A Presentation to the American Psychological Association On Primal Therapy (Scotsdale Arizona)

Bob Shaef spoke to introduce the workshop:

I am pleased to be here. It's been a long time since I've been to a Division 29 mid-winter meeting. It touches me deeply to see some familiar faces among you. (I was thinking here how beyond the pale of respectability I've felt.) I am especially pleased to have four colleagues here with me so that the burden of representing this new and innovative therapy, which has not been taken into the mainstream of psychotherapeutic practice, does not rest solely on my shoulders. So let us tell you each in our own way what we have learned.

Michael: The proposition that Janov set out was that the abuse and neglect and trauma that we've all suffered gets locked into our systems, and when we have to repress that so as not to allow any natural response to the pain to occur, to show, it creates behavior in adult life which we call neurotic and psychotic. That's a very orthodox and basic kind of idea he was putting forward. When he said something very different than what had been said before was that pain, those events, can be re-experienced, and through re-experiencing them the body goes through a curative process, a healing process. It integrates what happened in your life into the present. You then can walk around in a more whole way, more capable of confronting life as it is instead of out of the push of the pain -- out of the push of the craziness.

Audience: Michael, I was very impressed that you actually went through the standard treatment with Janov.

Michael: Yes I did.

Audience: How long did it take, the whole process? I know the time that he proposes, but it seems like what I have heard on the East Coast is that people seem to never end the Primal process. They go on being group patients and never end being patients.

Michael: It is not a process that takes place over six months and then you are well.

Audience: Which he sort of gives the idea of.

Michael: He very definitely gives that idea both in his earlier books when you might say he didn't know better and later on when he definitely should have known better, he certainly didn't retreat from that position. He let that stand. He's an expert showman. I don't want to put him down too much although the feelings come up when I start to talk about it.

Audience: Let your feelings come up! That was exactly what we experienced in New York. Usually in our existence as therapists we share our knowledge just as scientists share they knowledge and move science on. He came to New York and acted like he had hold of a precious turd that he wasn't going to share with anybody.

Kathy: I'd like to speak directly to the question you raised before, "When does the process end?" What people are actually learning to do is to meet present situations that trigger a big load of life-long maladaptive behavior patterns and yet be able to see that the situation stays itself. It's not the same as when your mother did this or that. You know that a feeling is coming up and either excuse yourself from the situation and let yourself have the feeling - let your body release what is there - or meet the situation now and give yourself some time later on to let your system release. The idea is not that you end up with a totally cleaned out body (not physically repressing specific feelings), but that you've cleaned out enough so that you're not all of a sudden blind with rage when something hits you, or else completely blank when the rage is going on down here (touches her stomach) and getting ulcers. It's that your body is open and when you meet a situation you're stable inside, and you can choose. Your system doesn't stop needing to release and you can just do it when it's appropriate in your life. And no, you don't have to stay a group patient for the rest of your life.

Michael: Feeling what happens inside is something that I and others who get involved with this therapy want to have access to for the rest of our lives. The huge push that I came into therapy with has slackened off a lot to the extent that it is not driving my whole life like a locomotive. But to want to go on having the access to feeling the pain, to getting in touch with it, to hitting into the areas that are blank in my life, to seeing what I'm doing with myself, is something that will go on as long as I live.

Audience: About how long does a person stay involved in a treatment capacity?

Michael: That depends very much on different people. Initially, the patient is very closely involved with his particular therapist. We start off with a three-week intense period when the person has a session nearly every day with the therapist -- a fairly open-ended session, two hours, two and one-half hours. During that three weeks he's introduced to group therapy gradually and after that he starts coming to groups on his own. Later, he starts what we call buddying with other people which means that a friend of his who's also in therapy will sit for him and in return he will sit for the friend. They will be helping each other getting to the feelings. So that there isn't particularly a length of time I could put on it. Some people come into therapy and stay for six months and they drop out and feel that they have gotten an important chunk of what they've wanted. Other people feel that just the whole thrust of the process is something they need to stay in touch with for a long time -- to be around other people who are open to seeing their feelings, to encourage them to have their feelings.

Kathy: I have another distinction to put in here too. There is no way to really categorize people into two different ways of having defended in their lives, but in general the people who have locked completely into their brains so that they wouldn't even know if they were short of breath, which I was, generally need to use the fact that the Center is there and people are acknowledging feelings all the time for a period of years. For me, after about four years I had enough validation that I could feel comfortable going anywhere and knowing that I live inside a physical body. There are people however, who have kept a sort of knowledge inside themselves all the time; that all the things that say, "Don't cry, don't feel, don't know that you live in your body," are crazy. They know they're alive all through whatever they go through.

These people, when they come to the Center, tend to just have enough validation for that part of themselves that after a couple of months their lives change so dramatically and they're so positive that they can live from inside themselves that they just come back to use us every couple of months when they hit a hard spot.

Michael: One more very important thing about the implications in Janov's writings -- there's a lot of emphasis in his books and a lot of belief at large that screaming is somehow central to this therapy. It isn't. It has nothing at all particularly to do with it any more than any other form of letting the emotions show. To imagine that just by screaming you could get in touch with the kind of trauma and pain which have happened in your life, and to get in touch with why you are behaving in a way that feels horrible to you and disturbing to other people, is absurd and degrading. So I want to erase the term "primal scream" from your thinking.

Audience: But in doing that you put yourself in touch with very many other therapists and suddenly you become connected with some of the hopes of even psychoanalysts.

Michael: Absolutely, and it's true as well that Janov made this artificial distinction that, "Suddenly I have made this huge step and I'm on a terra incognita as far as the rest of you are concerned. It's a totally new land out here, come over and join us." It's not true. He was standing on other people's shoulders. he was using a lot of techniques, a lot of awareness that he'd learned from Reich, Rank, Freud and Perls and so on, who he didn't give credit to. The difference is this -- that we are aware that the body physically stores the record of neglect and abuse. Physically, not just in the sense of mental structures and behavioral structures, but physically and that that record is accessible in the therapy we do. We are aware that people will get on a track, i.e., that the feelings of their life will start to emerge and will have a coherence and a direction about them which is particular and individual to them and they won't deviate from it. They will come out at their speed, in their time and in a way which is appropriate to how it was laid down for them.

Barbara: In fact, this is what's happening anyhow, that this is a natural inclination of the organism to do this and what you learn, what I've learned, is to suppress, to defend, hold down the body's inclination to go towards the truth which is often synonymous with pain. A lot of people do it really successfully --they learn really appropriate, successful defenses and those you don't see in therapy because they get along quite well.

Michael: One thing I think is very important is that Primal pain goes back extremely early -- that it's not just infantile and childhood pain, that it's laid down in the fetus in the womb, that it is laid down at birth and that the sort of trauma that happens at that stage of development is extremely intense because there isn't any kind of baffle to experiencing things at that stage of development. So, it's very intense and becomes both diffuse and very widespread in the person as he grows up. The traumas that occur at this early stage which we consider to be absolutely fundamental to our understanding of how people operate, of how people are, are very deep, very profound and very difficult to get at. It relies on the therapist and patient having a trust in the natural process of his pain being accessible.

Audience: I was practicing in L.A. when Janov first presented to the psychology association his concepts and he brought some of the people he had been working with to sort of validate what he was doing and of course had the tapes that emphasized the scream and dramatized this aspect of it. The group he developed there was almost a cult. This was obviously because of Janov's own needs for this kind of position, and this kind of significance. And therefore, for people like you to begin to move away is a kind of step for all of you. But I think the thing that also struck me was that now you're talking about people reaching a place where they go back and live with the world rather than in the cult. Which of course is the essence of the ultimate attainment of one's own identity, when you can be with the world and still be with yourself at the same time and maintain that integrity within yourself.

Michael: That's the difference between a therapy and a religion.

Audience: That's right and this is the thing I was responding to that feels good to me.

Kathy: I have something about how it moved from "Janov must be right and there must be a cure and you must have to scream and is this really a Primal etc." into, "Here we are as human beings and here are our lives." How it moved was that in the years of experiencing the process -- the physiological process in ourselves -- and seeing it happen all the time with other people and seeing how not to get in the way of this process. It was like nurturing a life force that was already happening in each person's body. And so the more the integrity of the process is seen and acknowledged the less possible it is to think that there could possibly be a scream, or a prescribed way of this or that. It's just, "How do you help someone really touch inside their bodies and touch that process?"




Michael: I wonder how clear it is to everyone what is meant by being on the floor, being able to go deeply into feelings?

Audience: No, it is not clear to me. I'd like first of all to know what does it mean to drop into your feelings.

Kathy: For instance, you notice that something is bothering you -- it might be someone else's tone of voice is starting to grate, or, "How could somebody else think that way?", or all of a sudden your brain doesn't grasp a point, or whatever, and you know that there are feelings going on beneath that are pushing that. Otherwise, you'd be right here in the present and everything would be just what it was.

And so you start with the trigger in the present, or the state that you find yourself in and notice what's happening in your body. Maybe say a few words to the person that's the trigger for you, e.g., "When I hear your voice that way it does this to my body," and just follow whatever your system does. Eventually, as you're following your body, tears might start to come, or you may find yourself short of breath. If you're focusing on this person's tone of voice, and your father always talked to you that way, the way your father's voice sounded will come right into your awareness and you'll be crying and releasing. . .

Michael: Sometimes I start feeling diffusely uncomfortable and I don't know why. If I lie down the physical discomfort starts to manifest itself in some way. I may have no idea then or subsequently of what that actually means. But its important for me to let myself have that. Otherwise I'm going to spend the rest of the afternoon struggling or fighting against the feeling, or doing something around that and not around what else is going on.

Audience: How do you find working with that energetic phenomenon that's going on in the organism with the person laying on the floor? It seems like the image I'm getting from hearing you, is that you do a lot of regressive work as opposed to getting a feel for that same system working with a person in a more adult position . . . say on their feet. I think different things happen when you're going through the same process of getting in touch with his breathing or what you were talking about when you're on your feet than when you are on the floor. I see that happening with my patients.

Michael: What happens with your patients?

Audience: A regressive phenomenon happens when a person's on the floor a lot of the time.

Michael: And what happens when they stand up?

Audience: In most instances I see with that same person that's standing on his feet more of a connection to a base, or there seems to be some sort of a power connection or a straight connection, either that or they then drop down into a more infantile connection. And I think that they're both important; I'm not discounting, I'm just asking.

Barb: I just want to put in that we say "on the floor" the way someone else might say "on the couch" or "in the office." It doesn't necessarily mean lying on the floor - it's whatever position the patient feels is appropriate to his feeling at that particular moment.

Warren: But it does bring up the issue of how you integrate the regressive phenomenon. We spent a lot of time on that. I'd like to share with you what I've done. I left the Primal Center primarily because of the changeover from a medical model to an educational model. What I've done is gone back to a general practice. What I'd briefly like to discuss with you is some of the things that I do differently in the general practice because of my experience in Primal Therapy. I do not now deal with the motivated patient. One of the things that comes out in the statistics is that the kind of patient we got had a great awareness, compared to the average person who comes into therapy, that he really was in pain and in a bad place. Now, I'm working with a group of people who are more typical - who come in with much less awareness about themselves.

On the other hand, I have one person I've seen once a week for two years who's done essentially a Primal kind of therapy. We've never labeled it as such - its never been identified as such and yet I think that's what occurring. I think that the bland white idea that Janov espoused that there's Primal here and everything else is over there is hogwash. There's a continuum. When people get into their feelings it isn't necessary that they spend the rest of their lives at the very depth of their feelings - they can experience the benefits of feeling at whatever level they are and wherever they are.




I get the idea sometimes when I attend analytic functions that the only benefit seen of feelings is catharsis, and that somehow that isn't therapeutic. It makes you feel better but it doesn't really do anything for you. And I believe that that's the big difference: in Primal we believe that the body feeling in itself puts things together.

I've had this happen to me - the connections that I've made about my breech birth. Throughout my life I've been able to go around the corner and come in the back way (cries briefly). When I made the connection that that was the result (cries) I don't want to make this too dramatic - it isn't just because I had a breech birth that I acted in certain ways, but the events of my life that reinforced the kind of pain that I experienced during my birth. By allowing myself to have the feeling, things feel into place about what I had experienced.




I think from a broader perspective what it's done in my life is to give me a greater appreciation for feeling. We're a very anti-feeling society. We're raised in a society that comes from Freud who believed we're instinctual beings who have to be controlled, or Christian society, which believes you're born in sin, got to be shaped up somewhere along the line. I think what Primal has done and the attitude I try to project with what I do with non-Primal patients is to have a greater respect for the nature of the human organism. The other part that I pay much more attention to now is what happened at birth, what happened at early times that I wouldn't even have asked before. We were asking to write a social history when I was in medical school, in which we always asked about birth and we always said, "Now why do we ask that question?" Well, now I know. We ask that question because it's crucial. I am thinking of the future we have come up with from the questionnaires, that 55% of our starting patients in Primal Therapy believe they had a normal birth, but I think maybe only 5% of those were actually normal births. What goes on in the delivery rooms in this country is a crime. They're all classified as normal deliveries. I think appreciation for and research into early development, how sensitive the infant - the fetus is, is just beginning to catch up - it's just beginning to go in our direction. It's very painful for me to go to the University of Colorado lectures and hear, as Coppolino, the head of the staff there said the other day, "You know this research we're doing, we're going to have to do a complete turn around of how we understand how sensitive the infant is." I could have told him that five years ago, but he couldn't hear me because we were doing, "crazy stuff called Primal Therapy." But the sensitivity of the infant and what it can take in is incredible.




Audience: How young have your clients been - do you have a minimum age for this philosophy?

Barb: We haven't taken anyone less than 18, and those (under 21) we carefully screen. We feel they're more successful if they've had some life experience to draw on. The oldest we've had, for no reason other than the oldest we've gotten, is 57. The mean is 29 so they lump fairly heavily between 21 and 35.




Kathy: I've seen a couple of things happen, which seem to the point here, and of course it depends entirely on how that particular person's body is organized against the pain. One woman came in who was raised by the epitome of the Hitler father - the whole Germanic structure. She came in and her body was totally rigid. One thing that helped, and it took a long time . . . One thing that worked with her was asking her to write down every day, every situation in which she notices that something strikes her and to ask herself, "What hurts?" And no matter how the words come, just put down as best she can, what hurts, what hurts?

Also there is a barrier inside every person's brain saying "What feelings? I don't have feelings, everything's fine," that they don't know anything's going on. And that premise is wrong. They do physically know. . . it just isn't conscious knowing. And if you speak to them over and over in the thousands of different ways that you physically know inside that they physically know inside, and you keep always reaching underneath their denials with your knowing, it really pulls on the feeling. I've worn down a couple that way - it just takes a lot of energy.

Bob: There's another thing too. . . sometimes they say, "I don't feel anything." You might comment on the lack of feeling as they're describing very emotional things. So you ask into that and they say, "well I don't feel anything." Then you can ask, "What's it like not to feel anything?" and you're into the feeling. In these 'dead' people they're talking about, the deadness can be the feeling. That's why screaming doesn't make any sense. It's that very quiet, dead place that they've been all their lives and have been struggling against, and when you ask into it and get them closer to it and can allow them in that space of deadness . . ..(snap) it'll go somewhere.

Audience: That's helpful.

Warren: There's another thing that I'm thinking of, which came up with a specific patient, who always said he didn't know what he was feeling - I got around that by saying. "Make it up."

Audience: What would you be feeling if . . . . .?

Warren: Precisely! He can't get to the feeling in his body because his brain has blocked all awareness of feelings. When he makes it up, it's incredibly right on. Unfortunately, in this case, this particular feeling still didn't happen. However, I was working with a woman the other day who kept laughing whenever the feeling would come up. I said, "What do you think the feeling is under that laughter?" She said, "I don't know," so I said "Make it up," and she really started crying hard.

Bob: Yes, very often if you can support the laughter, let them have it, then it dissolves into whatever is the underlying feeling.

Warren: She was also talking about some memory from childhood, and was having the same difficulty typing it into a feeling, so I said, "If you heard that story about some other child who was treated that way, what would your reaction be?"

Kathy: Yeah, taking it a couple of steps away so it doesn't block the brain. People come in and the only thing they can cry about is a baby bird or something.

Kathy: Something we have to be true - and I'm sure you have too - is that the feeling is already present and its the consciousness that has to expand out to meet it. Crying about the baby bird, for example, might take them right into deep body feelings, and if they can do it enough times, just that releasing as opposed to the constant swallowing down of feelings that they have been taught to do, allows more opportunity for bringing it closer to themselves. Coughing may be very important too. I have found that sometimes just before the opening into the true meaning of some feeling or event comes, coughing often starts to happen, and allowing that to happen, allowing the mucus to come up, is an important part of opening up.

Audience: Are you talking about spontaneous coughing or something that you encourage?

Kathy: Spontaneous.

Barb: I can remember in the old days before we really knew what we were doing, how we would be encouraged to suppress the cough, "crying around the cough," or something crazy like that.

Warren: We've come a long way in these past 5 years.

Bob: That seems to be a good place to stop. We'll be around the rest of the week and would be glad to talk to anyone individually. Thank you for coming.

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