Let’s imagine that a thirty-year-old man comes to a consultation, who presents obvious symptoms of an anxiety disorder and expresses the inability to relate deeply with anyone. As the session progresses, the therapist asks him about his childhood, to which the patient tells him with apparent normality that he suffered mistreatment and sexual abuse at the hands of his uncle, who raised him after the death of his parents in a traffic accident.
The subject, at that time a minor, indicates that he forced himself to be strong and resist his guardian’s attacks so as not to give him the satisfaction of seeing him suffering. It is also mentioned that at the time he did not discuss it with anyone and that in fact it is the first time that he has discussed it in public. Although the comment has arisen spontaneously and does not seem to awaken an emotion in the subject, the therapist observes that in reality this fact caused him deep suffering that has prevented him from trusting others.
At that moment, he decides to apply a type of therapy that can help the patient be able to externalize his pain and work on it in order to improve his symptoms and his difficulties in interacting with others: Arthur Janov’s primal therapy.
Arthur Janov’s primal, primitive or scream therapy It is a type of psychological therapy which is based on the basic idea that the suffering of human beings due to the non-satisfaction of basic needs needs to be expressed in a symbolic way. For Janov, the symptom is a defense mechanism against pain.
Throughout childhood and development, human beings can suffer from severe traumas derived from the denial of primary needs such as those of love, acceptance, experimentation and sustenance. Likewise, in cases in which the expression of said needs is punished in such a way that the individual cannot be loved if he expresses what he is, he will end up developing ways to replace them that, by blocking what he really wants, will generate a high level of anxiety. level of distress.
Such psychological pain should be expressed. However, this pain and suffering tends to be repressed and separated from our consciousness, which little by little is stored in our unconscious. This repression accumulates as basic needs are denied, which represents a great increase in tension for the body that can generate neurotic difficulties. For example, there may be fear of intimacy, dependency, narcissism, anxiety or insecurity.
The objective of primary therapy would be none other than to reconnect our suffering with our body, so that we can relive the pain and rework it, expressing it. What Janov calls a primal reaction is sought, a re-experiencing of childhood aversive experiences on a mental, emotional and physical level.
Classifying primal therapy
Janov’s primal therapy can be classified as one of the body therapies, a subtype of humanistic therapy whose main operation is based on the use of the body as an element to be analyzed and through which to treat various psychological disorders and problems. Thus, in the set of so-called body therapies, it is the body itself that is treated under this approach, awakening or focusing on the various sensations perceived bodily.
Despite being considered humanist, it is possible to detect in its conception a strong influence of the psychodynamic paradigm, considering that the main objective of this therapy is to reconnect our repressed and unconscious part with the body, so that it is possible to externalize the pain. There is talk of pain repression and re-experiencing, as well as the fight against neurotic defense mechanisms. In fact, there have been multiple subsequent efforts to modify it and integrate into it the advances of different currents such as humanism.
The application of primal therapy or the Janov cry, in its original version (later reworkings have been made that reduce the time required), requires following a series of steps that we will explore below.
Therapy must be carried out in a padded and preferably soundproof room and the patient is asked to temporarily cease activity at different levels for the duration of the treatment.
1. Interview
First of all, it is necessary to establish whether or not this therapy is suitable for the patient and their problem, not being suitable for psychotic patients or patients with brain damage. It is also necessary to take into consideration whether the patient suffers from any type of medical problem for which treatment adjustment or non-application may be required.
2. Isolation
Before starting the treatment, the subject who is going to receive it is asked to remain isolated the day before the start, without sleeping and without carrying out any type of action that would allow the anguish and tension to be discharged. Is about that the subject perceives and cannot evade the anguish without being able to repress it.
3. Individual therapy
Primal therapy begins with individual sessions, in which the subject must be placed in the position that represents the greatest degree of vulnerability for him, with his limbs extended.
Once in that position, the patient must talk about what they want while the therapist observes and elicits the defense mechanisms (movements, positions, babbling…) that the first person manifests, and tries to stop them from acting so that they can express and immerse yourself in emotional and physiological sensations caused by his repressed feelings.
Once the emotion arises, the therapist must encourage said expression by indicating various exercises, such as breathing or expression through shouting.
It can be necessary establish rest periods between sessions or that the subject isolates himself again to further weaken his defenses.
4. Group therapy
After individual therapy, it is possible to carry out several weeks of group therapy with the same functioning, without interactions between patients within the process.
Criticism
Janov’s primal therapy has not received wide acceptance by the scientific community. Its focus on repressed painful aspects has been criticized, ignoring the possible presence of other sensations that may be associated. Also the fact that the original model does not take into account the effect that the therapist himself has as a transference element. Another criticized element is that it requires time and effort that can be complex to carry out.
It is also considered that There have not been enough studies to demonstrate its effectiveness as well as the fact that its effects are limited if they do not occur in a context of unconditional acceptance and therapeutic work beyond expression.
