Primal Therapy And Humane Care in Mental Health
Source document: Int. J. Environ. Res. Public Health 2021, 18(12), 6625; https://doi.org/10.3390/ijerph18126625
Radosław Stupak and Bartłomiej Dobroczyński at Jagiellonian University are Polish Researchers whose sourced research critiques the current medical model approaches to mental health. Here are some of their findings:
· Despite the overwhelming increase in psychiatric services, there has been no improvement in outcomes for people diagnosed with mental illness.
· Recovery outcomes have only worsened since the dawn of the medication era.
· The number of people taking long-term prescriptions continues to rise. And,
· Suicide and disability rates due to mental illness continues to rise.
They conclude that:
“The progress in neuroscience does not seem to translate into better treatments, and new drugs are no better than those discovered by accident in the middle of the 20th century and work on the same underlying principles.”
“The biomedical model encourages people to see their emotions as chemical imbalances, rather than as the body’s natural response to trauma and other social factors.”
“One particularly worrying consequence of this……..is the fact that some people with psychiatric diagnoses may even lose the ability to understand their mental states as something that is directly connected to the lives they live.”
In other words, if people think that their “broken brain” is the problem, they may feel powerless to ever escape that distress—and focus on treating their “mental illness” with drugs rather than changing that problematic life situation.
Continuing with their findings:
· Psychiatric drugs do not act in a specific, identifiable manner on known biological processes. Instead, they have widespread effects across multiple systems in the brain and body.
· Psychiatric diagnoses are vague, ambiguous, and subjective. Two people with the same diagnosis often have widely varying experiences and “symptoms.”
The authors suggest some humane alternatives to the biomedical approach:
Open Dialogue approaches: This approach includes all members of the distressed person’s social system and tries to engender dialogue so that the system can find new ways of working together to meet everyone’s needs. The identified problem is viewed as a dysfunction in the social system, not in an individual.
I DISAGREE... The traumatic event happened to an individual. Its devastating effects continue to exist inside of her, as unconsciously expressed survival reactions. A dysfunctional social system did the abusing. History shows us that, when approached, this system will subsequently maintain the effects of the trauma by protecting itself…hiding what happened. Psychologists then maintain the effects of the individual’s trauma by controlling how the abused expresses his distress. This happens by getting the client to verbalize it, rather than expressing the physical artifacts of the trauma. And, sensorimotor therapists will strictly control the expression of those artifacts by directing the client away from his emotional responses. To the extent that the sensorimotor artifacts enter consciousness, this is helpful. But, the domain of the client’s original reaction to the trauma was so much more energetic and encompassing than those tiny unconscious physical movements. There is so much more traumatic information that remains unprocessed, if its full expression is denied. Left unprocessed, the unconscious survival reactions will continue to exist in their original intensity and will continue to drive the anxiety neuroses.
Also: The last thing that someone who have suffered trauma needs is a house person telling them that they have a biochemical imbalance or a broken brain. They don’t need someone telling them that “we’ve all been there.” They certainly don’t need someone telling them that the problem will always be there…that they must manage it from day to day…for the rest of their lives. Talk about hopeless despair!
Instead, the house person needs to help the client understand that their distress is NOT pathological . Rather, that it is a call to heal. That distressful symptoms are a natural consequence of trauma. And, that these symptoms can be facilitated and made less compelling. Mostly, recovery REQUIRES giving the sufferer the opportunity to express what happened to them during their traumatic experience. AGAIN…NATURE HAS ALREADY PROVIDED THE MEANS TO RECOVERY. Our mental health system just needs make it possible for the sufferer to fully express the distress.
Finally, we need to understand what happens to the brain during trauma. Depending upon the severity of a traumatic experience, the individual’s reactions to it will be mostly unconsciously enacted survival responses. There will be little or no conventional memory of the abuse. So, giving a voice to what one has suffered involves the re-expression of whatever unconscious survival reactions occurred during the trauma…not verbal dialogue about it (there is little/none). THIS IS WHAT OUR MENTAL HEALTH COMMUNITY IS MISSING ENTIRELY.
Residential-style care centers: Consistent with Open Dialogue, these homes would focus on “being with” the person in distress, rather than “treating them.”
This is a great idea if it is fashioned after the primal intensive concept. The “house person”, trained in the practice of emotional release, would always be available to a person in her distress, as the distress happens, and for however long the distress cycle lasts. The model for this “house person” would be the attentive mother as described by Aletha Solter and other attachment oriented psychologists.
Primal Therapy is overlooked because it allows emotional release. The therapeutic community has been taught that emotional expression in therapy somehow “hijacks” healthy processing of trauma. This is an assumption based upon what may now be an outdated idea that primitive subcortical areas of the brain generate emotional experience, independent of higher-order information processing. Joseph LeDoux says that emotional experiences arises out of conscious processing of unconscious (subcortical) signals. Emotional expression, then, may be an important part of the healing process. It may indicate to us that previously unconscious traumatic information is being processed.
Resistance to the expression of deep emotion in therapy is more a result of living in a repressive society, which actively suppresses it We fear it and think that a person will “lose herself” in deep emotional expression. Since psychiatric professionals are human beings who are just as uncomfortable with emotion as is anyone else, their first response is to distract the person from strongly expressed emotion by encouraging “talking about it”. Or, as is the case with sensorimotor processing, the client is encouraged away from the emotional expression to intense focus on subtle body movements.
Traumatic experience is a life-threatening, messy, and chaotic ordeal. Nature protects consciousness from this overwhelming chaos by dissociating it…holding it in primitive, unconscious brain structures. But, it can also reverse dissociation after the trauma is over. This occurs naturally with animals, as described by Levine. In humans, the survival reactions require being played back in a way that does not re-trigger dissociation. That “way” must include the client’s feeling a sense of safety and being in control as the process is re-experienced. Playing back our reactions to trauma involves giving the victim the permission and opportunity to express all of the messy unconscious survival reactions that occurred during the trauma…in the same intensity as they occurred. Arthur Janov gives us a very good example of how to safely process the content of the Imprint: “During this process, it is entirely possible that she won’t know what she is going through until months after the primals have been started. This is because she will only feel a piece of the original trauma at a time, just enough to be integrated. Later, the trauma will begin to make overall sense as more and more of it is experienced. It is like putting the pieces of a puzzle together”.
Primal therapy is NOT "regressive therapy". It is not reliving the past. It is real time processing of heretofore unprocessed information. Getting that information into consciousness lets the brain shut down those now-useless artifacts of the trauma. Having reached consciousness, traumatic information automatically becomes part of the individual's life story and thus begins to make sense within that larger context. This is what high-road information processing does, automatically. It organizes input from lower brain structures, associates it with other information, and generates informed responses to incoming data. Of particular importance to healing from trauma, is the brain's ability to shut off lower level danger signals, when those signals do not match up with what is happening "now".
Engaging in primal therapy empowers people to view themselves as active participants in the improvement of their lives- in stark contrast to the biomedical view, which engenders a sense of victimhood, brokenness, and despair.
Based on their research into the common factors of therapy, the authors of this research conclude that “It may seem that, in reality, the possibility to have a comfortable, caring, respectful conversation with another person is what is most important and helpful in a vast majority of cases.”
This is a start. However, where a person’s traumatic past is driving his anxiety neuroses, chronic anger, emotional withdrawal, and addiction, there is a necessity to lovingly and unconditionally support that person’s distress in all of its manifestations…for as long as it takes. The source of this distress is the imprint…the conditioned fear response. Consciously and intentionally self-witnessing the discomfort will make it go away, incrementally and for good. This is healing. Biomedical symptom management is not.
A denial of our traumatic past is a denial of the self. Why, then, should we be surprised to find that medical suppression of the imprint ...the suppression of the physical evidence of what happened to someone... has led to the increase of suicide rates in those who suffer.