Janov asserts that neurosis is a disease caused by the denial of feeling. The remedy is to feel.10 blocked feelings are non-integrated experiences which flood the body with an overload of pain.11 The body reacts to this pain by constriction and withdrawal - a normal reaction to pain - but one which causes chronic muscular tension and other physical symptoms which develop later in life.12. The psychological reaction to the pain caused by the unfulfilled early needs is a split in the child's personality, which ultimately results in the development of an "unreal self" or facade.
Thus, the major goal of primal therapy is for the patient to feel what is happening in the present instead of using the present as a trigger setting off old hurts and needs which are far removed from consciousness. This can only be accomplished by integrating (blocked feelings of) the past.
In this chapter, I shall first present my understanding of primal therapy as practiced by orthodox Janovians at the Primal Institute in Los Angeles, California.13 Second, I will present critcisms of the Janovian approach. Finally, I will expand on the eclectic approach which has become known as "Primal Integration." It is the latter which I practice in both individual sessions and in groups of adults who are functioning in society without severe classical symptoms of the neuroses, psychoses or personality disorders.
The client is then sent instructions which Janov states, "must be followed without deviation in order for the treatment to be effective."15 In summary, the instructions require the client to give up all smoking, drinking of alcoholic beverages (including beer and wine), aspirins, sleeping pills, tranquilizers, mood elevators, stimulants or any other mind-altering drugs forty-eight hours before entering therapy. Any other tension-relieving behaviour such as compulsive eating, snacking, nail biting, over-sleeping, must also be stopped, to the best of the client's ability, several days before therapy. The purpose of these preparations is to increase the client's level of tension as much as possible.
Twenty four hours prior to therapy, the client is to check into a hotel room near the Institute and remain there until his appointment the next day. He is not to read, watch television, telephone or see friends. He is, therefore, to be totally isolated with nothing to do except experience himself. He may only keep a diary of his thoughts and feelings while in isolation.16
The client is now ready for the initial phase of his therapy - the three-week intensive where he is seen daily by his therapist for as much time as he needs, usually about two to three hours. The purpose of this intensive treatment is to allow the client the opportunity to concentrate on nothing except the shattering of his defense system. He is not permitted to work, attend school or perform any other activities during this period. His therapist is on call for him twenty-four hours a day.
After the initial three weeks, he may resume his activities. He should, then, be quite connected to his primal feelings and no longer need to live in isolation. He is now ready to enter the second phase of his therapy, which is mainly the participation in primal groups several times a week. He will only receive individual attention if he needs it and at an additional cost.
These primal groups are three hours in duration and are held in a large padded room designed to accommodate as many as fifty participants. There is one therapist for approximately eight clients. The participants simply lie down and have primals while the therapists circulate among them. There is little or no interaction among the group members. The client receives seventy-five tickets entitling him to that number of groups upon entering therapy. If a client needs more groups after he uses up his seventy-five tickets, he may purchase more at a cost of twenty-five dollars each.17
Every technique used by pure Janovians has one, and only one goal - to feel the pain of childhood. Because of the isolation and deprivation that precedes the first day of therapy, the client usually enters the process feeling at his worst. He is never allowed to talk about his feelings, but instead talks to key figures in his life, such as parents, as though they were in the therapy room. He is always encouraged to let his feeling overtake him, and to become the scared, hurt or angry child of his past. If he is resisting his deep feelings, he may be directed to return to his hotel and not sleep all night, or simply breathe deeply - lying in a very defensive position for a long period of time.18
Transference between the client and therapist is not dealt with in primal therapy. Instead, the client is directed toward his parents in a way that intensifies the pain of what he is feeling.19 If words appear to be keeping the client on an intellectual level, he is told to simply make sounds and let his body move freely. Whenever a client is experiencing a feeling in the present, he is told to recall a time in his childhood when he felt that way. He may then ask for help from a parent, for instance. As previously pointed out, the client is always the one who determines his material.
Janov's most important innovation is that he has designed the most intensive therapeutic situation to date. The three-week intensive format has become very widely used by primal therapists to shatter the neurotic defense system of shut down clients. Janov's rediscovery of Breuer and Freud's cathartic technique has produced such a stir that even some of the most controversial Freudian analysts have taken another look at what they were doing.
Janov ignores experiences such as sexual and spiritual experiences, massage and meditation, by asserting that these are ways in which to avoid feeling one's pain. He always places these, as well as other positive joyful and nurturing experiences, in the same category as drinking, smoking and other compulsive forms of acting out. I believe that finding one's sexuality, adult joy, spirituality and healthy form of nourishment should be an important goal of any therapy. To the extent that this can be a part of one's life, there is, in my opinion, no need to feel the pain of childhood.
Most unfortunate of all is the fact that primal therapy has forfeited the possibility of any recognition from many psychotherapists who have equated Janov with a quack medicine man, arrogantly offering something almost magical which they feel does not exist.
Per-numbering the seventy-five groups, as contained in Janov's package prior to entering therapy is also an idea that, for me, is hard to follow. In addition, this has helped to make the cost of pure primal therapy prohibitive for most people.
I have never found it necessary to require people to isolate themselves in order to primal . A person who genuinely wants to work will generally not have that much resistance. Perhaps that is because I was trained to accept a client in spite of his resistance and allow him to take all of the time he needs to break down his defenses at his own pace, rather than to come on as a bulldozer in the manner Janov describes.
In short, Janovian primal therapy needs humanization. Giving a person the freedom to explore his own feelings and to make his own insights, while defining the norms within which he should live, seems grossly inconsistent.
I believe my goal as a therapist is to use whatever techniques, theories, or methods I know to help a client through the five phases of the primal process as outlined in Chapter I.
Therefore, an eclectic or primal oriented therapist generally agrees with Janov in respect to his theory of the cause of neurosis, but will substitute his own principles, techniques and attitudes where he thinks that Janov's are inadequate or invalid, or when he is simply not comfortable with them. For instance, most therapists evaluate each patient in terms of the nature and severity of his difficulties before determining how the case will be handled. I've met almost no one who has a set format, such as used by the Primal Institute. So, by the very definition of the word, each eclectic therapist will operate differently, according to his own training, and depending on the area in which he is comfortable. With that in mind, I shall explain my eclectic approach to the primal process which has become known as Primal Integration.
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10Janov, op. cit., p. 385
11Janov, The Primal Revolution, New York, Simon and Schuster, 1972, p. 197
12 Janov, The Anatomy of Mental Illness, New York, G.P. Putnam's Sons,
1971, p 83
13Janov, ibid., pp. 79-80
14Janov, op. cit.
15Janov, op. cit.
16Janov, op. cit
17Freundlich, Janov's Primal Theorv of Neurosis and Therapy, New York,
Center for the Whole Person, 1973, p. 9
18 Janov, op. cit., pp. 91-92
19 Janov, op. cit., pp. 245-248.
20 Janov, op. cit. pp. 19-41
22 Brown, The Healinq Touch, Berkeley, California, Berkeley Institute
for Direct Body Contact 1973, pp. 253-261
22 Webster's New Dictionary, New York, Pyramid Communications, Inc. 1972
p. 172
23 Freundlich, op. cit., p. 16