Debunking Primal Therapy

A response to the scientific revolution claim and an updated

discussion as to whether primal therapy is a science or not

 

             When The Primal Scream was published in 1970 it stirred great popular excitement and is said to have sold over a million copies. The author Arthur Janov Ph.D. claimed to have discovered “the cure for neurosis” through his invention he called “Primal Therapy” (Janov, 1970). The popularity of primal therapy peaked in the 1970s and then declined, although it is still practiced today in a few places: there are two practices in Santa Monica for example. Janov went on to write many more books and throughout this time has maintained the claim that his primal theory is a science (Janov, 1970, 2008a).

For example, on Janov’s official primal therapy website he subtitles his page “where Primal Therapy is a science” (Janov, 2008a). Janov’s official blog cites Thomas Kuhn and suggests primal therapy is a new revolutionary scientific paradigm-shift in the field of psychology (Janov, 2008b).

            However, critics have questioned the validity of primal therapy’s scientific status.  For just two of many examples, primal therapy was criticized heavily in the book ‘Crazy’ Therapies and listed as a pseudoscientific therapy by the National Council Against Health Fraud (Singer & Lalich, 1996; NCAHF, 2001). Highly intelligent people have defended primal therapy and theory, although intelligence does not always predict critical thinking skills or rationality. Independent psychologists, philosophers of science and scientists have seemed reluctant to criticize or praise primal therapy in an in-depth or serious way, perhaps judging it either as a kiss of death for their career, maybe judging it as too insignificant or too insane, or perhaps fearing legal consequences. This means there is a gap in the discussion that can be filled with this essay, which will discuss how the problem of demarcation (the question of what is science and what is pseudoscience) applies to primal therapy in a way that has never been done before.  The question is an important one because if primal therapy is a protoscience perhaps research should be directed towards it; if it is a pseudoscience perhaps people should be warned and protected from it.  I will argue that primal therapy is not a scientific discipline because it lacks falsifiability from a Popperian perspective, it is not a valid new scientific paradigm even from a Kuhnian view, and that it is not a good theory from other perspectives too.

 

What is Primal Theory?

            Primal theory states that you can recover old repressed memories in an exact form, relive them in therapy and regain the health, sensations, feelings and wholeness you had as a child.  It claims that the only way to heal neurosis in a complete way is through the integration of feelings and thoughts.  This is done by the deep expression of anger, tears, sadness and even birth traumas in the therapy session.  It is a therapy that offers not only to restore the person’s psychological and physical health, but also as perhaps the only hope for a real world and political peace (Janov, 1975).

            Primal Pain (Janov used capitals for his concepts) is stored when a person experiences trauma in childhood or during the birth trauma.  It builds up over time cumulatively to form a Primal Pool of Pain.  This causes psychological disorders and physical disorders.  By doing Primal Therapy, the Pain is relived, and it comes out of the system, gradually reducing the Primal Pool of Pain until neurosis, psychosis and the physical problems are gone.  During the reliving of the trauma, the person may do any number of things including scream, cry, writhe, rage or flop around reliving birth (Janov, 1991).

            Janov’s theory was similar to Freud’s, although Janov decided that defenses are generally not necessary or desirable (Freud thought mature defenses like sublimation were essential, helpful and useful, Janov did not).  Janov reignited early Freud by believing in the catharsis (reliving) of early traumas.  He retained the hydraulic model of trauma that Freud and others in the late 19th and early 20th century had used (significantly, the age of steam engines).  The hydraulic model stated that feelings (or Pains) build up, become pent up, and have to be released to remove them from the system.  Without release, the theory goes, pent up emotions or traumas can do damage (much like too much steam pressure in a steam engine) in terms of neurotic symptoms or physical maladies.  Janov’s theory is a very appealing one because it also offered the promise of an end to war, an ideal society, and advocated strongly for the gentle treatment of children and the preservation of their rights and feelings.

 

What would Popper Say?

            Karl Popper regarded Freudian theory as unscientific on the grounds that it was unfalsifiable (Popper, 1953).  Popper’s criticisms were that Freud used invisible constructs (id, ego, repression) to explain phenomena after-the-fact and predicted nothing; that it avoided risky experiments and was set up so there was no possible event that could disconfirm it. Popper noticed how the vague, ill-defined theory could find confirmatory evidence everywhere by never taking risks.  It explained everything, yet that was precisely its problem. 

           Although Janov criticized Freudian theory, it was for different reasons.  Janov himself made the same mistakes with regard to falsifiability as Freud did.  Similar to Freud, Janov used invisible and untestable constructs (the Primal Pool of Pain, repression) to explain phenomena after the fact, predicted nothing risky that could be conceivably tested, and failed to identify any possible falsifying events.  From a Popperian perspective it is just as much a pseudoscience as Freud, because Popper did not criticize Freud on the grounds that defenses were good or bad or on the amount of catharsis. For Popper the problem was that it was untestable.  In addition to this, Janov’s fusion of Marxist ideas with Freudian ideas would not have sat well with Popper because Popper also viewed Marx’s theory as unfalsifiable (Janov, 1972; Popper, 1953).

            An example of unfalsifiability in primal therapy was the invention of the false-feeling (which Janov rather confusingly called “abreaction” or “catharsis”) in a therapy session which can have all the appearance of being true but actually is false.  This makes it impossible to falsify the therapy because if the patient has a feeling session that looks like a real “primal,” and the patient does not subsequently report it helped heal him, then the therapist can just say the feeling must have been false.       

            But one may argue that if Janov makes a specific claim like primal therapy cures cancer surely can you not test that – thus making primal therapy testable but not yet tested?  Well, one problem is that Janov repeatedly alludes to the cure of cancer in his books, giving the distinct impression through inference that it will prevent or cure it – but usually avoids making the claim in a direct way that could then be tested (Janov, 1991, pp. 257-259).  Indeed Janov hints at a cure for cancer in his chapter called “Malignant Despair” in the New Primal Scream by writing “when we alter personality in our therapy, we also alter susceptibility to disease” (Janov, 1991, p. 269).

            As with other pseudosciences the critic has the choice of either arguing it is untested or untestable.  In the case of primal therapy, both concepts are essential to understanding the problem.  If cancer does kill people who have been through primal therapy, as indeed it has, that does not seem to deter Janov.  The explanation as to why cancer occurred in post-primal individuals can invoke the false-feeling hypothesis or an enormous Primal Pool of Pain – thus making the claim impossible to prove wrong.  So the approach Janov chooses, that does not allow for independent scientific investigation by outsiders, is untestable.  If independent scientists could gain control over an experiment into primal therapy, you could say the claim for cancer cure is testable – and I believe would lead to data that debunks primal therapy.  So in this sense the claims of primal therapy are untestable in the same way that Benjamin Rush’s approach to bloodletting was untestable – that is: every successful recovery is attributed to the treatment and every death or failure is attributed to the severity of the disease.  It’s a “heads I win, tails you lose” unfalsifiable approach. It was Rush’s or Janov’s attitude to the problem that made it unfalsifiable, although strictly speaking the claims could be tested and debunked later by independents using the scientific method.

            In contrast to the claims of primal therapy, which could be seen as untested or untestable depending on the perspective you take, the theory itself is more obviously purely unfalsifiable.  This unfalsifiability centers around the concept of the unconscious and repression.  In order to understand this you have to think about what possible occurrences could disprove primal theory.  First of all, the theory says that if someone encounters an infantile trauma then they will have neurotic symptoms later.  Now if someone with such a trauma were to report no problems, then the primal theorist would simply say that the person must not really be happy – they must be pretending, and the Primal Pain of the trauma is still doing damage invisibly.  So the theory is immunized in this respect and unfalsifiable here.  Now consider another falsifying event: say someone has psychological problems in adulthood but experienced no infantile or birth trauma.  In this case the claim would be that they in fact do have hidden trauma- and the concept of repression is used to explain how it must have been forgotten.  Therefore the theory is unfalsifiable due to the repression and unconscious concepts in a very similar way to Freudian theory.

            Popper’s idea that science should be testable is the core of what science is.  The loss of the testability criteria in science would be a step backward that would resemble the loss of knowledge that followed the demise of the ancient Greek and Roman cultures.  Science is in a constant fight with appealing ideologies and unfalsifiable ideas – a fight that was lost in the dark ages. Popper’s work is crucial and important, and indeed led to psychologists reformulating the concept of repression and the unconscious to make it testable.  Such testing revealed that although there is an unconscious, it is nothing like what Freud or Janov thought it was.  I understand that there were arguments put forth against Popper’s contribution, but mostly I feel these are unfair and present straw-man arguments.  In defense of Popper, after considering all the arguments against falsifiability, I think it still is a crucial concept, and that science at its best is indeed testing risky predictions.

            Now we move on from Popper, who would likely call primal therapy a pseudoscience, to his antithesis in the philosophy of science, Thomas Kuhn.  We will address whether Janov is right when he says that his theory and therapy is a Kuhnian revolutionary scientific paradigm-shift in the field of psychology. 

 

What would Kuhn Say?

            Thomas Kuhn’s most famous work introduced the idea of scientific revolutions and paradigm shifts (Kuhn, 1962). By paradigm, Kuhn means a framework of beliefs that are self referential and represent a certain way of looking at the world. A paradigm is the lens through which one views the world.  Kuhn describes scientists as “puzzle solvers” who merely solve problems within their blinkered paradigm in order to fit data into the paradigm.  In a sense Kuhn was a relativist in that he seemed to believe that no one paradigm is any better than any other.  He wrote that paradigms are incommensurable, that is they cannot be compared, because they used different frameworks. Viewing the world through a given paradigm, each phenomenon is seen to confirm the paradigm, and it is the job of the “puzzle solving” scientists to fit phenomena into the paradigm. Kuhn used a parallel between scientists and ideological authoritarian political regimes saying that they were resistant to change and gave rise to the need for overthrow by means of revolution and an almost religious conversion. Kuhn interpreted the history of science in such a way as to confirm his idea that old theories die hard and are completely replaced by new paradigms.  He insisted that due to this process, and due to the incommensurability of paradigms (i.e. paradigms cannot be compared), that science was not really accumulating knowledge.

            Before I move on to a Kuhnian discussion of primal therapy, I should quickly point out that I severely question Kuhn’s ideas with regard to the non-cumulative growth of science and his view of the history of science.  Where I see a steady improvement in the accuracy and predictive power over the last three hundred years, Kuhn seems to see no build up of real knowledge, only equally valid paradigms that come and go out of fashion.  Where Kuhn sees a scientific revolution with Einstein completely throwing out Newton, I see Einstein standing on the shoulders of giants (including Newton, Euclid and Michelson) using their formulations and experimental findings to investigate the special case of near light-speed travel and energy and mass equivalence.  I do fail to see a scientific revolution that parallels the political overthrow of authoritarian regimes.  After all, Einstein’s work was published in a journal in 1905, long before it was tested by experiment (the Eddington eclipse observations, that provided evidence in favor of Einstein, came many years later in 1919) – there hardly seems to be a conspiracy of orthodox science.  Science strikes me as relatively more democratic than authoritarian because the knowledge is public, can be tested by independents, it rewards new ideas that fit the data, and the knowledge comes from evidence rather than from the personal attractiveness, power or charm of the expert (as it often does in ideologies and unfalsifiable theories). I believe some of Kuhn’s ideas have had a damaging effect on people’s perception and trust in science.  Nonetheless, Kuhn’s paradigm-shift idea is so popular that it is here to stay; and in its weaker form can actually be a useful way of viewing theories which are untestable or lacking in evidence.

            It is possible that Janov, in 1967, was directly or indirectly influenced by Kuhn’s very popular idea (presented in 1962) of paradigm-shifts and revolutions in science when he started primal therapy. This is indeed a challenge to unravel, especially if one considers Kuhn to be a relativist in which “anything goes” with respect to theory choice.

            Kuhn’s paradigm-shift idea is one that has been used legitimately by good scientists in useful and helpful ways, but it has also been used inaccurately by some to undermine trust in science and to promote pseudoscientific products or services. Janov, on his internet blog mentions Thomas Kuhn’s work and states: “in our view, Primal Therapy and Primal Theory represent a major paradigm shift in the science of psychology” (Janov, 2008b). In addition, in Janov’s online book Grand Delusions, Agustin Gurza gives a passionate and erudite defense of primal theory in which he frequently refers to Kuhn’s 1962 popular and appealing book The Structure of Scientific Revolutions (Gurza, 2005; Kuhn, 1962). Gurza, who in the article admits that he himself is a primal therapy participant, argues that in the history of science, new ideas have been resisted by orthodox science.  Using direct quotations from Kuhn for his examples from the history of science, he argues that Primal Therapy is currently suffering the same type of oppressed struggle that scientific revolutions have in the past.  He argues that psychology is in a crisis and that primal theory offers a solution to the crisis. At one point Gurza writes that Freudian theory is in crisis, and that Janov’s formulation solves the crisis.  The evidence that Gurza supplies for this is the evidence reported by Janov himself in his books. For example Janov’s reports of curing anxiety are taken as proof that primal theory must have overthrown Freudian theory since Freud did not cure anxiety (Gurza, 2005).

            Let’s unpack Gurza’s specific points.   First of all, Gurza assumes that psychology is in a state of crisis, which is in some doubt.  Currently there are dozens of psychology journals with a vast array of scientific experiments and evidence that provide a deep understanding of human behavior. During the past 30 years, psychological science has made impressive progress, it is hardly in crisis.  In comparison, primal therapy in that same time frame has made no contribution to scientific knowledge. Although Janov and Gurza may not pay attention to the evidence in psychology journals due to their belief that it is part of another false paradigm (therein lies the problem of seeing things through a Kuhnian blinkered lens), the evidence does exist – and due to its experimental nature it is more valid than Janov’s anecdotal case studies.  The evidence in developmental, memory and clinical psychology actually contradicts primal theory in several ways. Gurza and Janov may be wise to see this data as coming from a different paradigm because that allows them to ignore such evidence.  In particular, the accuracy of memory recall of children has been called into question, which is contrary to Janov’s idea that memories are stored and recalled pristinely (Loftus, 1993, 2003; McNally, 2005).  Memory recall by adults of events in early infancy is not supported by the evidence, yet Janov claims his followers re-experience womb-life, birth and very early vivid memories (Janov, 1991, p.144; Eacott & Crawley, 1998).  Studies in clinical psychology show that angry catharsis often just makes people angrier, which contradicts Janov’s hydraulic model of emotion expression (Lohr, Olatunji, Baumeister, & Bushman, 2007; Bushman, 2002; Chaffin, Wherry, & Dykman, 1997).  Studies in the field of medicine have shown a negative health effect of anger expression which contradicts Janov’s prediction that it would improve health.  Anger’s adverse effects on arteries was investigated, amongst many others, by Ironson et al., (1992), heart disease by Kawachi et al. (1996), and stroke by Everson et al. (1999).  It seems that it is not so much psychology that is in crisis, more that primal therapy is in crisis.

            Gurza’s article is flawed in other ways too.  He presents Freud as the current paradigm and Janov as the new paradigm.  This is extremely misleading, almost disturbingly so.  Freud currently carries absolutely no weight whatsoever in modern psychological science.  Freud’s theory is seen as unfalsifiable and deeply flawed by the vast majority of university psychologists. Not only that, Janov’s theory is almost the same as early Freud – that early trauma causes neurosis,  that a defence system protects against those feelings and that catharsis can release those feelings and reverse neurosis.  But not only that, Janov’s other ideas also closely resemble ideas from other earlier writers.  His idea of birth trauma was written about decades earlier by Otto Rank.  Wilhelm Reich talked about feelings being stored in the body long before Janov. Scientologist founder L. Ron Hubbard talked about stored early traumas, including that of birth, being stored as “engrams” long before Janov talked about stored early traumas being stored as “imprints.” So Gurza is presenting a straw man argument because Freud is not the current paradigm; primal theory is not all original work and it does not do a better job of prediction or explanation than current psychological science.

              Having spent some time discussing Gurza’s article directly, let us take a different approach. If, according to Kuhn, every paradigm is correct according to its own framework, and that paradigms are incommensurate (incomparable), then how do we know modern psychological science is any better than primal theory? Surprisingly, the answer can be found in Kuhn’s later work, in which he gives us some guidelines for a good scientific theory (Kuhn, 1977). He gives five characteristics of a good scientific theory: accuracy, consistency, scope, simplicity and fruitfulness. Let us now discuss each one of these with regard to primal theory.

            1. Accuracy, for Kuhn, means the predictions the theory makes should be demonstrated with the results of existing experiments.  In the case of primal therapy, the theory predicted an ability to cure cancer, something that has not been demonstrated. In fact there are no exemplar demonstrating experiments within the primal therapy movement, unlike other sciences.  Further, psychologist Timothy Moore states that contrary to primal theory, “evidence from research on memory and emotions, however, does not support the existence of retrievable memories of birth trauma” (Moore, 2001).In other words there is demonstratable evidence from existing experiments that contradict primal theory (as was also discussed early).

            2. Kuhn states that a theory should have consistency with itself and with other currently accepted theories.  Primal therapy has inconsistencies between itself because Janov claimed in The Primal Scream that “by the time someone has reached his eighth month [of primal therapy] he is generally well”; yet in The New Primal Scream, Janov says that “sometimes after two years the patient will get into very deep material and need constant therapy” (Janov, 1970, p. 101; 1991, p.346). There are primal participants who started primal therapy in the 1970s who still practiced it decades later, and these long term patients suffer from some of the afflictions that primal therapy had predicted to cure or prevent in 1970; which is a double internal inconsistency (Janov, 1970; 1991, pp. 82-104, 227-229, 351-361; 2008a; Knecht, 1991).

            Primal theory is also externally inconsistent with the theory of evolution because Janov claimed that:

“Darwin’s theory of adaptation…may not be true at all. The foundation of evolution resides in the way the organism utilizes its own inner resources for survival and changes internally in response to the external environment.  It isn’t that the external environment ’selects’ those types most fit to survive but rather the environment actually produces different structures for survival” (Janov, 1980, p. 238).

By saying that an individual produces structures during its lifetime in response to the environment, Janov is rejecting modern evolutionary knowledge and returning to the early nineteenth century ideas of Jean-Baptiste Lamark, which were disproven.  The foundation of evolution has been found not to be due to the internal changes within an individual’s lifetime, but due to genetic variation and natural selection. 

            Another inconsistency is that Janov initially predicted that spouses and family members would be able to help each other have primals, and that in time “real” people would be able to help each other heal (Janov, 1973).  Yet today, after many problems with people attempting to do primal therapy with disastrous results, Janov warns about the dangers of anyone doing primal therapy outside of his Primal Center (Janov,  2008c). The fact that reliving Pain, or that doing primal therapy is dangerous when done by any independent outside practioner, is inconsistent with the initial theory that said that reliving Pain cures neurosis.  It is inconsistent with the concept of scientific replication by independent scientists, and despite of this Janov still claims primal therapy is a science.

            3. Scope is Kuhn’s concept that says a good theory should extend “beyond the particular observations, laws, or subtheories it was initially designed to explain” (Kuhn, 1977).  A good example of this would be how the theory of gravity not only applies to falling objects on earth, but also to the moon, the sun and beyond. Primal theory in one sense does have scope, yet in another important way it doesn’t.  It has scope in the sense that it does explain (but does not predict) things like wars and why people believe in ideologies.  However, it does so in an untestable and simplistic way that involves circular logic (people go to war or believe in religion because they have an invisible entity called “Primal Pain”).  There are alternative explanations in the fields of philosophy, psychology, sociology and evolutionary theory that explain the same phenomena better – and some of these theories come out of experimental data in contrast to primal theory, which is based on case studies. Primal theory lacks scope in the sense that it is very much confined to a certain set of cultural beliefs that are ideological in essence and not universally applicable to all humans.  The cultural values primal therapy promotes, and indeed defines as “real” involve high levels of expression, full emotional reactivity, a belief in individualism, the reliving of past traumas and the valuing of emotions over intellectualism.  Although these beliefs may work in an isolated culture or subculture, and are particularly valued around the Los Angeles entertainment industry, it is questionable if these values will be of any benefit, or even hold true, in other cultures or areas.  In essense it is a specific subculture of specific values that does not have much, if any scientific validity. It lacks the kind of scope that other areas of psychology do not.

            4. Simplicity says a good theory should be simple and give one explanation of a set of phenomena that otherwise would have to be explained individually.  This is not the case in primal theory because the explanation of people’s problems is done on a very vague case by case basis.  For example, if a person is very active that may be explained by birth trauma by one primal theorist, or by infancy traumas by another. 

            In addition, primal theory became more complicated because the simple version of the theory simply did not hold.  For example, Janov’s theory predicted that primal therapists would need no ethical guidelines because ethics would come naturally from their feelings. When Janov-trained therapists went on to break ethics laws and lose their licenses (Ayella, 1998; Mithers, 1994) the basic theory was made ever more complicated in order to explain how the therapists Janov himself trained went wrong.  Janov adapted by proposing that it was not as simple as expressing feelings that would cure, but now it involved expressing feelings only at his institute. 

            Complicated explanations arose to explain bad results. To explain why people were not getting cured of cancer, psychosis, etc, Janov place the onus on the patient, saying they must not be doing it right, in short they must be having false feelings or just discharging them (Janov, 1991, p.341-342).  Adding to the complexity, society was blamed for the non-acceptance of his therapy, introducing a complicated sociological explanation as to why the current paradigm in mainstream society was suppressive of feelings. 

            Janov complicated the theory even more when he resorted to claiming that some of his former patients/therapists were “failures” because they were “psychopaths who incorporated the therapy into their tendency to scam and fake.” (Janov, 2007, p.270). In short, the explanations became more labyrinthine in every subsequent book that Janov authored since 1970, in order to explain poor results, the lack of evidence and the lack of support from other psychologists.

            5. Fruitfulness is Kuhn’s final criteria for a good theory, which states that “a theory should be fruitful of new research findings” (Kuhn, 1977).  However, Timothy Moore, chairman of the department of psychology at York University’s Glendon College in Toronto, states that “Janov’s assertions of scientific linkage are based on uncontrolled case histories and personal observations, and as such his work has not been scientifically validated” (Ornes, 2007).  Searches on scientific databases such as Pub Med, EBCOST and JSTOR (search performed in December 2008) reveal no research findings from primal therapy that have been accepted into the scientific literature in the whole 38 years since Janov’s first book.  In contrast, some of the areas of psychological science which Janov has so maligned in his books, have been very fruitful in the last few decades.

            Therefore, on all five Kuhnian criteria, primal theory fails to show the characteristics of being a good scientific theory.  This is a complete confutation of the claim that primal therapy is a Kuhnian scientific paradigm-shift, as was proposed in the online article “Primal Therapy: A Revolutionary Shift in the Paradigm of Psychology” (Gurza & Janov, 2005). I propose that Kuhn was an admirer of science, who wanted his idea of “paradigm shifts” to open up people’s minds to any new ideas in science that had good evidence for them; and that he likely did not want his ideas misused by non-scientific theorists that presented no credible evidence.  That being said, the only place a primal theorist will likely find solace in the field of the philosophy of science is in a very strong reading of early Kuhn which ignores other aspects of his writings. One could argue that Kuhn, despite his criteria of a good scientific theory, still believed his earlier account of science and scientific revolutions was roughly correct.  From a strong Kuhnian perspective you could indeed view primal theory as a new paradigm, and like all paradigms it would be considered incommensurate to any other, but it is not a good scientific theory according to Kuhn’s criteria in 1977.

 

What Would Other Philosophers of Science Say?

            To illustrate that a strong reading of Kuhn (or perhaps Feyerabend, see below), namely a purely relativist position, is the only hiding place in the philosophy of science for the primal theorist, I will briefly discuss how some of the other famous philosophers of science would likely view primal theory.

            Heavily influenced by the 1960s mindset, Paul Feyerabend perhaps is most well known as being a kind of ”anything goes” philosopher of science, and as such helped society take a rather disturbing step backwards. His work undermined the promotion of science, trust in scientific method, and rational critical thinking.  There was something about doing that that will always appeal; especially to nonscientists or academics on the fringes. At first glance, it would be tempting for a primal theorist to grab hold of Feyerabend’s relativism (like Kuhnian relativism) and use it to defend primal therapy.  However, even that falls down because although Feyerabend did promote an anything-goes attitude to science, he did so so that every possible way of gathering knowledge was acceptable so that a kind of Darwinian selection of all the theories coming out of it could occur. Bad theories would be left behind, but some good theories may come out of this anything-goes approach.  From a Feyerabendian perspective, primal theory is clearly one of the bad theories was rejected and not accepted into science, for quite legitimate reasons.  So despite Feyerabend being a thorn in the side for the scientific skepticism movement, there is an argument that his perspective would reject primal theory and similar dead-in-the-water theories that spun out of Freud’s mistakes.

            Thankfully, in contrast to Feyerabend and Kuhn, most of the other philosophers of science  have much more grounded, and a less relativistic view of science. Larry Laudan wrote that science is a testable empirical claim that relates aims to the successful meeting of the goals set. Science is a success because it predicts, it allows manipulative control of the environment, it is precise and it provides a simplified picture of the world (Laudan, 1984).  Primal theory would not meet these criteria that are set out by Laudan.  Firstly, aspects of primal theory are unfalsifiable, and thus untestable.  Secondly, it is very imprecise in that it predicts generalities as vague as does astrology.  For example, it predicts someone with birth trauma could become active or inactive, it predicts a cold father could lead to homosexuality or heterosexuality.  In short, predictions are so vague they include everyone, in much the same way that astrology predictions are vague enough to capture everyone.

            Pierre Duhem argued that “good sense” should prevail in the face of contradictory experimental evidence, and that the scientist should use unbiased judgment in the light of the data, and warns of vanity and the prior commitment to ones own hypothesis (Duhem, 1906).  This, it could be argued, is prophetic of Janov’s dogmatic clinging to his original theory after many instances of disconfirming evidence, both in his own patients (Rosen, 1977; Ayella, 1998; Knecht, 1991) and in psychological science’s progress in repressed memories which contradicts Janov’s model of trauma, the storage of pain, the recall of pristine repressed memories and the alleged subsequent healing (McNally, 2005).

            Bas C. van Fraassen introduced the idea of a theory being “empirically adequate,” which means the theory provides a good model for all observable phenomena (van Fraassen, 1982).  He does not regard a belief in scientific realism, or a belief in ontological truth as necessary or justified.  Thus Janov’s claim to have found the underlying truth behind human behaviour, and his statement that he believes in one central truth, would not have likely gone down well with van Fraassen (Janov, 1970).  But more than that, primal theory does not pass the empirically adequate test because it is not a good model in that it ignores disconfirming evidence such as the scant evidence for memories before age 3 (Eacott & Crawley, 1998; Loftus, 1993) and the research into false memories (Loftus, 2003).

            Carl Hempel had two criteria for a good scientific explanation, relevance and testability (Hempel, 1966).  Relevance means that the scientific theory will give good grounds that the observed phenomenon will logically follow from it.  With regard to primal theory the link between theory and observed fact is a tenuous one because the theory predicts all possible outcomes for adult neurosis from a given childhood traumatic situation. Primal theory may say post hoc that a trauma for example of being beaten led to the current problem of biting ones nails.  However, it is not a deductive logical progression from theory to observation because a beating, according to primal theory could lead to any possible adult outcome, from sublime success to abject failure, from a severe psychological disorder to perfect functioning. The second requirement of testability states that that the theory must be capable of empirical scientific testing.  Since Janov’s concept of “Primal Pain” is an invisible concept that is so badly defined it can vary from lack of oxygen at birth to emotional psychological distress in childhood, it is impossible to measure and quantify.  It is such a vague concept that it makes no risky predictions that can then be tested empirically.  The outcomes of primal therapy itself are almost impossible to empirically test because the goal of therapy is not well defined, so that most outcomes can be viewed as success. Even unemployment, apathy, asocial behavior, lying around listening to music, cutting off relations with family and dropping out of professions were reported by the patients as successes (Janov, 1970).

 

The Perspective of Psychologists on the Demarcation Problem

            Some psychologists have fused their knowledge of science, psychology and the philosophy of science to come up with even more accurate and reliable ways to distinguish science and non-science in psychology.  The work of Keith Stanovich in his book How To Think Straight About Psychology relates logic, social psychology, science and the demarcation problem in a way that provides specific guidance for the specific field of psychology (Stanovich, 2001).  Due to the specific set of problems in psychology, where “cheap theories” can quickly and easily be thought up to explain everything in human behavior, and where appealing theories are preferred in commercial bookstores and on television, falsifiability is the central key to demarcation in this field.  Stanovich proposes that Freud got the field of psychology off to a bad start with his unfalsifiable theories, and successfully uses the falsifiability concept to explain errors in logic.  By applying Stanovich’s ideas one would conclude that primal therapy would not be a science because it is a restatement of some of Freud’s theories, which are still unfalsifiable.  Stanovich discusses many criteria and logical errors such as the single-cause error (chapter 9), lack of replication and peer review, errors in intuition, the problem with vivid testimonials (chapter 4), the “great leap” model error and converging evidence (chapter 10) that I believe expose Janov’s mistakes in a more complete way than any single philosopher of science that was discussed earlier (Stanovich, 2001).  Space does not allow for further elaboration in this particular essay, suffice it to say further reading of Stanovich’s work is recommended.

            In the book Science and Pseudoscience in Clinical Psychology, psychologists Lilienfeld, Lynn and Lohr (and other contributors) present improved criteria for distinguishing science from pseudoscience (Lilienfeld et al., 2003).  It is a synthesis approach that draws on several philosophers of science and in doing so it overcomes some of the criticisms that could be leveled at Popper or Kuhn. These criteria include:

            1. The over use of ad hoc hypothesis that immunize claims from falsification. This has already been discussed to some extent, see section above on Popper.  

            2. The absence of self correction, which is the failure of a pseudoscience to change in response to evidence.  An example of this in primal therapy is Janov’s adherence to his concept of the “Primal Pool of Pain” (he capitalized these words), which he thought could be emptied through reliving Pain. Thirty years after the original concept, Janov said he still believes “this notion is as true today as it was then” (Janov, 1991).   He believes this despite the fact that his original prediction that the primal pool of pain could be almost emptied in about 8 months, some even earlier (Janov, 1970) did not turn out to be true, and many patients actually spent years in therapy and even then did not apparently empty the “primal pool.”

            3. Evasion of peer review is the next clue, and this is truly applicable to primal therapy.  Janov has only had one peer reviewed article published in a psychosomatic journal in 1977, an article which was more a discussion of “primal-consciousness” rather than science,  an article that resembled his 1975 book (Janov, 1975, 1977).  It should be noted that a psychosomatic journal in the 1970s was likely to be more sympathetic to the psychodynamic branch of psychology, including the hydraulic model of emotion. This means that in the last 38 years Janov may well have been evading the valuable and helpful feedback he could have gained from peer review.

            4. Emphasis of confirmation rather than refutation is the next sign, and again primal therapy fails on this. Janov has not been trying to prove himself wrong at all.  He has consistently sought only confirming evidence for his claims. His studies, using vital signs measurements during feeling sessions, could not possibly refute his theory because no matter how the heart rate changes this has been taken as confirming evidence through the use of explanatory stories such as “the vital signs went up because that is what happened originally.”

            5. The reversed burden of proof is Lilienfeld et al.’s next sign of a pseudoscience that again primal therapy exhibits. The approach seems to have been that therapists are allowed to practice primal therapy until someone proves it wrong.  However, proving the none existence of invisible constructs is near impossible. Surely the right approach would be to show efficacy in a university experimental setting, with independent replication, before therapies make it to market. Indeed primal therapy supporters consistently commit this reversed burden of proof error as demonstrated on the James Randi Education Foundation’s forum called “is primal therapy woo?” (JREF, 2008).

            6. Absence of connectivity. Indeed primal therapy does commit this error, alluded to earlier, in that it claims to be a new paradigm in psychology made of whole cloth, rejecting areas of psychology such as cognitive, social and behavioral (Janov, 2008b).  There is some question as to the connectivity to evolutionary theory, as mentioned earlier, because Janov believed that his concept “Primal Pain” was a previously missed essential factor in the evolution of humans and that Darwin could have been wrong (Janov, 1981).

            7. Over-reliance on testimonial and anecdotal evidence. Indeed, Janov’s books and websites only provide evidence of this type.  Even when he claims to have done experiments or a study, further investigation reveals it usually still testimonial or case study type evidence (Janov, 1970, 1980, 1991, 2007, 2008; Moore, 2001).  The valid experimental evidence that Janov does cite is not his own and does not provide any direct support for his type of therapy.

            8. Use of obscurantist language. It could be argued that Janov invented terms such as sympath, parasympath, Primal Pain and the Primal Pool of Pain; and used scientific terms such as energy, levels of consciousness, tripartite brain, valence, etc in order to provide his discipline with the superficial appearance of scientific legitimacy.

            9. Absence of boundary conditions.  Good theories provide clear limits under which the predicted phenomena will and will not apply.  However, Janov proposes that his treatment is a cure for virtually all mental disorders and many physical disorders (Janov, 2007, p. 255).  He also uses his concepts to explain larger phenomena such as war, politics and other sociological phenomena.  Indeed he wrote “I believe this new Primal consciousness is the only hope if mankind is to survive, for it is out of neurotic consciousness that social institutions are erected” (Janov, 1975, p. 449). 

            10. The mantra of holism. In the case of primal therapy, the claim is that primal therapists treat the whole patient, and in keeping with holism, they avoid the independent measuring of a specific symptom because the results cannot be judged in isolation anyway.  Thus instead of say measuring patients on a scale of depression, and allowing outside testing that involves a comparison with say cognitive behavioral therapy (CBT); primal therapists are apt to say they are aiming to help the person become whole again (and other vague notions).  In this way it protects the theory from falsification because if symptoms do get worse, or if CBT helps depression more, the primal therapists can say that you can’t just consider one measure, you have to take it as a whole.

            Summarizing the results of the Lilienfeld, Lynn and Lohr signs of a pseudoscience, primal therapy shows signs of each of the 10 considerations, some stronger than others.  On balance, when I weight the relative strength of compliance with these considerations I would conclude that primal therapy is a pseudoscience.   

Conclusion

            When we consider the demarcation problem with respect to Popper, and even with regards to his antithesis Kuhn, and others, one would conclude that primal therapy does not qualify as a science. A Popperian view would label it a pseudoscience, whilst a Kuhnian view would say that although it is a new paradigm, it is not a good scientific paradigm that improves on current psychological science. From reading Janov’s works through the prism of scientific critical thinking, I would strongly conclude it is not science. Judging whether something is a pseudoscience involves weighing a lot of different factors. Even in cases like astrology, there are counter arguments that will argue it is science, and so it is in primal therapy.  After careful consideration though, I have about the same level of certainty that primal therapy is not a science, as I do about astrology.  That is not to say there is no moral value in some of what Janov wrote (for example he advocated against war and child mistreatment), or that his examination of valid research is not helpful (he sometimes highlights some important valid research, done by others not connected to primal therapy, that shows that distress does effect development).  However the central theory that includes the concepts of Primal Pain, the Pool of Pain, the birth reliving, the prolonged deep feelings, and the belief that reliving of trauma will cure a wide variety of diseases is not science. If it indeed is not a science, if the practitioners are not responding to contrary evidence, the importance of this article becomes apparent, because it could be hazardous and cultic. There could be serious financial, personal and opportunity costs for participants. I sincerely hope that in the future, the idea of the paradigm-shift will not again be misused in order to dupe those unfamiliar with the evidence in the field of psychological science and of the processes of basic science, into buying into primal therapy.  

 

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Written: November 2008.

Last Updated: January 2011