Cohort Observations

The Observations of a Five Year Primal Participant (early to mid 2000s).

  Did Primal Therapy Work for Cohorts?

 

     Here the use of the word cohort means the group of people who did primal therapy at about the same time as I was there in the first half of the 2000 decade at the Primal Center in Venice, California.

 

     Independent clinical testing has not been done yet on primal therapy. The following observational evidence does not match clinical controlled studies. However, I still think it is of interest to the consumer to hear what I observed in terms of efficacy and safety of the therapy.  Bear in mind that the information here is of the case study or testimonial type discussed in section 5.  I have decided to include such testimonial evidence because the positive testimonials in the primal books and websites I think give a shockingly misleading impression.  With those testimonials, you only get to hear positive things, written by people with a strong social stake in primal therapy.  Complaints do not make it to print.  If those patients no longer agree with their earlier testimonials, that also never makes it to print.  

 

     Some of this observational evidence is based on information I gathered by asking lots of questions in a variety of situations and places. These questions were at the time attempts by me to find information that confirmed my primal theory beliefs.  In retrospect, once I had time away from the center, it became clear to me that the information I had gathered rose serious questions about primal therapy efficacy, and even primal theory. The fact that it took a year or two away from the Primal Center to put all this information together, indicates how brainwashed I was and how unscientific my thinking was when I was still at the Primal Center.

     Of the more than 20 primal participants I knew well,  friends or former friends, in my judgment the impression I got of primal therapy is that it is worse than what you would expect from placebo. This suggested to me that not only is “primaling” not a positive active healing mechanism, but also that there must be some iatrogenic factor(s) involved in order to make it less effective than placebo. Although some participants are doing okay after therapy, it was at no rate higher than what you would expect with placebo or spontaneous remission.  Many suffered more in life as a result of the therapy (or theory), than they would have had they not ever heard of The Primal Scream. Some suffered deep depression in or after therapy.  This rate of depression I judged to be greater than what it would have been without primal therapy or primal theory.  On occasion, some of these people who seemed to get worse physically or mentally still reported they believed that the therapy helped them, and in some cases even wrote testimonials for Janov. 

     Under assessment is the change in physical or mental health that is above placebo, spontaneous remission and social support effects.  Even if I thought the changes were negative in some way, this by no way means this is a judgment of the absolute physical or mental health of any post primal individual, it is possible that they are still relatively healthy in both respects. Given this, it should be clear that no post primal person who was one of my cohorts should take this section as a personal insult; I sincerely hope they don’t misunderstand these points.

     At least two cases had temporary problems with psychotic-like symptoms during and after therapy (persons who had no psychosis before therapy).  Confusion of present reality including false memories of the recent past were rare but present.  Recovery seemed to occur once these cases stopped doing primal therapy and they got support from non-primal sources.  Even in these cases, the patients often do not want to be labeled a failure (or worse) and continue to say how primal therapy helped them.  I believe this is due to the social pressure that I consider unethical in primal therapy.  Even those who obviously got worse and whose whole lives disintegrated during therapy, often their primal “friends” advised them to go back to primal therapy.

     False memories of childhood may have been more common in the earlier decades of primal therapy, but this is a very difficult thing to be sure of.  There is some evidence of it in Rosen’s book Psychobabble, and I did meet someone who claimed to have recovered memories (in 1970s primal therapy at Janovs official Institute) of being sadistically abused by both parents in infancy.  The age of these memories was before what is thought possible by memory experts. But not only that - there was also no other evidence apart from the memories the therapist had helped ‘recover.’  In other cases I think people confabulated memories surrounding there birth or womb-life. I believe it still is a problem today, and it is caused by primal theory’s assertion that adult neurosis can be reversed by remembering repressed traumas.  This assigns a high value to finding repressed memories which may lay the seeds for false memories. However, false memories did seem less common in modern day primal therapy than in the repressed memory therapy that was investigated and exposed in the 1990s.  

     It’s important that I should mention that 2 of those I knew committed suicide.  Since I didn’t keep in touch with everybody, it is difficult to say what percentage committed suicide. (But to give the reader an idea of the size of the Primal Center at the time - there was about 5 active therapists with about 20 active participants at any given time.  Today I can account for about twenty who did not commit suicide and two who did- just to give you a rough idea of the numbers). Suicide was not an uncommon occurrence in primal therapy in decades-past either.  There were two suicides apparently in the late 1990s of Primal Center patients (see FORMER TRAINEE INTERVIEW).  And in earlier decades, a former therapist writes that ”a significant number became so distraught that they killed themselves.” (see FORMER THERAPIST ARTICLE, he is talking about the 1970s and 1980s) (my emphasis)

     Of the self-reported successes, I still have questions.  How objective are they being? Are they just high on the religion of Primal? Is the rate of success greater than, equal to, or lower than that of spontaneous remission or placebo effects?  Spontaneous remission rates are surprisingly high for some of the things primal therapy claims to help - once you decide to measure them, as is the placebo effect.  Also, are the success rates greater than that found in say a Christian hands on healing group?  Those types of comparisons are needed.

     I am suspect of the reported successes, and I’ll explain why.  There is enormous social pressure involved in not being labeled a primal failure (or worse).  The assumption is made a priori that primal therapy works if you feel real feelings.  To suggest it didn’t work runs the risk of having your feelings labeled false.

     In addition, praising primal therapy, and reporting success keeps the individual well ranked in the social group, with all it’s support and advantages.  Although reports of success are almost always sincere, they are encouraged and usually compensated in some way.  (And that testimonial is unlikely going to be removed if they feel bad later, especially if it has already made it to paper print). 

     Those testimonials, written when the patient feels good one day out of the year, are then in my opinion cast in stone online, and in the primal books.  It is severely biased sampling.  Even those individuals that write them, and I knew many of them, in my (and sometimes their) opinion they did not benefit from primal therapy as the testimonials suggest.  Lots of information is left out. Some of those patients themselves, were later honest enough to say that.  In one case I interviewed, someone whose testimonial was printed in a Janov’s book in the 1995-2005 time frame, Dr Janov asked him/her to rewrite the case study saying more about birth trauma.  This person does not believe it was due to birth trauma, but rewrote it anyway, and it is set in stone in a book forever now. This type of thing is also captured in the book Therapy Gone Mad, where one of the case studies in the original Primal Scream later admits that in retrospect, his testimonial was premature and misleading.  Apparently, another The Primal Scream case study retractor came forward later, although I don’t have the details on that yet.

       It is encouraged that any former patients publicize anonymously, whether they would or would not recommend primal therapy to a loved one, despite once writing a testimonial about it.  You can email this site if you wish to do this, I have a section called “your stories” or do it independently if you wish.  I personally knew some people who had testimonials in Janov’s books, from Why You Get Sick and Why You Get Well (1999) onwards, who it seems would NOT recommend primal therapy, especially to those close to them. One person said they are doing well now precisely because they STOPPED doing primal therapy so that they could get the qualifications and job they needed! I salute them for being honest about that, but they have not put their dissent into print, either online or otherwise.  Unfortunately I have lost touch with most of them, and some of them still believe in primal theory, and just believe their therapists were flawed, which puts them at odds with this website.   Maybe in the end, self enhancement pressures, social factors or fear of retribution may override the ethical call to publish retractions and warn the next generation.

 

     Self enhancement is such a big factor in primal therapy testimonials, in my opinion.  For those who know primal therapy literature they may recognize what I mean when I hypothesize that primal theory encourages a type of narcissism (I use the word in a non-clinical sense - I don’t mean narcissistic personality disorder). Some people say that although primal therapy obviously didn’t work for most people, it did for them!  People are able to find something special about themselves, but maybe judge others more realistically.  In my observations those who produced the testimonials did not benefit from primal feelings as they suggest, and in some cases are less honest and more cultic than those that report less or no success.  In my opinion, their insistence in persistent self enhancement through testimonials give a false impression to potential consumers as to the effectiveness of primal therapy, and misleads young people into a kind of awe towards “post-primals,” a kind of awe that can be used for the benefit of the claimants financially or socially.

 

     Regarding the high costs of therapy - it is expensive to stay in primal therapy, but for some people they can manage that expense.  For others, they would prefer to live poor and be part of the group they so strongly believe in, rather than lose that social contact and support.  So even if feeling birth trauma or deep crying is not useful, or even damaging, and the personal attacks may be damaging too, it should be clear how the social influence can override that, and color judgment.  But it is more than this, deep crying and reliving birth does actually feel really good afterwards, probably due to endorphin release, so this also effects testimonials. On occasion deep feeling may benefit an individual, I don’t know, it may turn out to have mixed results when studied further, and the question may never be resolved.

 

     As far as I can tell many cohorts were meaner later in therapy or after therapy than they were before or at the start of therapy.  Some seemed to lose tolerance and trust of others.  They usually lost some or all of their idealism. As one cohort said that they didn’t seem to have the innocence in their eyes like they did when they were new patients.

 

     Contrary to what you would predict from primal theory, many people became more angry as a result of their angry feelings being expressed in therapy.  An older participant, a veteran of primal therapy would find it hard to control their anger and in at least one case ended up picking fight(s).  My impression was that it was a general trend too, with some of those who had done enough therapy being angrier than they were initially.  Not all of these people went around expressing anger physically, some just became more mean, judgmental, mistrustful, or impatient,  etc (sometimes more racist on occasion, sometimes in a conventional way or sometimes in new ways “Italians don’t need therapy”, in contrast to “Scandinavians don’t feel anything.”  All of which confirms my hypothesis that primal people lack falisfiability in their logic).  That general trend of anger seemed to hold true in some form for those patients and therapists who engaged in angry feeling sessions.  (some participants didn’t fit this trend, some were more depressed than angry or mean, a few seemed okay in this respect too).

 

     It doesn’t mean that that iatrogenic anger has to be permanent. It seems that by stopping primal therapy, specifically the anger expression part,  people can recover from these effects.  There seemed to be a temporary break from anger after an angry primal session, where the person feels really relaxed and good, but overall I observed anger in primal therapy makes people more angry or mean (on average, not in every case). 

 

     There have been studies that showed angry catharsis, rather than getting all the anger “out” (making people less angry), actually makes the participants more angry (Catharsis or abreaction are the words used in general psychology to mean expression of feeling; because Janov has redefined the words to mean unreal or unconnected feeling he has inadvertently immunized his theory from such studies and comparisons.)

     I also noticed a kind of grandiose, entitled or impatient attitude in some respects in some post primal people.  In my opinion, some post primal patients seemed to think they had such a great natural insight into things that they felt entitled them to give advice on, or practice alternative nutrition before fully learning nutritional science, or to become therapists before thoroughly learning psychological science.

    

     Addressing the important claim in some of Janov’s books that post-primal people are physically unusually healthy: I would estimate that the rate of physical illness is perhaps slightly higher in post-primal people, in comparison to a similar group of similar socio-economic status (SES), level of education and similar level of interest in organic foods and nutrition.   Certainly, I am sure the level of physical health is in the range of slightly worse, about equal to or slightly better than a comparison group of non-primal people.  Post-primal people got diseases after their therapy just as much as those who did not do primal therapy, which is disconfirming evidence for Janov’s claims - claims that still attract clients even today.  Contrary to Janov’s predictions, post-primal people did develop diseases like cancer, skin disease, migraines, digestive problems, psychological disorders, stroke, eye-related problems, heart problems, etc. just as much as anyone else.

 

     Contrary to Janov’s claims and hopes in The Primal Scream, I did not see or hear of anyone with improved eyesight as a result of the therapy.  Although one person had a prescription change which was documented and reported as a testimonial to the therapists, it was due to a different approach by the optician since the person couldn’t read road signs properly after the prescription change compared to before.  I should know - I had to read the road signs for that person after the prescription change when I rode in the car with them.  The optician did have a good rationale for the change, but I saw no objective evidence of eyesight improvement.  This evidence is further reinforced that at least one therapist and at least one trainee has laser eye surgery.  Of the others, most of them used glasses or contacts- which is understandable, but it does contradict one of Janov’s claims.

     I did not hear of any of the soft tissue growth mentioned in early books.  To be specific - I think the claim of women’s breast growth or men’s genital growth were false claims.

I did not observe anybody gaining thicker beard growth, or gaining beard growth for the first time in their twenties, as mentioned in The Primal Scream.

Longevity and Aging

     I saw no evidence that post-primals live any longer than the rest of the population.  The length of life seems to fit pretty much with what you would predict given an individual’s status, wealth, access to health care and the quality of the health care.  The information is still incomplete on this - but the enthusiastic optimism of the early 1970s has been damaged by disconfirming evidence.

     Similarly, I saw no evidence that primal therapy helped slow the aging process as was claimed by Janov (who likened primal therapy to a spring of eternal youth - in one of his early books).  Although the impression of youth could be given by association with things usually associated with the young -  style of expression, dress, accessories, hair, context, behavior, etc, -  objectively any sane person would conclude from observation that post-primals age just like everybody else, at the same average rate.  Those who engaged in healthy living aged the same on average than people following a similar healthy lifestyle without primal therapy.  Those who used the many tools available and make an effort to look young did not seem to look any younger than the many others in Los Angeles who do the same without primal therapy.  Although post-primals may think they age differently to previous generations, this is also true of their peers not in primal therapy so may be due to other factors such as lifestyle, nutrition, healthcare, health knowledge, etc.

                                                      Relationships:

     In comparison to a similar group of similar socio-economic-status (SES) and education, I would estimate that on average primal people were more often without an intimate partner.  With regards to the quality of intimate relationships that did exist, the relationships are more volatile and hurtful in the primal group than in a non primal comparison group (on average, not in all cases).  

    I would estimate post primal people had fewer friends on average, and on average lower quality friendships than a similar group not in primal (due to poor boundaries in primal-primal friendships with regard to subtle primal-theory-driven personal attacks on the self and on feeling authenticity).

                                               The Rebound Effect

    I observed a kind of rebound effect with some participants whereby once they saw contradictions between Janov’s books and the actual results - they then went on to reject some of Janov’s helpful ideas, rules or good causes.  In doing this they usually also retained some primal theory beliefs that led them to feel quite torn about there new behavior.  For example, some returned to alcohol consumption despite Janov’s idea that it is “acting out.”  Instead of replacing their belief system with another that led to a healthy life style (for example they could use science to reject alcohol) they concluded that they needed to “act-out” a little or use alchohol to kill some of their “primal-pain.”  A similar rebound effect happened with some who were encouraged to exercise to “drain birth trauma pain,” who then rejected this when they saw contradictions at the Primal Center.  Again, a more grounded, solid, scientific theory about why exercise is important to mental health would have been preferable to this kind of rebound effect.  This rebound effect also occured in some with regards to some of the political ideas that they had believed in when they were previously inspired by Janov’s early writings.  For example at least one person supported the Iraq war despite Janov’s earlier theory that war is always “unreal.”  Some chose gas guzzling cars despite Janov’s early writing that it is an act out. (This kind of vulnerability to drifting into a kind of free floating, ethically uncertain, fuzzy-thinking mindset is probably what happened in the case of The Center For Feeling Therapy (CFT).  Combine with this Janov’s idea that “real” people need no ethical guidance- that it all comes naturally from one’s feelings- and you get a fuller explanation of the CFT.)

 

 

 

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