The goal of primal integration is very simple and straightforward, and can be stated in one sentence. It is to contact and release the real self. Once that has been done, enormously useful work can be done in enabling the person to work through the implications of that, and to support the person through any life-changes that may result. But until the real self has been contacted, the process of working to release it will continue (see Rowan 1983, Chapter 5).
This is actually a very common notion in the whole field of psychotherapy, as the following table will show:
Many other writers could be cited, particularly Reich, who however did not have any such neat statement of the matter as that given by those above. What they are all saying, in theirvarious ways, is that in therapy we have to encourage the person to move from exclusive concern with what is peripheral in the personality towards what is central in it. Unless this move is made the person will continue to go round in the same circles.
What primal integration says is that this process carries on by the integration of splits in the personality, the most important splits being those which are due to unconscious processes of defence. When we get beneath the defensive layers, we very often find primal pain due to early trauma; and we believe that unless and until the primal pain is experienced and dealt with, the split cannot be healed. However, we say that primal joy is important too. An experience of real love can be just as powerful, and just as primal, as anything else. This point is made very powerfully by Lonsbury (1978) who quotes a case where Tom deeply cries out to his grandfather "You really cared, Pop." This was actually very important and very primal, but it was not an experience of Pain with a capital P:
The deep crying for his grandfather was that of purest love. I can be explicit on these matters because I am Tom. (p.25)
And Lonsbury quotes another case history where love and joy were the key primal feelings for the individual concerned.
So primal integration keeps on coming back to the central value of reality, truth, authenticity, whatever you may like to call it - the main existentialist concern. Friedenberg (1973) sums up this position thus:
The purpose of therapeutic intervention is to support and re-establish a sense of self and personal authenticity. Not a mastery of the objective environment; not effective functioning within social institutions; not freedom from the suffering caused by anxiety - though any or all of these may be concomitant outcomes of successful therapy - but personal awareness, depth of real feeling, and, above all, the conviction that one can use one's full powers, that one has the courage to be and use all one's essence in the praxis of being. (p.94)
In recent years, the whole subject of the real self (existential self, integrated bodymind self) has been clarified and illuminated by the work of Ken Wilber (1979, 1980). What we are talking about here as central is what he calls the centaurstage of psychospiritual development. It lies between the mental ego and the subtle self, and represents from one point of view the highest development of the individual personality, from another point of view the foothills of spiritual development. To put the centaur stage within this context makes contacting the real self more of an objective reality and enables us to see it as quite a modest and achievable aim.
Freundlich (1974a) suggests that there are four phases we have to work through as clients involved in this process of moving from what is peripheral to what is central within the person: first, reliving primal experiences; second, connecting up those experiences with present-day existence; third, action in the present where we keep our feelings open instead of being shut down; and fourth, taking resonsibility for our own lives and changing what needs to change. Freundlich holds that these phases are not sequential, but simultaneous processes which reinforce each other.
We would now go further and say that contacting the real self now makes it easier to go and contact the transpersonal self. This can be conceptualised as going deeper into the center - in other words, the centre is itself a series of concentric circles (Rowan 1983).
The 'person' of the therapist
Probably the best discussion of the whole question of the person of the therapist comesfrom Alvin Mahrer (1983). He suggests that there are four basic paradigms of thetherapist-client relationship: a parent and a child, where the parent knows more than the child and controls the child; a saint and a supplicant, where the saint is holier than the supplicant, who tries to live up to the standard set; a scientist and a subject, where the scientist knows just what to do to transform the subject; and his own form of therapy, where the therapist identifies with the client.
While we cannot discuss this in full here, in terms of these paradigms Janov's work seems closest to the scientist-and-subject model. It is quite technique-based and results-oriented, as can be seen in Albery (1985). And although primal integration therapy is quite different from Janov's work, and even has some different roots (as for example the encounter group background of Swartley and the LSD research background of Lake and Grof) it does still share something of this approach, even though considerably softened and modified. We do not usually assign homework (which is one of the hallmarks of the scientist/subject approach, according to Mahrer), but we do use methods freely taken from gestalt, psychodrama, encounter, bodywork, art therapy and so on, as well as of course the basic regression approach. It often does not seem to the client that we are very technique-oriented, because we can be so flexible in following the client's own experience and needs moment by moment. I once heard a good therapist say that her attitude towards clients was one of tough loving, and that has always struck me as one of the best descriptions of what the primal integration therapist is aiming at. It is the loving which lets the therapist stay so close to the client's experience, and it is the toughness which lets the therapist notice and act when clients are avoiding, contradicting or otherwise defending themselves against themselves.
But there is one aspect which is missed in Mahrer's account, and which is crucially important. This is that the primal integration therapist feels it very important to be authentic. If the aim of the therapy is that the client should be enabled to contact the real self, as we have said above, then it is important for the therapist to model that, and to be a living example of a real human being.
So this gives us the paradox of primal integration therapy relying at one and the same time on authenticity and tricks. At first sight these two things seem simply contradictory. How can I be real and at the same time be using techniques, which by definition must be artificial? I think Bergantino (1981) puts his finger on the answer when he says:
Being tricky and authentic can be two sides of the same coin. Being an authentic trickster will not destroy the patient's confidence if the therapist's heart is in the right place. (p.53)
A similar point is made by Alan Watts (1951), who tells us that in Eastern religious disciplines the learner is often tricked by the teacher into some insight or breakthrough or awakening. The tricks (upaya) which are used are an expression of spiritual truth. In primal integration, we may use deep breathing, massage, painting, guided fantasy, hitting cushions or reliving birth, all in the interests of enabling reality to dawn.
The style of the primal integration therapist varies greatly among individual practitioners. In Lake's groups there was often a procedure of taking turns to work. In Swartley's groups there was a formal go-round at the beginning, where people had to state what piece of work they wanted to do, and what they wanted to do it with. Emerson's groups are different again, and he does a lot of work with children. Grof does more individual therapy, and so do I. In individual work the therapist will often use a similar approach, educating the client to the point where one can say at the start of a session - "What would you like to work on today?" But this is even more variable, in line with the needs of the client, the personality and experience of the therapist, and the interaction between the two.
We do tend to get clients every so often who may or may not have read Janov but in any case somehow expect to get into primals at once. If they find, as many do, that in fact they are nowhere near ready for that because their defences are much stronger than they thought, they become disappointed. People too often abandon the here-and-now and shoot for the deep cosmic experience. This can sometimes produce the phenomenon of the pseudo-primal, where a client tries to make a primal happen by sheer effort of will. But feelings cannot be forced, and primals cannot be manufactured.
Again we are sometimes faced with a client who expects to get immediate entry into the world of deep feelings, which up to now they have been avoiding. When such a client says - "I'm not feeling anything," or "I can't get in touch with my feelings" - it is usually due to not paying attention to gentler feelings, such as relaxation or mild restlessness, because of trying so hard to feel something else. The thing we do is not to get the person out of this, but simply to encourage focussing on this itself. Go into the lack of feeling, really experience it, focus on it, sink into it, be it. In that way it can lead us to whatever is really there.
People often expect the primal integration therapist to encourage them to scream,' but in fact we do not do that. Nor do we think that screaming is essential; it can be very important for certain clients, but quite often it is not. Experience has taught us that primal experiences vary tremendously from one person to another, and even within one person over time. In any case, the process is much more important than simply having cathartic primal experiences. Indeed, it is even possible to get addicted to primaling, at the expense of any proper integration.
So the style of the primal integration therapist is very broad and sensitive, and places a good deal of emphasis on listening at all levels: body, sexual, emotional, imaginative, intellectual, spiritual, social, cultural, political. We also place emphasis on countertransference, recognizing that in primal work it is very easy for the therapist to avoid the deepest levels of experience, because these can be so painful. As Freundlich (1974b) says, we have to be aware of our inner feelings as therapists and then decide what to do with them. And because of our more active approach, this may mean taking risks. For example, he says:
In a group session I revealed, with embarrassment, that I was having sadistic punitive fantasies toward Marianne, and this was a reaction to her passive, pouty and uncooperative efforts in the group. My interaction with her was an opening to explore how she had expressed anger toward her mother in a withholding, obstructionistic manner. (p.7)
I don't like the tone of this example, but it does show how the therapist was able to get the client into some very important material by using his own countertransference. And it does show the mixture of authenticity and trickiness which was mentioned earlier. In sum, the therapeutic style is essentially one of spontaneity, which allows intuition and a creative flow.
Major therapeutic techniques
Obviously the main technique is regression - that is, taking the person back to the trauma on which their neurosis is based. Laing (1983) has argued that we should also talk about recessionthe move from the outer to the inner world. And Mahrer (1986) makes a similar point. Going back is no use unless at the same time we are going deeper into our own experience. We agree with this, and find that recession and regression go very well together. One of the clearest statements of the case for doing this comes from Grof (1975) when he talks about the COEX system. A COEX is a syndrome of experiences which hang together emotionally for a particular person. It is a pattern of feelings, meanings and other mental and physical experiences which keeps on reappearing in the person's life.
This gives us one clear way of working with a client. I might take an experience in the present and say something like - "Get in touch with that whole experience. What does it feel like? How does it affect your body and your breathing? What are the thoughts and meanings tied up with it? (Pause) Now see if you can allow a memory to come up of another time when you had that same sort of experience. Don't search for it, just focus on the feelings and let them float you back to an earlier time when you had those same feelings." When a memory comes up, I encourage the person to go into it and concretize it as much as possible - relive it in some detail, getting right inside it, express whatever needs to be expressed there, deal with any unfinished business from that time. Then we go back further, in the same way, and do the same thing with an earlier memory. Then again, and again, as often as necessary. In this way we descend, as it were, the rungs of the COEX ladder which leads us into deeper and deeper feelings, further down on the affect tree we noted earlier in this chapter.
As we do this, I go into the experience with the client, much in the way which Mahrer (1986) calls 'carrying forward experience' - that is, entering into the experience and co-feeling it with the client. In this way I can say things which make the experience fuller and richer for the client, and which take the client closer to the heart of that experience.
Often it also helps if the client breathes more deeply and more quickly than usual. There is a very good discussion of the whole question of hyperventilation in Albery (1985), where he examines the medical evidence in some detail. It does seem to all of us who work in this area that deep breathing is very helpful in allowing access to deep emotional layers, going deeper both in regression and recession.
Now it is obvious that a procedure like this takes time, and it is really best to go all the way with a particular COEX in one session, rather than trying to take up the tail of one session at the head of the next, which usually doesn't work. This means that the primal integration therapist tends to prefer long sessions, which also enable the client to take a break or breather if need be during the session. I personally conduct some one-hour sessions, but I also have some 1 1/2-hour, 2-hour and 3-hour sessions; some people working in this area have used up to 10-hour sessions. One situation we like is the group experience over several days, where each piece of work can be a long as it needs to, because we often have two or three pieces of work going on at the same time in the group, either in the same room or in different rooms. We often have two leaders and one or two assistants to make this way of working possible.
In this process people open themselves up to deeper feelings, and thus become more vulnerable. So a high degree of trust has to be built up between client and therapist. But in reality,trust isn'tafeeling, it's a decision. Nobody can ever prove, in any final or decisive way, that they are worthy of this trust, so the client just has to take the decision at some time, and it may as well be sooner as later.
In this and other ways we lay a lot of stress on the self-responsibiIity of the client to do the work and make the necessary internal decisions. For example, in a group where the person may need to go back to a situation where they were being physically squashed or hurt in some way, and where they may need to say all sorts of things about getting away, stopping it, not being able to stand it and so on, we have a rule that if a client says - "Stop! I mean it!" - everyone immediately stops what they are doing without question or delay. Wetrust the person to have enough ego outside the regressive experience - vivid though it may be - to know when things are going too far, for any reason. It is the client who decides about readiness to proceed with any approach or method.
It is useful to know where the person has got to in the process of regression. Body movements can be very helpful in enabling the therapist to assess this, particularly in the pre-verbal area. Swartley (1978) gives some guidelines in the matter:
Conception trauma: Hands at sides, feet move like a tail, most of the physical activity is focussed at the top of the head. (Sometimes the client will identify with the egg.) Implantation trauma In most cases, the psychosomatic energy is focussed in the forehead which searches for the right spot of skin on another person on which to attach. Birth trauma: Here the energy is directed toward breaking out of mother's womb. Pushing with legs very characteristic. Pain in head, which wants to be held tight.
Emerson also has some unpublished work on the typical movements associated with the first trimester in the womb.
If the body gets stuck - that is, there are signs of tension but the body is not moving - we may do some primal massage. We look for the tense spots and very gently move into them with our hands. This very often releases more feelings and more movements. Or sometimes it is pressure which is needed, on the head or on some other part of the body. We encouragethe person to make sounds of any kind, as this helps to mobilise energy and keep things moving. If we can just keep the client still moving, still active, still breathing, more regression is likely to occur.
But there are other ways of enabling the client to get in touch with inner experience. A useful approach is simply to get the client to talk to a person, rather than talking about them. For example:
Client - My father never paid any attention to me. He always. . .
Therapist - Try putting your father on this cushion and talking directly to him.
Client - That's ridiculous. He's dead.
Therapist - He may be dead out there, but the father inside is still just as much alive as ever. Just imagine him sitting there on the cushion, and say whatever comes. It may be telling him something, asking him a question, making some demand on him, anything at all.
Client - That won't do any good: he never listened anyway. He always ignored me by . . .
Therapist - That's the point: he won't listen to you. Just see him sitting there and tell him that.
Client - Daddy, daddy, please pay attention to me. Please put down the newspaper and talk to me. Daddy, please look at me. . .
Doing it this way triggers far more feelings and memories than talking about the father or hearing interpretations about the therapist being the father. And because the therapist is outside the action and facilitating it, it can be pushed further and further into deep unconscious material. Like the psychoanalyst the primal integration therapist is very interested in working with the fantasies and primary process thinking of the unconscious, but prefers to work directly with them rather than refracting them through the transference. Again here our work is close to that of Grof (1985) and Mahrer (1986).
When memories come up, the primal integration therapist likes to make them as full and detailed as possible. A dim light often seems to facilitate this, by cutting down the distractions of the environment, so usually we will work in a room with a dimmer switch and heavy curtains or blinds. If the client wanders away from a scene which seems to be important, we often re-establish it by picking on some vivid detail already mentioned, and pulling the client back with it. We always use the present tense in this work.
Freundlich (1974c) says:
To support the emerging feelings and to work through the defences I encourage the person to repeat the key words and phrases which contain the feeling. (p. 5)
This repetition of key phrases is a favourite move in most cathartic forms of therapy, for example co-counselling and Gestalt therapy, and as Mahrer (1986) points out, it is one way of amplifying bodily sensations, The repetition of the primal words in a louder voice helps to intensify the feeling as the defence recedes. The person's throat opens up, the voice comes out more clearly, and the person is able to say the words which were held back for years. The hurt and need are finally felt and experienced. If the original splitting was severe enough, the original emotions may hardly have been experienced at all, so they may now be felt for what is virtually the first time. The person is then freer to make current needs known because the fear of rejection, for example, is finally connected to where it belonged in the past.
Music is a potent way of increasing an emotional charge, as Grof (1985) has pointed out, and primal integration therapists often use music for this purpose.
Bill Swartley suggested the principle of opposites: If something doesn't work, try the exact opposite. When a person won't express the feeling, perhaps it is more possible to express the defence against it. Many times, when a person has said that they seem to have a block against doing something, I have asked them to draw a picture of the block, or put the block on a cushion and talk to it, or to speak for the block. This often results in a strong and effective piece of work, where the block is perhaps a parental voice, or some other important subpersonality or deeper potential.
In my own work, I have found the notion of subpersonalities extremely useful. Very often a person's defences have got into such a convoluted tangle that they are very hard to sort out by following any one single line. But by eliciting thesubpersonalities we can then see exactly how the internal games are constructed and played out (Vargiu 1974, Rowan, 1983b). The idea of subpersonalities was developed most fully in psychosynthesis (Ferrucci 1983), and we have found these ideas very useful
in understanding what goes on at the level of the higher unconscious or superconscious.
One of the things that happens in primal work, as Adzema (1985) has recently pointed out, is that the deeper people go in recession and regression, the more likely they are to have spiritual experiences too. Shirley Ward believes this is because the psychic centres open up. However, in this area there is one very common error we have to guard against. Grof (1980) points out that blissful womb states,which primal clients sometimes get into, are very similar to peak experiences (Maslow 1973) and to the cosmic unity which mystics speak of as contact with God.
This has led some people - Wasdell for example - into saying that all mystical experiences are nothing but reminiscences of the ideal or idealised womb. This is an example of Wilber's (1983) pre/trans fallacy. Grof himself does not fall for this error, and has a good discussion of some different forms of transpersonal experiences. I have tried to be even more specific in discussing the various types of mystical experiences (Rowan 1983c). The whole point is that we repress not only dark or painful material in the lower unconscious, but also embarrassingly good material in the higher unconscious (Assagioli 1975).
This can come out in guided fantasies, in drawing or painting, or in dreams. I like working with dreams, as they can always be interpreted, understood or simply appreciated on so many different levels (Wilber 1984). If we want to do justice to the whole person, then we have to be prepared to deal with the superconscious as well as the lower unconscious. This seems to me part of the general listening process (Rowan 1985) which is absolutely basic to all forms of therapy and counselling.