Imagine that a thirty-year-old man comes to a clinic, has obvious symptoms of an anxiety disorder and is unable to have a deep relationship with anyone. As the session progresses, the therapist asks him about his childhood, to which the patient explains with apparent normality that he was the victim of sexual abuse and abuse by his uncle, who l raised after his parents died in a traffic accident.
The subject, then a minor, indicates that he was forced to be strong and to resist the attacks of his guardian so as not to give him the satisfaction of seeing him suffer. It is also mentioned that at the time he did not discuss it with anyone and that in fact this is the first time he has discussed it in public. While the comment arose spontaneously and does not seem to arouse emotion in the subject, the therapist notes that this fact actually caused him deep pain which prevented him from trusting others.
At this point, he decides to apply a type of therapy that can be used to make the patient able to externalize their pain and work on it in order to improve their symptoms and difficulties in interacting with others: Primordial Therapy by Arthur Janov.
Primary therapy and Arthur Janov
Primitive, primitive or cryotherapy therapy by Arthur Janov it is a type of psychological therapy which starts from the fundamental idea that the suffering of human beings in the face of the non-satisfaction of basic needs must be expressed symbolically. For Janov, the symptom is a defense mechanism against pain.
Throughout childhood and development, human beings can suffer severe trauma resulting from denial of primary needs such as those of love, acceptance, experimentation and sustenance. Likewise, in cases where the expression of these needs is punished in such a way that the individual cannot be loved if he expresses what he is, he will eventually find ways to replace them only by blocking but what he really does. they will generate a high level of anxiety.
This psychological pain must be expressed. However, this pain and suffering tends to be repressed and separated from our consciousness, so it is gradually stored in our subconscious. This repression accumulates as the basic needs are refused, which means for the body a strong increase in stress that can generate neurotic difficulties. For example, one may be afraid of intimacy, addiction, narcissism, anxiety or insecurity.
The aim of primal therapy would be none other than that of reconnect our suffering to our body, So that we can relive the pain and rework it, express it. He seeks what Janov calls the primitive reaction, a re-experimentation of the aversive experiences of children both mentally, emotionally and physically.
Classification of primary therapy
Primary therapy of Genoa it can be classified as one of the body therapies, A subtype of humanistic therapy whose main function is based on the use of the body as an element to be analyzed and through which to treat various mental disorders and problems. Thus, in all of the so-called bodily therapies, it is the body itself which is treated within the framework of this approach, awakening or focusing on the different sensations perceived by the body.
Although it is considered humanistic, it is possible to detect in its design a strong influence of the psychodynamic paradigmWhereas 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. We talk about repression of pain and re-experimentation, as well as the fight against neurotic defense mechanisms. In fact, there have been many subsequent efforts to modify it and integrate the advances of different currents such as the humanist.
Applying the primal therapy or Janov’s cry, in the original version (later touch-ups were made to reduce the time required), requires following a series of steps which we will explore below.
Therapy should be carried out in a padded and preferably soundproofed room, And the patient is advised to temporarily cease his activity at different levels during the course of treatment.
First, it is necessary to establish whether or not this therapy is appropriate for the patient and his problem, and not suitable for psychotic or brain damaged patients. It is also necessary to consider whether the patient is suffering from any type of medical problem for which he may need treatment adjustment or non-application.
Before starting the treatment, the subject who is going to receive it is asked to remain isolated the day before said start, without sleeping and without performing any type of action to release anxiety and tension. This is that the subject perceives and cannot escape anxiety, Without being able to repress it.
3. Individual therapy
Primary therapy begins with individual sessions, in which the subject must be placed in the position which assumes a greater degree of vulnerability for him, with the extremities extended.
Once in this position, the patient must talk about what he wants while the therapist observes and arouses the defense mechanisms (movements, positions, babbling …) that the first manifests, and tries to prevent them from acting. so that he can express i immerse yourself in emotional and physiological sensations that cause him his repressed feelings.
Once the emotion has arisen, the therapist should encourage this expression by indicating various exercises, such as breathing or speaking through screaming.
It may be necessary establish rest periods between sessions, Or that the subject becomes isolated again to further weaken his defenses.
4. Group therapy
After individual therapy, it is possible to perform several weeks of group therapy with the same operation, without any interaction between patients during the process.
Primary therapy of Genoa it has not been widely accepted by the scientific community. His 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 transferential element. Another element criticized is that this is a time and effort requirement that can be complex to achieve.
It is also considered that not enough studies have been done to demonstrate its effectiveness, As well as the fact that their effects are limited if not given in a context of unconditional acceptance and therapeutic work beyond expression.
Ametller, MT; Díaz, M. and Jiménez, G. (2012). Psychotherapies. CEDE PIR preparation manual, 06. CEDE: Madrid.
Janov, A. (2009). The primordial cry. Edhasa.