The Primal Paradigm
Stephen Khamsi, Ph.D.
[Originally Published in The Humanistic Psychology Institute Review, Vol. 3,
No. 2, Fall 1981, pp. 51-60.]
ABSTRACT
The author describes the theoretical model of the person upon which primal
therapy was initially constructed, pointing especially to its delimiting and
restrictive aspects. He proposes to expand the model to make it more
compatible with humanistic approaches to psychotherapy. The complementarity
between primal therapy and humanistic psychology is explored, and
modifications are suggested which would enhance this complementarity. The
author concludes by offering a brief review of the literature that
illustrates innovations in primal therapy.
All systems of psychotherapy employ conceptual models that function
much like a set of blinders, enabling the practitioner to focus on important
matters while disregarding the irrelevant. In any therapeutic encounter
the practitioner's conceptual model of the person determines the treatment
procedures employed. A therapist employing a behavioral system might treat
a patient a particular way, while a psychoanalyst would think of and
therefore treat the same patient in a completely different manner. A
therapist's philosophy affects treatment in a way that is physical, not
merely metaphysical or conceptual; a person who is being treated with
aversive conditioning, for instance, is being subjected to a physical reality.
Primal therapy also has a guiding conceptual model, or paradigm. The
original primal paradigm presented by Arthur Janov (1970) suggests that
all persons have basic needs that must be fulfilled in order for proper
psychophysiological development to occur. If basic needs are unmet, pain
results. Overwhelming and sustained pain leads to physical repression
and a splitting of affective from cognitive awareness. One then proceeds
through life unaware of real needs and feelings and so must pursue symbolic
substitutes. This process of pain and subsequent repression is called
neurosis. The only way out of neurosis is to fully experience and integrate
the major pains that led to primal unconsciousness and symbol-seeking
behavior. This process of reexperiencing and integrating early pain is called
the cure. More succinctly, people are "prisoners" of their pain until they
feel it; they are then free of their "life sentences."
Janov's primal therapy, like Freud's psychoanalysis and Reich's
vegetotherapy, was developed within an essentially medical framework and is
aligned with the disease model of functional psychiatry. "Doctors" perform
"therapy" on "patients" because they have "mental illnesses." Whereas
psychiatry recognizes many functional afflictions, primal theory recognizes
only one: neurosis, a disease of feeling (Janov, 1970, p. 20). Neurotic
symptoms are seen as stemming from underlying "primal pathophysiology"
(Holden, 1977c). Psychoses are quantitative extensions of neurosis.
What are the clinical complements of such a model? Pain is to be felt
at any expense. The patient's defenses are met with a "frontal assault"
(Janov, 1977, p. 335) so that they may be stripped away. The primal model
justifies the use of any technique that helps the patient (re)experience pain,
such as name-calling or arriving late for sessions to heighten anxiety.
Authoritarianism and "busting" may be considered necessary. In short, the
therapist does something to the patient to put him or her into the "primal
zone" (Holden, 1977a, 1977b).
Implicit in this model is the notion that it is best to reexperience
the earliest pain one can. Some therapists come to emphasize birth and
prebirth ("first line") experiences to the exclusion of childhood ("second
line") pains, which are considered to be of secondary importance. Moreover,
the relationship of any of these feelings to the patient's present life may
be neglected. This approach is what the psychiatrist Warren Baker (1980)
calls "radical primal."
Radical primal has made a core contribution to therapy. . . . It is
not, however, sufficient in itself for optimal growth to occur. The
human being is far more complex and remarkable. It deserves and
requires having all aspects, i.e., all feelings, intellect, words,
structure, action, present life, humor, defenses, even soul, utilized
as well in any effective therapy. This is our idea of effective
primal therapy. (p. 4)
Just as a model of this kind determines which treatment procedures
are indicated, so it defines which methods are rejected. If reexperiencing
pain is the prime goal of primal therapy, then a therapist will seldom if
ever deviate from the orthodox strategy by showing empathy or kindness to
a patient (except to increase access to primal pain) or by "allowing" a
patient to express strong feelings directly to the therapist without
performing a primal reduction, thereby "permitting" transference. Nor will
the therapist share a personal experience with a neophyte primaler, thus
initiating a primary relationship in the present. As Baker (1980) points
out, "What is lacking in other therapies, i.e., feeling early body and
psychological pain with a therapist capable of deep empathy, becomes the
'end-all' of primal. . . . What is of value in other therapies, i.e.,
intellect, words, insight and action, is often deprecated in radical primal"
(p. 2). Clearly, there is a danger that a patient in orthodox primal
therapy could meet the very type of maltreatment that he or she is in
therapy to resolve; one must certainly be judicious in the application of
such radical techniques in order to avoid compounding the pain and
defensiveness of the patient.
Such is the model of primal therapy still being espoused by its
founder ("An Interview with Arthur Janov," 1977; Janov, 1980). However, most
veteran primal therapists have actually expanded and modified their approaches
to include aspects of treatment and philosophy not contained in the orthodox
model. Although the orthodox primal model initially led to important
breakthroughs in the practice of psychotherapy, it no longer offers optimal
support for primal practitioners.
The primal paradigm was formulated by Janov beginning in 1967, when
his first patient underwent an intense abreaction, which he later termed a
"primal." The psychologist Leslie Pam ("Primal People," 1974), a certified
senior therapist at the Primal Institute, described an early model of the
primal therapeutic process that was very different from the current orthodoxy.
In the early days . . . after you felt one feeling then Art [Janov]
would say, "You're never going to be sick again, see?" If you felt a
feeling and you came out of it and said, "Geez, I was really crazy,"
he would say, "Well you'll never be crazy again." . . .As though one
Primal could work the cure! (p. 158)
There were three primals . . . the birth, the death and the life . . .
and you had to have those three Primals. You had to do it on command.
(p. 162).
This early theoretical model, in which patients were expected to be
cured after experiencing three specific primals, paved the way for the
estrangement of patients from their actual experiences, for responding to the
myth instead of to oneself. Patients treated while the primitive three-primal
model was in effect began to have those three primals. In an interview
published in 1977, Vivian Janov (Arthur Janov's wife) explained how her
privileged position allowed her to move beyond the myth of the three-primal
model and to connect with her own genuine experience.
I began to realize . . . that some of those early patients were being
too much influenced by each other and by Arthur, intellectually. And
I just felt like they were getting a little mystical about it.
I guess I had more courage than they did to say to Art,
"You're wrong, there is no Death Primal, and here's what's really
happening. . . . I'm discovering that there's more than two or three
pains down there. You know, it's like a whole big storehouse, a big
ball of Pain with a lot of different labels on the ball that you have
to keep hitting.
I think they were all afraid at the beginning. Everyone was
so excited and exhilarated and I think they were afraid to burst Art's
balloon by telling him that they were starting to feel bad again after
they were supposed to be "cured." ("An Interview with Vivian Janov,
1977, pp. 184-185)
At this time primal theory was still in its formative stages. The
theory was flexible; when anomalies were experienced the theory embraced them.
The theoretical formulation, helping at first to focus on and organize
observations and experiences, expanded as experiences broadened. Subsequent
experience has shown the three-primal model to be notoriously simplistic and
limiting. In my own clinical practice, for example, I have observed primals
that derive from hundreds of different types of experiences.
Primal therapy has progressed from these primitive beginnings to a
much more refined and systematic approach through evaluation and alteration.
This process of refinement should continue. Primal therapy must remain open,
as it has in the past, to evaluation, reevaluation, and modification. One of
the ways that the orthodox primal model might be amended is by incorporating
certain concepts from humanistic psychology. Primal therapy and humanistic
psychology are compatible and complementary, each potentially extending and
strengthening the other.
Humanistic psychologists tend to think of the person as a conscious
agent, freely making choices and acting with intentionality; he or she is
active, autonomous, creative, and self-governing, motivated by an organismic
propulsion toward self-actualization. Carl Rogers (1980), for example,
speaks of the "actualizing tendency" of human beings: "Individuals have
within themselves vast resources for self-understanding and for altering
their self-concepts, basic attitudes, and self-directed behavior" (p. 115).
He also posits "an underlying flow of movement toward constructive
fulfillment of . . . inherent possibilities" (p. 117). This is a picture of
a person undistorted by chronic primal pain, an individual who is in touch
with his or her "real self," no longer deadened or defended, ready to live
now to the fullest.
While the primal model is helpful for understanding and working with
someone in pain, its utility fades as the pain diminishes. This is where
a humanistic model can be of assistance. A person who feels and integrates
primal pain has the potential to become increasingly more conscious and free,
much like the humanistic model's image. The deterministic influence of
chronic, unfelt pain now becomes softer and more shadowy. The application
of the humanistic model helps in understanding and working with people who
have "felt through" their primal pains and have thereby heightened their
ability to make use of inner potentialities.
A close look at humanistic psychotherapies suggests a reappraisal
of the therapist-patient relationship offered by the orthodox primal model.
For example, Rogers believes that three conditions must be present so that
clients can be helped to tap their inner resources for growth: genuineness,
unconditional positive regard, and empathetic understanding. I wish to make
it clear that I am not implying that primal therapy should become strictly
client-centered. Rather, I believe that the client-centered approach offers
insights and possibilities for the receptive primal practitioner. It is
important that a therapist be as therapeutically responsive as possible;
this means neither attending exclusively to pain nor attending to everything
except pain. We all have pain and, at the same time, we are all much more
than just pain. The goal must be to respond to the whole person.
Primal theory complements humanistic psychology in that primal pain,
largely unaccounted for in the humanistic paradigm, helps to explain much
of the so-called existential anxiety and deficiency motivation that
purportedly plague humankind. What is missing in humanistic psychology is
an appreciation of the magnitude of primal pain as a reactive force in human
experience and an awareness of the healing effects of reexperiencing these
pains. Maslow's (1968, chap. 3) proposal, to take one noteworthy example,
conspicuously lacks the notion of primal pain and its effects in determining
one's status relative to deficiency- or growth-motivation. Likewise, Rogers
is accepting of the person but underestimates the importance and power of
facilitating primal experiences for people in pain. Humanistic
psychotherapies can strengthen themselves by becoming familiar with and
embracing this core principle of primal therapy.
Primal therapy already draws on several humanistic themes. For
example, there is little or no emphasis on psychodiagnosis per se;
experience is prized as highly as analysis; experienced reality is considered
valid; and advice regarding the conduct of one's life is rarely administered.
Furthermore, many examples of humanistic innovation in the theory and
practice of primal therapy have been described in the literature. Vivian
Janov (1973) early on questioned using the labels "therapist" and "patient"
in primal therapy. Her article, "The Cure for Neurosis?" also offered a
translation of the medical concept of "cure" into experiential language.
Leslie Pam ("Primal People," 1974) expressed his belief that besides
understanding defenses a primal therapist must be a human being with a
patient. A therapist is someone who can "reflect back the truth. . . .
It's sitting there and just being real" (p. 165).
Many similar contributions have come from therapists outside
Janov's Primal Institute. Hannig (1980) stressed that primal therapists
must be flexible in providing other avenues of self-growth. In
contradistinction to Janov's insistence that a primary relationship is
detrimental to the primal therapeutic process, Hannig believes that the
success of any therapeutic intervention is dependent on the nature and
quality of the therapist-client relationship. Humanists are intimately
familiar with this idea, that of the importance of the "therapeutic
alliance."
DiMele (1974) insisted that primal therapists must examine their
working assumptions, guidelines, and goals; otherwise "we may be limiting
the client strictly to experiences which fall within that structure. If
instead, our approach is to constantly examine the structure for that
which may be limiting the client, then we may be able to facilitate the
client's breaching his own protective boundaries" (p. 23). Weiner (1975)
noted that Janov had "seriously underestimated the strategic significance
of at least one very central aspect of long term psychotherapy--the
transference phenomenon" (p. 21). He further observed that "the role of
pleasure . . . is conspicuously absent in Janov's theory" (p. 21). He
added that "given the complexity of life-long reinforcement of neurotic
character structure in our . . . neurotic culture, the expectation of a
'cure' seems a patently naive one" (p. 22).
Freundlich (1976) describes several pitfalls of primal therapy,
including the glorification of pain, primaling everything, the denial of
transference and countertransference, "getting into feelings," distrusting
positive feelings, and the premium placed upon dramatic primals. He
advocates a more open system, one that is sensitive to subtle nuances of
feeling in both therapist and client. He also urged that discretion be
exercised regarding which experiences are processed primal reduction.
Expanding on the last point, Lonsbury (1978), writing in the
Journal of Humanistic Psychology, stated that "the primal reduction does
not fit all forms of deep feeling experience" (p. 19). Issuing an
indictment of orthodox primal therapy, he explained that "those who commit
themselves to the primal process are presented with a distorted approach
to emotional life. . . . Patients are conditioned not to validate feeling
a need for love or any other deep feeling" that does not result in a primal
discharge (p. 21). Lonsbury speaks from direct experience, having undergone
primal therapy with Arthur Janov. In fact, Lonsbury's is the case history
presented under the name "Tom" in the appendix of Janov (1970) Primal Scream.
More recently Roland Peters (1980), an MD who is a therapist at
Janov's Primal Institute, started that "the individual can only feel each
feeling when he ready for it in his life as a whole" (p. 2). Dr. Peters is
interested in all facets of his patients' lives, not just in their symptoms,
pain, and defenses. He moved beyond the orthodox primal model in stating
further that "feeling is only a part of the whole process" of primal therapy
(p. 2), implying a more holistic, developmental viewpoint.
Two processes, building up to the feeling on the one hand and
making new steps on the other, are synchronous, being dialectical
parts of the same process. The dialectic is that making progress
in life may often allow the old feeling to come up, and then feeling
the old deprivation in turn allows one to go even farther in
satisfying needs. In the long term, these things happen together.
The process is not complete and does not work unless each component
is present. I see feeling Primal pain as an inherent part of
growing, but not as the whole growth. (p. 2)
All of the preceding examples are important theoretical and clinical
issues. I wish to cite one last article, written from one client's personal
experience, that illustrates the beauty and the power of a more humanistic
primal therapy. Psychologist Ruth Loveys (1980) described her experience of
transferring from the Primal Institute in Los Angeles to the Denver Primal
Center. In Denver she found the therapists not so distant from the clients
as in Los Angeles. She met greater flexibility and was generally allowed to
follow her own instincts. No longer was she labeled "neurotic" nor drugged
to counteract "mysterious pain overloads." Instead she was told that she
held within herself "pockets of richness" which were as important and
formative as her pain, abuse, and trauma. Because of all this, she stated,
"the complete me--not just the sick side--was free to surface" (p. 9). She
was thus empowered to overcome what she termed her "Primal neurosis," in
which her defenses were inadvertently reinforced by the therapeutic
procedure.
I am now able to allow my thoughts to flow more freely--especially,
to open up to the distinct possibility of incorporating the good
that is be found in other psychological theories and movements into
the Primal framework. More than that, I believe that these other
points of view must be merged if the Primal community is ultimately
to survive. And this must be done very soon. (pp. 11-12)
REFERENCES
Baker, W. (1980). Toward a more effective primal therapy. Denver Primal
Journal, 2(2), 1-4.
DiMele, A.F. (1974). Innovations in primal-oriented therapy: The
all-sound method. Primal Community, 1(1), 22-25.
Freundlich, D. (1976). Pitfalls of primal. Primal Community, 1(4), 13-18.
Hannig, P.J. (1980). Therapeutic alliance: A necessity of the future?
Feeling People Newsletter, 4, 6-7.
Holden, E.M. (1977a). The dialectical unity of healing and suffering--The
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Holden, E.M. (1977b). Practical applications of the primal zone principle.
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