Neurosis and Primal Therapy

AN the capacity to feel the misery of one’s past actually C be the “cure” that Arthur Janov has claimed in his book, The Primal Scream (1970), or is it more appropriate to consider such a capacity a “curse”? To the hundreds of per- sons across the country who are “Primaling,” either within a structured therapy setting or on their own, there is little question as to their conviction that feeling one’s pain is the only way to live one’s life. For others, the prospect of pur- posefully regressing into one’s past is such a frightening and dangerous proposition that they cannot allow themselves to 34 VOLUME XV NO. I 1976 Neurosis and PrimaZ Therapy bg Norine Herr find anything of value or merit in Primal Theory or Therapy. Part of the controversy stirred up by the Primal movement can be attributed to Janov’s claim that neuroses can be cured and eradicated only by Primal Therapy. Janov says, “Primal Therapy purports to cure mental illness. Moreover, it claims to be the only cure. . . . This renders all other psychologic theories obsolete and invalid.” (1972, p. 19) The concept of cure has become so alien within the field of psychiatry and psychology that to claim it is possible is to invite professional disbelief. Consequently, this issue, as well as others related to NURSING FORUM 35 it, can easily be misinterpreted if taken out of context or not viewed within the total framework of Primal Theory. When given close scrutiny, even seemingly grandiose state- ments claiming cure become more reasonable. Essentially, Primal Theory holds that people come into treatment because they have a core of unresolved pain which has arisen from childhood experiences. When these pains cannot be fully experienced or integrated, they are stored in the body as tension. Primal Therapy is a process of therapy that allows the person to re-experience these early, core pains. As the pains are relived and integrated into the conscious adult ego, tension levels in the body steadily decline, thereby eliminating long-standing physical and psychological symp- toms. The early pain is brought forth into awareness through an orderly dismantling of the defenses that have acted here- tofore to keep the pain repressed. With the defense structure weakened, and with active therapeutic measures taken, the pain is mobilized in such a way that the person is transported back into his past. This journey into one’s past in which a segment of that past is relived is what is known as a Primal; that is, an intense feeling-thought-body experience in which one relives specific childhood events which, owing to the great overload of pain- ful affect, have been repressed and not accessible to con- sciousness. A Primal is usually accompanied by such basic feelings as need, frustration, fear, anger, sadness, helpless- ness, and aloneness. To be in Primal is to be “back there,” experiencing the exact emotions that were too painful to bear the first time around. Thus, if a person is reliving a scene in which his father almost kills him during a murderous rage, he will experience the same panic and terror in the therapy session that were originally present. He is fully emerged in 36 VOLUME X V NO. 1 1976 that past during a Primal, both physiologically and psycho- logically. The Primal Scream itself is simply one expression of the pain being experienced during a Primal. Janov likens it to the scream of someone who is about to be murdered. An analogous situation may occur when an ill child is left stranded in the hospital without his mother. The scream that the child emits, particularly the toddler, at the precise, agonizing moment he comprehends that his mother is going to leave him there alone and helpless, is a scream that contains all the stark terror of a Primal Scream. Primal Pain refers to the early catastrophic hurts that the child experiences in relationship to his parents from the moment of his birth throughout his childhood. These early psychological hurts seem to have an origin common to most patients. Simply stated, they arise from a basic abuse of the child as an individual worthy of respect, and involve a funda- mental rejection of him as a lovable human being. Although Karen Horney has not written much about the childhood factors responsible for the development of neurotic disorders, she does identify the parental attitudes that create the climate for neurotic development, which gives support to Janov’s contention that neurosis is nothing more than the constella- tion of defenses utilized to cover the reality of being unloved. She states: . . . i t all boils down to the fact that people in the environment are too wrapped up in their own neurosis to be able to love the child, or even conceive of him as the particular individual he is; their attitudes toward him are determined by their own neurotic needs and responses. In simple words they may be dominating, overprotective, intimidating, irritable, over- exacting, overindulgent, erratic, partial to other siblings, hypocritical, indifferent. . . . ( 1950, p. 18) NURSING FORUM 37 The parental behaviors most frequently cited by patients as connected to painful scenes involve being ridiculed, ignored, criticized, and humiliated. Ridicule is perhaps the most effective means of crushing a child’s sense of self and his desire to experience new situations. Unfortunately, mak- ing fun of a child’s efforts becomes adult sport to those who have no other way in which to feel adequate. Like ridicule, constant criticism will tend to warp initiative and cause the child to grow to believe that nothing he can do is right. Fre- quently this is manifested in later life by an aversion to any kind of effort. A child is humiliated by any act that forces him into a submission that opposes his natural inclinations. When a child is forced to say he is sorry when he feels wronged, when he has to smile and pretend he is happy when he really feels furious, his internal experience will be one of humil- iation. Being ignored or “not seen” is another common hurt from childhood for many persons, who then spend their lives acting out “see me.” The pain lies in not being seen for the real self, the self that hurts or is scared, or the self that may have feelings or opinions separate from the parents. Indeed, neurotic parents may be quite incapable of acknowledging anything in their child that is separate from themselves. The pain of not being seen, of not being acknowledged as unique, separate, real, and valid, is a core pain involved in not being loved. The slow accretion of one pain after another eventually leads the child to defend against the painful feelings by erecting neurotic defenses, and this transition into being more defended than feeling is the hallmark of neurosis. The critical shift from a tense state into a neurotic one occurs when the child begins to make sense out of all that has happened to 38 VOLUME XV NO. I 1976 him. The everyday, painful incidents add up in his mind to the fact that he is not loved, that he is totally alone, and that there is no one whom he can really count on. For the first time he begins to comprehend that he has been treated unkindly simply because no one feels kindly toward him. A young child cannot integrate the terror of this realization, therefore, he reflexly represses conscious awareness of it. It is at this juncture that he becomes truly split. For, in the process of repressing the catastrophic nature of the rejection, he must also repress the authentic self that has been the object of that rejection. Janov terms this the Primal Scene and describes it as the “single most shattering event” of the child’s life . . . that moment of “icy, cosmic loneliness” when he begins to discover he is not loved for what he is and never will be. (1970, p. 25) Janov says: It is when for one fleeting moment he sees that he cannot be himself and expect to be loved by his parents. Undefended children do see the truth readily . . . so he becomes what he must in order to survive with his parents. He will stop crying, stop sassing, stop saying what is on his mind without a con- scious effort. ( 197 1, p. 24) The idea of being “loved” or “unloved” can be fully understood only on a feeling level; when talked about intel- lectually the terms become vague and nebulous. What we can say is that feeling loved is not just a cerebral experience, it is a totally connected body-mind experience that will not occur simply because verbal protestations of love are being offered. Feeling loved “happens” when the child has a sense of his parents’ interest in him and his world. One of my patients, recalling his most significant Primal Scene, remem- bers the day being quite ordinary, but as exempllfying the NURSING FORUM 39 futility of his attempts to engage his mother’s interest in him. Having just arrived home after school, he rushed into the kitchen to tell his mother about the rabbit his home-room class had “adopted” that day. Her response was not atypical as she snapped, “Oh, for Heaven’s sake not now, I’m busy. Go outside and play until dinner’s ready.’’ For whatever reason, it was at this particular moment, on this particular day, that the meaning of those words uttered a hundred times before, finally began to sink in. “She really doesn’t want to listen to me . . . she really doesn’t cure about what I do . . . she really doesn’t care about me.” Unable to tolerate the catastrophic nature of this realization, the thought is banished from consciousness before it can be totally absorbed. How- ever, after this particular day the young boy’s behavior be- came subdued, his enthusiasm muted, and his need to be listened to deeply buried. At the major Primal Scene, the fundamental parental attitude toward the child is finally understood by him. Ob- viously, the mother who is only occasionally “too busy’’ to listen will not create a neurotic child. But the mother who is predominately unable to give of herself because she is so self-absorbed will truly not care about her child‘s day at school. This is what the child understands for at least one fleeting second at the major Primal Scene. A basic lack of love for the child can be manifested in numerous other ways. A loved child experiences parents who provide him with some sense of safety and security. Neurotic parents, far from providing the safety and protection needed by a growing child, are often themselves the source of the danger the child feels. Another patient told it this way (Here the patient was talking about what happened. In the therapy session he would be back there reliving it, not reporting it.) : 40 VOLUME XV NO. I 1976 It was Saturday and I was just loafing around in my room, you know, just lying on the bed listening to Beethoven and kind of drifting with the music. All of a sudden the door flies open and my dad barges into the room, his eyes wild with rage, his fists tightly clenched, and his face all bulging. H e was screaming something like ‘What d o you think you are, some kind of privileged character . . . is that all you have to d o . . . how many times d o I have to tell you . . .? H e was pissed off because I didn’t d o some stupid job I was supposed to have done; I don’t know, I can’t even remember what it was now. All I know is that when I looked up at him standing there I felt dizzy and sick ‘cause I knew for sure he wanted to kill me. And i f I had back talked or protested in any way, he would have, too. Another patient describes her “moment of truth.” I can remember how my sister used to pinch me. This one time when I was about five and she was 13, she was really in a foul mood. She began hitting me for no reason at all, and when I started to hit her back, she pushed me down on the floor and sat right on top of me. Then she grabbed my neck and pinched as hard as she could. I really thought I was going to pass out, the pain was so awful. When I finally did manage to get loose, I ran crying upstairs to where my mother was. She was in the bathroom scrubbing the tub or something. Anyway, she takes one look at my tear-stained face and a t my sister behind me and starts hollering, ‘Oh, for God’s sakes, can’t I leave you two alone for one minute? I want you to go to your room right this minute. I am just sick and tired of you both.’ I’ll never forget the smug look on my sister’s face, as if to say, ‘See, no one is going to help you.’ Part of me died right then. She was really right; there was no one to help. T h e event a t the Primal Scene need not be traumatic in and of itself, but according t o Janov the feeling that accom- NURSING FORUM 41 panies it, the insight that is involved, is the significant factor. It is that insight the child defends himself against by splitting from his feelings. “This separation of oneself from one’s . . . feelings is an instinctive maneuver in order to shut off exces- sive pain.” (1970, p. 22) The mechanism of splitting away from one’s genuine feelings is an aspect of the neurotic process that Horney writes about. She views this movement away from self as a primary and inevitable component of neurotic development. She says: Even more basic is his I the child’s] beginning alienation from self. Not only is his real self prevented from a straight growth, but in addition, he is forced to over-ride his genuine feelings, wishes and thoughts. To the extent that safety has become paramount, his innermost feelings have had to be silenced and have become indistinct. ( 1950, p. 118) When a child must exist in a world where it is unsafe for him to be himself, his natural spontaneous responses to that world will be inhibited. Rather than being free to react in accordance with his internal reality, he will be forced to think first about what impact his actions will have on his parents: “Will mommy be mad? Will daddy holler at me?” The kind of behavior expected from the child will depend upon the nature of the parents’ neurotic needs. A father who had to submit to cruel paternal domination is likely to need and demand respectful obedience from his son. The son’s reactions will then become guided by the implicit parental demand. “Do what I say without question.” This forces the young boy to tune out his own wishes and inclinations because to be aware of them would bring him into serious conflict with his father’s demand for unquestioning obedience. Likewise, a woman who was never allowed to experience 42 VOLUME XV NO. I 1976 being the baby or little girl during her childhood may demand that her children grow up fast, i.e., become “big” fast so that they can take care of her. She needs them to baby her so that she can act out her life-long need to be taken care of. She may demand excessive help with housework, may be frequently “sick” and need care, and in general, hand over the tasks of running a household to her children. A daughter in this situation will struggle to become the “good mommy” for her own mother. In all likelihood such a daughter will be described as helpful, mature, serious-minded, and the “model daughter.” She will act out being the good girl, but she will be neither herself nor real. To be herself she would have to experience her own basic need to be mothered. To be what her mother needs, she must not feel her own need; she must indeed stifle any awareness of it at all. This stifling of basic need transforms the child from a healthy, spontaneous being into a tense, neurotic one. For according to Primal Theory, the healthy growth of the child ultimately depends upon the fulfillment of his natural needs. Natural needs occur spontaneously and include “the need to be fed when hungry, to be kept warm and dry, to be stim- ulated and held, and to be allowed to develop at one’s own natural pace.” (Janov, 1971, p. 22) The idea of freely meeting the child’s need tends to make many people nervous. Such people would claim that if you gave a child everything he wanted he would become a spoiled brat. In realiJy, a “spoiled brat” is a demanding child precisely because his needs have not been met in a consistent and loving manner, and consequently he feels empty, hurt, cheated, and deprived. His spoiled brat behavior is a plea to be accepted and cared for. But neurotic parents, far from being able to meet the child’s needs, are looking to the child to meet their NURSING FORUM 43 needs. Since the core of neurosis lies in the experience of being unloved, they secretly look to their offspring to give them the sense of being loved that they crave and never felt from their own parents. Whether the feeling loved means being treated with respectful obedience or whether it means being taken care of, the important point is that in a neurotic household it is imperative to the child’s survival that he become deadened to the need inside himself, and become attuned to the need outside himself - i.e., his parents’ need. The attempt on the part of the child to be what his parents need him to be is what Janov terms the “struggle.” The struggle involves all that the child does and attempts to be- come in order to evoke a loving response from his parents. He tries to give them what they want in the hope that he will get some warmth and attention in return. The uncon- scious hope is that he can convert his parents into something other than what they are; that he can get them to love him. This hope keeps him alive, for if a young child were to feel the hopelessness of ever getting what he needed, his survival would be severely jeopardized, if not rendered impossible altogether. So armed with nothing more substantial than this unreal hope, the child strives to get mommy in a good mood by being bright, clever, and helpful, or tries to mollify daddy by being meek, unobtrusive, and accommodating. Life thus becomes a series of struggles to achieve the impossible, to win love that was never there to be had. For if love existed, the child would not have to struggle to get it. These same central core struggles are carried over into adult life and symbolically re-enacted with the predictability that Eric Berne’s concept of “life script” would suggest. The neurotic adult will act out with people in his present life the early unresolved struggles of his childhood, giving the same 44 VOLUME XV NO. I 1976 familiar theme to his life no matter how many years have passed. The woman with an alcoholic father who marries an alcoholic man is a common example. In this situation the struggle of converting daddy into a warm, decent responsible man can be continued over a lifetime without interruption. The struggle to receive a bit of attention, the attempt to extract a warm smile, the maneuvers to forestall a bruising attack - all will continue in adult life with “symbolic others” as long as the neurotic has hope of getting what he needs. He continues to act out the childhood struggles because not to do so would plunge him deeply into Primal Pain and hopelessness. To give up the struggle would mean to relin- quish hope and to experience the hopelessness of struggling for something that never existed. It was precisely this hope- lessness that was suppressed at the Primal Scene. The hope- lessness of ever being loved by his parents has never been consciously acknowledged, accepted, or integrated by the neurotic individual. Instead, he split off from his feelings and erected defenses to protect himself from that truth. The truth of being unloved is the truth that neurosis seeks to negate. Neurosis thus serves the function of substituting a distracting struggle for that reality. Because the struggle serves the protective function of keeping a person from knowing the truth, the neurotic will remain locked into all kinds of struggles in spite of incredible damage to himself. Richard Burton and Elizabeth Taylor demonstrated this dramatically in “Who’s Afraid of Virginia Woolf?” The viewer is able to sense the immense emptiness underneath their intense, destructive struggling with each other. When the passion of their hatred is depleted, they are left lifeless; when their struggle to defeat each other is suspended, they are left without reason or will to live. In NURSING FORUM 45 a dynamically similar way the achievement of some long sought-after goal, i.e., an advanced degree, may precipitate a severe depression in the vulnerable individual. For at the end of all neurotic struggles there is only the same painful emptiness that the struggle has sought to negate. Thus, the neurotic may free himself of one struggle, only to quickly emerge himself into another. Always in flight from his pain, he can never relax but must zealously guard against the intrusion of his pained self into conscious awareness. In the Primal View all mental illness is a flight from pain; a flight from reality into madness. Neurosis offers refuge from unbearable pain, but then extorts the very soul of its victims once they seek its protection. For the price the neurotic must pay not to feel his pain is not to feel much of anything at all. As long as a person must block out parts of his life he lacks unity, wholeness, and realness. Primal Therapy is a process of becoming real; a process of discarding all the unrealness and pretenses that have kept a person from feeling his pain. By stripping away the layers of defenses that have kept him removed from his feelings, Primal Therapy returns to the person both his pain and his capacity to feel. There is nothing other to gain in Primal Therapy than the opportunity to retrieve the forsaken self. REFERENCES Horney, Karen, Neurosis and Human Growth, New York: W.W. Janov, Arthur, Anatomy of Mental Illness, New York: G.P. Norton and Company, Inc., 1950. Putnam’s Sons, 197 1. Schuster, 1972. Company, Inc., 1970. ..................... ..., The Primal Revolution, New York: Simon and ......................... The Primal Scream, New York: Dell Publishing 46 VOLUME X V NO. 1 1976