: a Critical Review” by Stephen Kamsi. This posting is NOT short!! The original article was longer...

Addition March 29: this article was published 1988. And the book referred to by Tomas Videgård came already 1984. And Vikegård seem to be active here in Sweden still, as teacher for therapists in training!! See link to this in the text below.

“Primal theory and object relations theory are in agreement that infants become neurotic because of ‘defective relationships,’ not because of asocial drives (p. 4). This is the basis for Videgard's dichotomy between the drive-oriented and the trauma-relations oriented perspectives (p. 9)./…/

In discussing the various disciplines that comprise the trauma-relations perspective, Videgard (1984a) notes that 'they all seem to participate in a common cause against traditional psychoanalytic drive-explanations and for the uncovering of the more or less subtle traumatization processes that, according to them are the real agents in creating neuroses' (p. 4). Neuroses, then, results more from environmental influences, especially human relations and psychological traumas, than from the frustration of instinctual drives./…/

[Videgårds critique of Primal Therapy:]

Videgard (1984a) credits Janov with sensitizing the psychotherapeutic community to the subtleties of childhood trauma and with developing effective expressive techniques, but hastens to add that the consistent application of Janov's 'discharge model' leads to therapy failures. Videgard argues that primal theory is insufficient and needs to be replaced (p. 296).

Primal theory, according to Videgard (1984a), is misguided with respect to human relationships. Primal theory suffers from an inadequate and underdeveloped model of personality development (p. 293), and Primal Therapy lacks an appropriate therapist-patient relationship Videgard, 1984a (p. 287).

The therapeutic relationship, in Janov's opinion, is of minor importance (p. 287). The role of primal therapist consists primarily of being a catalyst for the emergence of stored historic pain. From the object relations perspective, however, the reliving of traumas is therapeutic only in the relational context of being heard and accepted (p. 294).

Research. Videgard (1984a) notes a serious discrepancy between Janov's claims of success and his own actual research findings. Videgard believes that ‘the published data are likely to represent an overestimation of the positive effect of Primal Therapy’ (p. 254)./…/

The Results /…/

13 subjects were considered to have had satisfactory outcomes, while between 14 (p. 295) and 19 (p. 303) had unsatisfactory outcomes.

How does Videgard (1984a) interpret these findings? ‘The main result is that about 40% of the primal patients achieve a satisfactory result within 15 to 25 months’ (p. 249). This statistic may be figured in many different ways, and various calculations of satisfactory results range form 39% for the random sample to 50% of the total sample (exclusive of subjects who could not be post-tested).

Which subjects benefitted most from Primal Therapy? Videgard correlated prognostic outcomes with several subject variables including (1) age, (2) sex, (3) marital status, (4) nationality, and (5) initial prognosis (i.e., the diagnosis). Several correlations were clearly evident between outcome categories and subject background variables. Although the small sample size allowed for only one statistically significant finding, some of the others are clinically significant and should be considered in future research.

1. An obvious correlation, suggesting a curvilinear relationship, exists with respect to age and outcome: Subjects between 30 and 40 (n=11) were more successful that subjects under 30 (n=15) [64% and 40% respectively], and no subject over 40 (n=5) was successful (Videgard, 1984a, p. 247). Perhaps there is an optimal age range for success in Primal Therapy (i.e., 30-40); in any event, the outcomes of the therapy were different for different age groups.

2. Are the results of Primal Therapy different for men and women? This study suggests not. Men (n=21) and women (n=10) showed very similar rates of success [43% and 40% respectively] (cf. Videgard, 1984a, p. 246).

3. The relationship between marital status and outcome revealed a highly significant finding (p < .01): married subjects (n=9) were more successful than divorced (n=5) or unmarried (n=17) subjects [67%, 60%, and 24% satisfactory prognostic outcomes, respectively] (Videgard, 1984a, p. 247). It should be added, however, that unmarried and divorced subjects actually came to Primal Therapy with more severe disturbances than married subjects: none of the married subjects (n=8) entered therapy with a ‘severe disturbance, although 71% of unmarried (n=17) and 67% (n=6) subjects did so. [Note: there is a discrepancy between the number of married (9, 8) and divorced (5, 6) subjects in the original Tables 4 and 5, respectively (cf. pp. 246-248)].

4. The correlation between nationality and outcome revealed that (1) Europeans (n=15) and (2) Scandinavians (n=12) were more successful than (3) American and Canadians combined (n=16) [53%, 50% and 31% respectively] (Videgard, 1984a, p. 247). As Videgard correctly notes, this may be a chance finding. Another plausible hypothesis is that (a) Europeans and Scandinavians were somehow different than North Americans--perhaps more highly motivated, since they had to overcome greater obstacles to obtain treatment, or (b) Primal Therapy is somehow more effective on the character structures of Europeans and Scandinavians than Americans and Canadians.

5. Subjects entering therapy with a ‘severe disturbance’ (n=16) are less successful than those entering with a ‘moderately severe disturbance’ (n=15) [25% and 60% satisfactory outcomes, respectively] (Videgard, 1984a, p. 248). 'The difference in outcome between the severe and the moderately severe groups is significant (p < .05). . . . Patients with deep disturbances are less likely to benefit from Primal Therapy than those with milder disturbances’ (p. 249).

6. An important but unreported correlation is that subjects with no previous therapy (n=11) were more successful than those with previous therapy (n=17) [55% and 41%, respectively] (cf. Videgard, 1984a, p. 246).

The following were reported by Videgard, but seem to have been derived in a less systematic fashion.

7. New memories (i.e., a reappearance of previously forgotten scenes) were reported by only a few subjects. This finding, however, should be qualified in at least the following ways. First, well-known childhood scenes reportedly took on new meanings. Second, many subjects reported strong feelings and bodily sensations which they associated with very early events but were unaccompanied by images or memories ‘in the common meaning of that word’ (Videgard, 1984a, pp. 274-275). In light of findings from Primal Therapy and other experiential psychotherapies, perhaps we need to expand the common meaning of the word ‘memory’ (cf. Khamsi, 1985, regarding ‘memory’ and the primal process). Third, it is probable that repression intervened between the time of memories experienced in therapy and the time of the posttest interviews. As a therapist, I have often seen the pernicious effects of repression; it is not at all unusual for a person to have deep experiential memories one moment, and literally be unable to recall them the next.

8. Videgard (1984a) reports that only three subjects had ‘connected’ birth feelings (p. 275), and that ‘integrated experiences,’ an undefined term, were rare before the ages of three or four. The reader may receive a false impression, however, since many more of these subjects reported having had numerous nonverbal, perhaps ineffable experiences--many of which were explicitly reported to be birth-related (cf. Khamsi, 1985, for a qualitative account of birth feelings in Primal Therapy). Videgard, then, appears to be extremely conservative in accepting nonverbal and birth feelings as ‘connected’ or ‘integrated,’ and thus as legitimate objects of scientific inquiry.

Videgard (1984a) believes that most, but not all, of his subjects may have done as well or better in more conventional therapies. ‘Except for the . . . three to four subjects who had been both 'desperate and integrated' and who had relived their birth-traumas, it seems the rest of the successful patients, at least in principle, could have achieved their results in good insight psychotherapy’ (p. 280). This is speculation, and I disagree. Videgard's own book, in fact, has innumerable statements of subjects that contradict the notion that other approaches would have worked as well for them. But it does indicate Videgard's unstated respect for the power of birth feelings--for certain subjects.

9. None of the subjects considered themselves cured (Videgard, 1984a, p. 275; cf. the ‘Failure Rate’ section in the ‘Discussion’ below).

10. Thirteen subjects reported improved relations with the opposite sex, and two reported improved relations with the same sex (Videgard, 1984a, p. 276). One-third reported a better sex life, one-third were unchanged, and three or four were ‘aggravated.’

In addition to the above findings, Videgard reported the following impressions from his research.

11. ‘A great majority of the patients found the Primal Therapy slower and much more difficult than expected’ (Videgard, 1984a, p. 273).

12. ‘Most of the successful patients had positive feelings for at least one or two therapists [while] none of the five least successful patients had developed strong positive feelings for any therapist’ (Videgard, 1984a, p. 273). Related to this is the impression that ‘about 50% of the patients wanted more individual contact with the therapists’ (p. 277). These findings provide strong support for Videgard's argument to rethink the therapeutic relationship in Primal Therapy.

13. Those patients whose childhoods had been characterized by a general lack of emotional contact with both parents seem to have very small chances of benefitting from Primal Therapy (Videgard, 1984a, p. 282). This finding underscores Videgard's concern about the importance of human relationships, both in development and in therapy.

14. No patient claimed to have experienced the complete sequence of events by which Holden (1976) describes a ‘primal’ (Videgard, 1984a, p. 274). So-called ‘primal screams’ were reportedly rare, and even screaming was an exception. According to Videgard, ‘most patients preferred to talk about feelings instead of primals.’ (p. 274)

There appears to be a chasm between Primal Therapy experiences as they are (a) lived and (b) described in the literature. Moreover, ‘primals’ and their neurophysiological correlates are apparently most intriguing to patients before their therapy, not after.

15. Most subjects had one or two key scenes, but crying was more often about generalized feelings than about specific scenes (Videgard, 1984a, p. 275).

Generalized feelings have been denigrated by Janov because his theory is based on the importance of reliving specific ‘primal scenes.’ According to these reports from Janov's own clientele, however, most feelings in Primal Therapy are in fact generalized and not specific./…/

The primal sense is a literal sixth Aristotelean sense, related to but different than the vestibular, kinesthetic and cutaneous ‘body senses.’

16. Improved work capacity was the only area of perceived progress for several subjects (Videgard, 1984a, p. 276). Obviously, these were subjects with unsatisfactory outcomes.

17. Videgard (1984a) discovered that ‘patients who did not perceive the threat in the last exposure of the DMT before therapy fail significantly more often than those who perceive the threat’ (p. 282). This is an important finding, and is deserving of future research attention.

Discussion

Videgard is clearly in favor of replacing the psychoanalytic paradigm. He has leveled a massive attack on orthodox ‘drive-oriented’ psychoanalytic theory and, drawing firepower from ORT [Object Relation Theory?] and Primal Therapy, has proposed as alternative--the "trauma-relations" orientation. In resurrecting the psychoanalytic paradigm, Videgard argues in favor of incorporating the theory and relational therapeutic context of ORT with many of the therapeutic techniques of Primal Therapy. In order to strengthen and further elucidate the trauma-relations position, Videgard has conducted an empirical outcome study of Primal Therapy./…/

Videgard (1984a) might also conduct one or more follow-up studies of these same primal subjects sometime in the future. This meritorious undertaking would begin to chart the long-term effects of Primal Therapy. ‘Cindy’ (pp. 39-43), interviewed seven years after beginning the therapy, shows that Primal Therapy outcomes may appear very different when evaluated over a longer period. Videgard could fairly easily expand his original project into a longitudinal study, retesting and/or reinterviewing the subjects periodically, perhaps once every five or ten years. Given the huge amount of work already invested, and the importance of the findings thus far, it may well be advisable to expand the research in this way./…/

Videgard concluded that the results of the psychoanalysis and pychoanalytically-oriented therapies at the Menninger clinic seemed less successful than his primal sample (p. 266). The Primal Institute, then, was considered to have slightly better outcomes than either the Tavistock or Menninger clinic.

The failure rate of Primal Therapy. Carlini and Bernfeld ('Questionnaire,' 1979) conducted a pilot study of 200 Primal Institute patients. They estimated an overall "failure rate" of Primal Therapy from the following: (1) 21% of their sample claimed to be unable to primal as described in the literature, (2) 24% claimed they had not reexperienced a repressed feeling or event, and (3) 19% stated that they were unable to feel previously-repressed feeling (p. 5). From their large sample, Carlini and Bernfeld estimated the failure rate of Primal Therapy to be approximately 21% (p. 5).

In Videgard's (1984a) study, however, ‘almost one-third (9 out of 31 patients) had either left the therapy prematurely (including one suicide) and/or expressed strong dissatisfaction with their own development and follow-up’ (p. 267). In all, 40% of Videgard's subjects were judged to have reached a satisfactory result (p.267); this contrasts sharply with Carlini and Bernfeld's explicit success rate of 79% and with Janov's implicit success rate of 90-98%.

How can such major discrepancies exist between these postulated rates of success in Primal Therapy? Clearly, part of the answer is that Videgard employed more exacting methods to determine therapeutic success and failure than either Carlini and Bernfeld or Janov; Janov's estimates have been impressionistic, while Carlini and Bernfeld's was based on data from self-reports. In any event, the primal community must continue to examine its therapy outcomes. There is a need to examine what 'success' and 'failure' mean in Primal Therapy, as well as how and why they do or do not occur. This is a deep and complex issue that deserves much future attention.

One important aspect of any therapy success or failure concerns the issue of therapeutic technique. Videgard (1984a) believes that 'at least some of the failures in Primal Therapy can be attributed to specific shortcomings in the way the therapy is done' (p. 284). This charge deserves comment.

The technique of Primal Therapy. Videgard (1984a) approves of the sensitive use of primal techniques (p. 288). He believes that the physical setting and focusing technique of Primal Therapy allow maximum freedom of emotional expression. ‘The primal technique,’ in fact, ‘may be a help to follow the patient's natural pace’ (p. 288).

Videgard (1984a) objects, however, to the lack of an on-going therapeutic relationship. Most Primal Therapy failures can be attributed to the lack of individual therapy sessions for most patients. The discharge-model is simply insufficient, says Videgard, so primal theory needs to be replaced and ‘continuous, individual therapeutic contact’ should contextualize the primal therapeutic process (p. 296).

Videgard is correct. In 1969, after leaving the Primal Institute, therapists at the Marin Center for Intensive Therapy began offering Primal Therapy that included an explicit and defined client-centered relationship. Since commencing therapy there in 1973 I have observed Primal Therapy practiced in many ways. /…/

What is Primal Therapy?

Certain facts about Primal Therapy have been established by Videgard. Following from these facts, he has provided an interpretation of the findings and has offered a well-reasoned argument in favor of an alternative paradigm--the trauma relations perspective.

Videgard's facts have been established with proper scientific rigor and reporting, and thus represent an important new source of information for the empirical data base of Primal Therapy. These data may, however, be interpreted in other ways. While I generally accept his data as facts, my own interpretations sometimes differ.

I find Videgard's findings plausible and his arguments fairly persuasive. I agree, for instance, that ORT is superior to primal theory with respect to developmental theory and client-therapist relationships. In a prior article, however, I interpreted these same facts in a slightly different way--my argument was in favor of a ‘humanistic’ or ‘client-centered’ Primal Therapy (Khamsi, 1981). With respect to this fundamental deficiency in primal therapeutic relationships, Videgard and I have offered similar, constructive alternatives. Primal theory needs to be reworked in light of its own failings, taking into account the strengths of ORT and person-centered theory.

In attempting to get at the core of Primal Therapy, Videgard (1984a) has attempted to determine if it is a unique method, i.e., if it is the only approach that is able to help certain people (p. 279). He believes that it may have been for some of his subjects. Unfortunately, Videgard here has pursued the 'primal-is-the-only-cure-for-mental-illness' myth, which is dated both as an honest misconception and as a sales campaign. Primal is one viable approach, preferred by many; but viewing Primal Therapy as discontinuous with and/or better than other approaches keeps us from understanding and researching exactly what it is and how it relates to any larger scheme of things./…/

Through imaginative variation we can see that the essence of Primal Therapy lies neither with primal screaming, nor three-week Intensives, nor particular techniques. Primal Therapy is a way of feeling and being real. This insight has been central to my own thesis that the primal sense dimension is most essential to the primal therapeutic process.

Primal is, in essence, a way of being real or authentic. It emerges from an individual's ‘decision’ to open to what is, to feel-change-grow in spite of pain or difficulty. Nothing done to a person--such as ‘therapy’--facilitates real change. Being real come from within. Therapist and client/patient/person can work together, sharing experiences, ideas and feelings, so that both may live with greater feeling, meaning and authenticity. Being real can never be forced./…/

With respect to trauma, we must distinguish between theories of etiology and theories of therapy. A trauma theory of etiology needs to show that personality development is significantly affected by traumatic incidents, and this idea has been widely accepted. A trauma theory of therapy, on the other hand, would need to demonstrate a prevalence of subjects reliving specific traumatic scenes--which clearly was not the case in this study. There were fewer reports of new memories and specific feelings--hallmarks of reliving traumatic scenes--than of general feelings about such scenes. In general, then, the data support a relational Primal Therapy and a trauma theory of etiology but refute a trauma theory of therapy.

Theory can open or close our eyes. Just as Janov opened eyes when his insights were fresh, we can continue to open eyes and hearts and minds by researching and reporting human experience as it is lived--not theorized. Janov helped us see beyond the bounds of psychological theories extant. Now we must see beyond his.”

"Etiologi är läran om orsakssamband, eller kausalitet. Termen kommer ifrån grekiskans aitia, orsak, och logia, lära, och används inom filosofi, fysik, psykologibiologi då man diskuterar orsaker till olika fenomen.

Inom medicin används termin specifikt för anledningar och bakomliggande variabler till sjukdomar och patologiska tillstånd.

Med begreppet kan också avses en orsakslära som i sagor och berättelser söker förklara hur olika företeelser, bruk och namn har uppkommit. Ett slags etiologier är bildliga förklaringar som då John Blund sägs komma med sömnen till barnen."

Getting out of a cult...

A former primal therapist writes:

"The running of the business was based on human greed, deep hypocrisy, and a need for fame and fortune at whatever cost.

Nor were therapists the 'Post Primal' people Janov described. Many had disturbing personal problems which had easily survived their own therapy. The Institute was a difficult workplace. Training techniques were abusive. The political infighting and positioning among the staff was the same as any business which offers lucre at the top. The humor, for the most part, was mean- spirited. Attitudes were arrogant and insulting of anything which challenged the Primal belief system.

Above all there were unethical and unprofessional practices built into the system: dual relationships (business and sexual) between therapist and patient, false claims of results, false advertising, interns working beyond their level of skill, treatment of patients who were too disturbed for this kind of 'therapy,' emotional harm caused by a system that opened people up to intense feeling without adequate follow-up, perhaps even medical malpractice by the neurologist who prescribed medication according to 'Primal' guidelines.

In this context, even therapists who wanted to provide effective therapy would fail. There were well-meaning and creative people who worked hard to make Primal Therapy live up to its promise. We failed. The system was too destructive.

That it took me eight years to learn this indicated how desperate my life was when I went to the therapy, how much I needed to believe in a powerful and omniscient world view, how isolated I was in the world, and how well Janov's promises matched my personal desires as well as the political and cultural forces of those times. It also speaks to the effectiveness of the Primal indoctrination techniques.

I also think it is an indication that there are aspects of Primal Therapy which contain therapeutic value. The techniques for eliciting painful feelings can be quite effective. The grief process is well understood and may be healing, depending on the context. Patients' experiences are often quite real and dramatic. Unfortunately, whatever there was of value was completely overshadowed and negated by the destructive superstructure within which it was housed.

I worked hard to become a competent therapist. I struggled against the drawbacks in the system. I became competent, but the system burned me out. When I left that world in 1982, it was a shock. I realized I'd been in a cult. As with anyone who leaves a cult, I had to learn different ways of looking at the world and myself in it. It was a confusing and disorienting process which challenged my beliefs on many levels.

I experienced deep ambivalence. My self-esteem suffered tremendously. I know how destructive the Primal world had been, yet I couldn't reject it completely. I had given such a big part of myself to it. I had to believe there was value there. I rejected the Institute and its destructive practices. I could no longer be a part of that. But I wasn't sure about the theory.

After almost a year of 'floating' and 'decompression,' I decided to continue working as a therapist. I wanted nothing to do with Primal Therapy. This meant I needed to open up to other ways of thinking and working in my profession. Even though I was already a licensed Marriage, Family and Child Counselor, I knew I needed to start learning my craft all over again./.../

The Therapy takes responsibility for changes that are positive. Failure is always the fault of the patient.

Patients' vulnerability, low self-esteem, and high expectations make them easy to indoctrinate into the Primal mind-set. Perhaps if the therapy were effective it would be okay. But when the results don't happen, it becomes a destructive process. /.../

The main purpose, though, was to make Janov famous and rich. Even without him, it remained a cult. /.../

He is aiming his promise at vulnerable and desperate people in an unforgivable way./.../

So Primal Therapy doesn't work. Once this is acknowledged, alternatives become possible. None are easy. There's no simple, quick cure. Healing is a complex process.

The following are some steps people might find themselves taking if they decide to leave a cult:

Physical separation: One must actually separate from the people and places which reinforce the cult mind-set.

Breaking the ritual: Stop the addictive habit of thinking that you need to 'feel a feeling' to solve every problem or whenever you feel bad.

Decompression: a floating kind of disorientation, ambivalence, and depression. Uncertain who you are or where you're going. Expect it; watch out you don't try to 'Primal' it away; experience it -- it'll be a part of your life for a while.

Anger and loss: As with an eating disorder, Primal intrudes into an essential area of human activity, our emotional life. These feelings need to be dealt with in a different way. Sometimes long periods of repression are necessary at first. Remember, it's okay (even necessary) to repress things at times.

Reconnection with the person you were before you came: your hopes, dreams, desires, and interests. This can be an exciting time of discovery as the world begins to open up for you. Expect uncertainty and anxiety as well.

Creating a place in the world for yourself; friends, family, work, fun, community. Widen your context and your perspective. There are many possibilities in the world.

Acknowledge and honor the needs which attracted you into the cult and which were satisfied by that tightly controlled world.

If necessary, get professional help: this could include groups with others who have shared the experience. This is not always necessary. Many can leave without professional help, if they have work, friends, and interests which are supportive.

Attend to the problems which made you seek Primal in the first place: Chances are some of them will still be around causing you havoc. It's a terrible feeling to have spent years 'in therapy' only to discover the same old awful problems in your life. A lot of anger and hopelessness here.

Hanging on: If you do seek professional help, watch out for all the comparisons you'll be making wherein the 'new' therapy won't compare well at all with the Primal one. You'll ask, 'Don't you BELIEVE in FEELINGS?' and the therapist won't know what you mean. Remember, feelings are just one of many human processes and experiences: there's nothing to 'believe' in. Also, the new therapy won't satisfy your addictive need for intensity. That will be hard [at] times but ultimately is a good thing.

Shame: It brings many to Primal Therapy in the first place, and it finds a convenient hiding place in those dark rooms and that 'special' world. When you leave, it can emerge like a serpent from hell to torment you. It is tamable.

Separate what has been of value in the Primal experience: It's not an all-or-nothing proposition. Some of what you learned and experienced may be of great importance in your life. Honor that."

More about therapy, sects, cults, guruism…

Accounts from patients in Primal therapy at Janov's center. Thought this was interesting. The quotations are taken from this site and this one. Also see "Surviving a therapeutic cult."

And I think Miller is right concerning failures in therapy (my amateur-translation!!):

If one uncritically cling to old methods' alleged infallibility (and she includes regressive techniques here AND primal therapy) and blames the client for failures, you inevitably land in the same fairways (waters) as the sect-guru, who also promises entire liberation. Such promises only produce self-destructive dependence which stands in the way for the individual’s liberation.

See former postings on therapy abuse. I would like to write more about Miller's views on abuse in therapy (and the vicious circle of contempt)...

“Once he told one of his therapists that she seemed to be feeling angry and defensive and she angrily denied it! This reminds me of how important it is that the person who is trying to help another is honest and authentic with his or her feelings. It also reminds me that one thing people want and need is to know that someone really cares for them. They don't just want techniques.

He said that if you questioned things you would be told standard defensive replies, rather than real answers [see what Miller has written about this. How the child was met when it asked questions, wanted to know, wondered and reacted over contradictions. And when patients in therapy start to see in therapy and start to ask questions. How this can be led back to the client in a lot of ways]/…/

He said they break down your defenses but they don't really help you solve your problem or go to the real core of your problem. He said they neglect the connections between your intellect and your emotions.

There was a lot of time spent on emotional release. But not enough time was spent on understanding where the emotions came from or how to make lasting changes.

He said the therapy did help some people, but in general it was not as helpful for highly intellectual and cognitive people.

He said some people were going there for years, even in one case a man was going there for over 10 years and was still releasing his anger and was still feeling resentment from his childhood.

I asked him if he felt more compassion for children after his time there. He said no. He felt less. This was because he felt resentful that he had spent so much time there and gotten nothing out of it. He didn't want to even think about how children felt. Instead if he was around a child and he started to feel annoyed and impatient with the child, he was tempted to hit the child, just as he had been hit by his father.

I asked him if the therapy gave him any lasting skills which he has used since he left. He said that it did not. He said that in fact, some of the people seemed to be more irresponsible than when they began therapy. He said too much was attributed to early childhood experiences. Some people used what they learned to get stuck in a trap of blaming their parents.

He said they were not taught how to take responsibility for managing their feelings./…/

Antonio and some of the others there were concerned about Janov's values. It bothered him, for instance, that Janov always flew first class and lived in a multi-million dollar home in Malibu, an expensive suburb of Los Angeles. Some people actually left when they found out how Janov lived. Antonio told me about something Janov had written in his book, ‘Prisoners of Pain.’ Janov wrote that cars are really only needed for basic transportation and yet people buy expensive, gas-guzzling cars. In this way they are used to try to fill other needs, such as the need to express their individuality and level of status, power and importance. Then as I was leaving, Antonio asked me what kind of car I thought Janov's wife drove. I guessed a Mercedes or a BMW. He said, ‘Close. A Jaguar convertible.’/…/

I feel a little disillusioned to hear these reports. It reminds me that all of us who are involved in the field of emotional healthy are always vulnerable to exploiting emotionally needy people./…/

I hope this section gives people a better idea of what can go on in primal therapy, in contrast to the miracle and idolizing testimonials in primal books and websites./…/

There seems to be some confusion over the secrecy surrounding primal therapy, so I need to state the obvious to those worried about it: You are allowed to tell your story! /…/

My therapist was so mean at the end of the therapy. /…/

I can't say much about Janov himself, or whether he consciously deceived people, since I rarely met him. But he had the usual charismatic aura. Once in a post-group I spoke about my sense of lack of meaning and conviction; Janov said, out of the blue, 'Your father made you afraid of your own convictions', although Janov had no first-hand knowledge of me or my life. It sounded very impressive at the time, as if Janov were psychic, but I realize now he was simply doing the Fritz Perls thing. (The Fritz Perls thing is of 'immediate challenge', of believing so entirely in your instincts as a therapist that you couldn't be wrong). Therapists couldn't really do wrong in their own eyes because whatever they said, if it seemed to lead to any kind of emotional reaction, they were successful…/.../

I think it can help to get some people in touch with suppressed feelings (I am still grateful for that - I do occasionally cry spontaneously, which would probably not have happened without primal therapy) and to encourage straight talking, but these are not at all unique to primal therapy. I would certainly like to see some programme of research into the primal-type process. Some stories about 'mystics' or shamans (read about Jiddu Krishnamurti's 'process' and U.G. Krishnamurti's 'calamity', for example) resemble the primal account but are even more impressive when the process is spontaneous and there is no therapist guiding or benefiting from it./…/

…also there was a general lack of transparency within an organization that preaches openness and honesty.

If you did make a complaint, it was ‘your feeling’ - it's Catch 22 - the patient was never right.

The Institute and therapists didn't want to look at themselves (as people who have feelings and defenses) and you had to be 'crazy' for wanting to question them.

Questions over ethics - if the Institute has become a law unto itself - who regulates it?

Therapists are treated as 'gurus' who can do no wrong

Group bullying was witnessed with ganging-up and groups taking the side of the therapist against individuals.

Some existing patients have been in primal therapy for 20 years+ which begs a question about its efficacy./…/

Most of the discussions were either warnings or negative acting out by primal cultists. Satisfied former customers never turned up to share their success stories.... although the cultists seemed to think it was enough to say: ‘It works because I say so!’ Then someone set up an alternative discussion forum two years ago. I was still hopeful. Not anymore. It started out with good intentions but ended up with the same mixture.... No satisfied former clients, except cultists.... If any ‘post-primal’ people really do exist I doubt they would want to hang out there. However, you might be interested to read an article by a disillusioned Primal Institute therapist.../…/

The therapy should be used to ‘manage’ your feelings and learn where in the past they belong should they be ‘just a feeling’. Smart patients know when to feel and when not to in the real world. That is the key and how it should work long term./…/

I would also tell them that for this therapy to work, that you must NOT spend all your time with primal patients. How to not make the therapy your life is key. Might be necessary in the beginning stages, but I'd explain that later on that it is very important to integrate into the real world separating your life from therapy and not making them one in the same./…/

Another problem I have with primal people is that most of them think it's ‘real’ to forget their manners. You, very rarely, hear a primal patient saying, ‘What's up?’, ‘please’, ‘thank you’, ‘I'm sorry’, ‘excuse me’, ‘pardon me’, etc. It's very frustrating when I find that they have totally confused and twisted the theory of PT to suit their own agendas and needs. Primal therapy, while it does emphasize being ‘real,’ it does NOT teach one to act impolite and inconsiderate of another person's feelings. Some primal people are downright rude in the name of ‘Primal Therapy.’/…/

I'm thinking that maybe I just needed someone to talk to - not PT [Primal Therapy]./…/

And the abuse in therapy puts a whole new layer of suffering (fourth line pain!) over childhood pain – it’s like getting dental floss stuck in your teeth when you’re trying to floss.

Without evaluation from people who are independent from primal (not Janov, not therapists, not ever-hopeful patients), the primal clique can continue to define the views of anyone who disagrees as not valid./…/

Janov starts from a solid core – the importance of love and caring in infancy and childhood. But he's not the first to point this out. /…/

The problem is lack of independence....He writes books which bring him income. He runs a Center which brings him fees from patients. Not that I think he deliberately misleads, he is just very selective in what he reveals and is optimistic that his great discovery will one day be vindicated. Wishful thinking supported by self interest.”

Also see this thread about Miller's lists on the net. Which is about trolls on the net and what they creates, or can create... Maybe Miller's unawareness about these things??

Addition: Something triggered this addition.

Miller writes in the epilogue to her book “For Your Own Good”:

“Are the detecting therapy-concepts free from manipulating elements?”

No, she doesn’t think so. She writes that we are hoping we shall get help with clearing the confusion up, so we can find clarity and “get our bearings” (??), but at the same time we are hoping that what we suspect and feel yet isn’t so bad, we are hoping our illusions still are possible to use.

If we land up with a traditional therapist we will get this confirmed through some theory, in Freud’s, Jung’s, Lacan’s or any other style.

The Primary therapies don’t come with those deceptively calming interpretations. Inasmuch their concepts aren’t manipulative. But the clients aren’t protected against therapists’ manipulations. On the contrary. This must be said clearly Miller writes. The dangers for abuse are as great in primary therapies as in other therapy forms. And the damage which can be caused can reach even deeper areas of the personality and still more aggravate the earlier incurred confusion.

And I am thinking about the moderators at ourchildhood once again. A woman sent this letter from Barbara Rogers to the subscribers at ourchildhood.int recently:

“...

I have translated and am posting here a recent answer of Alice Miller to a reader's question about ‘the development of the ourchildhood forum.’ Below it, I have posted as a reminder ‘the forum's purpose’ that Bob and I have developed.
We will continue to protect this forum from confusion, arrogance, intimidation and destructive agendas,
Barbara and Bob

AM [Alice Miller]: If you want to hear my opinion, then it is this: Moderators are humans like we all and not superhuman. They cannot run an IDEAL forum that suits everyone who enters it. As humans, they can only judge SUBJECTIVELY. This is not only their right, it is their duty towards themselves to stay truthful to their feelings and to not betray them in order to please others. But I can understand that their SUBJECTIVE decisions do not suit everyone. Then those who are disappointed are fortunately free to visit other forums, which suit them better and that hopefully are also guided truthfully.

As adults we are however not reliant on changing our parents or suffering their tyranny. We have other alternatives and are free to choose. The moderator of a childhood forum is not father or mother but a human being with his/her own feelings (hopefully) who is has taken on the task to enable others, according to HIS/HER knowledge and conscience, to articulate themselves about their childhoods and thus find more clarity about it. He or she alone are responsible that confusing contributions are not posted, and they do not owe anyone an explanation for their decision because that would only increase the confusion. As all people who participate here have been harmed greatly as children, they tend to stage here their fate and to see their parents in the moderators. That goes beyond the responsibility of a moderator, he is not a therapist, does not need to give interpretations, he only creates the prerequisites, the technical platform so to speak, to TALK, to finally be able to tell the truth. And this is already very, VERY MUCH. One should highly respect this and not attempt to use blindly, by
means of the childish, unreflected blindness, innocent people as scapegoats for badly abusive parents.”

Are moderators on a forum discharged from liability? And moderators for a forum called Alice Miller’s forum don’t they have a little more responsibility than usual, with the “quality-mark” of being Alice Miller’s list? Even if they are no therapists and this is no therapy, they nevertheless easily get a parent-figure (and authority) role. And would it be wrong if they admitted to wrongdoings? Would that be a model for other on the forum to follow?

And of course they shall see so some posts aren’t posted!

Act as all who are in a position of power has to?? As I as teacher has! If I have a group of pupils/students. I have to protect the ones I am responsible for from abuse of others in the group! But of course here it is a question of young people…

And a boss at a work-place also has this responsibility.

And both the teacher and the boss have a responsibility to motivate rejections, punishments etc. not least to the one he/she rejects or punishes!?? But of course this has to have limits (which and where can of course be difficult to judge about and to draw)?

By the way, quite ironically, I wonder if the most abusive and the worst cases are treated better too many times (everywhere it's the ones that are screaming highest that are being met and being seen, being visible). And the less problematic (??) are given less efforts!??? The worst (or real) bullies one argues with much more!?? And how was it now with the Master Suppression techniques? One of those was making invisible. Yes, it was this with the Wall of Silence… A method parents used to punish a child. Not informing i what she/he had done wrong. And if she/he didn't understand what she had failed than this was (really) a proof of ones badness.

I came to think yesterday abut a woman who was subscriber at the same time as I who was really provoking. She started a hot mothering-debate which caused a storm of feelings and reactions (and here was also a man that was a bit bully-like, but his bullying was less visible right away?? Because he was more intelligent?? So had means t hide it more?).

What she (and other bullies and provokers) did was abusing those who had had real problems with their own (abusive) mothers. Maybe some provokes without being aware of it?

Why shouldn’t moderators have to motivate their decision AT ALL or ever?? I can’t really understand this. Unless there aren’t subscribers who are abusive again and again, and not possible to speak to! Of course there can be limits where no motivations or talk will change anything…

This move sounds “a bit” authoritarian, rather strengthens what I felt then!!?? They are behaving as our parents once, who didn’t have to motivate their rejections, refusals, punishments it feels to me. Or this is maybe tremendously authoritarian!??

And hasn’t Miller written that criticism and questioning always can be referred to the “earlier address” (i.e., early childhood experiences), exactly as people have written about Janov’s therapists!?? See above:

"He said too much was attributed to early childhood experiences."

If you have nothing to hide as moderator would it be any problem to (briefly) motivate a refusal, so as to avoid confusion??

But, yes, I have seen what people can write on the net!! That’s for sure. What so called trolls write! And they are usually not possible to speak to at all!!?? It looks. There truly exist provokers on the net. Maybe enjoying provoking people as much as they can?? And no motivations or talk will change them.

Is Barbara Rogers trying to grant herself (and possible co-moderators) discharge? And Miller also contributes to this of some reason? I wonder what reason... The purpose of the forum was changed during the fall 2005 when Barbara Rogers had become co-moderator... I still thinks, from what I remember, that Bob Sharf's purpose (created together with Miller?) was better...

And I come to think what a Yanis wrote in this thread:

"I was among the first people to arrive at Miller's forum. I remember the course of events. I was reminded of it because on Saturday a friend returned to me the Alice Miller mini-library she borrowed before Xmas. My friend asked what happened to the forum on Miller's website that was mentioned in 'The Truth Will Set You Free'?

I explained to her that within a few weeks it became a magnet for trolls who wanted to tell Alice Miller what was wrong with her thesis. The most common were spanking advocates ('a little slap does no harm') and those who said 'Your therapy isn't complete until you've forgiven your parents' (even if the parents deny they did anything wrong). After a while, messages like that were being posted every day, and Alice Miller was deleting them every day. These were the people who lit Miller's fuse, even before Dennis and Jim Rich arrived. I'd agree that she overreacted. I'd say she was quite naive to think that only unquestioning supporters would turn up at the forum to praise her work."

A proposed inner child...

from a walk February 11, 2007.

Back from a walk, sweaty... Now some lunch on the stove.

On the walk I came to think about the topic inner child triggered by something I wrote in a posting to a person... About second childhoods and the child inside you...

Bosch writes about this and Jenson too. And Miller in her first book (the revised edition) that this notion is problematic. But she seems to have abandoned this idea!?? But we can't give a thought child anything. And Bosch, Jenson, and Miller too then, radically said that there exists no inner child, e are no any children any more, but grown up. And this realization about our losses and all they have led to maybe can start a healing... And is the only way to healing?

When I came indoors now I also came to think: it is as if therapists and helpers thinks the truth is too much for their client/s (i.e. us)??? And this not outspoken message doesn't a sensitive client catches this? And what does this bring about?? Even more fear... And...

What is done is done. We can't go back and change anything. There's a risk the False hope is strengthened instead (and False hope is a defence protecting us against the pain, and for grown ups False hope still has that function; to protect ourselves against the/a pain we couldn't survive then, but can now with appropriate help, or in the best, but rare cases, on our own), and the risk is that we instead are protecting ourselves against the truth - and pain. And actually very little or nothing changes. Healing can't take place.

But this sort of work probably feels good?? And much better than using Bosch's and Jenson's method???

Struck me; what does Stettbacher writes about this? He uses a sort of inner child work? I must check this and maybe come back to this topic later.

---

Ingeborg Bosch writes at page 101 in "Rediscovering the True Self":

"Therapies that use regression as a method (including Neuro-linguistic-programming- NLP, Hypnotherapy, Regression therapy, inner-child work and Pesso therapy) often encourage the client to imagine, during the regressed state, that they can now get or do what they couldn't then. For example, the client might be instructed as follows: 'Let your adult-self take the child by the hand and protect her from her father.' Or, 'Imagine your mother comes over, notices your pain,, looks at you in a loving way and hugs you.' Or, 'You can get angry at your mother and make her stop yelling at you.'

Such regressions often succeed in helping the client access the old pain. However, the healing effect of giving in to the old pain is cut short by taking the pain away prematurely. Taking it away by letting clients imagine that they can get now or do now what they couldn't then.

Seen from the PRI perspective this will undermine the healing process, even though clients experience relief in the short run.

It seems probable that the reason for this is that we need to fully open up to and ride out the 'amygdala's wave' of alarming feelings, in bombination [??? should be combination??] with the structural reversal of our defences before new neural paths can be established. This will enable the cortex to take over the processing more and more in similar situations."

See earlier postings on the label "the brain", here, here, here and here. LeDoux and his findings on the brain are referred to too.

---

Tillägg på kvällen: Jenson skriver på sidan 129 i sin bok "Att återerövra sitt liv" om inre barn. Hon skriver:

"'Mitt barn' är inte korrekt av flera skäl. Vi är givetvis vuxna oberoende av om det är den vuxnes eller barnets medvetandetillstånd som vi befinner oss i.

Föreställningen att vi 'har ett barn inom oss' (upphovet till uttrycket mitt barn) var avsett som en metafor för barndomens medvetandetillstånd, men många har tagit uttrycket bokstavligt. Vissa terapeuter har till och med byggt vidare på denna föreställning och talar inte bara om 'ditt barn', utan grundar sitt behandlingsprogram på att hjälpa människor att vårda detta barn och nu ge det, från 'din vuxna del', vad det inte fick då. Detta är inte bara ett misstag utan farligt, eftersom det splittrar vår person i olika delar - och vissa människor använder denna splittring som försvar. Vad som behövs är mer integration, inte mer separation.

I vilket fall som helst är detta sätt att tänka rätt och slätt meningslöst. Vi 'har' först och främst inget barn. Och om vi hade det skulle vi inte kunna göra det förflutna annorlunda genom att göra saker nu. Även om vi uppfattar termen som den metafor den är kanske vi ändå tror när vi känner att vi är i detta barndomstillstånd att vi kan läka de gamla såren genom att ge oss själva den kärlek som vi inte fick då.

Vissa terapeuter uppmuntrar individuell regression till spädbarnsstadiet i gruppsessioner och förmår sedan gruppen att 'välkomna barnet' till denna värld med kärleksfulla ord. Detta kan kännas mycket bra för tillfället men det ger ingen läkning. Vi är inte längre den baby [det barn] vi var och det är bara denna baby som behövde bli kärleksfullt välkomnad till denna världen.

De vuxna vi faktiskt har blivit behöver inte längre detta. När vi befinner oss i detta tidiga medvetandetillstånd kan vi tro eller känna att vi behöver det (kanske i någon symbolisk form) men det är inte möjligt att återvända till den tiden och tillfredsställa detta behov. Händelsen ifråga är förbi och över. Vad som inte är förbi och över är minnet av, eller smärtan förknippad med, händelsen.

Även om vi inte kan rätta till den genom regression kan vi återvända för att få kontakt med och känna den. Det är bara på detta sätt vi kan uppnå läkning. Eftersom det är 'barnet vi var' som måste få kontakt med vad som hänt och känna smärtan i det, använder jag 'barnet' för att syfta på det medvetandetillstånd i vilket den gamla smärtan upplevts."

Undrar var Miller har skrivit om detta... Återkommer kanske om det.

Se två tidigare inlägg där jag översatt delar av Arthur Janovs bok "Primal Healing", här och här.
Här ytterligare en översättning om tre ickekännande terapier också ur Janovs bok:

"I kognitiv beteendeterapi fokuserade terapeuten nästan helt på att be mig ändra mina negativa tankar till mer positiva. Till exempel kände jag mig mycket negativ under den tidpunkt denna terapi ägde rum och jag fann mig själv i tankebanor som

”Jag är ett enda stort misslyckande i min karriär.”

Terapeuten bad mig att ändra detta till

”Jag lyckas inte i min karriär just nu.”

Men detta hjälpte inte ett dugg. Faktum är att allt helt enkelt blev en enda röra av mekanistiska sätt att försöka hantera inre problem, försök som bara slutade i frustration och modlöshet.

Ett annat huvudangreppssätt hos denna kognitiva beteendeterapeut var att presentera en lista med 12 bordepåståenden som människor tenderar att använda. Sedan bad hon mig att repetera dessa påståenden utan att använda ordet ”borde”. Till exempel kunde ett av dessa påståenden ha varit

”Jag borde vara mer kompetent”.

Hon bad mig ändra detta till att säga

”Jag är kompetent”.

Naturligtvis hjälpte inte detta alls därför att jag blev helt enkelt inte mer kompetent genom att helt enkelt säga

”Jag är kompetent.”

Mycket av hennes angreppssätt kretsade kring att övertyga mig om det irrationella i mitt beteende genom användandet av ”bordepåståenden”. Hon försåg mig i stor utsträckning med en lista med regler och bad mig att lyda dessa regler. Detta angreppssätt ignorerade totalt känslorna som fanns under ytan, känslor som drev mig att känna det jag kände och därför att säga det jag sa. Hennes angreppssätt tog inte i beräkning bortträngningens princip.

Denna terapeut blev väldigt frustrerad av att arbeta med mig. Faktum är att hon reducerade och förnekade känslornas roll i den terapeutiska processen. Jag reagerade på hennes sätt genom att bli frustrerad, missmodig och desillusionerad därför att hennes sätt inte fungerade för mig.

I jungiansk terapi introducerade terapeuten mig i de klassiska koncepten inom jungiansk psyklogi: arketyper, anima, animus, kollektivt omedvetet, persona, skugga, aktiv föreställning, guidad föreställning, självet och drömtydning. Han försökte också att bli kvar i den klassiska jungianska psykologiska modellen i sitt terapeutiska sätt med mig. Han var en väldigt intellektuell person i sig själv och att jag förstod dessa grundläggande koncept var viktigt för honom. Därför ägnade han en massa tid åt att helt enkelt hjälpa mig att förstå alla dessa jungianska termer och koncept. Han erkände och godtog bortträngningens princip och han sa att de saker som jag hade trängt bort nu var i "min skugga". Hans hela sätt att angripa det hela resulterade i den nödvändiga förutsättningen för helande från patientens sida; den att patienten måste ha ett förstående av dessa termer, koncept och principer. Hans premiss var enkel: så fort patienten får en förståelse av sina problem och dessa jungianska koncept kommer helande att ske naturligt. Så förståelse för automatiskt med sig helande.

Men i mitt fall förde inte förståelse med sig helande. Förståelse förde bara med sig mental gymnastik. Processen att erhålla en intellektuell förståelse förde med sig en falsk illusion av helande. Jag sa ofta till mig själv

"Nu när jag har en intellektuell (intelligent) förståelse av vilka problemen inuti mig är, kommer jag att bli kurerad."

Jag hade denna tro igen och igen, men den förde inte med sig helande. Istället förde den med sig en tillfällig, falsk känsla av förtroende att

"Nu har jag fört ner problemet till dess rötter, nu kommer jag att bli bra."

Det angreppssättet hjälpte mig bara tillfälligtvis och då bara lätt/litet. Men varje gång som jag tyckte mig förstå problemet trodde jag verkligen att jag skulle bli kurerad. Detta hände aldrig. Som resultat av detta blev jag missmodig och desillusionerad. Processen av intellektualiserande saktade faktiskt ner helandeprocessen genom att den täckte över de verkliga känslorna som behövde kännas.

I gestaltterapi gav terapeuten mig det första intrycket att känslor skulle spela en primär roll i min terapi. Men faktum är att det gjorde det aldrig. Gestaltterapi för mig slutade någonstans mellan kognitiv beteendeterapi och jungiansk terapi. Min gestaltterapeut använde lekens/spelets roll som ett sätt att hjälpa mig att nå insikt i mitt beteende. Hon kunde säga,

"Jag vill att du spelar din far och använder detta scenario."

Andra gånger bad hon mig att spela min chefs roll, med vilken jag hade svårigheter just vid denna tidpunkt. I alla dessa fall förde rollspelandescenarierna inte med sig något helande.

Terapeuten var väldigt imponerad av sitt eget sätt att angripa det hela och med det hon trodde hände, men jag upplevde inget signifikant i form av verkliga framsteg. Därför blev jag under en period av sex månader eller ett år missmodig och desillusionerad med processen. Faktum är att jag förlorade förtroendet för just detta sätt liksom för terapeuten. Hon kände min frustration och detta orsakade friktion i vårt förhållande. Slutligen avslutade jag min terapi med denna terapeut.

Som slutsats, låt mig kommentera det jag ser som behovet hos patienten att utvärdera och erhålla feedback från terapeuten. Det skulle vara enkelt för terapeuter av alla psykologiska skolor att utveckla en utvärdering/feedback för att söka feedback på hur den terapeutiska processen går/utvecklar sig. Det som terapeuten tror händer kanske inte alls är vad som händer."