The author's credentials are both as physician and clinical psychologist. His interests are in medicine,
neurology, biology, evolutionary principles, analysis and object relations,
animal psychology, regressive work, primal therapy and hypnotherapy.
In a series of e-mail exchanges, he wrote some interesting observations about primal theory and therapy which I thought should be shared with the primal community. I am happy that he agreed to do so.
-- John A. Speyrer, Webmeister, The Primal Psychotherapy Page
I had been practicing deep therapy
in a city office building that also had a clinic in addition to the offices
with people buzzing in and out for different business. We had to be very
creative in noise reduction and used everything from cushions to stuffed
animals to coats and jackets to crying into someones shoulders, to raging at
chairs, etc. It was a challenge.
For several years I was in charge of training and
supervision the M.A. level or higher students and they found the
deep work to be unlike anything they had heard of or experienced before. My experience was that these trainee therapists got frequently
stirred up by the work and their supervision frequently included deep
feelings that needed to be cleared up for the work to continue properly and
for their own wellbeing too. White noise generators were helpful in masking the noises as it generates a bland sound that can mask several frequencies.
* * * *
I believe that patient-sensitive primaling is a healing and growth inducing process.
This type of healing is like a scalpel or a laser; in the right hands,
can do miracles. But give it to the wrong person and you may have a
corpse ( physical or mental) on your hands!
To be fair, however, one should admit that many other therapists ( primal or otherwise ) do commit blunders. A blunder by someone dabbling in the deep unconscious though can have serious ramifications, and the damage may be great if it remains unrepaired as one has touched and re-arranged the psychic innards rather than
the skin surface. But then again, the damage is also a function of the
patients pathology, the depth of the transference and the therapist's level
of goof, so to speak.
While a cognitive therapist's mistake can irritate the
patient or anger him at the "head" level, a mistake with a patient
regressed during "deep" therapy can induce severe re-traumatization adding
new insult to ancient injury, perhaps permanently damaging the patient, (
unless repaired ) or pushing the patient to flee and thus keep the damage
forever as if it were an old parental trauma. In such cases, some patients never return to therapy. Some end up on long term medications unless some healing occurs.
When working at a deep level, it is best to have a lot of experience,
otherwise, just act humanely and supportively as a kind mother would with a
disturbed child. It is not a safe thing to know a little primal or a
little deep hypnosis or a bit of gestalt, etc. Either know the field real
well, or let it go and just be supportive and humane.
Genuine kindness or
listening or allowing the person to be can go a long way and is much safer
than guessing at feelings or "steering" the person and playing therapist.
This is especially true of the deep level therapies.
Some speak of clearing all defenses! This is not a very healthy
state. It was tried before with early primal. A complete loss of defenses is
akin to disintegration. Replacement of early defenses with more mature ones
is the goal to attain, but not a disintegrated state.
Another error some make is using the words regression and emotional
discharge interchangeably. These are not the same and it is incorrect by
definition to fuse them together. One can emote without any regression and
conversely one can be regressed to the hilt and yet not emoting. In therapy
we aim to release the locked emotion from earlier on. At some point in the
process the patient will be emoting while regressed; at other points the
person can emote as a grown up too.
* * * *
As for touch when needed in primal-type therapies, it is scientifically irrelevant what Janov or others say. What really matters: only the results. Removal of symptoms, and
suffering are more eloquent than anything Janov could say. There may be legal fears associated with touching in a therapeutic situation in a lawsuit-crazy
setting. That may explain the shying away from touch. Another is that a
meaningful touch is hard to fake and patients with a lot of fears or who
have withdrawn ( not to generalize ) may require more touch communication and
deeper transference than what many therapists are willing to commit to.
Finally, touch will deepen a transference and many therapists shy away from
that as they themselves may be unable to handle the infantile issues, needs
and feelings that some patients will exhibit especially those with bonding
and attachment issues or other trauma at the infant stage.
* * * *
As far as helping people experience and express feelings deeply even if the
therapist has not been in primal or any other such therapy, of course it is
possible. It mostly requires healthy structures in the therapist and some
training when it comes to preverbal and birth issues. Problems will arise
if the material confuses or frightens the therapist. Also re-traumatization
will occur if an issue comes up strongly and the therapist moves or steers
the session in a different direction due to the therapists own defenses
There are certain combinations that will work when the therapist has not
himself experienced deeply, such as, a relatively healthy patient with a
healthy or somewhat sub-optimal therapist. This will work with minimal or
minor intervention as the patient has well internalized objects and requires
minimal engagement of the therapist.
Other combinations are a recipe for true
disaster such as a patient with moderate to severe disturbance with
a non-processed therapist with moderate or severe problems. In this case both
transference and counter-transference are strong and at the pre-oedipal
level. i. e., the blind leading the blind. In these situations, severe mistakes
will occur unless the therapist has been processing old issues regularly and
successfully resolving these issues. Even so it is not advisable for the
therapist to conduct a session with a sick client when the therapist is not
in a calm spot himself.
It is not enough to be in a deep therapy to become a helpful therapist. It
is more important to be healthy enough to conduct deep therapy regardless of
whether you were lucky enough to be healthy or achieved this growth with
some deep process. ( I personally achieved my deepest re-living and
resolving with the spontaneous help of a sensitive, loving non-therapist ).
Years of therapy after that could never match these experiences and neither
could processing on my own.)
A person who allows feeling in his patients but has not
primalled himself, may or may not wish to primal, but he would need
weekly or every other weekly supervision to make sure his issues, that may be
unconsciously triggered by the deep work of his patients, are not welling up
and stressing him or clouding his ability to continue the deep work.
At some point such a therapist will feel a need to process, especially if some of his patients engage his true self or re-activate his unconscious traumas.
* * * *
Under the right conditions, even
the most disturbed patient can be helped and almost always there is
a substitute parenting going on, mostly unconscious, if the work is
properly done. Developmental damage can be reversed and healing work associated with personality disorders and psychoses can be accomplished.
Through different interventions , you can grow an
arrested self, even if the arrest is at the fetal stage! Object relations
theorists assume the birth of the real self occurs several months after
birth, however the self goes through many evolutions and forms of the real
self can receive intra-uterine trauma and fifty years later undergo
conditions within therapy or outside of therapy that are conducive to a
forward evolution into the different stages of self passing through the
stages that object relation theorists talk about and occassionally deal
Touch, or other forms of nurturing, applied AT THE RIGHT MOMENTS and BY THE
RIGHT PERSONS ( as dictated by the patient's unconscious ) will help grow a
"self", will send that self forth into more mature stages and will create a
healthy person. But it is not touch alone that does this, nor is it other
verbal or non-verbal nurturing alone, as the losses do need to be mourned
properly in the context of a fully trusting relationship and at the level of
the original arrest.
If the core issue happened when you were two weeks old,
then that two-week-old self needs to heal and it is there ready for the right
conditions to heal ! Sometimes nurturance and touch and lullaby and rocking
and gazing ( again at the right time by the transferrentially correct person )
will all be needed to re-animate that two-week-old-self to do the emotional
healing work. At other times, after trust has been created for that self,
neurologically and psychologically active at two weeks of age, some minor
withholding may be sufficient to trigger the "old" pain or hurt.
early stages may take weeks to years to activate depending on trauma that
followed or preceeded and the level of distress in the current time. Too
much overload and challenging will definitely shut-off the process. Only
gentleness and a general atmosphere of nurturing or a stabilizing soothing
hug can return the patient on track. Another alternative is to medicate ( but
not over-medicate ), and then continue the healing.
* * * *
I find that few people know how to work with the more
vulnerable patients. I find that sad. It relegates these patients to a life
of permanent medication or poor therapy. I think dealing with more
vulnerable patients has been a theoretical failure with Janov and all those who parrot him.
The premise that certain patients can not be helped with their feelings is
totally false. With the possible exception of some who have some
neurological damage, everybody else can feel and integrate and get better.
Just because someone has early trauma as
suggested by nasty symptoms does not mean that we should process those very
early events right away. In fact it may take a long time of processing and
soothing and strengthening before the early stuff is spontaneously reached.
Problems arise when a therapist insists on processing all patients the same
way. It is like giving everybody aspirin regardless of their diagnosis, some
will benefit, some will feel nothing and some will get ulcers and bleed to
death! This is neither the fault of aspirin nor the patient. It is the inexperienced and rigid healer. The same is true for all the psychiatric
patients of different diagnoses; they can all primal safely and heal
wonderfully on condition that the healer knows how to bring them SAFELY and
EFFECTIVELY to the point of feeling.
It is in this pre-primal facilitation
where different diagnoses require different approaches. Once the person
feels and connects, the form (not content) of the healing is similar for
most patients. the secret is in how to get them into and out of primal
When a therapist insists on not
providing soothing when needed by the therapeutic flow, then they are as
damaging as a dysfunctional parent. Such a therapist cannot help any but the
most healthy patients. Those who have enough of a functional inner self can
provide self soothing - something that takes a newborn at least 3 and a half
to 4 years of sensitive parenting to achieve!
Only then can an individual
utilize self-soothing. This is what separates the success stories with
fragile patients from the failures or horror stories and suicides. This also
differentiates therapy that achieves major healing in a reasonable time as
opposed to patients who do 20 years of therapy without resolving the core
issues. It (success) needs proper application of the suitable intervention
at the right time. That is the essence of good therapy, not sweeping
statements and rash generalizations that we often hear.
Any therapeutic intervention, whether verbal or otherwise,
including consolation, should be applied AT THE RIGHT TIME when the healing
process dictates it. All healthy mothers use consolation when appropriate
to facilitate sobbing and wipe the infants pain. Suffering grown ups also
need consolation regardless of whether the suffering is due to current
factors or old factors or both.
When the patient is grappling with an
overload of pain or terror, for example, the therapeutic flow may shut down
completely, leaving the patient in a potential re-traumatization mode
identical in its essence to past parental insensitivity. Insufficiency,
neglect and emotional abandonment by failing to soothe occurs. Even animal
mothers do what is needed without any theory guiding them! When a therapist insists on not providing soothing when needed by the therapeutic flow, then they are as damaging as a dysfunctional parent.
Existing primal theory is totally lacking in a true clinical
understanding of almost all diagnoses where the core damage is at the dyadic
pre oedipal stage before a true and completed process of
separation-individuation has occured. This encompsses all patients with
various personality disorders, psychotic problems and youngsters with all
forms of attachment problems, separation and abandonment issues.
As you can see these days, dyadic patients are on the increase and neurosis
is no longer the dominant form of problem.
The reason possibly is that
infants no longer have a steady caretaker with most mothers being
unavailable, as such dyadic pathology would increase as it factually is.
Therefore, we cannot keep parroting Janov or other theorists who mimic his
deficiencies and shortcomings and then blame it on the patient.
Even psychoanalysts these days can help these dyadic patients better than Janov style primal and that is a SHAME.
As deep expression of unfelt feelings with a
safe dyad (even in a group) is the royal road par excellance to reverse the
deepest of pathologies, the secret is in how to get these patients there to
the point of feeling. If primal is to survive successfully, it should prove
itself capable of expanding its already rigid theoretical formulations to
encompass both in theory and in safe clinical practice all those other
patients who are frequently rejected or blamed for therapist's failures.
This is neither fair nor scientifically correct as these patients, whose
numbers are steadily on the increase, deserve to be facilitated into the
natural healing process and given a chance to have a healthy, enjoyable and
* * * *
Finally, I also want to touch on self processing. Unfortunately self
processing is always second best. It never reaches the depth and resolution
that that very same issue could reach within an accompanied processing with
the right person. And self processing can occur at all only if enough
healthy self structures are internally available to provide some self
soothing. That is why for some, it takes years of healing before they can
self help. but even then , the results will not match those acheived in an
interactive (transferrential) framework.
* * * *
Using hypnosis I found that you can run a whole trauma in an unconnected fashion, very dramatic, yet with no clinical effect whatsoever and potentially dangerous! It is better to facilitate 2 minutes of connected minor trauma than 2 hours of unconnected birth. That is the nature of the healing process!
You can run both a
disconnected re-live or a connected one if the patient is ready. Hypnosis is
a versatile tool. I can get information without feeling and I can get feeling without
information and one can get both if the client is ready for integration. Frequently
the patient will exit the hypnotic state spontaneously if a connected
feeling starts to emerge. Sometimes, therapists go only for the information sans
feeling, and this is do-able in hypnosis. But, without merging the emotional
component, this practice is not really therapeutic and sometimes the information is
not factually correct. The depth of attached feelings lends much more
credibility to hypnotically remembered information.
* * * *
underwent a lot of stretching and evolution as I learned more from my
patients and my own personal healing over the course of twenty-seven years. Although fully exposed to Janov and Alice Miller and Freud and Jung and Winnicot and Bowlby and Reich and Mahler and Masterson (whom I like too) and Kohut and
Giovacchini, etc. - yet I finally reached my own combo of theory based on
what I experienced personally or clinically.
All the above people have said
some very valuable things and opened my eyes and mind to some facts that
turned out to be clinically relevant, however none of them was correct about
everything. Freud refuted his early trauma theory and thought that early
trauma was either non-existent or non-analyzable. Mahler believed that the
self begins months after birth. Janov lumps under neurosis all kind of
different pathologies and wants to give them a blood pressure drug. Masterson does a good clinical job but knows little about the early ( 0-6 months ) self. Alice Miller is brilliant but she still does not know what the best therapy is after she
followed, then rejected Stettbacher. Even amongst the somewhat new wave of
attachment therapies, the theories differ and all claim that they have a key
to the final truth.
In this maze of theories and therapies one can find a lot of things that
resonate with one's belief system or are confirmed by one's
experience ( personal or clinical ). Many times in my search for "The Truth"
there were things that I strongly held as beliefs until clinical experience
forced me to reject or modify them. And conversely, many clinical or
personal experiences with verifiable removal of symptoms forced me to
develop theoretical formulations that previously were unthinkable! I was
forced to filter all theory ( brilliant or otherwise ) through the filter of
It does not matter if the theory proves itself in or outside
treatment settings. If it works, it works, and we may or may not have an
explanation of the mechanism of action. Good results speak for
themselves. For an example when clinical experience forced a change of theory in my mind:
- The spontaneous primalling of a past-life trauma
will give observable symptom removal in many cases of patients or therapists
that have no theoretical framework to explain the results in accepted
scientific terms. Is it placebo? Is it really a past-life? Is it a powerful
fantasy? Is it a borrowed metaphor that fits the feeling locked by the
trauma? is it possible?
I do not have a good answer as to theory, however
as a result of powerful re-experience and freeing of affect, many of my
clients experienced symptom removal. When this first happened neither I nor
the patient had any belief whatsoever in such situations, but I opted to
continue and process it as I would a current situation and it proceeded to
take the form of a deep emotional release and a flood of insight as it would
with a traumatic situation in childhood.
And again I was forced into a theoretical re-evaluation:
- The re-appearance
of giant hand marks on a patient's body ( I had to theorize why the hands were
so big; it may be because she was a tiny child in relation to the abuser's
big hands when she was slapped).
And still again:
- The re-emergence for many minutes of newborn reflexes in a grown woman who had just re experienced birth. Being initially skeptical, I tested for babinski rooting, sucking, and moro reflexes and they all tested for newborn! This was
impossible by medical standards unless the person had some neurological
affliction, which was not the case.