Natural vs. Directive Primal Therapy

By Harley Ristad


In this article I will explain the difference between natural and directive primal therapy, and tell why I prefer natural primal therapy.

The following are my definitions of the two therapies:

NATURAL PRIMAL THERAPY - The therapist, first, discovers or feels what the patient is feeling and, then, helps the patient go deeper into that feeling. The therapist doesn't necessarily say or do something; he (she) might just be there for the patient, If the patient doesn't have a feeling, he is helped to go deeper into "not having a feeling. " There is no hierarchy of feelings; all of them have equal value. "A feeling is a feeling is a feeling." Feeling the pain of a divorce is as important as feeling the pain of not having your mother's love. The therapist doesn't direct the patient to earlier feelings. If the patient, on his own, goes to earlier feelings, then the therapist will help the patient feel them with greater intensity.

DIRECTIVE PRIMAL THERAPY - The therapist uses techniques to break down the patient's defenses. The therapist helps the patient get into feelings, then leads the patient to those earlier feelings which the therapist considers to be more important.


I am now taking natural primal therapy in Denver. In the beginning, I anticipated that the therapy might not work for me. I was rejected by Janov with no reason given. However, I was forty-nine, and Janov doesn't take anyone over fifty. I was very much in my head, and Janov says: "Those who have fled to their head are the most difficult to cure." Now, in my eleventh month of therapy, my progress has far exceeded my expectations.

I feel that I had good therapy from my therapist during my three week intensive. He did so little and yet he did so much. It seemed that I found my own way and did my own therapy. I didn't notice in what ways he kept me on track. I believe my therapy would have gone badly if my therapist had been anxious about directing and controlling me. When I was into feelings, he let me be there. Because so much of primal therapy is about one's mother, I often wondered during those three weeks why I didn't have any feelings about my mother. It wasn't until the last session of my intensive that I shrieked, "I can't find Mother because I never had her."

In my eleven months of therapy, there has been no attempt to "bust" me or break down my defenses. The center doesn't believe this can be done in any meaningful way as the patient is going to block, or overload, or build up a new defense. (The defense system is a symptom; buried pain the cause.) Each hour that I have been into feelings has opened me by a small amount, which in turn has caused me to feel more, which has opened me up some more, etc. In this way, the closing-down of my childhood was being reversed slowly and naturally.

During my fourth month of therapy, a mistake was made whereby I was subjected to some directive therapy which brought up some pain out of its natural sequence. I was a willing and cooperative participant who believed that good therapy had been done. It was two months later when it suddenly became clear to me why my therapy had stagnated. I believe this mistake set my therapy back more than a month. Because of this mistake, I have learned how very good natural primal therapy has been for me.

It happened on a Friday; I had been deep into my feelings for six hours, and came out of a two hour primal in, the middle of post group. (Patients are in separate rooms during group, and meet in one large room for post group.) It was then that another patient, who was a stranger to me, dumped a lot of anger on me. I was very together, felt his charges were nonsense, and chose not to dignify his diatribe with a defensive reply. Instead, I tried to share with the group that I had just primalled being left all night alone in a hospital when I was about one year old with my arms strapped to my sides like a slab of beef and insects biting my face. When I was in most need of support for my feelings, the therapists joined the goup with their need to see gladiators in action. They urged me into a different response, and I replied with anger.

At my next session, the following Monday, my therapist chose to talk about the Friday anger dump. I was told that, as an adult, I can see that the anger is crazy, but when I was a little boy I couldn't. In post group the same patient dumped his anger on me again. This time, I followed my therapist's suggestion and went with the feeling of being small and not being able to figure out the craziness. I went down on the floor, and went real deep, My therapist greatly intensified the pain when she put her hand on my shoulder.

Being pushed to where I wasn't ready to go was so unnecessary. The anger dumps were locked in my memory. At some later session, when my body was ready, I could have gone into feelings about them. Natural primal therapy assumes that there is a natural sequence for a patient to feel his buried pain which is unique for each patient and can never be known by the therapist.

Below is a quote from page 28 of his book In the Middle of Things, where Michael Rubin describes his first session in primal therapy. I see this as directive primal therapy in its most blatant form.

"In the semidarkened office she tells me to lie down on a black leather mat, a box of tissues nearby. She asks me to breathe deeply-arms spread out, legs spread out, making me feel awfully vulnerable. Always dutiful, I do as directed and feel myself beginning to get dizzy from so much deep breathing.

Does she sense it? She says, 'Say, Mama.'
Like a baby doll, I say, 'Mama.'
She says, 'Again.'
'Mama,' I say. Then again. And again.


I don't know how or why, but eventually I begin to say it for its own sake, and at her suggestion, louder and louder: 'Mama. Mama Mama!!'

And before I know what's happening I find myself weeping and then screaming it out, calling for her: 'Mama. Mamal Mamal!'
She tells me to pound the mat.
I scream louder. I pound. Pound. Pound."

The therapy here is similar to that done by many of those who do primal therpy after reading Janov's Primal Scream. On page 107 Janov says: ". . . practically no details of technique have been included in this book." I don't know what kind of therapy Janov is doing now, but there are clues in the book to indicate that when it was written (before 1970) Janov was doing directive primal therapy. On page 96 Janov says: "By the end of the third week the major work of dismantling the defense system is done." On page 81 is an example of giving directions: "He is instructed to lie spread-eagle." Another example on page 123: "breathing is one of many devices we use." Another on page 126: "When the Primal Therapist slows down the rapid speaker and makes him 'take pains' with his speech, he is cutting into a defense mechanism." And on page 250: "I was informed by Art Janov that I would receive no more therapy if I were ever late again." On page 262: "We force the patient to be direct. Instead of allowing him to be obsequious or intellectual, we tell him to fall on the floor, screaming, 'Love me, love me!' directly to his parents." On page 296: "I would not allow her to be the sweet person she had always been." And on page 357: "I stopped a Marine Captain from swearing during treatment." An example where Janov finds the patient's truth for him is on page 48: "Sometime soon in his treatment I call him a fag. Now he is anxious. I have found him out -- that is, I have put my finger on his suppressed need."

I have talked with patients who believed they were badly damaged by the primal therapy they received at other places. As they described what happened in their "bad" therapy, I became increasingly aware of the ways they were getting a lot of direction and control. They were being pushed where they weren't ready to go; and they were in a constant struggle with their therapists who were anxious to do something to appear smart, or who were acting out needs to be helpful.

In directive primal therapy, you might be told to work with your shit and yell at your mommy and daddy. The patient, who was originally split by parental instructions, is again split by therapeutic instructions, analysis, and interpretations. To be told to breathe deeply, scream, and concentrate on your body, is telling your mind to drive your body. This increases the mind-body split. Directive primal therapy is a merry-go-round struggle where manipulations, instructions, and techniques are used to try to remove blocks which have been caused by earlier manipulations, instructions, and techniques.

In directive primal therapy, the therapist does so much but accomplishes so little. The therapist never doubts and always tries something. For example, the patient, who is treated as an object, is often placed in a spread-eagle position. However, in natural primal therapy, the therapist does so little but accomplishes so much. When in doubt the therapist does nothing. The patient is a subject who finds his own position according to how he feels.

What the directive therapist is trying to accomplish when a patient is "busted," or his defenses are assaulted, the natural therapist accomplishes, unobtrusively, by being "straight."

In natural primal therapy, transference is a helpful part of feeling your pain; whereas, in directive primal therapy, it becomes a problem. This is because you are driven to parental feelings out of sequence, and you act out your pain in an endless cycle.

Although natural primal therapy might seem simple, the demands on the therapist are great, therefore, he should be feeling and undefended. This is best realized at a center where it is easier for the therapists to (1) have their own feeling sessions (2) occasionally become a patient (3) take needed vacations (4) refer a patient to another therapist.

Sometimes the natural therapist will be directive; for example, a patient, who is feeling empty and hugging a pillow, might be asked to give up the pillow and feel his emptiness.

In natural primal therapy, the patient is helped to go deeper into his feelings by the therapist who (1) is there for the patient, (2) is a good listener, (3) is totally accepting, and (4) has the patient talk to a person as though he were in the room. (It's impossible for the directive therapist to be totally accepting because instructions carry an implication of non-acceptance.)

I know some primal therapists who did a lot of directing at first; but, over the years, have learned from their mistakes, and are less directive. But a therapist is still practicing directive primal therapy if he (1) assumes the responsibility to get his patient into feelings (2) directs his patient back to earlier feelings (3) helps his patient with analysis (4) breaks down his patient's defenses.

I would consider any eclectic approach (combining primal therapy with drugs, encounter, psychodrama, rolfing, etc.) as being directive primal therapy-which becomes a stagnant pool of mistakes where each new mistake is compounded. Natural primal therapy is like a running brook. If a mistake is made, the brook will eventually clear itself.


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