Answers To Feeling Therapy Oriented Questions (November, 1997 - Using or Not Using the 3-week Intensive in Regressive Therapy) by Paul Vereshack M.D.

Question:-- Why do you not use the traditional three week's intensive period which most primal therapists use at the beginning of therapy to lower a patient's defenses? -- Anonymous

(Notwithstanding his M.D. Dr. Vereshack is not a licensed physician)

by Paul Vereshack, M.D.

I am lying in a comfortably large darkened room. The walls are padded and sound proofed. It is the Fall of 1976.

The door opens and closes behind my head, and there is a slight rustle as someone sits down.

I know nothing about this person, except that she is a woman in her mid twenties, who has done a great deal of successful feeling oriented regressive therapy with the psychiatrist who is running this practice.

She has no formal psychiatric training. Her name is Sue, and she is by way of interest, a registered nurse who works in obstetrics.

She will be my therapist for three hours each working day for the next three weeks.

Mostly, I am aware of the silence and the almost complete darkness. The silence stretches on and on. Then without any warning I begin to shake. The shaking gets worse and worse, lasts about twenty minutes and finally dies away, leaving me exhausted.

"Those are your feelings Paul," says a soft voice above my head. My primal intensive has begun.

* * * *

We had been told to move out of our homes, and give up all the pleasurable activities that normally keep us away from painful feelings. Walks with the dog, music, reading, unusually rich food, sex; all of it had to go.

At the end of our second week, we were invited to start attending primal ( feeling oriented, regressive ) groups in the evenings. From seven o'clock until ten, twenty or more of us would gather in the basement of a concrete office building, in a very large darkened soundproof room, where we would lie on mats and be attended by five therapists who would move from person to person as needed.

Our instructions were always the same, namely, to stay in what we were feeling, instead of talking about it, and to externalize the pain with the words and sounds that came up from it.

From ten o'clock to eleven, we gathered in a circle, to share what we were doing with one another. Interaction between members was not encouraged. If we had a response, we were to lie down and feel what had triggered it. That we could share. Groups were available, five evenings a week, and extra help, anytme we needed it.

At the end of the three weeks, we moved back to our homes, and attended as many evening groups as we wanted. Again, extra help was always available.

Most people attended one or two groups per week for several years. Many have continued primaling across their lifetime, using the buddy system or working alone. They did this as a way of honouring their inner processes, not because the therapy crippled them in some way. Getting straight and honest, and trying not to dump our unworked through material on others was the only way we could now proceed through life. Some people took months or years off work; others never missed a day.

The psychiatrist who took us through all this was a friend of mine from medical school. She had just returned from a year's work, as a client, with Arthur Janov in Los Angeles. She ran a very classical primal practice. There were no "frills" or extras; just lying down and feeling our feelings until deeper material broke through to yield insight and healthy function.

I did not find all this easygoing. It took me six months to utter a single non verbal cry. My therapist, that night, pounced on it and said, "That is your sound,Paul, don't lose it." My pain drove me downstairs into my own primal room very early in the morning across many years, after the four I spent in Mary Lou's practice. I worked alone or with occasional help, and I still have to access painful material once or twice a month. All I can say is, I thank God for the skills I have acquired. They are very carefully outlined in my book, Help Me - I'm Tired of Feeling Bad.

* * * *

Four main issues come up in my mind when I ponder on any deep feeling oriented intensive work.

1. Therapist commitment to client.

2. Therapist commitment to self.

3. Informed consent and mutual responsibility.

4. How I resolved all this for my practice.

1. Therapist Commitment To Client:

What I had seen in my Intensive and afterward, was that to run a deep feeling oriented practice, especially where intensives were concerned, the level of commitment to clients must be very high indeed. It took one psychiatrist and five therapists to provide round the clock coverage, for between twenty and forty deeply working patients. This level of help seemed to be a necessity.

I also could not escape the notion that the time line of commitment should be very long. I felt from that early vantage point , that it should a commitment for life. Later, I came to see that this must only be so, if the work was productive; not if the client was caught in some defensive co-dependency.

Slowly, as my time in this kind of therapy, as a client, lengthened, I came to see that I could tolerate doing no other kind of work with my own people. I lost my belief in all other therapies, as the power, directness, and wonder of this regressive work was born in upon me.

I had a very serious problem, however. I worked alone, and I always had.

Over the previous fifteen or so years, I had found that I simply didn't agree with, or trust other people's interventions. This feeling was very intense in my hospital training, and continued into private practice. What I was suffering from, I think, was a premonition that there were better and deeper ways to respond to people than I was seeing. I was suffering also from the feeling that therapists were responding, all the time, at a tangent to the real issues. Although I felt aligned with what my patients were saying, and was, I think, reasonably good at making reflective responses, it would be a long while before I fully realized how much depth was missing. What I was sure of, however, was that I wanted to explore and work alone.

How on earth could I provide real therapy, as a solo practitioner, remain true to myself, and true to the essence of this newer and so much deeper type of healing ?

2. Therapist Commitment to Self:

It is a very basic truth in psychotherapy, that a therapist must not move, for an extended period of time, beyond what he or she can comfortably and healthily provide. If they do, either they and/or the therapeutic process will break down.

Therapists who routinely overwork, in terms of time, and intensity are, in my opinion, using their work as a defense. Neither I nor any other client have been placed on this earth to enable this kind of behaviour. I don't trust it, or them.

I say this because in what follows, I am going to chart a path that many may disagree with. And I want the two paragraphs above to stand out very clearly. There is, however, one more thing that we must talk about, before we chart this path.

3. Informed Consent and Responsibility:

A man is standing in front of me shaking with anger, and that anger is directed at me.

He has just returned from a holiday in Europe where, he tells me, he had a complete emotional breakdown.

One night, on his trip, far away from home, he was suddenly and with no warning, flooded with feelings of fear and depression. So overwhelming were these feelings that he went immediately, by taxi, to the nearest hospital, was placed on medication, and returned to Canada on the next flight he could get.

He said something to me in that moment, which was to become one of the most significant phrases I would ever hear.

He said, "What have you done to me?"

This client had been lying in my primal room for a year and a half, unable to feel. I had, over this time been gently but insistently urging him to find whatever feelings he could. He had had no success. Then he went on a vacation, and feelings came to him.

There will always be people with a broad intellectual understanding of deep feeling oriented therapy, who will enter intensive experiences, only to find that they didn't truly comprehend what they were getting into.

Some will move forward and be profoundly healed. Some will run away. Some will run away and blame the therapist or the therapy. They will say, "What have you done to me?"

* * * *

4. How I Resolved All This For My Practice

In childhood, we are "Done To." External forces hurt or help us. External forces move our world and our lives.

When we grow up ( if we ever do ), we replace this infantile approach with something completely different. We come to see that complex forces within us, far below what we can see, are arranging our passage through life, and indeed much of what happens to us from the so called outside world.

We end up asking the question, "What has my unconscious arranged for me this time?"

Unfortunately, those of us who seek treatment are never fully mature. We suffer from what might be called, "Multiple Yes and No." Layer after layer of us downward into the depths of our being, says, "Yes, I want therapy," Layer after layer of us downward, into the depths of our being says, "No, I do not want therapy." And floating around between the layers is an agonized child crying, "Make me better!"

High speed, high impact therapy, such as a deep feeling oriented intensive, stands a greater chance of getting someone deeply into their pain than a less intensive experience. Where the patient is genuinely ready to break apart, and the decision is as mature as it can be all things considered, a primal intensive is probably the most profound and healing journey available on this earth. There just isn't anything even approaching its healing power.

No one before experiencing it, can ever really know what it will be like. Everyone involved moves on an act of faith. Everyone takes a risk.

Is there any way around this problem of uninformed risk? Is there any way that a solo practitioner can hope to handle all the issues we are raising? Some time around 1980, I decided to try.

The truth of the matter is, I began lying people down in my own primal room and started asking them to stay with their feelings because I had no choice. I realized from my own work, that anything less was a lie. Just as we can't go backwards in our own growth, we can't go backwards in what we offer others. To do so is a betrayal, so huge, that the entire self becomes crippled by it.

This was the only therapy, that I knew of, which gave permission for growth, on a level so deep, that it touched, shifted, and healed the very foundations of the body and mind. Everything else, paled in comparison. I knew that, at last, I had come home.

I also knew that I could not offer it in the same way that it had been offered to me. I could not possibly provide unlimited emergency coverage to the thirty or so people in my practice at any given time. Even the six therapists at work in Mary Lou's practice seemed at the five-year point to be burning out and withdrawing from therapy altogether. And I had twenty years to go.

I remember how fearful I felt when I decided to cut across the two great authority systems in my professional life; the first being, all the classical psychotherapy teaching I had received in the hospitals where I was trained. This included five thousand hours of supervision with more than ten different teaching psychiatrists, ranging from the eclectic general psychiatrists who ran the hospital wards, where I did my four years of residency training, to the most senior teaching psychoanalysts in Toronto at that time. Not to mention seven years of private practice with extra work in encounter groups and Gestalt Training, plus teaching posts in two major Universities as a visiting consultant.

The second major authority that I decided to cut across, was the very classical primal system I had just been through.

So there I was, very, very afraid, but determined to have a therapy practice that was within my health limits and didn't withhold the feeling orientation that I now felt was so vital to healing.

Therefore, what I offered was this: I would see anyone routinely once, twice, or three times a week for therapy sessions given in a primal room, in sessions which lasted an hour to an hour and a half. I told everyone that I was permanently on call, but I asked them to try and restrict their work with me to their week-day hours.

I would, of course, always be available in an emergency and could always arrange more regular hours, if needed. I told my clients that I felt once or twice weekly regular sessions were enough to get the job done.

I have always felt that more that two good sessions per week constitute emotional overload, except during occasional periods of unusual breakthrough. I believe that it takes days for a really good session to be integrated.

So I did not offer intensives as such. There was no way I could put thirty people on hold for weeks at a time. Extra and long sessions could be scheduled, if absolutely needed, on weekends. But this was rarely necessary. My clients did not flood me out with calls at night and on Saturdays and Sundays. In fact, emergency calls were relatively rare. Connecting with me directly over the phone was usually reassurance enough.

It was my goal that every session have a reasonable level of completion. In my own mind I started calling these completions, "Sequences." What this means is carefully outlined in my book, Help Me - I'm Tired of Feeling Bad. See Chapter Eighteen, Possible Results of Merging.

While it is very important not to force closure into mental processes, it is possible to go for mini-closures that bring relief and yet leave the mind ready for the next step. How all this is accomplished, is, as I have said, very, very carefully explained in the book.

Offering this kind of service produced a practice where my clients were working at every level of intensity, from simple hesitant conversation, to gut wrenching early work.

The biggest question that I faced in all of this, was whether or not I was creating primal defenses by going in a slower, more measured way. It is possible that I was.

On the other hand, I have seen many people thrown into extreme defense by primal intensives. They don't always work to open clients up. In addition, they produce in some people such extreme chaos that it may take years to reintegrate. So "you pays your money and you takes your choice."

The great thing about slower, yet feeling oriented work, is that everyone picks their rate of descent into pain and the level of intensity that is right for them. They do this out of "informed choice." They are informed by their ongoing experience, not by what they "think" they are going to need. Therefore, it is extremely rare to hear the question, "What have you done to me?" Once I found my feet, I never had anyone complain to me that I was holding them back.

It must be remembered, however, that one's personality is constantly reforming itself into its' protective modes, and it does so unconsciously. That means that people don't always know if they are being held back. They may think something wonderful is happening, when it might be more wonderful somewhere else.

We could all really do a number on ourselves about this, but somewhere we have to say, "O.K., I am doing the best that I can, and it has to be enough." Let those who want intensives, choose them. They are not good or bad within themselves. They are simply a tool of great power, no more and no less. When the right therapist and the right client come together for a primal intensive, wonderful is the result. When one of them isn't right for it, the result is very, very unwonderful.

Should you wish to participate in a regressive intensive experience, I would make the following suggestions, so that you can arrive at the most informed consent possible.

1. Read several books about this kind of journey. I believe my own, Help Me-I'm Tired of Feeing Bad, is the most detailed description of Deep Regressive Therapy available in the world today. I know, anyone coming to see me for this kind of work must read this book. When they do, I feel I am dealing with a reasonably informed person.

2. Discuss deeply, with someone who has been in this work for at least a year, what is to be expected when doing it.

3. If possible observe a primal session or primal group in action.

The bottom line is, whether or not I would choose my kind of work for myself, if I had it to do all over again? I would!

Paul Vereshack M.D.

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