Recovering from Trauma and Neurosis: What Primal Therapy can contribute

by Marc-André Cotton*

This lecture was presented at the IPhA’s 48th Annual Conference Imagining Brighter Futures for our Divided World: What Psychohistory Can Contribute on May 24, 2025.

Download here the PowerPoint of this presentation!

Abstract : The individual and social consequences of what is generally termed as neurosis are at the core of our dysfunctional world, including collective violence and the profound impact on the physical and mental well-being of our contemporaries. As early as the 1970s, the charismatic and controversial psychiatrist Arthur Janov claimed that is was possible to reverse this deplorable process. The presentation addresses this claim and focuses on the unconscious motivations that can drive individuals to engage in irrational behaviors such as involvement in cults, groupthink, and blind obedience to ideologies as well as violent acting-out on minorities serving as scapegoats. It also addresses the neurological processes that help us cope with feelings of helplessness experienced very early in life, through ideas and beliefs.

Keywords: Arthur Janov, Primal therapy, trauma, neurosis, violence, primal pain, childhood, beliefs, neurobiology, triune brain model.

Image 1: Recovering from Trauma and Neurosis

My presentation will focus on recovering from trauma and neurosis, individually and collectively.

It will focus on healing—and Primal Therapy can help as we shall see.

There is no need to remind you of the extremely tense situation we’re currently experiencing, both nationally and internationally.

But I think it’s important to remember that these circumstances are largely the group effects of neurotic symptoms that are present and active within individuals. (clic)

To keep it simple, we all suffered from trauma, we are all a bit neurotic and can behave irrationally under certain circumstances.

Indeed, we must admit that we do participate in the development of the collective neurosis, though mostly unconsciously, through irrational behaviors for instance.

Neurosis is a physiological process that helps us cope with pain. And we all have our hidden wounds.

If we can understand why these mechanisms exist on a neurophysiological level, we’ll be better at counteracting them around us and, most importantly, within ourselves.

In doing so, we’ll be focusing on the major issues that our conference is meant to address, that is healing a divided world, finding solutions to global conflicts, and exploring new ways to create a peaceful world.

We’ll be “reversing neurosis” as Janov was used to put it.

So, what does he have to say about neurosis? And how can his work help us? (clic)

 

Image 2: Articulation of the Presentation

In this presentation, I’ll give a quick overview of the historical context behind Janov’s research.

We’ll take a look at what Primal Therapy is about and what it is not.

We’ll go into detail about the role of beliefs and ideologies as coping mechanisms that Janov addressed in his last book Beyond Belief.

We’ll also talk about the Primal Therapy process and current research on the topic.

Finally, I’ll suggest ways to implement this process in our daily lives, both individually and within our communities.

A community like the one gathering around this very conference for instance. (click)

 

Image 3: The Context of the 60’s

Let’s start with the historical context.

Dr Janov accidentally discovered Primal Pain in 1967.

During a group session, he suggested to one of his patients that he call “Daddy, Mommy”—a simple proposition that had not yet occurred to him.

To his demise, the young man became deeply disturbed and writhed on the floor in violent convulsions.

Between two convulsive breaths, a heart-rending scream erupted from the depths of his bowels, which Janov likened to the scream of someone being murdered.

This eerie cry, Janov famously wrote in his introduction to The Primal Scream, “was to change the course of my professional life and the lives of my patients”. (clic)

In the following months and many more observations, he refined his understanding of the process and introduced what he would call Primal Therapy: The Cure for Neurosis.

For him, the non-fulfilment of fundamental needs in childhood and infancy generates pain so intense that it activates the repression mechanisms at the root of neuroses.

Through primal therapy, patients are gradually brought to feel these repressed pains and to access their childhood needs, thus reversing the neurotic process.

In many ways, this approach reflected the prevailing attitudes and trends of the time.

In the context of post-war uncertainty and the emergence of the hippie counterculture, the pursuit of happiness and the human potential movement offered the prospect of personal fulfilment. (clic)

His first book and many more, such as this one published two years later, became widely recognized and influential elements of the cultural landscape—a formidable revolution indeed.

Several celebrities including pop singer John Lennon and his wife Yoko Ono, publicly endorsed Primal Therapy.

As a side note, Janov had sent his first book to some of them.

After reading it, Lennon invited him to England to start working with him.

And since his two children were Beatle fans, he went!

So what is Primal Therapy? (clic)

 

Image 4: What Primal Therapy is About

Let’s begin by clearing up a common misconception.

Primal Therapy is not about screaming.

The confusion likely stems from the title of Janov’s first book, The Primal Scream, which left a powerful impression on the public.

As a pioneer in his field, he was outspoken—and often controversial.

He made enemies by boldly claiming, as he did in The Primal Revolution, that Primal Therapy was the only true cure for neuroses—because it aimed to resolve the underlying cause of psychophysical illness, not just the symptoms.

“By implication, Janov wrote, this renders all other psychologic theories obsolete and invalid.” (p. 19)

Another misconception is that Primal Therapy is about retraumatizing people. It is not. (clic)

Like Freud and others, Janov believed that the repression of pain is the psyche’s primary survival mechanism—a way to protect us when the pain is too much to bear.

Like Wilhelm Reich, he referred to a psychobiological rather than a psychotherapeutic approach in which chronic tension generates a host of symptoms.

Like Donald Winnicott and Alice Miller, he argued that Primal Pain structures the character by splitting the personality into a Real Self and an Unreal Self—a True Self and a False Self if you will. (clic)

And to conclude about neurosis, here is what he wrote in the same seminal book:

“Neurosis is a symbolic behavior in defense against excessive psychobiologic pain. Neurosis is self-perpetuating because symbolic satisfactions cannot fulfill real needs.” (p. 23)

As you can see, Janov’s work is part of a broad school of thought, now supported by more recent discoveries in neurobiology as we shall see.

Let’s now dive into the heart of my presentation with Janov’s view on belief. (clic)

 

Image 5: Belief as a Coping Mechanism

Incidentally, the psychopath who shot John Lennon ten years later, claimed to have received instructions from God, because the pop singer had insulted his beliefs in Jesus.

What Janov wrote—and what Lennon echoed—is that our beliefs serve as coping mechanisms meant to suppress the Primal Pain.

According to Janov, an episode of psychosis, such as Lennon killer’s acting out, could be defined as too much access to imprinted pain, the person being flooded by his traumatic past when his or her beliefs are challenged. (clic)

Janov likes Primal Pain to geological fault lines that are embedded in our subconscious from an early age.

To counter and alleviate this pain, we are inclined to grasp at ideas that may not be entirely relevant or realistic.

What matters is how these ideas can help us to release, channel and absorb the energy of the pain.

Janov writes in Beyond Belief that hope functions as a painkiller.

The early imprinted hopelessness of getting love elicits hope through the secretion of repressive biochemicals. (clic)

When a child’s basic needs are not met by loving and attentive caregivers, the resulting aloneness can have a significant and potentially life-threatening impact on the infant’s physiology.

Someone criticizes your country, and you get angry as if you were personally attacked.

Your sense of patriotism might serve as a defense against the fear of not belonging.

Instead of feeling alone as you once were, you feel like an integral member of a group. (clic)

Cults and radical groups often attract individuals who have been rejected and unloved as children, Janov has found.

With such a high need for approval, one may embrace a belief that a deity or a guru will provide full consciousness, nurturing and protection to fulfil these unmet needs over several years.

One key biochemical reason for this is that love increases the secretion of oxytocin and serotonin—two endorphins that suppress pain and maintain comfort.

And a lack of love correlates with a lack of these biochemicals in the body. (clic)

Our defensive belief systems come into being early in a child’s life, when we are taught not to express feelings, not to speak thoughts that are not acceptable like resentment or jealousy.

Once installed this censorship process continues, and the child comes later to substitute ideas for what he or she feels. (clic)

But how do feelings transpose into ideas?

Here is a representation of Paul MacLean’s Triune Brain model.

His model certainly oversimplifies the complexity of our brain but will prove useful for our comprehension.

Originally, feelings follow evolution and move from brainstem early memories of survival toward the limbic system, and then prefrontal cortical connection for integration.

That is from stage 1 to stage 2, and then to stage 3.

As the prefrontal cortex comes into play, the lower sensations and feelings areas of the brainstem and limbic system decrease in activity.

These sensory, emotional and thinking brains are three specific developmental stages with specific timelines of maturation.

Janov respectively coins them as first, second and third level of consciousness. (clic)

But when trauma is imprinted very early in life, it sets a deviation of key structures in the brain.

A system of gating is being set up between the Reptile and the Mammal, as well as the Rational brains.

Suppression of feeling is the most common expression in such situation.

This mechanism of suppression responds to specific traumatic events and to accumulated pain over time—a lack of consideration for a child’s feeling for instance.

But the pain never disappears.

Later in life, we may be anxious or have panic attacks, that is pain and terror rising to the third level of consciousness.

And we use both hemispheres of our neocortex to cope with this overload of pain.

We transpose feelings into ideas and symbolic representations. (clic)

 

Image 6: The Primal Therapy Process (1/2)

So how do you reverse this process?

Remember that for Janov, treating neurosis means taking it in reverse.

He compares our psyche with a beautiful tree: its leaves and flowers are the most visible parts, they emerge from branches, the trunk and ultimately the roots of that tree.

Likewise, neurotic manifestations are the most visible expression of our wounded psyches.

They are rooted in traumatic experiences going back to childhood and ultimately prenatal and perinatal imprints.

For Janov, they are ultimately rooted in our parents’ neurosis. (clic)

The therapeutic process starts from current experiences and present problems and progressively defuse the defenses that prevent the person from feeling.

We follow the Primal Chains through the person’s history to reach progressively the earlier branches and roots of his or her pain.

The aim is to connect the needs of the body with the memories stored in the unconscious.

Primal Therapy is an approach centered on the person’s history and closely follows his or her internal process.

From that point of view, Primal Therapy is similar to Psychoanalysis.

But in Primal Therapy, feelings are at the heart of the process.

They are not only evoked but fully re-experienced in their original context.

And this puts an end to the repression, this is what heals.

Before going deeper into this understanding, let’s consider a few quotes about feelings in Janov’s works. (clic)

How are they relevant to the context of extreme antagonism we are currently experiencing globally? And how can we find a path for healing?

First: “Neurosis is a disease of feeling.” (The Primal Scream, 1970, p. 20)

Indeed, we are currently overwhelmed by bad news that trigger our most profound fears.

We must shut down our feelings to survive psychologically.

As a result, we are prone to engage in neurotic behaviors such as hostile defensiveness, avoidant strategies or emotional numbness—that is fight, flight or freeze. (clic)

The second quote is: “We are inhuman to the extent that we cannot feel.” (Prisoners of Pain, 1980, p. 72)

This certainly helps explain the lack of empathy one can experience when caught in a state of siege mentality or defensive hatred.

Ideologies often serve to justify such hatred and violent acting-out, especially in the context of war, when the other is perceived as an existential threat. (clic)

And the third quote: “Feeling not only heals, it gives meaning.” (The New Primal Scream, 1991, p. 366)

This statement highlights the profound link between feeling and healing.

It suggests that re-experiencing one’s pain and ending repression can lead to a radically different mindset.

One rooted in reconnection with the real self and, consequently, with others as fellow human beings.

It points toward a state of peace and a desire for resolution, motivated by the well-being of all parties involved. (clic)

 

Image 7: The Primal Therapy Process (2/2)

Let’s dive deeper into the process, linking it more clearly to the Triune Brain Model, and exploring a brief illustrative case study.

Arthur Janov emphasizes that our three brains each have their own modes of expression—their own language.

Our neo-cortex is verbal: it allows us to reason, rationalize, and find meaning through art, ideas, and abstract thinking.

This is the part of the brain addressed by the “talking cure” of psychoanalysis, or by Cognitive and Behavioral Therapies, for example. (clic)

But there is a whole world of non-verbal emotional and relational experiences, especially linked to early attachment deficits and possible traumas.

To avoid feeling these deep pains, we often use our neo-cortex to rationalize, minimize, or justify them.

Whenever emotional pain is triggered, we tend to instinctively retreat into this cognitive brain—we return to our beliefs and narratives.

This disconnection from emotional reality is a defense mechanism against what Janov calls Primal Pain.

Repression and dissociation are active not only during therapy but also in our daily lives, and even on a collective level.

As psychohistorians, we study how groups and nations can unconsciously delegate to their leaders the task of repressing fear and channeling anger—for instance, by waging war.

We are witnessing these phenomena right now in this country, with the rise of the radical right. (clic)

Now there is a third brain—actually the first to develop ontogenetically—known as the reptilian brain, which also has its own language.

It is a pre-verbal world centered on physiological processes, bodily sensations and primitive survival impulses.

This brain, also called the brainstem, is primarily responsible for survival.

It is here that the body stores memories of the earliest traces of trauma—including pre- and perinatal traumas like birth complications, neonatal isolation, or deprivation of essential physiological needs.

We generally have no conscious access to these profoundly repressed memories—until a triggering event forces them back into awareness.

Such moments can be agonizing, as they arise beyond our control and overwhelm our defenses.

Primal Therapy also addresses these resurfacings and, as we have seen, proposes that re-experiencing these deep imprints within therapy has a reversing effect on neurosis.

It is important to remember that neurosis is not random: it is the product of repression, gradually structured throughout childhood by the repeated activation of these deep, early imprints. (clic)

 

Image 8: A Brief Illustrative Case Study

Let us now look at a brief illustrative case study of the therapeutic process.

The patient is a woman whom I will call Mary.

Mary has two young children and is a devoted housewife, as well as a fervent Catholic who attends church every Sunday.

She is married to Peter, a highly controlling man who systematically demeans her when she tries to express herself.

She has no control over their household finances and must beg Peter for even the smallest expense—let alone having any money of her own.

In the course of her therapy, Mary came to realize that she was trapped in a relationship of coercive control, much like the one she had witnessed between her own parents.

Despite all this, Mary could not bring herself to leave Peter—not only because of her financial dependence, but even more so because the prospect of following her own path terrified her.

One day, Peter and Mary had yet another argument over a trivial matter.

Unable to react to a torrent of insults hurled at her in front of the children, Mary stood speechless, able only to count the curse words Peter threw at her. (clic)

Mary expresses her feelings in words and begins crying:

“I feel dirty, and I can’t defend myself! He will always have the advantage and end up crushing me. I feel really weak!”

Mary feels an intense rage, similar to what she once experienced toward her parents.

She oscillates between her feelings and her reasoning, trying to make sense of Peter’s behavior while taking the blame upon herself.

The therapist suggests: “What is the feeling? What is crushing you?”

“I’m scared. I’ll never be able to make my voice heard. It’s the words themselves that crush me. I even feel unfit for the world, without any resources.”

Mary now connects to the longstanding fear of being molested by men, a fear rooted in her past experiences.

She also recounts her mother routinely shouting demands at her and molesting her during childhood.

Mary continues to delve into these deep feelings of despair, and her crying and sobbing intensify as she does. (clic)

At one point, the therapist invites Mary to pay attention to her bodily sensations.

Mary feels cold, as if her head were disconnected from the rest of the body—a sensation akin to dying.

In a previous session, she had realized that she was born a “blue baby”, meaning she had suffered from anoxia during birth.

Now Mary is connected to her brain stem and has no word for what she is going through, just intense, almost unbearable sensations.

At one point, her dog, which had been sitting next to her quietly during the whole session, comes to lie down on her affectuously, right over her heart, and then leaves. (clic)

After a while, Mary emerges and shares her insights. She described her sensations as if she had been dead and brought back to life.

“I felt my body as a baby! A part of myself has remained dead since then! My loneliness began at that very moment!”

Through her insights, Mary realizes that the imprint of her traumatic birth has developed over the course of her whole life, rooted in that early pain. (clic)

Her session ends with these powerful words:

“There’s a part of me that doesn’t want to live this life! I am not the source of the impulse to live, so other people do what they want with me!”

So how does Mary feel after re-experiencing this traumatic birth imprint?

Surprisingly, she feels good—even revigorated.

Although she will likely revisit this imprint again in future sessions, she will probably do so with greater willingness, having already experienced the liberating effect of this breakthrough. (clic)

Let’s consider the course of this illustrative case study along with the Primal Therapy process suggested by the Triune Brain Model.

During her session and for a relatively long period of time, Mary oscillated between the third level and second level of consciousness.

She then delved into her feelings and experienced deep level of emotional pain on the second level.

She then paid attention to her bodily sensation and slowly entered the first level of consciousness bringing her back to the early imprint of a traumatic birth.

There were no words nor emotions at that point. Just sensations of helplessness, of dying and being brought back to life.

When she emerged, Mary felt revigorated and saw more clearly what really forbids her to take hold of her life.

It’s a traumatic imprint that goes back to the first hours of her existence and that has been continuously resurfacing through her childhood and adult life. (clic)

 

Image 9: Self-Regulation in Public Debates

Of course, I have lost sight the purpose of this presentation.

What can Primal Therapy offer—us and our contemporaries—knowing that most of us may never undergo such a process ourselves?

What drives us, nonetheless, is the desire to better understand our inner world—and search for tools that help us face what we uncover.

So I’d like to conclude by focusing on what we often encounter in public debates, especially when the topics are emotionally charged.

Today, those might include war in Ukraine or the Israeli–Palestinian conflict—whether within the IPhA or in broader society.

At the heart of these moments lies a crucial capacity: self-regulation—our ability, as adults, to manage what happens inside us when we feel emotionally triggered.

Self-regulation is about transforming how we understand and respond to stress—in ourselves, and in those around us.

One initiative in this area is The MEHRIT Center, founded by Dr Stuart Shanker of York University in Toronto.

Building like Janov on Paul MacLean’s Triune Brain model, Dr Shanker has studied the impact of excessive stress and the role of self-regulation in the mental and physical wellbeing of children. (clic)

When children are overstressed, they react in distinct ways.

Some become hyperactive or nervous; other withdraw into silence.

Some talk incessantly, while otherslash out in anger or aggression.

Too often, these children are misread as disobedient or defiant, when in fact they are simply overwhelmed.

And as adults, we carry many of the same stress patterns within us.

What happens when we experience excessive stress in a public setting—like during a heated debate?

Dr Shanker suggests that when overstressed, both children and adults are driven by primitive brain mechanisms, especially from subcortical regions, which push us them to lash out, shut down, or flee.

In these moments, the prefrontal cortex—the part of the brain responsible for reasoning—is temporarily disabled.

This understanding invites a very different approach to managing aggression in public discours.

An approch centered on feelings rather than arguments.

Not about reacting—but about pausing and asking ourselves:

“What exactly am I feeling right now? Why is this affecting me so deeply? And why is it happening now?”

We begin to recognize hidden stressors—often subtle, often specific.

We reduce stress whenever possible.

We reflect on which words or expressions trigger aggressive reactions, and we reframe them—when appropriate—in their historical context.

We remain aware when unexpressed emotions and beliefs are being acted out in public arena.

And we create space for emotional expression—space to calm down, to rebalance, and to reconnect.

Later, we reflect:

What state was my mind and body in—before, during and after those challenging moments. (clic)

To me, this is a beautiful example of applied knowledge—of what it means to understand the brain not just in theory, but in everyday life, especially in our relationships with those we deeply disagree with.

In doing so, we take care not to undermine anyone’s sense of value as a human being—friend and foe alike.

Because as Janov as Janov reminds us: “Feeling not only heals, it gives meaning.”

Thank you for your attention!

If you would like to explore Arthur Janov’s work further, you can access my review of his book Beyond Belief by scanning the QR Code below. (clic)

 

Image 10: Questions Opened for Discussion

We now have 30 minutes for discussion.

Here are some questions you may wish to explore:

• How do our hidden wounds resurface, particularly during troubled times?
• In what ways do we cope with this resurfacing, both individually and collectively?
• Could a better understanding of the three brain languages offer new paths for healing?
• How can we move beyond the fight, flight or freeze response?
• Can we learn to self-regulate in public debates and discourses?

End or the presentation.

*Marc-André Cotton, MA, the President of the International Psychohistorical Association, and an International Member of the Psychohistory Forum, is a teacher, independent scholar, and director of the French website Regard conscient, dedicated to exploring the unconscious motivations of human behavior. He authored the French psychohistorical book Au Nom du père, les années Bush et l’héritage de la violence éducative published in 2014 by L’Instant présent (Paris).