What Is Primal Therapy?
Primal therapy is a type of psychotherapy that focuses on helping people connect with their deepest emotions and feelings. The goal of primal therapy is to help people resolve psychological issues by allowing them to express their emotions and feelings in a safe and supportive environment.
Primal therapy was developed in the 1960s by Dr. Arthur Janov, a psychologist and psychoanalyst.1In his book “The Primal Scream,” Janov outlined his theory of primal therapy.
Janov’s theory is that psychological issues are caused by repressed emotions and feelings. He believes that these repressed emotions can cause a variety of psychological problems, including anxiety, depression, and rage.
Janov’s theory further asserts that repressed pain from a person’s life can be converted into physical symptoms, such as ulcers, headaches, and asthma. According to Janov, psychological pain goes back to incidents in people’s lives that were too traumatic for them to fully accept or integrate into their conscious selves. Incidents could include physical or emotional abuse, neglect, or a traumatic event such as war.
Janov believed that the only way to resolve psychological problems is to express repressed emotions and feelings. Janov’s theory is that people need to release these repressed emotions in order to heal and resolve their psychological issues.
In primal therapy, people are encouraged to express their thoughts and feelings freely in a safe and supportive environment. This can include talking, crying, shouting, or making sounds. During this process, people in therapy are encouraged to pay careful attention to the release of any repressed emotions they may be experiencing.
“There is one neurosis, many manifestations and one cure “feeling.”
Repressed pain divides the self in two and each side wars with the other. One is the real self, loaded with needs and pain that are submerged; the other is the unreal self that attempts to deal with the outside world by trying to fulfill unmet needs with neurotic habits or behaviors such as obsessions or addictions. The split of the self is the essence of neurosis and neurosis can kill.
That pain is the result of needs and feelings that have gone unfulfilled in early life. Those early unmet needs create what I call Primal Pain. Coming close to death at birth or feeling unloved as a child are examples of such Pain. The Pain goes unfelt at the time because the body is not equipped to experience it fully and deal with it. When the Pain is too much, it is repressed and stored away. When enough unresolved Pain has occurred, we lose access to your feelings and become neurotic.
“The number one killer in the world today is not cancer or heart disease, it is repression.”
Primal Therapy is important in the field of psychology, for it means, ultimately, the end to so much suffering in human beings. Discovering a way to treat Pain means there is a way to stop the misery in which so many of us are mired every day of our lives. After two decades of research, after dealing with thousands of patients with every imaginable psychological and physical affliction, we have arrived at a precise, predictable therapy that reduces the amount of time one spends in treatment and eliminates all the wasted motion. It is a therapy that has been investigated by independent scientists and the findings are consistent. Primal Therapy is able to reduce or eliminate a host of physical and psychic ailments in a relatively short period of time with lasting results.
“Feeling Pain is the end of suffering.”
We have found ways to measure the ongoing presence and chronic effects of early trauma. We have observed time and again that even though it is not felt, the force of the memory remains in the system, reverberating on lower brain levels and moving against the body wherever it happens to be vulnerable. It shapes our interests, values, motivations and ideas. By reliving these traumas, patients can return back to early events and know with certainty how they formed adult behavior and symptoms.
“Repression is the hidden force behind illness”
We can see how buried memories constantly activate the system, putting pressure on vital organs and creating disruptions which can eventually result in serious illness. The problem for too many of us is that suddenly we find ourselves with afflictions or obsessions and have no idea how it all happened. We don’t know why we can’t sleep, why we can’t find a mate, why we are obsessed with this idea or that or why we don’t function as we want to, sexually. Primal Therapy can clarify these seeming mysteries.
It sometimes seems that everyone is suffering in their own way and few are aware of it. Television is riddled with ads for ibuprofen, aspirin, sleeping pills and other pain killers, implicitly acknowledging the Pain we are all in but without ever acknowledging it explicitly. Nothing dramatic happens but so many of us have developed this disease or that, from high blood pressure to allergies, colitis, anxiety attacks, asthma, circulation problems and heart palpitations (our history literally becomes palpable). So many ailments that seem inexplicable — depression and phobias, ulcers and migraines — may all stem from the same source. So might many of our personality quirks, our habits and behavior patterns, our drives and obsessions. One powerful piece of evidence for the fact of the same kinds of Pains being behind so many different afflictions and behavioral problems is that the same kinds of tranquilizers or pain killers are used to treat all of them.
In the fields of medicine and psychotherapy today doctors deal with symptoms. Just look at the DSM-IV, the psychiatric diagnostic and statistical manual, with page after page of every conceivable variation of neurosis. And in Washington, D.C., they have erected monuments to symptoms, a building for each one “drug abuse, alcoholism, heart disease, cancer and so on. Experts specialize in treating colitis, ulcers, migraines, diabetes, high blood pressure, asthma, anxiety, depression, marital problems, eating disorders, etc.; knowing more and more about narrower and narrower subjects. They add salt, take away salt, add thyroid, remove thyroid, speculate about the reasons for one’s allergies or unhappiness, analyze dreams and nearly always prescribe medication. They are trying to normalize the symptom instead of normalizing the person who has it; trying to normalize the manifestation instead of the system that makes it manifest.
Delving deep into the unconscious has allowed us to clarify the basis of adult behavior. We have a good idea what lies in the unconscious and it doesn’t seem to be the mystical emporium so often described. We have learned in Primal Therapy that irrespective of whether the Pain is manifest in the body or in the mind, the person is not himself; there is a dislocation of function which is global. Both emotional and physical pain deform cells and cause alterations which show up in measurements of vital signs, brain function and chemistry, the immune system, hormones, peripheral blood flow and in a person’s behavior. Everything is askew.
Primal Therapy works in reverse of the normal approach. Instead of working from symptoms to possible causes, we work from causes to symptoms. The focus is always deep. From this approach we have developed a more profound understanding of who we are and what drives us, our basic, hidden, unconscious motivations.
The Discovery of Primal Pain
“During a lull in our group therapy session, he told us a story about a man named Ortiz who was currently doing an act on the London stage in which he paraded around in diapers drinking bottles of milk. Throughout his number, Ortiz is shouting, “Mommy! Daddy! Mommy! Daddy!” at the top of his lungs. At the end of his act he vomits. Plastic bags are passed out, and the audience is requested to follow suit.
“Danny’s fascination with the act impelled me to try something elementary, but which previously had escaped my notice. I asked him to call out, “Mommy! Daddy!” Danny refused, saying that he couldn’t see the sense in such a childish act, and frankly, neither could I. But I persisted, and finally, he gave in. As he began, he became noticeably upset. Suddenly he was writhing on the floor in agony. His breathing was rapid, spasmodic; “Mommy! Daddy!” came out of his mouth almost involuntarily in loud screeches. He appeared to be in a coma or hypnotic state. The writhing gave way to small convulsions, and finally, he released a piercing, deathlike scream that rattled the walls of my office. The entire episode lasted only a few minutes, and neither Danny nor I had any idea what had happened. All he could say afterward was: “I made it! I don’t know what, but I can feel”
“What happened to Danny baffled me for months. I had done standard insight therapy for seventeen years, both as a psychiatric social worker and as a psychologist. I was trained in a Freudian psychiatric clinic, as well as in a not-so-Freudian Veterans Administration department. For several years I had been on the staff of the psychiatric department of the Los Angeles Children’s Hospital. At no time during that period had I witnessed anything comparable. Since I had taped the group session that night, I listened to the recording frequently over the next several months in an effort to understand what had happened. But to no avail.
“Before long I had a chance to learn more about it.”
“A thirty-year-old man, whom I shall call Gary Hillard, was relating with great feeling how his parents had always criticized him, had never loved him, and had generally messed up his life. I urged him to call out for them; he demurred. He “knew” that they didn’t love him, so what was the point? I asked him to indulge my whim. Halfheartedly, he started calling for Mommy and Daddy. Soon I noticed he was breathing faster and deeper. His calling turned into an involuntary act that led to writhing, near-convulsions, and finally to a scream.
“Both of us were shocked. What I had believed was an accident, an idiosyncratic reaction of one patient, had just been repeated in almost identical fashion.
“Afterward, when he quieted down, Gary was flooded with insights. He told me that his whole life seemed to have suddenly fallen into place. This ordinarily unsophisticated man began transforming himself in front of my eyes into what was virtually another human being. He became alert; his sensorium opened up; he seemed to understand himself.
“Because of the similarities of the two reactions, I began listening even more carefully to the tapes I had made of Danny’s and Gary’s sessions. I tried to analyze what common factors or techniques produced the reactions. Slowly some meaning began to emerge. Over the next months I tried various modifications and approaches in asking the patient to call for his parents. Each time there occurred the same dramatic results.
“I have come to regard that scream as the product of central and universal pains which reside in all neurotics. I call them Primal Pains because they are the original, early hurts upon which all later neurosis is built. It is my contention that these pains exist in every neurotic each minute of his later life, irrespective of the form of his neurosis. These pains often are not consciously felt because they are diffused throughout the entire system where they affect body organs, muscles, the blood and lymph system and, finally, the distorted way we behave.
“Primal Therapy is aimed at eradicating these pains. It is revolutionary because it involves overthrowing the neurotic system by a forceful upheaval. Nothing short of that will eliminate neurosis, in my opinion.
“Primal Theory is an outgrowth of my observations about why specific changes take place. Theory, I must emphasize, did not precede clinical experience. When I watched Danny and Gary writhing on the floor in the throes of Primal Pain, I had no idea what to call it. The theory has been expanded and deepened by the continuing reports of one patient after another who has been cured of neurosis. This book is an invitation to explore the revolution they began.”
– from The Primal Scream by Dr. Arthur Janov
The following paragraphs cover Dr. Janov’s theory of neurosis:
We all are creatures of need. We are born needing, and the vast majority of us die after a lifetime of struggle with many of our needs unfulfilled. These needs are not excessive–to be fed, kept warm and dry, to grow and develop at our own pace, to be held and caressed, and to be stimulated. These Primal needs are the central reality of the infant. The neurotic process begins when these needs go unmet for any length of time. A newborn does not know that he should be picked up when he cries or that he should not be weaned too early, but when his needs go unattended, he hurts.
At first the infant will do everything in his power to fulfill his needs. He will reach up to be held, cry when he is hungry, kick his legs, and thrash about to have his needs recognized. If his needs go unfulfilled for a length of time, if he is not held, changed or fed, he will suffer continuous pain either until he can do something to get his parents to satisfy him or until he shuts off the pain by shutting off his need. If his pain is drastic enough, death may intervene, as shown in studies of some institutional babies.
Since the infant cannot himself overcome the sensation of hunger (that is, he cannot go to the refrigerator) or find substitute affection, he must separate his sensations (hunger, wanting to be held) from consciousness.
This separation of oneself from one’s needs and feelings is an instinctive maneuver in order to shut off excessive pain. We call it the split. The organism splits in order to protect its continuity. This does not mean that unfulfilled needs disappear, however. On the contrary, they continue throughout life exerting a force, channeling interests, and producing motivation toward the satisfaction of those needs. But because of their pain, the needs have been suppressed in the consciousness, and so the individual must pursue substitute gratifications. He must, in short, pursue the satisfaction of his needs symbolically. Because he was not allowed to express himself, he may be compelled to try to get others to listen and understand him later in life.
Not only are unattended needs that persist to the point of intolerability separated from consciousness, but their sensations become relocated to areas where greater control or relief can be provided. Thus, feelings can be relieved by urination (later by sex) or controlled by the suppression of deep breathing. The unfulfilled infant is learning how to disguise and change his needs into symbolic ones. As an adult he may not feel the need to suck his mother’s breast owing to abrupt early weaning but will be an incessant smoker. His need to smoke is a symbolic need, and the essence of neurosis is the pursuit of symbolic satisfactions.
Neurosis is a symbolic behavior in defense against excessive psychobiologic pain. Neurosis is self-perpetuating because symbolic satisfactions cannot fulfill real needs. In order for real needs to be satisfied, they must be felt and experienced. Unfortunately, pain has caused those needs to be buried. When they are buried, the organism goes into a continuous state of emergency alert. That alert state is tension. It propels the infant, and later the adult, toward the satisfaction of need in any way possible. This emergency alert is necessary to ensure the infant’s survival; if he were to give up hope of ever having his needs fulfilled, he might die. The organism continues to live at any cost, and that cost is usually neurosis–shutting down unmet bodily needs and feelings because the pain is too great to withstand.
Whatever is natural is a real need–to grow and develop at one’s own pace, for example. This means, as a child, not being weaned too soon; not being forced to walk or talk too early; not being forced to catch a ball before one’s neurological apparatus can do so comfortably. Neurotic needs are unnatural ones–they develop from the non satisfaction of real needs. We are not born in this world needing to hear praise, but when a child’s real efforts are denigrated virtually from birth, when he is made to feel that nothing he can do will be good enough for him to be loved by his parents, he may develop a craving for praise. Similarly, the need to express oneself as a child can be suppressed, even by the lack of anyone listening. Such denial may turn into a need to talk incessantly.
A loved child is one whose natural needs are fulfilled. Love takes his pain away. An unloved child is the one who hurts because he is unfulfilled. A loved child has no need for praise because he has not been denigrated. He is valued for what he is, not for what he can do to satisfy his parents’ needs. A loved child does not grow up into an adult with an insatiable craving for sex. He has been held and caressed by his parents and does not need to use sex to satisfy that early need. Real needs flow from inside out, not the reverse. The need to be held and caressed is part of the need to be stimulated. The skin is our largest sense organ and requires at least as much stimulation as other sense organs. Disastrous consequences can occur when there is insufficient stimulation early in life. Organ systems may begin to atrophy without stimulation; conversely, as Krech has shown [D. Krech, E. Bennett, M. Diamond, and M. Rosenzweig, “Chemical and Anatomical Plasticity of Brain,” Science, Vol. 146 (October 30, 1964), pp. 610-19], with proper stimulation they may develop and grow. There must be constant mental and physical stimulation.
Unfulfilled needs supersede any other activity in the human until they are met. When needs are met, the child can feel. He can experience his body and his environment. When needs are not met, the child experiences only tension, which is feeling disconnected from consciousness. Without that necessary connection, the neurotic does not feel. Neurosis is the pathology of feeling.
Demands for the child to be unreal are not often explicit. Nevertheless, parental need becomes the child’s implicit command. The child is born into his parents’ needs and begins struggling to fulfill them almost from the moment he is alive. He may be pushed to smile (to appear happy), to coo, to wave bye-bye, later to sit up and walk, still later to push himself so that his parents can have an advanced child. As the child develops, the requirements upon him become more complex. He will have to get A’s, to be helpful and do his chores, to be quiet and undemanding, not to talk too much, to say bright things, to be athletic. What he will not do is be himself. The thousands of operations that go on between parents and children which deny the natural Primal needs of the child mean that the child will hurt. They mean that he cannot be what he is and be loved. Those deep hurts I call Primal Pains (or Pains). Primal Pains are the needs and feelings which are repressed or denied by consciousness. They hurt because they have not been allowed expression or fulfillment. These Pains all add up to: I am not loved and have no hope of love when I am really myself.
Each time a child is not held when he needs to be, each time he is shushed, ridiculed, ignored, or pushed beyond his limits, more weight will be added to his pool of hurts. This pool I call the Primal Pool. Each addition to his pool makes the child more unreal and neurotic.
As the assaults on the real system mount, they begin to crush the real person. One day an event
will take place which, though not necessarily traumatic in itself – giving the child to a baby sitter for the hundredth time? will shift the balance between real and unreal and render the child neurotic. That event I call the major Primal Scene. It is a time in the young child’s life when all the past humiliations, negations, and deprivations accumulate into an inchoate realization: “There is no hope of being loved for what I am.” It is then that the child defends himself against that catastrophic realization by becoming split from his feelings, and slips quietly into neurosis. The realization is not a conscious one. Rather, the child begins acting around his parents, and then elsewhere, in the manner expected by them. He says their words and does their thing. He acts unreal–i.e., not in accord with the reality of his own needs and desires. In a short time the neurotic behavior becomes automatic.
Neurosis involves being split, disconnected from one’s feelings. The more assaults on the child by the parents, the deeper the chasm between real and unreal. He begins to speak and move in prescribed ways, not to touch his body in proscribed areas (not to feel himself literally), not to be exuberant or sad, and so on. The split, however, is necessary in a fragile child. It is the reflexive (i.e., automatic) way the organism maintains its sanity. Neurosis, then, is the defense against catastrophic reality in order to protect the development and psychophysical integrity of the organism.
Neurosis involves being what one is not in order to get what doesn’t exist. If love existed, the child would be what he is, for that is love-letting someone be what he or she is. Thus, nothing wildly traumatic need happen in order to produce neurosis. It can stem from forcing a child to punctuate every sentence with “please” and “thank you,” to prove how refined the parents are. It can also come from not allowing the child to complain when he is unhappy or to cry. Parents may rush in to quell sobs because of their anxiety. They may not permit anger–“nice girls don’t throw tantrums; nice boys don’t talk back”–to prove how respected the parents are; neurosis may also arise from making a child perform, such as asking him to recite poems at a party or solve abstract problems. Whatever form it takes, the child gets the idea of what is required of him quite soon. Perform, or else. Be what they want, or else–no love, or what passes for love: approval, a smile, a wink. Eventually the act comes to dominate the child’s life, which is passed in performing rituals and mouthing incantations in the service of his parents’ requirements.
It is the terrible hopelessness of never being loved that causes the split. The child must deny the realization that his needs will never be filled no matter what he does. He cannot live knowing that he is despised or that no one is really interested in him. It is intolerable for him to know that there is no way to make his father less critical or his mother kind. The only way he has of defending himself is by developing substitute needs, which are neurotic.
Let us take the example of a child who is being continually denigrated by his parents. In the schoolroom he may chatter incessantly (and have the teacher come down hard on him); in the schoolyard he may brag nonstop (and alienate the other children). Later in life he may have an uncontrollable craving for and loudly demand something as patently symbolic (to the onlooker) as the “best table in the house” in an expensive restaurant.
Getting the table cannot undo the “need” he has to feel important. Otherwise, why repeat his performance every time he eats out? Split off from an authentic unconscious need (to be recognized as a worthwhile human being), he derives the “meaning” of his existence from being greeted by name by various maitre d’hotel in fancy restaurants.
Children are born, then, with real biological needs * which, for one reason or another, their parents do not fulfill. It may be that some mothers and fathers simply do not recognize the needs of their child or that those parents, out of a desire not to make any mistakes, follow the advice of some august authority in child rearing and pick up their child by the clock, feed him by a timetable an airline would envy, wean him according to a flow chart, and toilet train him as soon as possible.
Nevertheless, I do not believe that either ignorance or methodological zeal accounts for the bumper crops of neurosis our species has been producing since history began. The major reason I have found that children become neurotic is that their parents are too busy struggling with unmet infantile needs of their own.
Many parents make the mistake of not picking up their child sufficiently out of fear of “spoiling” him. By ignoring him, this is precisely what they do, and later they will be swamped by the child’s insatiable demands for symbolic substitutes–until the day they crack down on him. The consequences of that are both inevitable and dreadful.
Out of his neurotic drama, he will make almost anyone (including his children) into parental figures who will fill his needs. If a father was suppressed verbally and was never allowed to say much, his children are going to be listeners. They, in turn, having to listen so much, will have suppressed needs for someone to hear them; it may well be their own children.
The focus of struggle shifts from real need to neurotic need, from body to mind, because mental needs occur when basic needs are denied. But mental needs are not real needs. Indeed, there are no purely psychological needs. Psychological needs are neurotic needs because they do not serve the real requirements of the organism. The man in the restaurant, for example, who must have the best table in order to feel important is acting on a need which developed because he was unloved, because his real efforts in life were either ignored or suppressed. He may have a need to be recognized by name by the maitre d’ because early in life he was referred only to by category-“son.” This means he was dehumanized by his parents and is trying to get a human response symbolically through others. Being treated as a unique human being by his parents would obviate this so-called need to feel important. What the neurotic does is put new labels (the need to feel important) on old unconscious needs (to be loved and valued). In time he may come to believe that these labels are real feelings and that their pursuit is necessary.
The fascination of seeing our names in lights or on the printed page is but one indication of the deep deprivation in many of us of individual recognition. Those achievements, no matter how real, serve as a symbolic quest for parental love. Pleasing an audience becomes the struggle.
Struggle is what keeps a child from feeling his hopelessness. It lies in overwork, in slaving for high grades, in being the performer. Struggle is the neurotic’s hope of being loved. Instead of being himself, he struggles to become another version of himself. Sooner or later the child comes to believe that this version is the real him. The “act” is no longer voluntary and conscious; it is automatic and unconscious. It is neurotic.
– from The Primal Scream by Dr. Arthur Janov
Techniques of Primal Therapy
While there are no formal “techniques” for primal therapy, there are certain stages that you will likely work through. These stages include the following:
1. Regression: In Regression, you will re-experience past traumatic incidents in your life. You may experience some of the same feelings and sensations that you had during these incidents. During this stage, it is important to allow yourself to feel whatever memory or sensation is coming up for you at the moment.
2. The Release: In The Release, you will be encouraged to express your emotions and feelings as they surface. This can include talking, shouting, crying, or making sounds. At times it may feel uncomfortable or even scary during this stage. You will likely experience the release of repressed emotions that have been stored in your body over the course of your life.
3. Integration: In Integration, you will begin to put together the pieces of your life story. This can be a time when you make connections between different events in your life and how they have affected you. You may also begin to forgive yourself and others for the things that have happened in your past.
4. Resolution: In Resolution, you will have a sense of closure around the issues that were addressed in primal therapy. You may find that you are now able to live more freely and without the burden of unresolved emotional pain.
What Primal Therapy Can Help With
Primal therapy is used to help people with a wide range of issues, including psychological problems such as anxiety, depression, and rage. Primal therapy may also be used to treat physical symptoms that are thought to be caused by repressed emotions. Symptoms treated with primal therapy include ulcers, headaches, back pain, asthma, hives, and even cancer.
Primal therapy may be used to help people recover from childhood issues, especially cases of abuse. This can include physical or emotional abuse, sexual abuse, or neglect. Primal therapy may be used to help adults resolve memories of incidents that they have kept repressed since childhood. This could include things such as the death of a parent, physical or emotional abuse, or neglect.
Primal therapy may also be used to help people process traumatic events in their adult lives. This could include major life changes, divorce, the death of a family member or friend, job loss, or any other traumatic event that may have happened recently. Some people engage in primal therapy to help them cope with emotions they are experiencing during these stressful times.
Benefits of Primal Therapy
The benefits of primal therapy have generally not been evaluated in the scientific literature.2 For this reason, it’s important to understand that the proposed benefits of primal therapy listed below are theoretical in nature, and haven’t been supported with adequate research evidence:
- People who undergo primal therapy may report feeling a sense of relief after expressing their emotions and feelings. They may feel that they have finally resolved some of the issues that have been causing them pain for years.
- Some people may find that they are able to resolve traumatic memories that they have been living with since childhood. This could be helpful for people who haven’t felt comfortable talking about specific incidents before primal therapy, or who haven’t fully processed the emotions surrounding them.
- Primal therapy may also help people process recent events that may have caused pain in their lives, such as divorce or the death of a loved one. This type of therapy can help people to cope with the emotions they are feeling and begin to move on from the event.
Things to Consider
Primal therapy is not for everyone. Some people may find the process of expressing their emotions and feelings to be too difficult or uncomfortable. It is important to remember that primal therapy is a personal experience and that what works for one person may not work for another.
If you are considering primal therapy, it is important to speak with a therapist who can help you decide if this is the right treatment for you. Not every therapist is skilled in primal therapy, so you will want to make sure that the person you choose is experienced with this. You can also discuss how much time a session might last and what to expect from the experience.
Primal therapy sessions typically last for around an hour. People who engage in primal therapy may notice a release of tension after each session. This is because the process of expressing feelings and emotions has an effect similar to physical exercise.
How to Get Started
If you are interested in primal therapy, your best option may be to speak with a therapist who specializes in the process. They can help you get started on your own personal journey of emotional release if this is something that feels right for you.
You may also choose to do more research on the process of primal therapy before working with a specialist. This can help you to understand the basics of the therapy and what to expect from your own personal sessions.
When would a clinician use Primal Therapy?
Primal Therapy is used to treat a wide variety of neuroses, including the treatment of anxiety and depression. The aim is to return to the origins of the pain (which always goes back to a lack of love in childhood, or a trauma at birth), relive the pain, and thus heal it.
The Primal Center. What Is Primal Therapy?
Ehebald U, Werthmann HV. Primärtherapie–ein klinisch bewährtes Verfahren? [Primal therapy–a clinically confirmed procedure?]. Z Psychosom Med Psychoanal. 1982;28(4):407-421.