AN ECLECTIC APPROACH TO PRIMAL INTEGRATION (1976)

By Michael Broder

Chapter II
A COMPARISON BETWEEN ECLECTIC PRIMAL INTEGRATION

and

JANOVIAN PRIMAL THERAPY

In 1970, Arthur Janov, a Beverly Hills, California psychotherapist , presented in The Primal Scream his theory of the causes and treatment of neurosis. One of his most significant contributions to the field of psychotherapy was the popularization of Breuer and Freud's early cathartic method of abreaction, stressing the importance of early childhood experiences and feelings in relationship to personality development.

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.

A. Janovian Primal Therapy
A person who wishes to undergo therapy at the Primal Institute is required to have a complete medical examination at the very beginning in order to try to rule out organic difficulties. He must then submit as part of his application, a detailed narrative of his life history with emphasis on his previous attempts at therapy and his present difficulties and symptoms. He is asked to go into as much detail as possible about his,childhood and his relationship with his parents and siblings, what he knows about his birth, and the general environment in which he grew up.14. Upon acceptance of his application, he is required to pay $6,000 as his commitment for the first six months of therapy. This pre-payment is Janov's way of discouraging clients from fleeing the process prematurely to avoid the inevitable pain of primal exploration.

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.

B. Critique of Janovian Primal Therapy
Despite the revolutionary impact of Janov's discoveries and contributions, his method has, in my opinion, several drawbacks and inadequacies. They include the following:

  1. Although I agree that feeling the pain of one's childhood is essential in the de-conditioning of neurosis, it's not the only technique that is therapeutically valid in the treatment of neurosis.

    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.

  2. Janov does not acknowledge any other school of therapy as having any worth in the treatment of neurosis. He likewise does not give proper recognition to others, such as Freud, Riech, Perls, Lowen, Moreno or Rank, who came before him and said much to which he lays sole claim. For instance, his chief technique, whereby the client talks directly to his parents, is essentially identical to Perl's empty chair dialogue where a client places people in his life with whom he has unfinished business in an "empty chair" and has a dialogue with them in the present as thouah they were sitting in the empty chair except that it is done with much more intensity in primal therapy. Bioenergetics and Reichian therapies have worked with feelings as intense as primal experiences for many years. When Janov refers to them, however, he points only to their weaknesses.20

  3. Janov's reference to primal therapy as the "cure for neurosis" is grossly incorrect. It implies that the treatment leads one to a never-never- land where everything will forevermore be euphoric. In my opinion that belief can only give the neurotic more false hopes because it does not leave room for the realization that as life goes on, growth will always produce conflicts. Thus, many people inquire about primal therapy who lack the drive to work in therapy, and think that the treatment compares to a penicillin shot that will cure them of their troubles.

    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.

  4. Janov's pre-set format (three weeks of individual intensive, plus seventy-five groups) ignores the complex differences that exist from one patient to another. Perhaps some people need no intensive at all. Some may need only a week, others two weeks and still others perhaps eleven weeks. Fortunately, other therapists using primal techniques have taken this into consideration.

    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.

  5. Janov denies the existence of transference in primal therapy. I have found transference to be one of my useful tools to get some people into primals. By encouraging a client to deal with any feelings that surface with the therapist in the present, the client can often make his own connections to the past. However, to assume that a client is always interacting with a parent figure when interacting with the therapist is - in my opinion - a very naive assumption. In addition, such an assumption seems to deny the human element of the therapist-client relationship.21

  6. Upon entering therapy, Janov requires his clients to give up all forms of tension-reducing activities, such as smoking, and all forms of alcoholic beverages, etc. While these things do work against the primal process, I believe that the rigidity of these as well as all of the other rules related to Janov's therapy tend to create another "bad daddy" or authority to beat down. It also robs clients of the right to mature at their own pace. I have found that my clients give these things up automatically as they are ready. The authoritarian medical model does not seem to be as effective as simple genuine human concern that a patient is getting what he wants out of the process.

    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.

  7. Presently, there are eight people who are certified primal therapists. They are all affiliated with Janov. There are, however, scores of people who had started training with Janov and found conditions at the Primal Institute impossible for them to tolerate for the three years necessary to gain certification. In almost all cases, these Janovian trainees have become eclectic primal therapists, recognizing the strengths of Janov's methods while drawing upon additional training in other schools of thought such as Gestalt, Reichian, psychoanalysis, etc.

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.

C. Eclectic Approaches to The Primal Process
The word eclectic means "selecting and using what are considered the best elements of all systems."22 Despite Janov's most eloquent disavowal, primal techniques are being incorporated into many other types of psycho-therapeutic orientations.23

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.


_______________________

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


Return to Contents