Thus, for example, the "three week intensive" becomes sacrosanct, and total isolation is demanded even of schizoid patients whose lives have been long scarred by chronic isolation. Similarily, the self-abnegating hair-shirter is proffered a "primal" hair-shirt. Pleasure and joy are not universally accepted. They often provoke intense anxiety among applicants to primal therapy. Yet, the role of pleasure, so important for Reich, is conspicuously absent in Janov's theory. He views the therapist as essentially a "dealer of pain."
An authoritarian pain-dealer, understandably, must dispense with the phenomenon of transference in the therapist. This eliminates the therapist's responsibility for excess and needless pain inflicted upon the patient. Seemingly, the more pain the better the primal therapy, for only pain provokes primal feelings. The simplism of this idea is demonstrated by patients who characteristically celebrate their screaming masochism interminably without therapeutic change. In such instances, an old child-parent transference may be re-enacted endlessly, just as it occurred in the crib.
The therapist does not wish to comprehend that he is now the uncaring mother who tolerates this old pain felt by the child. Urging the patient to "tell it to your mommy" does not exonerate the therapist's ignorance of transference. The specific nature of the transference and of the ther-apist's own emotional reactions, must ultimately dictate what the therapist does or does not do. If the patient's mommy felt helpless, or annoyed, or angry, or indifferent, eventually the therapist will begin to feel those corresponding parental feelings.
Only by understanding the nature of such re-enactments in the here-and-now with himself, can the therapist hope to transcend his own reactive transference feelings towards the patient. If not, he will unconsciously conspire with the patient to recreate the old child-parent pattern. Not only will the painful pattern of feelings be perseverated. needlessly, but the patient may lose trust in a therapist who can only deal him the same pain his parents dealt him.
Primal therapy is deceptively simple. Almost anyone can learn to begin the primal process in someone else. And, the primal process is sufficiently powerful to provide dramatic and early breakthroughs. But there is much more to therapy than primalling, for at certain junctures, impenetrable resistances may arise which tend to halt and even undo earlier gains.
It is at these crucial points that the therapist's knowledge of his own reactions as a potential part of the therapeutic blockage may be vital. His own transference and counter-transference feelings may provide stifling feedback and keep the patient "stuck" in therapy. That is the junction at which gimmicks and techniques may provide illusory but short-lived movement. No technique, however powerful, can substitute for critical self-awareness in the therapist once the primal honeymoon is over. At this point, the primal facilitators and the competent psychotherapist may be distinguished.
The transference (or re-symbolization) of unfelt early feelings is endemic in our culture. It finds expression in every variety of symbolic substitutes for the past, in present "objects," physical tensions, and in behavioral patterns. An optimal "primal" is an actual living out of an experience that has been repressed rather than fully felt and expressed. It is, ideally, a return to the origins of the transference. This primal paradigm probably led Janov to dispense with transference. "The primal does not deal with the transference." He is busily engaged in having the patient feel his wants towards his parents. In fact, "the patient-therapist relationship is ignored entirely."
Then, he paraphrases Freud: "I believe the transference is the memories. . ."; Janov, however, believes that all transference acting out can be "shut off by the primal therapist" as he pushes the patient to feel his pain. Moreover, the problem of counter-transference in the therapist is presumably resolved because no Janov certified primalist is still neurotic.
One could heartily wish that Janov was, indeed, right about this. But, neurosis, and therefore transference and counter-transference, are here to stay - at least for several more generations. The patient-therapist relationship "ignored entirely" by the therapist, stubbornly remains operative. To ignore these ever-present two-way interactions between the therapist and the patient serves to emasculate the primal method, and it deprives the therapist of a very importanL source of self-awareness. For example: The therapist's need for "success" with his patient, can become part of the patient's problem, because of his own earlier experience with his parents' need for success foisted upon him.
In such a case, the primal work may circle endlessly around these old family feelings blindly re-enacted by both patient and therapist. Subtle, but persistent needs for power and control by the therapist may limit the primal work as it sets up an apriori inequality: the real, non-neurotic therapist vs. the unreal, neurotic patient. Once again, here, an old and familiar parent-child relationship is repeated and reinforced. At some point, the patient is compelled to choose continued submission and abasement, etc., or exacerbation of somatic symptoms, or acting-out in his external life, or even flight from therapy rather than express his mounting rage towards his parent-like therapist.
The potential infantilization (not therapeutic regression) of the patient implies the overly sanguine division of humanity into the sick and the healthy, the patient and the therapist, as propounded by the notion of a "cured," transference-free therapist. It is difficult to imagine a more "unreal" conception than the "normal therapist" notion!
However curative the primal experience may be, there is no evidence and even less reason to assert that primal therapy can finally "cure" neurosis. Janov has made an overly zealous leap from his brilliant primal paradigm to the unreal belief that primal actually produces non-neurotic therapists as well as "normal" patients. Given the complexity of life-long reinforcement of neurotic character structure in our almost totally neurotic culture, the expectation of a "cure" seems a patently naive one. Certainly the ex-patients and therapist-trainees of Janov's thus far encountered are visibly far from cured non-neurotics.
The "primal pool" dug by decades of living cannot be totally drained by several weeks of intensive and 18 months of group work. Nor does the primal pool seem likely to have a finite depth in any practical sense. What must be admitted, however, is that primal therapy can be quicker and more profound in its therapeutic impact than any other known form of psychotherapy. This palpable efficacy is the major cause of primal's rapid, world-wide dissemination. More people are turning to primal for help, and more traditional therapists are beginning to modify their practice in a primal direction.
The primal breakthrough, after three quarters of a century of fairly futile psychoanalytic therapy, is indeed an epochal one. Its immense efficacy is very promising both for the individual and for society. But like all great revelations, primal is quickly threatened with dilution and erosion. Its experiential core becomes overlaid and obscured by dogma and ritual in the very process of transmission from teacher to student, from guru to followers.
The pioneering genius who cuts a path into the wilderness of the unknown, begins to block the path with his own formidable stature. As he defends his precious discovery, his views may become defensively rigidified and his followers may begin to worship his personal idiosyncracies which become elevated to dogma. Dumb fetishism and cultism begin to flourish around the leader as idolatry obscures fresh experience and further discovery.
But the primal breakthrough can continue to break through only if it continually faces this ancient parent-child repetition. That "repetition", in the therapy sphere, is transference to and from the patient and the therapist. The elimination of transference is an ideal goal which may be approached for the greater good of both patient and therapist, if the therapist continually directs his patient and himself back to the underlying origins of the transference neurosis. This is much easier said than done, but it must be worked on ceaselessly. Let's face it: Sisyphus is still alive, and not well.
This article is from the Fall, 1975 issue of the International Primal Association's journal, Primal Community. Reprinted with permission.