Historical Context & Developments in Britain
Primal Integration is a form of therapy brought over to Britain by Bill Swartley, although it was also pioneered here by Frank Lake. It lays the major emphasis upon early trauma as the basic cause of neurosis, and enables people to regress back to the point in time where the trouble began, and to relive it there. This often involves a cathartic experience called 'a primal'. But some people using this approach do not like this language, and instead call what they do regression-integration, or reintegration, or holonomic integration, or intensive feeling therapy. It is strongly influenced by the research of Stanislav Grof (1975), who pointed particularly to the deep traumas often associated with the experience of birth.
Historically, this approach is close to early Freud, early Reich and Janov. But all of these adopted a medical model of mental illness, which primal integration therapists reject. As Szasz (1961) pointed out long ago, neurosis is only a metaphorical sickness. Rather do we stand with those who say that we are less concerned with cure than with growth.
As soon as one gets down into the early roots of mental distress, deep and strong feelings come up, because the emotions of early life are less inhibited, less qualified and less differentiated than they later become. And so the whole question of the importance of catharsis in psychotherapy arises here. As Kaufman (1974) has reminded us:
It was Reich and Perls, not Janov, who discovered the techniques for deep emotional release that are utilised to produce primals. . . the Reich ian-oriented therapist Charles Kelley (1971) used the term 'an intensive' years before Janov to describe experiences identical to primals. (p.54)
One can go further back and say that catharsis is found in prehistoric shamanism, Greek tragedy, the work of Mesmer and throughout world literature. Nichols & Zax (1977) have a very full discussion of this long history, where they say:
. . . catharsis has two related but separate components: one is Relatively intellectual-the recall of forgotten material; the second is physicalthe discharge of emotion in tears, laughter or angry yelling. (p.8)
But in the kind of work which is done in therapy it seems better to be more specific, and to say with Pierce et al (1983) that catharsis is the vigorous expression of feelings about experiences which had been previously unavailable to consciousness. This lays more emphasis upon the necessity for the emergence of unconscious material.
What Swartley, Lake, Grof and others did was to bring together the idea of catharsis and the emphasis on getting down to the origins of disturbance with another very important question-the transpersonal and the whole area of spirituality. (These terms are explained very well elsewhere in this book, particularly in the chapters by Whitmore & Hardy and Gordon-Brown & Somers.) This means that primal integration therapy can deal with the major part of the whole psychospiritual spectrum mapped out by Ken Wilber (1980). I believe it is unique in this, except possibly for the holotropic approach recently described by Grof (1985).
In 1973 about a hundred people met in Montreal to form the International Primal Association (IPA), founded by Bill Swartley, David Freundlich, William Smulker and others. In an attempt to get Janov to admit that he was part of a wider movement, he was offered the position of first president, but declined. In 1974 a journal was produced, called Primal Community, and Janov proceeded to sue for infringement of his registered service mark Primal Therapy. After a court case (the high expense of which meant that Primal Community could no longer be produced), the IPA won on the grounds that the word 'primal' had been used by many other people (including Freud) over the years, and could not be taken out of the public domain in the way required for Janov to win the case.
Swartley travelled round the world starting up primal integration centres of one kind and another, and in Italy a very good one of these still exists, run by Michele Festa, who is very active in Rome in the whole field of humanistic psychology, and who has now also extended to Zurich.
Developments in Britain
Frank Lake started to work with LSD at Scalebor Park Hospital in 1954. He discovered, as Grof (1975) was also finding at about the same time in Czechoslovakia, that getting in touch with perinatal (round about birth) experiences could be very important in the process of psychotherapy. Around 1970 he discovered bioenergetics and the Reichian and neo-Reichian work of Boadella and others, which showed that LSD was not necessary to get into the reliving of early traumas-all that was needed was permission and possibly some help with breathing. This connected with the earlier work of Rank (1934), Fodor (1949) and Mott (1948) who had been unjustly neglected, mainly perhaps because they did not have any technique to offer other than the very slow and tortuous analysis of dreams. It also connected with the work of Donald Winnicott (1958) and the rest of the object relations school, who stressed the importance of pre-Oedipal problems.
Lake started calling his work primal integration only in the 1970s, after meeting Swartley. He then went on to further discoveries about foetal life (compare Verny 1982), and later produced some of the most exciting work yet done on foetal traumas (Lake 1980, 1981). His death in 1982 robbed us of much more exciting work. Recently his major work has been published in abridged form (Lake 1986), making it much more accessible.
Another pioneer was William Emerson, another member of the IPA who spent a good deal of time in Europe. He had been trained as a clinician, and worked for some time in hospitals, but got more and more involved with regression and integration therapy. He also started calling his work primal integration, and was a quite separatesource of influence in this country. He pioneered the idea of actually working in a primal way with children, and produced a pamphlet on Infant and Child Birth Re-Facilitation (Emerson 1984) and a video film of his work with them.
Also in the mid-seventies Stan Grof cameto Britain several times; he had met primal integration people at the second IPA conference and had found there the way of carrying on his work without the use of drugs.
I came across Primal Integration in 1977, and worked closely with Bill Swartley until his unfortunate death in 1979. We who had been involved with Swartley carried on for a while as the Whole Person Cooperative, but this no longer exists. At present Richard Mowbray and Juliana Brown are doing excellent work at the Open Centre in London. I am doing individual therapy, and a few training workshops. The CTA carries on teaching Lake's approach, and many of Emerson's pupils are now working. An important centre is Amethyst in Ireland, where Alison Hunter and Shirley Ward work themselves, and also bring over Emerson and others to develop the work.
It will be clear from what has been said that Primal Integration is a syncretic approach which brings together the extremes of therapy: it goes far back into what Wilber (1983) calls the pre-personal realm and deeply into the internal conflicts of the individual; and it goes far into the transpersonal realms of symbols, intuition and the deeper self. It is this combination of extremes which makes it so flexible in practice.
Image of the person
The person is at bottom human and trustworthy. Deep down underneath all the layers and the roles and the defences and the masks is the real self, which is always OK. This belief gives great confidence in going down into those areas of the client which he or she finds the deepest and darkest. Here we are very much in agreement with Mahrer (1986), although the language is different.
The person starts early. Memory can go back to before language is acquired. People can often remember their own births. The foetus is conscious. All these statements are empirically checkable, and in recent years more and moreevidence has been appearing about them. Much of this material is now written up and easily available in Verny (1983)-this Canadian therapist was actually one of the founders of the IPA. More evidence about consciousness at birth is given by Chamberlain (1984).
This means that Swartley (1977) can write about eight major categories of trauma which may occur and be important in later life, all located in time between conception and the end of the first hour of life: Conception trauma (Peerbolte 1975); fallopian tube trauma; implantation trauma (Laing 1976); embryological trauma; uterine traurna (Lake 1980, Feher 1980, Demause 1982); birth trauma (Grof 1975, Janov 1983, Albery 1985); and bonding trauma (Klaus & Kennell 1976). Of these, the birth, uterine and implantation traumas are the ones which come up most frequently in therapy, though Shirley Ward believes that conception trauma may come up more often if we allow it to do so.
So to sum up, our image of the person is essentially of a healthy consciousness which may become visible as an ego at any point between conception and about three years old.
Some primal integration practitioners are prepared to work with the notion of previous lives (Netherton & Shiffrin 1979, Grof 1985), and this is done at the Amethyst centre in Ireland, but I have little experience of this myself and prefer not to talk about it until my understanding is greater.
Concepts of psychological health and disturbance
We are naturally healthy mentally, just as we are naturally healthy physically. We have basic needs to exist, for protection against danger, for contact comfort, for love, for sustenance, forexploration, for communication, for respect, and so on. As long as these needs are satisfied, we will stay healthy and grow, as Maslow (1970) more than anyone else has insisted. But if we get poison instead of food, isolation instead of contact, exposure to danger instead of protection, hate or indifference instead of love, insecurity instead of security, emotional withdrawal instead of support, mystification or double-bind instead of learning, then those basic needs will remain unmet or unfulfilled.
When such primal needs are unmet by parents or other caregivers, or seem to be from the infant's point of view, the child will experience primal pain. And needs do not go away - they still remain - so the child has primal pain and unmet needs, too. This is what is meant by trauma.
This primal pain can be too much to bear. Lake (1980) describes four levels of experience:
- Level 1 is totally need-satisfying: everything is all right.
- Level 2 is coping: there are some unmet needs but they are bearable, still within the realm of the 'good enough'.
- Level 3 is opposition: pain of this order cannot remain connected up within the organism; it is repressed, and many aspects of the matter are pushed into the unconscious, in the manner suggested by Freud. Defences are then set up to preserve this solution, and to make sure that it stays forgotten.
- Level 4 is transmarginal stress (this term is taken from Pavlov's work) and here the pain is so great that the much more drastic defence of splitting has to be used. The whole self is split into two, and only one part (the 'false self' as described by Winnicott (1958) and others) is adapted to the new situation, while the other part (Winnicott's 'true self') is hidden away as too small, too weak and too vulnerable.
The self is then defined as not-OK or bad (this is now the false self, which is all that is present in awareness) and can even turn against itself, willing its own death and destruction. In this area Reich, Balint, Winnicott, Janov, Grof and Laing are in substantial agreement, emphasizing that Level 4 is not an unusual response.
The earlier the trauma, the fewer resources the infant has for dealing with it, and the morel likely it is that the more drastic defense will be used. In this context, health is staying with the true self (real self) and disturbance is whatever leads to the setting up of a false self (unreal self). So in adult life many people, not just a few, cultivate their false selves (persona, self-image, role, mask) rather than keeping or retaining touch with their true selves.
Alice Miller (1985) has attracted a good deal of attention recently by her criticisms of many psychoanalysts for ignoring early traurna, and has specifically said that the primal approach has a much better record in this respect. But she shares with Janov a tendency to blame the parents and leave it at that, which we in primal integration
do not do. FreundIich (1973) makes it clear that this is not a criticism of parents in general, or mothers in particular:
Thus primal pain will occur no matter how loving and caring parents are, and how diligently they attempt to fulfil the child's primal needs. Since the child is helpless and dependent and cannot understand much of what occurs in his world which is beyond his control, he experiences pain even though the intent of those around him may be loving. (p.2)
What we are saying, therefore, is that most people have some degree of disturbance rather than being totally healthy. If this is so, we shall expect to see neurosis on a vast scale. And according to Mahrer (1978), deMause (1982), Wasdell (1983) and Miller (1985) this is indeed the case. They have brought out social analyses which demonstrate in great detail just how much our whole society is subject to projections, denials and other defences on an enormous canvas.
Acquisition of psychological disturbance
We have already said that neurosis is acquired through traumatic experience. The same is true of psychosis and borderline or narcissistic conditions, except that here the trauma is earlier in time, The most adequate account of this is to be found in Wilber (1984), who develops the notion of a fulcrum. A fulcrum, in his terms, is a point where a developmental step has to be made by the individual. There are three things which we can do when faced with such a developmental moment:
Wilber (1984) distinguishes nine such developmental fulcrums, though he says much more about some of them than about others. Janov (1975) has his own simpler version of this idea, and describes three broad stages of development, which correspond to different traditions in psychotherapy, and also to three different areas in the brain:
- We can retreat and resist altogether (this is most likely to be when the previous step was so traumatic that defences were raised which placed the utmost emphasis on safety and security);
- We can go halfway and then get stuck (this will be mostly when a trauma hits the person during the process of that particular developmental moment); or
- We can go all the way and thus ready ourselves for the taking of the next developmental step.
Where we would differ from Janov, however, is that we do not believe that experience is reducible to brain function. It seems clear now from all the research on the near-death experience (Gray 1985) that the brain can be completely knocked out while experiencing continues. Similarly in foetal experience, as Mowbray (1985) points out:
- Third-line traumas are those which occur when we have access to speech. These are the events which the classical Freudian analyst is most commonly working with-the Oedipus complex may be involved in some form. They are registered in the cerebral cortex-the newest part of the brain-and language and meaning are very important. Often three peopleare involved in such late traumas-the child and the rival parents.
- Second-line traumas are much more primitive, going back to the time before speech came on the scene, but when emotions were developed and deeply felt, often involving dramatic fantasies. Language is not important in these cases, and may be altogether absent. And this is usually a pre-Oedipal two-person relationship, which the object relations school are very happy working with (also Kohut and Lacan). Such traumas are involved with the limbic system of the brain-this is the area in which tranquillizers are aimed at, and where they have their main effect.
- First-line traumas are more primitive still, going back to the time before any differentiation of the emotions took place, and where survival is the main issue. This involves the reptilian brain or R-complex-the most basic and oldest part of the
brain, which we share with most of the animal realm. There is hardly even much sense of two-ness here - just deep fundamental feelings of positive or negative.
Certainly there are more physical and survival traumas in the early stages, however there is also a being there experiencing the meaning of these, and the splitting-off of the memory is not necessarily an event in the brain alone. Thus we find aspects of these very early experiences that are expressible in words. (Personal communication)
Even when the earlier traumas are not expressed in words, it often takes many words to work through the experience of reliving such a trauma and to integrate such a breakthrough into current daily life.
What we find is that third-line traumas tend to produce neurotic defenses, while first-line traumas tend to produce psychotic defences. (Second-line traumas may go one way orthe other, or produce borderline or narcissistic conditions, as Kohut (1971, 1977) has suggested.) And again, this suggests that psychosis is more common and more ordinary than we thought. Some of us now talk about the 'normal psychotic' just as a few years ago we used to talk about the 'normal neurotic'.
This means that we are apt to regard as screen memories (that is, memories which purport to be basic but which are actually hiding something more fundamental) the material which many other therapists are quite willing to treat as bedrock. Swartley (1977) gives the analogy of tearing down a rotten building: you tear it down until you get to something solid, and then you build up from there:
Or you might have to go further back again. In one case this woman was dying of tuberculosis, knew she was dying, and when she knew she was pregnant she didn't want to know, she rejected the baby right from the start, and that was transmitted to the child in utero. And there was no good motherhood to look back to, the mother had never been a good mother. So this person had to go further back, we took her back to Jung's archetypal level and she found inside herself the archetype of the Great Mother. And that is somehow inherited as part of the racial heritage, and she went back to Ireland and nourished herself with the Great Mother inside of herself. And that was 'solid' for her. (p. 168)
It can be seen here how the transpersonal comes in as an integral part of the process of therapy, as Grof (1985) also emphasizes.
But of course traumas are seldom as dramatic as this. The commonest causes of neurosis are simply the common experiences of childhood - all the ways in which our child needs are unmet or frustrated. Hoffman (1979) has spoken eloquently about the problem of negative love. Because of the prevalence of neurosis and psychosis vast numbers of parents are unable to give love to their children. Hoffman says:
When one adopts the negative traits, moods or admonitions (silent or overt) of either or both parents, one relates to them in negative love. It is illogical logic, nonsensical sense and insane sanity, yet the pursuit of the love they never received in childhood is the reason people persist in behaving in these destructive patterns. "See, Mom and Dad, if I am just like you, will you love me?" is the ongoing subliminal query. (p. 20)
This is not necessarily a single trauma, in the sense of a one-off event-that is much too simplistic a view. Rather would we say with Balint (1968) that the trauma may come from a situation of some duration, where the same painful lack of'fit' between needs and supplies is continued.
Perpetuation of disturbance
We have many, many ways of maintaining our neurosis. Our defences have been built up over years, and they are designed to keep the system going - painful as it may be. Losing them feels very dangerous.
If we study ourselves as we go around our world, we find that we are talking to ourselves the whole time. This is a very old observation, which Buddhism and Yoga noted and commented on centuries ago. There is a sort of chatter which proceeds independently of our will or control. Recently the cognitive therapists such as Beck and Ellis have been spelling this out at length. And with neurotic people, the talk is usually negative (though it can also sometimes be grandiose), consisting of statements like: "you'll get it wrong;" "you don't deserve to have any pleasure;" "they will all reject you;" "you aren't worth anything;" every possible self put-down.
This is part of the defensive system, and part of the negative love system, and the whole object of it is to keep us safe. But of course it doesn't keep us safe at all. It compulsively keeps us down. And it is our character.
This is a radical position, close to that of Reich, who said somewhere that character is neurosis. What this means is that all our rigidities, and particularly the good ones are holding us back and stopping us from developing any further. But they are not under our conscious control because they have their roots in our defensive system, which has its roots in our primal traumas. So the self-talk, whether negative or positive, actually keeps us away from the deeper parts of ourselves - what Mahrer (1978) calls the deeper potentials. And in fact the object of the self-talk is precisely to do this, in just the same way that the muscular defences described by Whitfield and Boadella in the present volume are there to keep us away from our deeper feelings.
And because much of the self-talk comes from injunctions given to us by our early caregivers, it is really the opinions of others which we are using to avoid our own deeper selves. We see ourselves through the eyes of others, instead of looking ou through our own eyes. We are alienated from our own selves and our own freedom. We are, in a word, inauthentic.
Society, of course, helps us to stay that way. It is very convenient for those who run the world to have working under them a great mass of people who only want to play roles and who have no desire to know who they really are. Our whole social system acts in such a way as to support our inauthenticity, our role-playing, our false selves. It continually tells us that the self-image is very important, the self not important at all. It even throws doubt on the notion that there is a real self.
This whole effort is strongest in the area of sex roles. We tell ourselves, and are told by others, that there is a right masculine way for men to be (Reynaud 1983), and a right feminine way for women to be (Condor 1986). This again is a socially sanctioned inauthenticity which enables us to hide behind a role and not know who we really are. If men are schizoid or psychopathic or rigid, this is partly because these things fit all too well with the masculine image; if women are masochistic or depressed or hysterical, this is party because these things fit all too well with the feminine image.
That is why we lay so much stress on integration. Integration is the process by which our insights and breakthroughs in therapy can be translated into action in the everyday world-what we sometimes call the unreal world. It is only in the nitty-gritty details of everyday life that we can stop the perpetuation of disturbance.