Friday, April 13, 2012

Another Look at Electroshock Therapy

Years ago my team and I watched something we had never seen before. Someone reliving something that looked like a birth primal and yet quite different. We let him go through it for about a half hour and then asked him what it was. He wasn’t sure. We then found that he’d had ten shock therapies in England for depression. He was reliving the shock, in the same way that another patient, also from England, was reliving her shock therapy (which we filmed). It looked to me like shock therapy and when I put a pencil between her teeth, her back arched and she went into what looked like an epileptic seizure. She knew when she came out of it what it was. It seems clear to me that what goes in has to come out; it is a shock just like any other shock we go through in our lives. It overwhelms the system and shuts down large parts of it. Patients need to relive electroshock therapy without a specific event in the same way as reliving the shock of seeing their parents die in a car crash. The system is overwhelmed in both cases. Part of memory is shutdown in both situations. The doctors find shock therapy helpful since it hides away past memory, keeps the person unconscious; but, as I have said before, “You cannot get well unconsciously.” It’s no different than hypnosis.

The authors of a recent study on shock therapy noted that over 10-20% of depressed persons unaffected by psychotherapy go on to shock therapy. This also seems to be true for tranquilizers, which often cannot touch depression. The doctors conclude that the only option left is to blast the patient’s brain with electrical energy. And again, there is no asking “why?” Why is depression there in the first place? Or even, what is depression anyhow? There is no thought that perhaps we need a therapy that goes deep enough to effect deep, suicidal depression.

The template here seems to be that a first-line imprint from gestation or birth leaves the prototype of hopelessness (or terror or rage, etc.), impressed into the system. Until that original imprint is addressed and relived there will always be a tendency to deep depression. Yes, it will help to discuss one’s feelings with another person, a therapist, but that still leaves the template intact. Still, talking it out eases the load a bit, even temporarily, and is a good thing.

It is not that depression is refractory to psychotherapy. It is that psychotherapy is refractory to depression. It is that current psychotherapy is too superficial to change anything profoundly. It is the fault of the therapy, not the patient. Once we know what it is and have the proper tools it is no longer untreatable. Cognitive therapy only worsens matters by remaining in the realm of cognition instead of feelings. Thinking “positive thoughts” will never change the feelings that are at the heart of depression. It isn’t that depression cannot be touched by therapy because it is such a serious affliction; it is that conventional therapy is not designed to probe the depths of the unconscious where generating sources lie. And today it seems that the only way conventional shrinks can get to those deep-lying imprints is through jolts of electricity.

Doesn’t it seem bizarre that when we are at a loss we start to blast the brain with electricity? But the shock doctors, they don’t see it as a loss. Of course there is memory loss in shock therapy; it is meant to happen. We are programmed to forget. In a way, our therapy is shock therapy in reverse. In reliving we are feeling shocked again but we can integrate that shock and so be done with it. We become superconscious, hyperaware of what went on. We don’t blast away the imprint; we approach it and finally welcome it. We don’t make it an alien force; we make it become part of us. Until that happens we must take measures to put down the force—pills, shots, shocks, endless discussion, cheerleading, jogging and exhortations to get going. And in cognitive therapy, the advice by doctors, “You see there is no reason for you to be depressed; your kids are healthy, your wife loves you…blah blah blah.”

The force is that ancient engraved imprint. The doctor is sitting behind his desk and cannot see an event that is forty years in the past. He therefore can draw no other conclusion: he (the patient) needs to get over it. For the cognition/technician it is all in the present, and seems to be irrational. They try to make it all rational without noting that the symptom has antecedents far back in history. And for such antecedents there are consequences—depression. It is all a logical extension, reacting to something specific in the past; once we get to the past it becomes eminently rational. To be bereft of the past makes it all seem irrational. We cannot make sense of any of this without referring to history. It is not just some bad thing we must blast away but specific feelings that need to be felt.

What is being blasted away? Often it is hopelessness and helplessness, the bedrock of most suicidal depressions. Those feelings are trying to make it up to the top for release, but alas, pills and then shock therapy keep it down. So the one thing that can cure is seen as the enemy, something to be avoided. What a strange paradox!

In shock, as in both that form of therapy and life, there is a fundamental disconnection from feeling centers to the top level comprehension areas of the brain (see Perrina, et al., 2012). A sort of functional lobotomy. The brain is saying, “I can’t take any more input so I will just shut down.” And with that shutdown come hidden forces that constantly render the person uncomfortable, like he is carrying a heavy load that he cannot get rid of (which he is—of feelings). His movements therefore are slow and labored; he has trouble breathing; it all seems like such an effort. There is no energy left to do anything in life, even eat. Repression is at an extreme,  and it weighs the whole system down. All energy is being used in the service of gating/repression.

The current rationale for depression seems to be that it comes out of nowhere (some textbooks state it thusly—“endogenous depression”), like some phantom to haunt us. And if we do not understand the imprint we are forced to call in the phantoms. We need to know that suicidal depression is something knowable and genuinely treatable. We don’t need to insert something like a shock machine into someone. All we are doing there is ensuring that would-be liberating memories are more hidden and inaccessible. There are treatments that are much easier, safer, and quicker; and a way to truly get rid of depression.

Perrina, J.S., Merzb, S., Bennetta, D.M., Curriea, J., Steelec, D.J., Reida, I.C., and Schwarzbauerb, C. (2012) Electroconvulsive therapy reduces frontal cortical connectivity in severe depressive disorder. Proc Natl Acad Sci USA, 109(14):5464–5468

24 comments:

  1. Quote: Thinking “positive thoughts” will never change the feelings that are at the heart of depression.

    Agreed. I work amongst some people who live in a kind of self-convinced mindset of happiness, that I personally describe as "depression in denial", only because that is what it feels like, from my end. The suggestion from their attitude and personaity is always happy, happy, happy...but the feeling I get from them is always that tired give-up-on-life depression underneath it all. So they tend to be hard work to be around (for me) and make me depressed a bit, because ultimately the have given up on a real happiness.

    Real happiness must of course be based on reality - like anything. The celebration of lies is the denial of truth. And it won't work. It is also the expression on the greatest true hopelessness, because to deny that a feeling/reality even exists is the most absolute way of never growing away from it.

    Think-happy-thoughts cognitivists are, from outlook, just agents of what I despise the most - the promotion and celebration of an ultimately morbid state of being.

    --sorry if that's a bit ranty.

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  2. well...what kind of evidence do they use to justify electroconvulsive therapy? it steers patients away from suicide? whatever statistics they are using....surely you can match them, art? and if you can match them, then you have a case, because surely they would accept a non-shocking way of getting the same statistics?

    your article is a very very clear and simple argument -- why can't we use simple statistical evidence as the rationale for choosing primal therapy?

    at first it seems so incredibly strange that your therapy has never been properly investigated when all other therapies provide LESS evidence of biological improvement, and certainly no MORE evidence of behavioural improvement. but it's not so strange; society wants a quick, quiet way to control the problem-people. primal therapy is not quick and quiet.

    obviously we shouldn't talk about 'improvement in quality of life' -- subjective interpretations cannot be used as evidence.

    can we build a portfolio of simple statistics? for example: a basic record of all the SUICIDAL patients who are no longer SUICIDAL, and a basic record of HORMONAL NORMALIZATION. the record would be an indicator. no expensive double-blind studies. just an indication that there might be a more ETHICAL alternative to all those "last resort" experiments. we could argue that it is UNETHICAL to proceed with extreme experiments before TRYING primal therapy. we could argue that it is UNETHICAL to WAIT for primal evidence when we could be TRYING proper primal therapy as an alternative. we could deliver your simple statistical portfolio like a petition.

    with our help, patients could sue the experimental therapists/surgeons on the grounds that they did not try an alternative which provides at least as much evidence as the tried alternatives.

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  3. Art,

    You're talking about the people who are leaking so much pain that can’t stand it... what about all these professors ... who manage to keep this suffering in place with their cognitive operations and allowed externalizing by keeping all those poor thing who suffers to suffer?
    It's about those who cause suffering... those who are guilty and must answer up to all this suffering as continue?
    Is it not a question of a legal process?
    I can not stand to be "knowledgeable" and ignored by using taxpayers funds as a resource to keep incompitens at power for what is regarding the psychological issues.

    Frank

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  4. In Swedish TV they have shown how patients with certain heart problems get treated. The heart beat rate has gone up and the amplitude down. The result is that the patients feel tired and exhausted. By using a defibrillator the patient is given an electrical shock when unconscious after having anesthesia. It locks frightening. The shock makes the body jump. The doctor checks the EKG and if the heart has not jumped back to its normal operating mode the patient gets another chock. After the treatement one patient said she felt much better. Of course,
    the reason why the patient had heart problems was never discussed, nor why an electrical chock would help. No information about side effects either.

    We have on my job defibrillators (or hart-starters) of an automatic type. The intention is that anyone quickly should be able to help a collegue with heart problems. The manufacturers claim the defibrillators are life-saving.

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  5. Hi everybody,
    What has really changed since 1938? http://www.pbs.org/wgbh/aso/databank/entries/dh38el.html
    No evidence that people are healed or have changed, only the devises for electroshock became more modern, that’s all.
    If you listen to, DR. WILLIAM MCDONALD, you come out of the shadows of depression.
    more at: http://www.pbs.org/wgbh/takeonestep/depression/ask-elders_3.html
    Sieglinde

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  6. Part 1.

    A round trip under the evolutionary umbrella.

    At 19, I developed epilepsy and my doctor prescribed anti-epileptic medication. Somewhat pointedly, I can say that I was given a chemical lobotomy. This was an alternative to the existing radical and grim choice of electroshock, which in turn was the step before the even more radical and most cruel of all existing options, ie surgical lobotomy. (This happened in the 50ies and in 1949 Egas Moniz had got the Nobelprize for having developed the lobotomy process...)

    These were several decades before Art had developed his principles about “Evolution In Reverse” and what I mean to paint the picture, from my youth, of the alternative methods to eliminate epilepsy, is that I am extremely happy today I got sick in just the time when “chemical lobotomy” was made available, and that I had the good luck of having a young and talented doctor (Dr. David Ingvar) who could guide me in a difficult time.

    Why do I use the phrase “chemical lobotomy” to describe the medical treatment, I, without a doubt, was in need of? Because it resembles the effects of a neuro-surgical procedure, a form of psycho surgery, believed to eliminate anxiety, pain and seizures. The advantage of the “chemical lobotomy”, according to reported experiences, is that it is not, to the same extent as surgical lobotomy, followed by severe depressions and apathy. It also had the extraordinary privilege when the Primal Therapy had developed into an alternative, that the medicine little by little could be eliminated.

    From the time, I received the benefits of modern “chemical lobotomy”, gradually my epileptic journey meant that I was turned off from contacts with that feeling part of my brain where my life-threatening birth process was imprinted. This gave me, of course, contingent benefits. I could survive short-term, career, develop many intellectual abilities, and I had the opportunity to create resources and contacts one day to be capable to “lay down and allow that stab of anxiety to overtake me and make me free”. When this happened, the direction of my journey changed, and I was able, during years, to dissolve the survival tools, like neurotic games, repression and other painkillers, provided by the evolution.

    Eventually, I searched and found help because I “knew” / guessed that my epilepsy and anxiety were caused by a pain that precluded my attempts to meet actual real needs. Due to survival reasons, I was instinctively an innovative producer of painkilling neuroses. My life was a trade mill that at no time stopped spinning and never gave any lasting rest and quiet. After 40 changing and stimulating years in and out of the Primal Therapy, I have learned to slowly cope with feeling repressed pain and scale off the countless layers of neurotic behavior and reflexes that my survival demanded. My neurosis have taken on both emotional, intellectual, physical and social expressions, and sometimes they have been favorably received by an impressed surrounding (which in no way made it easier later to remove these neurotic behaviors, at least initially).

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  7. Part 2.

    After 53 years, I have contacted the woman, Eva, who had a decisive influence on me before I developed epilepsy, ie before I was “chemically lobotomized”. As I have mentioned in a chapter of my book “Evolution in Reverse /Demystifying my Epilepsy,” she then (1959!!!) in a letter, with an attached photo, tells me that I was the love of her youth. That is, she had cared for me, including my cocky immature way, before I became “chemically lobotomized” and still was in comparative youthful harmony with myself. Following 40 years of Primal Therapy, and after finding back to a sense of relative harmony. which has been buried in neuroses, medicines and act outs, gradually I, due to Eva’s and my conversations, experience how I continue to develop the missing part of myself from the point at 19 when medication preventing laid a number of filters over.

    An important prerequisite for my survival over the years has been tied to that, I, as in Maslow’s Pyramide, has created a large number of short-term subjective well-beings. Through the Primal Therapy and Evolution in Reverse, it feels at last that I have become free from the effects of having been “chemically lobotomized”. At more than 70, I experience my first objective well-being. Without euphoria. With no need to impress. Without feeling anxiety. As Eva and I take and give with the same desire, life feels easy right now.

    My epileptic journey has been an exciting adventure, a kind of round trip through a crucial part of evolution. I feel I finally come aboard the right train!

    The “travel agency” is located in Los Angeles, and you impart your own feelings!

    Jan Johnsson

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  8. Off topic:

    Evolution of the defense system:

    One thing I have long noticed is that if I start to fall asleep too quickly, I begin to have a night terror. But the night terror never really happens because my brain instantly senses it and I "jolt" into a fully wake state - that is, my neocortex is instantly switched back on.

    But why, and how the did the failure to decend into sleep (without the night terror) occur?

    Hypothosis:

    Take, say, a 3 year old child. The have a neocortex that is not dominant so their defense system, and defensive structure, is based predominantly on the brain-stem and limbic system (only). Now, as the child gets older the neocortx comes into the game (fully), so the typical operating defense system is no longer a stand-alone mid-brain and limbic system, but all three brains (that is, including the neocortex). So with the two earlier brains now "leaning" on the neocortex, you might presume that the defense system involving the earlier brains in now operating differently to some degree, as compared to when the child was just 3 years old.

    Ok. So, what would happen if you took your, say, a 17 year old child and somehow instantly shut down their neocortex so that they're thrown right back into the operational brain structure of a 3 year old? You could speculate that the earlier brains have been caught by surpise with the removal of the neocortex, so that they are, for a moment, not ready to operate a proper defense system as a stand-alone entity (1st and 2nd line, only). The result being an instant intrusion from a failed defense system - a night terror or psychotic episiode, etc.

    Maybe what's really going as we gradually fall asleep is that the earlier brain/s are "booting up" old defensive structures; that is, defenses naturally developed in very childhood which allowed the brain to defend *independant* of the neocortex. And if we decend too quickly, so the boot-up can't happen properly, intrusion becomes inevitable.

    Speculative? Yep. But I think it makes a lot of structural sense, as a hypothesis. And if it's right then we might expect advanced primal patients to fall into deep sleep relatively quickly (without intrusion) simply because they don't have to so much boot-up old defensive structures, because they don't need to defend so much regardless. Maybe there's a relationship between blocked pain, the integrity of the defense system, and the speed in which someone can decend into deep sleep.

    And maybe part of the reason why it's vital not to decend into early pains too quickly in primal therapy, is simply because the defense system also has to progressively readjust itself to the new realities.

    This may also explains why primal therapists must be feeling people - if they can't meet a patient on their (decended) level, then not only will they not know how to communicate with them they will also tend to drive them out of their 'zone' by activating their neocortex, and likewise driving the patients brain and defense system out of context. If the therapist lives in his head, then so must his patients? I would guess so.

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    1. Andrew: you are right. I will check and see how quickly my advanced patients fall asleep. art

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    2. at the risk of becoming an obnoxious bore, i must say, it's not that simple.

      normally i will start to doze off, jump with fright, doze off again, jump again, for hours until i finally fall asleep. first line pain pushing against leaky gates?

      but whenever i do a night shift, i come home desperately tired, go to bed and fall asleep immediately.

      perhaps the human brain has some very fundamental hardwired defenses; perhaps it can, at any time, override the usual neurological functions in order to address it's most urgent requirements. in my case, it is sleep.

      when a person faints at the sight of blood -- does he faint because of an overload (malfunction) or does he faint to avoid an overload (defensive function)?

      those tentacle thingies that extend all the way from the brain stem to the neocortex...i wonder if they are main feeds which can be gated off to allow a rapid descent into slumberland.

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  9. Art said: 'In a way, our therapy is shock therapy in reverse. In reliving we are feeling shocked again but we can integrate that shock and so be done with it. We become superconscious, hyperaware of what went on.'

    It recently struck me that Primal Therapy is a mode of existential therapy. By this I mean that it is based on the premise that that which is unconscious is accessible to consciousness and that there is no Freudian 'censor' intervening between the two to maintain the conscious v unconscious divide. (Therefore, for Sartre, no psychoanalyst is needed necessarily as the individual in most cases can explore himself.) It would be interesting to know to what extent Art was influenced by existentialist philosophy esp. Sarte. Regardless of this I think that what PT does is force people to become conscious of those areas of their life they have negated (or split from) due to the pain. For Sartre the idea that consciousness is that which negates itself (e.g. as a positional consciousness in the world) is an anti-psychological approach. In other words, he thinks that psychology simply muddies the water rather than clarifying what is going on by offering explanations that claim to irreducible when in fact they're not. I think the same 'anti-psychological' attitude comes across in Art's work too except that Art is arguing for the necessity of a particular therapeutic approach that rejects the supremacy of analyst as 'expert' in favour of the patient as self-expert. Sorry if I am deviating from the main point of this article but I thought this was relevant too to the use blunt psychological approaches such as electrotherapy.

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    1. Will: I read Sartre, especially No Exit and find him to be un-understandable. Too intellectual for me. When I lived in Paris I used to sit near him while we had our coffee at La Coupole. art

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    2. Will: I was never an existentialist because after you mastered it the only solution was to take a gun and kill yourself. art

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    3. Ha ha ha, making me laugh- existentialism

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  10. Hi Andrew,
    -I work amongst some people who live in a kind of self-convinced mindset of happiness, that I personally describe as "depression in denial"-.

    I bet they dislike any-one remotely depressed unless they take the positive thought advice and 'snap out of it'. . .

    It's re-assuring for me to know Andrew, that I'm not the only person observing this crass veneer that denial puts onto the only lives we will ever have. Thanks, the tears are rolling down my cheeks.

    Also: -"If the therapist lives in his head, then so must his patients"-.

    Well exactly, and where else could a therapist (who has not thoroughly re-lived his own griefs) 'live' whilst 'observing' his patients' grief? My therapist was exactly thus, when push came to shove we ended up arguing over interesting intellectual technical details because both of us could not handle our pain.

    No wonder the intellectual types are attracted to psychotherapy as a profession because they can effectively make money out of voyeurism masquerading as 'care' and get the patient to collude. Particularly us 'bright ones'.
    All of us 'bright' individuals would fall for this if we didn't know Primal Theory. It should be taught in schools from reception class onwards.
    Paul G.

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    1. Paul,

      One guy I have briefly met and spoken to is an extreme case of 'think only happy thoughts', and he very recently almost died of cancer which is still a looming threat for him. I would love to suggest PT to him, and explain the basic dynamics of blocked pain, but I just know it would all fall on deaf ears in the end. He would twist everything he hears from me into a 'happy' interpretation as opposed to a real one.

      I think when the defense system demands a certain level of delusionment you have no choice but to write certain individuals off, as a lost cause.

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    2. Andrew: “He would twist everything he hears from me into a 'happy' interpretation as opposed to a real one.”
      I can relate to your statement, I heard it many times, seams to be a standard denial. They either like to think-positive, stay in the here-and-now, or pray to a God. My question to the one in denial is; for how long will you be doing this – how long until it works?
      Sieglinde

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    3. Hi Sieglinde,

      -"My question to the one in denial is; for how long will you be doing this – how long until it works"?-

      And Andrew,

      -"I think when the defence system demands a certain level of delusionment you have no choice but to write certain individuals off, as a lost cause"-.

      These two statements seem related, I have very close members of my family and friends who are directly influential on my children who qualify exactly for these remarks. All I can say is I try to focus directly on my relationship with my children and think of nothing else. Until these individual adults decide that 'reality' could be something different from their (second hand, ie: acquired from some-one else) reductionist viewpoint then I have to endure them. I used to try to appease. . . That is like using petrol to put out a fire.

      Paul G.

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  11. This is one of the reason they give electric shock therapy.

    Today ... only in my mind… I can imagine someone saying "That's great Frank" and my feeling is at the surface of the needs I struggle with throughout my life. "SOMEONELIKE ME" it does not get bigger than that.

    My reaction has always been of inferiority when someone gave me praise... it's hard to imagine... but I understand now what the reaktion of "being loved" integrated into my system would have caused... it would have led to a disaster... a disaster as there was no love for me as young... love... necessary for my life... something I never had... something necessary to avoid or ending up in a disaster.
    The disaster does not change his face until we know what caused it... to love as adults become a threat for us... and because of that... we get electric shocks. WHAT TO DO?

    Frank

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    1. Frank: Stay away from shock therapy. Great line: The disaster does not change face until we know what caused it. so true. art

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  12. There was a very good recent BBC Drama called White Heat which followed the lives of a group of friends from the 1960's to the present day. One characters Mother suffered from Depression and was also rather manic at times and she asked for Electro Shock Therapy. It was quite the most barbaric and shocking scene. In the end she killed herself with carbon monoxide in her car.

    More trauma to cure trauma. Such Bollocks!

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  13. To all the intellectual,

    What it is that is myself? I will wonder about as long as there is something to wonder about… and about that tell all my symptoms. What I'm trying to explain here on the blog are also symptoms "if" it performs the function for it. I do not always know if it do or not... but I am cautious when it means to be alive or find myself in a vacuum of myself.

    I need to "consciously" changing doings to get on with my suffering... I mean... do something because I can not get any futher... try other things... change in my routine. Routines often binds incredible suffering... it is like a behavior with the aim to endure.

    What it is that is "myself"? That is all there is between my need for mom and what I am today. It's all about unbearable pain... it sounds in it self unbearable but is so liberating because the pain becomes awareness to deal with... it is words that come to life by feelings... feelings when they are in their proper context.

    Being a little boy in an adult body for what a little boy's needs were... to now... relieve suffering of it... it is not an easy thing to correct.

    Frank

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  14. An email comment:
    "Art thanks for writing this about ECT.

    What struck me in the article, is how psychiatry does ECT, without any understanding of what it does, or any reasonable rationale for why it's done as a treatment. Yet its precisely this same approach that is used when prescribing psychotropic medications. They don't understand why they work, but prescribe them anyway.

    Psychiatry has a long history of doing these things to patients, from hydro therapy, to insulin shock, pre frontal lobotomies, and the drugging of whole wards with chlorpromazine as a means of control. (Chloropromazine initally developed as an insecticide, brought to America from Europe and approved despite a complete fabrication of clinical trials.) All of these treatments were done without any real understanding of their biological action and relation to symptom reduction. But with the belief that since patients would likely be insane for the rest of their lives anyway it didn't really matter. ECT, is the same, the psychiatric rationale is that since the patient is never likely to improve anyway, then the risks out weigh the benefits.

    However autopsies of patients treated with psychotropic medications, and ECT have shown massive brain damage, as a result of these procedures. Symptom reduction is more a measurement of brain dysfunction than of improvement. In fact the symptoms associated with some mental diseases, didn't exist before the introduction of psychotropic medications like haldol and chrolopromazine.

    This is the underlying problem with psychiatry. Psychiatrists have no understanding of what causes their patients to be ill, and they don't know how to treat them. Instead they just make their ideas up out of thin air. Its all a shot in the dark.

    ECT is particularly insidious, its done on children, drug addicts, the depressed, and those with BI-Polar. Insurance often don't require review. Psychiatrists sometimes schedule 20 or 30 patrients a day, and are rewarded in the thousands of dollars per session. Also the FDA, does not require that ECT machines be calibrated.

    For many treated with ECT, their symptoms will return, with a vengance. This can lead to maintenance ECT once a week for years and years. There are also experimental treatments in which pacemakers are atteched to the vagus nerve, that give a continous shock. Called VNS, the FDA allows it for children as young as 15.

    The end result is quite horrible. People robbed of that internal spark that makes them human, they have no joy of life, their memories both past and present are gone, and they may be unable to function even at the most basic level. At this point, there is nothing that can be offered except long term assisted llivng, and the condolences of those that did this to them.

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    1. To the person who wrote the above comment about ECT and other treatments that cause brain damage -
      where did you get the information? You write very well for the purpose of provoking an emotional response. If I combined the above letter with some statistics obtained from the Primal Center, I could send a powerful letter to the appropriate people.

      Art, these patients who have not yet received but qualify for ECT.....are most of them too insane to benefit from your therapy?

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Review of "Beyond Belief"

This thought-provoking and important book shows how people are drawn toward dangerous beliefs.
“Belief can manifest itself in world-changing ways—and did, in some of history’s ugliest moments, from the rise of Adolf Hitler to the Jonestown mass suicide in 1979. Arthur Janov, a renowned psychologist who penned The Primal Scream, fearlessly tackles the subject of why and how strong believers willingly embrace even the most deranged leaders.
Beyond Belief begins with a lucid explanation of belief systems that, writes Janov, “are maps, something to help us navigate through life more effectively.” While belief systems are not presented as inherently bad, the author concentrates not just on why people adopt belief systems, but why “alienated individuals” in particular seek out “belief systems on the fringes.” The result is a book that is both illuminating and sobering. It explores, for example, how a strongly-held belief can lead radical Islamist jihadists to murder others in suicide acts. Janov writes, “I believe if people had more love in this life, they would not be so anxious to end it in favor of some imaginary existence.”
One of the most compelling aspects of Beyond Belief is the author’s liberal use of case studies, most of which are related in the first person by individuals whose lives were dramatically affected by their involvement in cults. These stories offer an exceptional perspective on the manner in which belief systems can take hold and shape one’s experiences. Joan’s tale, for instance, both engaging and disturbing, describes what it was like to join the Hare Krishnas. Even though she left the sect, observing that participants “are stunted in spiritual awareness,” Joan considers returning someday because “there’s a certain protection there.”
Janov’s great insight into cultish leaders is particularly interesting; he believes such people have had childhoods in which they were “rejected and unloved,” because “only unloved people want to become the wise man or woman (although it is usually male) imparting words of wisdom to others.” This is just one reason why Beyond Belief is such a thought-provoking, important book.”
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Quotes for "Life Before Birth"

“Life Before Birth is a thrilling journey of discovery, a real joy to read. Janov writes like no one else on the human mind—engaging, brilliant, passionate, and honest.
He is the best writer today on what makes us human—he shows us how the mind works, how it goes wrong, and how to put it right . . . He presents a brand-new approach to dealing with depression, emotional pain, anxiety, and addiction.”
Paul Thompson, PhD, Professor of Neurology, UCLA School of Medicine

Art Janov, one of the pioneers of fetal and early infant experiences and future mental health issues, offers a robust vision of how the earliest traumas of life can percolate through the brains, minds and lives of individuals. He focuses on both the shifting tides of brain emotional systems and the life-long consequences that can result, as well as the novel interventions, and clinical understanding, that need to be implemented in order to bring about the brain-mind changes that can restore affective equanimity. The transitions from feelings of persistent affective turmoil to psychological wholeness, requires both an understanding of the brain changes and a therapist that can work with the affective mind at primary-process levels. Life Before Birth, is a manifesto that provides a robust argument for increasing attention to the neuro-mental lives of fetuses and infants, and the widespread ramifications on mental health if we do not. Without an accurate developmental history of troubled minds, coordinated with a recognition of the primal emotional powers of the lowest ancestral regions of the human brain, therapists will be lost in their attempt to restore psychological balance.
Jaak Panksepp, Ph.D.
Bailey Endowed Chair of Animal Well Being Science
Washington State University

Dr. Janov’s essential insight—that our earliest experiences strongly influence later well being—is no longer in doubt. Thanks to advances in neuroscience, immunology, and epigenetics, we can now see some of the mechanisms of action at the heart of these developmental processes. His long-held belief that the brain, human development, and psychological well being need to studied in the context of evolution—from the brainstem up—now lies at the heart of the integration of neuroscience and psychotherapy.
Grounded in these two principles, Dr. Janov continues to explore the lifelong impact of prenatal, birth, and early experiences on our brains and minds. Simultaneously “old school” and revolutionary, he synthesizes traditional psychodynamic theories with cutting-edge science while consistently highlighting the limitations of a strict, “top-down” talking cure. Whether or not you agree with his philosophical assumptions, therapeutic practices, or theoretical conclusions, I promise you an interesting and thought-provoking journey.
Lou Cozolino, PsyD, Professor of Psychology, Pepperdine University


In Life Before Birth Dr. Arthur Janov illuminates the sources of much that happens during life after birth. Lucidly, the pioneer of primal therapy provides the scientific rationale for treatments that take us through our original, non-verbal memories—to essential depths of experience that the superficial cognitive-behavioral modalities currently in fashion cannot possibly touch, let alone transform.
Gabor Maté MD, author of In The Realm of Hungry Ghosts: Close Encounters With Addiction

An expansive analysis! This book attempts to explain the impact of critical developmental windows in the past, implores us to improve the lives of pregnant women in the present, and has implications for understanding our children, ourselves, and our collective future. I’m not sure whether primal therapy works or not, but it certainly deserves systematic testing in well-designed, assessor-blinded, randomized controlled clinical trials.
K.J.S. Anand, MBBS, D. Phil, FAACP, FCCM, FRCPCH, Professor of Pediatrics, Anesthesiology, Anatomy & Neurobiology, Senior Scholar, Center for Excellence in Faith and Health, Methodist Le Bonheur Healthcare System


A baby's brain grows more while in the womb than at any time in a child's life. Life Before Birth: The Hidden Script That Rules Our Lives is a valuable guide to creating healthier babies and offers insight into healing our early primal wounds. Dr. Janov integrates the most recent scientific research about prenatal development with the psychobiological reality that these early experiences do cast a long shadow over our entire lifespan. With a wealth of experience and a history of successful psychotherapeutic treatment, Dr. Janov is well positioned to speak with clarity and precision on a topic that remains critically important.
Paula Thomson, PsyD, Associate Professor, California State University, Northridge & Professor Emeritus, York University

"I am enthralled.
Dr. Janov has crafted a compelling and prophetic opus that could rightly dictate
PhD thesis topics for decades to come. Devoid of any "New Age" pseudoscience,
this work never strays from scientific orthodoxy and yet is perfectly accessible and
downright fascinating to any lay person interested in the mysteries of the human psyche."
Dr. Bernard Park, MD, MPH

His new book “Life Before Birth: The Hidden Script that Rules Our Lives” shows that primal therapy, the lower-brain therapeutic method popularized in the 1970’s international bestseller “Primal Scream” and his early work with John Lennon, may help alleviate depression and anxiety disorders, normalize blood pressure and serotonin levels, and improve the functioning of the immune system.
One of the book’s most intriguing theories is that fetal imprinting, an evolutionary strategy to prepare children to cope with life, establishes a permanent set-point in a child's physiology. Baby's born to mothers highly anxious during pregnancy, whether from war, natural disasters, failed marriages, or other stressful life conditions, may thus be prone to mental illness and brain dysfunction later in life. Early traumatic events such as low oxygen at birth, painkillers and antidepressants administered to the mother during pregnancy, poor maternal nutrition, and a lack of parental affection in the first years of life may compound the effect.
In making the case for a brand-new, unified field theory of psychotherapy, Dr. Janov weaves together the evolutionary theories of Jean Baptiste Larmarck, the fetal development studies of Vivette Glover and K.J.S. Anand, and fascinating new research by the psychiatrist Elissa Epel suggesting that telomeres—a region of repetitive DNA critical in predicting life expectancy—may be significantly altered during pregnancy.
After explaining how hormonal and neurologic processes in the womb provide a blueprint for later mental illness and disease, Dr. Janov charts a revolutionary new course for psychotherapy. He provides a sharp critique of cognitive behavioral therapy, psychoanalysis, and other popular “talk therapy” models for treating addiction and mental illness, which he argues do not reach the limbic system and brainstem, where the effects of early trauma are registered in the nervous system.
“Life Before Birth: The Hidden Script that Rules Our Lives” is scheduled to be published by NTI Upstream in October 2011, and has tremendous implications for the future of modern psychology, pediatrics, pregnancy, and women’s health.
Editor