The Origins of Anxiety, Panic and Rage Attacks

This is a report of clinical observations over forty five years. We describe the difference between limbic fear versus brainstem terror. The earlier a patient relives events from childhood, and infancy, the deeper into the brain he may reach. In the process, the affective responses become more exaggerated; for example, mild hopelessness becomes suicidal hopelessness, fear becomes terror, and anger becomes rage. The responses become more primitive as they emanate from a brain that is more primitive; older and pre-human. (Janov), (2011) That primitive brain inside of us provides all of the responses that existed hundreds of millions of years ago. In some respects we are still that alligator or shark with no pity or remorse, just instinct. Those primitive responses are pre-emotion, before mammalian caring and concern evolved, and they do allow us to murder when evoked. They also permit panic attacks which evolved to be life-saving in situations where rapid and vigorous responses meant survival. A person responding with rage or terror is overwhelmed by his brainstem activity and is reacting exactly like the alligator does. These deep and early processes have largely been ignored in clinical work and must be revisited.


IN TROD UCTION
In my previous w ork, I have d escribed the d ifference between lim bic fear versu s brainstem terror; that is, the earlier a patient goes w hen reliving events from child hood , and infancy, th e d eeper into the brain he reaches. In the process, the affective resp onses become more exaggerated ; for example, mild hopelessness becomes suicid al hopelessness, fear becomes terror, and anger becomes rage. The resp onses becom e more prim itive as they eman ate from a brain that is m ore primitive; old er and pre-hu m an (Janov, 2011) the brainstem.
That primitive brain insid e of us provid es all of the responses that existed hu nd red s of millions of years ago. In some respects w e are still that alligator or shark w ith no pity or remorse, just instinct. Those primitive responses are p re-emotion, before mamm alian caring and concern evolved , and they d o allow us to murd er w hen evoked . They also p ermit p anic attacks w hich evolved to be life-saving in situations w here rap id and vigorou s responses meant survival. A person respond ing w ith rage or terror is overw helmed by his brainstem activity and is reacting exactly like the alligator d oes (Panksep p , 1998).
Those responses are often caused by a birth trau ma w here a 130 p ou nd m other is given anesthesia that suppresses so m any of the functions of a 6 pou nd fetus, includ ing breathing. (Lew it, 2009;Singer, 2004, p 141, 215-228). This com bined w ith a m other w ho sm oked to p rod u ce an oxygen d eficit in the fetu s. (Cannon, 2008, p . 797-802;Fent, 2008, p . 138-145) The breathing app aratus is im paired ; that m ay be imprinted and end ure for a lifetime. It is an imprint of impend ing d eath--terror. Fright becomes a permanent accomp animent. And phobias and comp ulsions may be the lifelong result.
What I am d iscussing are d angers for the baby that menace his life. H is system reacts w ith terror becau se that is the highest level of brain d evelopment, at the m oment, and becau se those events are most often life-threatening. Key biologic set-points are altered , leaving a vu lnerability to d isease later on. (This inclu d es cortisol levels, natu ral killer cells as w ell as imipram ine bind ing, all research w e have d one, and d iscussed in my Prim al H ealing) (Janov, 2007).
That heavy d ose of anesthetics to the mother d uring the birth process can shut d ow n the baby's respiratory system and bring him near d eath. This is the time of rapid brain d evelopment w here trau ma can have long-lasting effects. It sets up a prototype and afterw ard can be the origin of migraines and high blood pressure, as the circulatory system is compromised . So later upset can trigger off a migraine as the vessels constrict as a d efense, and a mem ory of w hat the vessels need to d o p hysiologically w hen und er threat -constrict. This is the same biologic reaction that prod uces pupillary constriction when viewing scenes of horror. We w ill d iscu ss this fu rther u nd er the section called resonance (H od ie, 2010, p . 430-437).
For purposes of this article I w ill concentrate on low er brain proce sses, omitting the very important limbic system. It is w hat I call the first -line that has often been neglected or ignored . The second line processes feelings/ emotions, w hile the third line is largely cognitive, intellectu al and also p rocesses belief syste m s. Thou gh highly interconnected , each level has ind epend ent fu nctions.
When I mention "going d eeper," it is specific to our Prim al Therapy w here p atients over the m any months d o d escend d eeper in the brain and remote past to touch on (relive) those lower brains. We see that patients approaching first-line-brainstem imprints have major spikes in brain-w ave patterns, blood pressure, bod y temperature and heart rate; the amou nt of change tells us on w hat level the patient is operating; rad ical alterations are inevitably first line. N ot only that, but there are key behavioral effects: loss of breath, certain p hysical movements not exclud ing fetal p osition, bringing up a great d eal of mucous, obviou s suffocation, and m ore. They are in the grip of that low er brain structure. (For more on this, please read m y Life Before Birth, Janov, 2011.) When w e d id brainw ave stud ies years ago w e found that a patient on the verge of first-line p ain had skyrocketing brainw aves; amplitud e of w aves m ou nted as m any more neurons w er e recruited to help w ith p ain and repression. The latest stud y, the fourth w as mad e u nd er the d irection of E. M. H old en (Janov, 1996).
There are tw o w ays that w e become in touch w ith first line. One, to be so fragile and d efenseless that the d eep imprints rise tow ard conscious/ aw areness; or tw o, p atients slow ly d escend over tim e (often m onths) to arrive at the first line. This is w here p anic lies, and w e see panic surging forth as p atients come in contact with brainstem im prints.
The p anic victim feels threatened but he d oesn't know w hat he is afraid of. Or sometimes, that he is even afraid . It sometimes d oesn't feel like fear; it is some u nknow n feeling of fright that seem s so alien. She is p anicked over w hatever lies in her brainstem. The reasons could be any nu mber of things: a m other's terror d uring pregnancy translated to her baby, suffocation and near d eath as the m other is given heavy d oses of anesthetic d uring birth, a fright, as w ith one of my p atients w ho w as involved in a serious auto accid ent in her eighth month. When I w as in grad uate school I learned about anteced ent-consequent reactions. All it meant w as that if there is a resp onse, something caused it. When there is rage and terror, something causes it. These are not ord inary reactions; they are primitive in the full meaning of the term. So far w e have not know n w hat that meant. The m ore w e learn abou t the brainstem and ancient parts of the limbic system, includ ing the am ygd ala, the more we come to und erstand these exaggerated reactions.
We now are learning that so-called anger m anagem ent therapy is useless against rage. Rage operates on a much low er level than cognitive-style therap y that focu ses higher up. We d on't w ant to manage feelings; w e w ant to feel them. But w hen there is no know led ge of deep levels we resort to management. Just another w ay of holding them down when they need to be expressed .
The central system, the brain and spinal cord , m atures in sequence: from first line (the tail) and then higher (the head ). And w e relive in exactly the opposite m anner: head before tail. Reverse evolution; w e are governed by the rules of biology.
By the fifth w eek of gestation w e find synapses are connecting nerve cells. A few w eeks later the w hole fetal bod y can curl, tw ist and turn. At ten w eeks h e can move his fingers. H e begins to move enou gh to be recognized by the mother at about eighteen w eeks. The emotional brain is d eveloping in the last trimester and months after birth. What happens then affects our em otional life perm anently. Dam age d uring this time can sometimes lead to those w ho seem to have no feelings, no concern nor empathy -psychop aths (Anand , 2000, p 69-82;Kap lan, 2008, p . 249-256).
There is a question as to w hen w e first become alert or conscious. It seems to be arou nd the 24 th w eek of gestation. That is w hen the thalam us and its nerve circuits to the cortex are in place; the cortex can get inform ation from below . That m ay be the beginnings of global aw areness.
There are three brains in our head . Thus the term The Triu ne Brain as o utlined and explained by Pau l D. Maclean, the grand father of m od ern neurology. (Maclean, 1990) The first part of the brain to d evelop is w hat I call the "first line." In the first line lies all of those instincts and prim itive reactions. When there is trau ma at birth or d uring gestation, long before w e have an intact emotional brain, our reactions are cod ed and stored d ow n on the first line. And w hen w e ignore this level there is no chance of a cu re becau se w e have not gone d eep enou gh in the brain, in the unconscious, to call it w hat it is: terror. As it w end s its w ay to the top level w e give it a name: anxiety. We then d eal w ith anxiety attacks because w e are unaw are of their real name -terror -or their d eep source -the first line.
There are plenty of attemp ts at improvement in conventional therap y, w hich is good , but the problem is obd urate, and w ill last a lifetime, as d oes the imprint that hold s the mem ory in storage and also hold s the symp tom in its grip and w on't let go until generating sources are experienced . First line is the found ation for our personality. As it evolves it shap es or d istorts the feeling and later the thinking system s.
Accord ing to the early w ork of Melzack and Wall, there is a gating system in the brain that has a specific function. Our clinical w ork find s the gating system has a d ifferent function from w hat they d escribe. It is mainly to block off pain and terror from reaching higher levels of consciou s/ aw areness. In brief, to keep us u nconscious of threatening imprints. (Melzack &. Wall, 1965). Their w ork w as the beginning of the gate control theory. When the baby suffers great traum a d uring those early times the gating system w eakens and w e have "leaky gates." The trau m a, when excessive, cau ses the brain to use up major supplies of repressive chemicals, such as serotonin. This imp airs the proper functioning of the inhibitory system, our d efense system (Teicher et al., 2006). N ot only d oes trau m a exhaust serotonin, it d amages parts of the brain that prod uce it, as well as d am aging the prod uction of d opam ine and epinephrine. Tranquilizers tend to replace w hat w as u sed up originally; serotonin is found in Prozac and many tranquilizers. Their function is to block serotonin uptake so w e retain supplies over time. It seems that it is simply buttressing w hat w as exhausted in the original battle.
When our p ain levels are high, and therefore w e are less d efend ed , w e may arrive at age thirty w ith a p anic attack, w hich becomes a mystery. And it is a mystery becau se its origin lies d eep in the brain. We can now u nd erstand its provenance: a remote nervous system. It is responsible for so much of our aberrant behavior as w ell as op aque and refractory symptoms. We now see in ou r clinical p ractice all those p rim itive instincts that su rge forth w h en p atients d escend d eep in the nervou s system. They keep u s on the qui vive all of the time -alert w hen w e shou ld be trying to sleep , over -reacting w hen it is not called for. Freu d called it hysteria (Breuer & Freud , 1895).
We see now that w hen w e act in the present and there is a resonance d ow n d eep w e react to both times at once: over-reaction. The resonance may be terror from a carrying mother w ho sm oked and d rank and w ho w as effectively killing or d am aging the baby from d iminished oxygen. That and m any other configurations conspire to inculcate terror in the baby that is imprinted and sealed in as a (prim al) memory. When there is a p anic attack or rage attack w e m ust look to that brain for u nd erstand ing and cure. It is only w ith that brain that w e can find causes and answ ers.
It is not just anxiety that is apparent bu t serious m ental illness, as w ell; the result of horrifying and inescap able experiences in the w omb, (very early in w omb -life). It is clear that the experience is inescap able w hen mother is infu sing d rugs into the fetus and low ering his oxygen. Patients down on that level (and I know how ridiculous that may seem to the uninitiated ) exhibit again the terror. They feel like they are d ying. They are ind eed approaching d eath. That is the memor y that end ures and show s up years later w hen the gates w eaken in panic attacks.
What is m ore im portant is that after a reliving, all key signs d escend below baseline, as long as it is an actual reliving. This is never the case w ith those w ho are in abreact ion (the release of the energy of a feeling w ithout proper connection). The point here for our d iscussion is that w hen a patient d escend s d eep into brainstem/ first line, w e see the terror and rage that w e d o not see w hen they relive on the limbic/ feeling level alone. H ere it is still anger and fear; it is only w hen w e go d eeper that it becomes prim itive terror and rage. Patients again on that level are in the grip s of terror, they may gasp and w rithe, until they make the connection. It is origins and generating sources that m ay ultim ately lead to cure.
Let me quickly ad d a p oint that m ay seem parad oxical: it is a p ain that d oesn't hurt all that much. It is both a hurt and relief, at the same time. It is a great relief to be rid of something lurking in the backgrou nd of our lives w ithout cease, something that shapes our lives, interests, choices and reactions. We d on't know w hat's there but it leaves in us a malaise and a chronic apprehension that is inexplicable. Because it is preverbal it takes time to learn w hat it is and w hat to d o about it. We need to be careful about how d eep to go and w hen. Going too d eep abru p tly can be d angerou s, as in the m ock p rim al p ractice of rebirthing. It is for this reason that our patients are never "led " or forced to those lev els; it happens automatically as a result of the techniques w e have learned over four d ecad es.
As feelings m ount, the reliving process m ay start w ith psychotic-like statements before patients are fully into the imprinted memory. As the terror rises tow ard consciou s/ aw areness, they m ay have the thought, "I am going to d ie! They are trying to kill me." And the cure involves reliving. Why? Because w hen the feeling rises fully it can connect to conscious/ aw areness. And connection is the summum bonum of cure. The p ain and terror have finally been lived and exorcised . They are no longer a threat, w hich is w hy ad vanced patients no longer suffer anxiety attacks.
The goal of our therap y is to retrieve memory, not only of the scene or the place but of the feelings belonging to them; that is w hat has been repressed and held in storage, the p ain and terror. When p atients experience those feelings they become integrated . They are aw are of the feelings even though they may not know exactly w hen it happened originally. It i s the feeling that cou nts. Actu ally, I mean "the sensation." Sensations pre -d ate feelings by m illions of years. Previou sly their valence caused them to be repressed (otherw ise there is overload ), and thereby m ad e them an alien force, u nable to integrate w ith the rest of our system. When they are fully felt they are now part of u s. It is how the first line connects. We connect, in short, on the level of the traum a and in that context only. And as the reliving goes on, there is a continuou s d rop in vital sign s, arriving below baseline.
We must never skip step s, forcing someone to make something verbal w hen it lives on a d ifferent non-verbal level. There is also connection to the neo-cortex w here w e are aw are of the feeling and how it d rives us. We are consciou sly/ aw are of it all. Quite d ifferent from aw areness w hich is solely third -line. Too many therapies d eal w ith aw areness and not consciou s/ aw areness. It is w hy insights m ake only su perficial change.
Because the first line is the found ation of so m uch later b ehavior, w hen it is felt it provid es so mu ch insight into a w id e variety of behavior. Those insights are based on d eep structures but are eventually u nd erstood on the highest level.
We cannot m ake progress on the third -line cognitive level alone. We can become aw are of w hy w e act the w ay w e d o but nothing changes biologically; thus getting w ell only in our head . Our biology has been left out of the therapeutic equ ation. It is like being aw are of a virus, w hich u sually d oes not kill it. So again, connection means liberation of feelings in context. That last caveat, in context, is important. There are those w ho scream and w rithe and cry out of context, as in an exercise. They make no p rofound change, but w hen the patient slow ly d escend s to d eep levels over tim e and reacts to the stimuli and events on that level w ith the neurological capabilities of that era, there is p rogress.
Consciou sness m eans all levels of the brain w orking flu id ly and in harm ony. N o levels are kept estranged from the others. We are "one" in the neuro-biologic sense of the term. And that should be the aim of serious p sychotherapy -consciou sness -not just aw areness.
Some time ago there w as a stud y of anxiety states that fou nd alterations in the lymp hocytes of the imm u ne system as though the system w as und er attack; and it w as by alien un-integrated forces. As the anxiety left there w as a norm alization of lym phocytes. It wou ld seem that repressed feelings become an alien force, a menace that mu st be combated just like an invading virus. Is it any wonder that people with anxiety commonly suffer imm une d iseases?
The theory of three levels is illustrated by p aranoia or bizarre id eation, often found in psychosis. What w e have found is that, as feelings rise, there is sometimes paranoia: "I am going to d ie, or I am dying." It is the direct analogue of the early imprint. It is not bizarre id eation w hen p laced in context. It is a d irect outgrow th of a memory of w hat happened to us. In paranoia it can become, "They are trying to kill me." A d rastically w eakened gating system, as w ith the chronic use of mariju ana, allow s the d eep feelings too facile access to higher levels w here id eation and belief take over to block, bind and absorb the feeling. We often see paranoia in those w ho take hallucinogens. Feelings are unleashed w hile the d efense system is w eakened . Paranoia often ensues. We mu st think of it as third line d efense. Und er d rugs such as LSD or m arijuana, it is still the same memory imprint at base, only the cortical mind is forced into a more elaborate confection. Deep feelings and sensations have been prematurely unleashed . "I am d ying" becomes "they want to kill me." Often there is the leitm otif of d eath. This establishes for us the origins of some p sychoses: the surging forw ard and upw ard of those d eep imprints (w here d eath w as imm inent), and the collapse of the gates. It forces the neo-cortex to concoct all sorts of strange notions to cap ture and encircle the feelings and give them some sort of rationale. So instead of feeling horrific pain and terror the cognitive brain concocts an elaborate fantasy/ d elu sion. (Thomson, 2007, p. 85-113). The person can justify his terror -"they are ou t to get me; they w ant to kill me" -instead of feeling naked terror. To reiterate: there is an imprint of impend ing d eath, on the first line. It w end s its w ay to the neo-cortex w here it provokes a cognitive d efense -"they w ant to kill me." The imprint is real; the id eation is not. The treatment mu st involve the first line, not just the paranoid id eation. The kernel of this id eation is nearly alw ays d eep brain.
The pain and terror arise but before there is complete aw areness and a full-blow n attack there is strange id eation. The cortex is pushed to its limits; the last refu ge of the d efense system. We can und erstand more about killer rage: w hen there is trau ma in the present the third line w eakens and is infused w ith d eep brain imprints. The person acts -out becau se there are no d efenses, for the moment. And w e know that the first line is involved because of the im mense rage w e see. In our p atients the vital signs rise significantly w hen the first line imprint is approaching.
With connection, there is an actu al living again of the repressed imprint and the p ain/ feeling becom es integrated ; the vital signs fall in u nison, not sp orad ically as hap p ens in abreaction w here there is no connection to the imprint, the generating source. This d rop informs us that a feeling in the session w as complete. The d anger is gone for the moment. The inner, imprinted d anger has been faced an d felt and integrated . Feelings, w hen inord inately p ainfu l and terror-rid d en, are a perm anent menace. The system is u nd er attack by them, so w hen they begin to rise w e hear "they are attacking me." It is not "they." It is the feelings.
Connection means full exp erience. It can be experienced uniquely on the non -verbal level (heart rate and blood pressure), or on the level of consciou s/ aw areness w here there is a cortical connection and complete und erstand ing of the feeling. Feeling and integrating the cau ses of behavior prevents them from being acted ou t: "My mother alw ays need ed to know w here I w ent so now I d on't use my turn signals because it is nobod y's bu siness w here I am going." The act-out is w hat is generally know n as neurotic behavior. The cure requir es a complete reliving experience to origins, w hich means connection. Our therapeu tic task is to help patients feel the pain/ terror and bring it to full experience. We can experience terror w ithou t a label; bu t the aim is to d im inish or erad icate rep ressio n w hich hold s the feelings in place (see: "EGG stud y of amp litud e and frequency in patients of a feeling therapy." UCLA Brain Research Bulletin, Don Walter, 1973).
One w ay w e control our hypotheses is to measure vital signs, w hich w e d o w ith every session. Feeling the terror physiologically can bring d ow n the vital signs on its ow n. Over tim e there is also a significant d rop in cortisol levels and enhanced natu ral killer cells. (see my book Primal Healing for d iscussion). The key metabolic changes also includ e a perm anent one-d egree low ering of bod y temperature; since bod y temperature is factor in our longevity and the w ork of our bod ies it is an imp ortant ind ex. It all means that w e are getting to the pain and und oing repression.

RESON AN CE
We have been investigating the process of resonance. The upper neocortical levels are intertw ined neurologically, and evolve ou t of those low er levels so that w hen something ad verse happens in the p resent it can resonate w ith or trigger related feelings on those d eep er levels. In the same w ay that w hen a patient is on the first line in the Primal he can sud d enly exclaim, "I feel like I am d ying." The feeling is of such a m agnitud e that it is sud d enly impelled into the top level and is expressed verbally. One new p atie nt in a session w as approaching first line terrible pain, sud d enly sat up and said , "God has just saved me. I have been saved ." The neo-cortex stepped in to absorb the overload and began its d efense: "I am saved ," or rather, "I have d eveloped an id ea of be ing saved so that it can stop the p ain." The third line is simply d oing its d uty. The belief, "being saved ," happened automatically as feelings compelled the cortical gating system to begin its d efense. Beliefs are not capricious but are in the natural ord er of things. It is not the therapeutic goal to change the id eas, but rather, to feel their und erpinnings.
A w ife leaving the home is often enough to cause rage in the husband . This is quite true if his p arents d ivorced w hen he w as a child and the mother left home w ith someone else. The resonance factor, set in m otion by the d ivorce, can trigger off the original traum a, one's mother running off with someone else. The old and new trau mas combine to prod uce inord inate reactions. One can be engulfed by those feelings and through resonance and become enraged . In an experiential therapy the p atient goes through those very same feelings, fury and killer rage. The d ifference is that he is in a safe environment w here he can fully express himself and feel the old trau m as that d rive it. This is not a one-time affair; sessions go on m any times, as the pain and terror cannot be relived all at once.
We have treated the resu lts of re-birthers w ho have d one ju st that, forced patients far beyond their cap acity to feel. The d am age is shattering (of d efenses) and ineffable. They begin to have pre-psychotic id eas: "I am one w ith the cosmos. I feel the universe insid e me," etc. These same id eas sometimes extend to frank psychosis.
Once there is terror installed in the evolving fetu s the genetic cells can change and becom e epigenetic. Those transformed cells are the carriers of terror. They d rive neurotic behavior and all sorts of seriou s d iseases inclu d ing cancer (the cells that block cancer cells from d eveloping are nearly alw ays heavily methylated , ind icating early trau ma). The process of this imprinting is carried by methylating the cells; ad d ing p art of the methyl group of chemicals to the gene. The cells then carry the "brand ," perhaps for a lifetime. There is such a d istance from the time of that imprint to terror of speaking in public at age tw enty, that the source is not even consid ered . What has been imp rinted is terror: terror of suffocation, strangling, d eprived of oxygen and of being blocked from getting ou t. All of thes e are lifethreatening and they rem ain in pristine form throughout our lives read y to su rge forth. So there is inord inate anger w hen he tries to explain something to someone w ho d oes not und erstand ; the feeling is, "I can't get through -to you." It has resonated w ith, "I cannot get throu gh, get out, be free." And that is entw ined w ith a lack of oxygen; I w ill d ie if I stay here and cannot get out. So there is a great urgency to get throu gh. First line is bursting through.
Thus, anxiety is terror emanating from the d eep reaches of the neuraxis; m ore precisely, from the brainstem that controls d igestion, breathing, elimination and other vital functions. Deep imprints can affect all of these processes and / or set up vulnerabilities to related d isease, from d iarrhea to pulm onary d ysfu nction. A first-line imprint evokes a first-line reaction, meaning mid line reactions. That is how w e know w hat level is likely involved in colitis. Since anxiety seem s to w ork in reverse ord er w ith telomeres (those caps on the chromosomes that ind icate how long we may live), it may be that experiencing imprints m ay lengthen life.
A heavy d ose of anesthetics to the m other d uring the birth process can shut d ow n the infant's respiratory system and bring him near d eath. This is the time o f rap id brain d evelopment w here traum a can have long-lasting effects. Later on in ad u lthood , there can be a comp ulsion to try the d oor ten times a d ay to m ake sure the house is secure. This comes out of a basic feeling of being "unsafe." It can d rive the compulsion for a lifetime. Or consid er the fear of failure, the feeling that so many p atients have. Originally, it starts w ith fear of failing to make it out of the w omb w ithout great stru ggle w hen failing to get out successfully cou ld have meant d eath. It is the struggle-and -fail synd rom e that d rives us to give up w hen faced w ith obstacles (Glu ckm an, 2005; Lew it, 2009).
Fear is the limbic p ortal of entrée to earlier im prints. It opens the d oor to the terror d ow n below , w hich is part of our primitive brain a nd pred ates our em otional brain by hund red s of millions of years. Terror is meant for rad ical and im m ed iate action; a key survival function. When a carrying m other is seriou sly agitated , she is activating her baby, as fear becomes installed in him. When sh e d rinks, uses tranquilizers or is seriou sly up set and fearful, it combines w ith the prim itive earlier activation to prod uce a com pou nd ed response. When the mother's em otional state goes on for an extend ed period of time it m arks the genetic cells of the fetus and alters them, imprinting the terror response as an end uring legacy. And w hen our patients relive those early imprints the w rapping comes off the anxiety and it becomes the terror it w as at the start; w e see it now for w hat it is and w as. It now has a context, an origin and a p rop er nam e. (Mykletu n et al., 2009, p .118).
When feelings burst throu gh to conscious/ aw areness later in life w e call it p anic or an anxiety attack. It is not; it is the same pure terror that w as imprinted perhaps d ecad es earlie r, now filtered throu gh the gates. It m ay arrive in d isgu ised form, a p hobia or com pulsion, but at base it is still that terror. When the terror is felt and exp erienced neu rop hysiologically, the phobias often fall aw ay as d oes migraine. We low er hypertension on average 24 points after one year of therapy. It is also associated w ith the low ering of cortisol levels. (Gold man, 1998, p. 936-940). We are taking the pressure out of the system and norm alizing the person.
We need to u nd erstand that the first line is the basic found ation of our system. It shapes the second -line feeling system, and ultim ately can d istort the third -line id eational one. To solve problem s on higher levels w e need to return to the basic found ation that formed and helped d e-route them.

ON RELIVIN G
The question is often raised , can w e relive events in the w omb w hile w e w ere being carried ? When a patient w ith leaky gates (the gates that sep arate levels of consciousness) starts to relive a trau m a about his infancy d uring a session, there is sometimes a breakthrough of birth events. The trau ma, say, of d iminished oxygen w here the mother w as given heavy anesthetics, intrud es; the p atient w ill gag and feel suffocated , u nable to catch her breath. So in the mid st of experiencing how it felt to be spanked or criticized as a four year old , there is sud d enly a suffocation; the patient is literally having a near -d eath experience. It is called first-line intrusion. We often see this in very d isturbed people or in d rugs ad d icts. There are preverbal m em ories that can intrud e and elevate key vital signs. The exaggerated reactions tell us that there are possibly early imprints that d rive and compel the reaction.
In therap y, the d escent to the d eep brain is slow , method ical and evolutionary; it is evolution in reverse. After one year of therap y there is a sustained d rop in blood pressure, heart rate and bod y tem perature. The key w ord is "sustained ." It is not palliation; it is m ore substantial (H offm an, 1981). We are governed by the rules of evolution and biology.

MORE ON RELIVIN G
One w ay w e can be sure about reliving on the first -line is the p atient loses all his w ord s; he cannot speak nor can he cry. H e is on a m ost primitive level of nervous d evelopment, long before there is the cap acity for w ord s and id eas. If the patient ever says a w ord d uring her birth Prim al w e know it is a false experience. It has never happened w hen the therapy is d one properly. We see this in those w ho come to us from those w ho claim to be d oing our therapy. They have learned to scream and pound the w alls and say, "I hate you, d ad d y." N ew borns d o not have w ord s.
It w as in 1965 that Melzack and Wall d escribed the gating process (previously cited ). It offered a new heuristic for the control of pain, and pointed the way for how w e modulate pain. When there is m uch abuse, violence and neglect in a child hood home, the gates suffer. They no longer have the chemical w herew ithal to com bat the imprint of p ain.
When gates are w eakened the energy of hid d en feelings can approach consciou s/ aw areness. This can leave u s anxiou s and agitated and still u naw are of w hat is happening.
Leaky gates allow those early imprinted sensations to rise, triggered off by something in the present (d ivorce or loss of job) that evokes the original generating so urce, and the same feeling -hopelessness. While w e experience something in the present, an old feeling from child hood can break throu gh to upset us. There have been hu nd red s of stud ies over the last few years pointing to w omb-life traum a and its later effects on our health and personality. (see again: The Fetal Matrix, cited elsew here). The earlier that trau m a the m ore w id espread and d eleterious the effects, not exclud ing cancer and Alzheimer's d isease.
(We are planning a research project on Alzheimer's u sing the questionnaire fou nd in the back of m y Life Before Birth. Prelim inary evid ence, u nconfirm ed , p oints to a connection betw een the d isease and terrible trau m a d uring w omb -life.) At the end of a session w hen the p atient has relived oxygen d eprivation, h e m ay begin rapid breathing to compensate for the lack of oxygen he experienced d uring the session. Or more likely, w hen a p atient is in full first-line suffocation he m ay begin w hat I call it locomotive breathing, rasp y and hoarse, rapid as though the p at ient is m aking up for the event by gasping for air. (We have d one research on this in 1992, together w ith the Pulm onary Laboratory of UCLA. Due to a change in d irector the d etails of the research has been lost. It has been film ed .) H eavy breathing can go on for many minutes, and then relaxation. It m ay take many sessions for the cause to be comprehensible. Thou gh this heavy breathing goes on for up to tw enty minutes there never is any hyperventilation. We have d one experiments w hen the patient is not in a m emory and after three minutes she gets d izzy and feels like she w ill faint. H er hand s get cramped and she loses some coord ination. It happens system atically to those w ho attempt to go back to the past w ithout being totally in the mem ory.
To und erscore: being in a past feeling is a total biologic state w hich permits d eep breathing for a long period . The patient is engulfed by the memory of d epleted oxygen and at that time need ed oxygen. It is one of many checks w e have on the Prim al state. Patients are ind eed in the past neuro-physiologically. We also verify w hether the vital signs d uring a session are coord inated as they move up and d ow n or d o they d o so in sp orad ic fashion. A real reliving means coord inated vital signs. That is w hy a p atient on the verge of high valence feeling has uniformly high vital signs: brainw aves, bod y tem perature, blood pressure and heart rate.
We w atch for first-line intrusion because it means a mélange of levels that prevents integration of a single feeling on a specific level. Wit h this kind of deep Prim al we can see apnea at the end that can go on for a full minute; no breathing w hatsoever. We can only hypothesize that it is a last effort to conserve oxygen. In the session w hen vital signs d rop after reliving a traum a it ind icates that integration is happening. There is no more anoxic feelings nor d eath-approaching fears; no m ore panic.
In som e resp ects a Prim al seem s to be a consciou s-com a, excep t it is also a p artially consciou s one. The p atient for the time is back there, slight ly aw are of the present; it is a true reliving. There is still a peripheral aw areness of the present, but w hen back there she can cry like an infant, w hich she can never d uplicate after the session. It shou ld read , "cry as the infant." It is the infant crying.
When the tw o sid es of the brain are better connected in a Primal session, there is a relaxation that end ures. Feeling connects them, w hile painful unfelt feelings keep them apart. There seems to be tw o sorts of connection and integration: right to le ft (horizontal) and bottom to top (vertical). When that happens w e begin to have norm alization. Erik H offm an and a colleague from Ru tgers University (L. Gold stein), found that the brains or our p atients seemed to equalize after one year of therap y, a chang e of pow er betw een anterior and posterior sections of the brain as w ell as betw een the right and left hemispheres. (H offman, 1981).
Throu gh the process of resonance the early p ain is d red ged up becau se it is in some w ay related to the cu rrent feelings. It m ay have something to d o w ith id entical or similar frequencies. The w ork of the late Mirecea Steriad e (1996) (Bucharest) help s explain the possible process through parallel oscillations of neurons. The early mem ory that is "resonated " can take the form of hopelessness or helplessness w hen the current situ ation leaves the person feeling both feelings (hopeless and helpless). When the clerk at the Department of Motor Vehicles keep s blocking a p atient's attempt to explain something and she says, "sorry, there is nothing I can d o." Rage m ay set in, controlled by the neo -cortex. Ostensibly, it is a Prim al about the DMV, w here hopelessness is felt. This m ay evoke the very early hopelessness felt w hen trying to get born and being suffocated w ith d ru gs, the truly Prim al hopelessness. Years later w hen trying to get throu gh to someone, in vain, that d eep hopelessness sets in and there m ay be d epression as one resu lt. The feeling is "I can't get throu gh---to them, and there is nothing I can d o." The first p art -"can't get throu gh" -expresses the early pain/ imprint perfectly. We note how the third -line accom mod ates and rationalizes the low er levels. The imprinted feeling, "cannot get through or get out" rem ains in pristine form throughout our lives. So long as the feeling rem ains u nlived and therefore not experienced , it w ill be acted out. So long as buried feelings remain comp artmentalized and an alien force the person is forced to act -out. H ere is w here so much trouble lies. Someone w ho could not trust her father w ho w as sed uctive w ith her, may be su spicious of her boyfriend and his motives. It is the first line that d rives the act -out of imp atience, im pulsiveness, screaming episod es, etc. It is u sually the second line limbic input that gives d irection to the feeling.
Those w ho relive hopelessness over time in therapy und o their d epression. This is d iscussed in my w ork (Janov, 2007). It is resonance that permits the p atient to go from one level and then d escend to another enabling incred ibly strong reactions. It alw ays s eem s like so incomprehensible w hen a child is very d isturbed , even thou gh she had good p arents and a normal child hood . All that w as left out w as the key period of their lives w hich w as so important, gestation and birth. H ere is w here w e see extreme reactio ns that p oint to d eep levels of p ain. It is measu reable. Generally, the higher the valence the more harmful the imprint. When a d epressed enters therapy in a cognitive clinic she can be labeled "end ogenous d epression," w hen it simply d erives from an imprin t w ell sequestered .
The w ay w e relive w om b-life can only be w ithin the p ossibilities of w hat the first line can d o; that is, relive the physiologic effects w ith no feelings p ossible, as yet. On that level w e can't shout nor cry/ sob. Feelings arrive later in phylogeny and ontogeny. So w hen w e have inord inate anxiety w hile w e are reliving something m uch later in our child hood , it signifies first-line breaking through; an ancient brain is informing a higher brain of its p ain. The first line, in brief, can only provid e simply biologic reactions of heart, blood pressure, bod y temperature, as w ell as changes in hormone output (our beginning p atients w ho w ere high in stress hormone levels, cortisol, became normal after one year of our therapy. (see: H offm an reference). We cannot expect the first line to speak. It "speaks" alread y, and w e are learning that langu age every d ay. For example, there is a certain foot p osition in reliving of birth; w hen not there the Primal is suspect. When w e look at a chart of the birth process w e alw ays see that foot p osition (except in breech birth). The face sometimes takes on a fetal mien. It is an ensemble of physical behaviors that inform u s as much as w ord s. The behavior is unique to the first line so that w e mu st not expect m ore m ature behavior; and of course, even in infancy, w e d o not expect to see ad ult w ord s such as "justification" or "sp orad ic." It all betrays the level of consciousness operating at the tim e.
The low er level intru sion gives the Prim al much m ore force, inord in ately so, more than w e can expect w hen the p atient relives something w hen she w as eight years old , for example. And w hen she is measured w ith a rectal therm ometer (thermistor) d uring the session w e w ill see significant sp ikes in m easurements. This hap pens w hen the current feeling has a strong first-line comp onent: This can raise bod y temperature tw o d egrees.
We often see intru sion in pre-psychotics w here there is nearly alw ays a first-line aspect, barely repressed . And for this they often need painkillers o r tranqu ilizers to repress the force. This is requ ired only for a time. Med ication is the not the aim of therapy; it is a temporary intervention to allow the p atient to have a single feeling to d eal w ith, w ithout inund ation. The reason w e u se med ication on rare occasions is because it helps sep arate the levels for a moment so that one level d oes not tresp ass on another. Dampening p ain on one level w ith m ed ication inform s u s of how each level, althou gh interconnected , has its ow n ind ep end ent existence and its ow n p ain. There are specific first line blockers such as Alprazolam (Xanax), that hold first line in place, w hile other pain med ications cannot. Certain med ications target first line w hile others are m ore lim bic d irected , still others are cortex oriented . Xanax is not sold as a first-line blocker; it is prom oted by the p harmaceu tical house as anti anxiety. And that translates to us as a first-line blocker.
Patients are often not aw are afterw ard that they relived on the level of the first line. It is only after m any relivings that it becomes apparent. The fetus certainly is not aw are of w here he is and w hat his surround ings are, yet he respond s to it. In the session he is again resp ond ing in the sam e w ay as originally, p ossibly w ith the sam e vital sign cha nges. We have noticed that w hen a patient is reliving a specific feeling time and again there is alm ost an id entical vital signs read ing.
When the mother sm okes it might lead to an offspring w ho hold s her breath und er stress. The original trau ma has set up a prototypic d efense app aratus. She is again conserving oxygen w hen stressed . When she is up set she m ay systematically hold her breath. It is again the Prim al/ prim ord ial reaction to suffocation. Migraines can also be set off as a response to red uced oxygen first in the room, then in the w omb. Vasoconstriction is one of m any biologic means to conserve oxygen.
The bod y's d efenses are rather exquisite. Patients sometimes enter the session in a fullblow n p anic attack; they are breathless w ith the heart poun d ing severely. They w ill lie d ow n and go straight to the first line. When the session is over they usu ally know w hat brou ght it on and w hat to d o about it. It is a relief to know that one no longer has to suffer in silencehopeless. There is something th at one can d o, and that is the message of this article; to know there is a p ossible answ er.
Prolonged anxiety m ay w ell cause a premature d eath, and in ad d ition w ill d am age the cognitive brain and d iminish its thinking/ reflective capacity later in life. Wha t it also d oes early on is inp ut so much neural inform ation as to keep the person from focu sing on one thing for any length of tim e. There is so much stimulation from the imprint insid e that there is little chance of allow ing serious input from ou tsid e.
I use the sequence of m y patients in their reliving as an example. First they feel am orphous p ain and suffering, then they attach a scene to it such as "they d on't love me," (furious), "You bastard s, w hy d on't you love me?!" Then the patient begs, "Please lo ve me." And finally, "It is all hopeless." It remind s us of the gunm an w ho seems to follow the same sequence. Often the w ife has left and taken the kid s w ho gave him love. H e is furious and w ants to kill (in Primal) but actu ally d oes kill in real life. The n there is the ultim ate hopelessness and giving u p (in therap y the p ain/ truth is finally felt and liberates the patient from the imp ortu ning imprint) bu t in outsid e life the gunm an stops at hopelessness and kills him self. H e has gotten rid of his anger but there is nothing left, now here to go w ith his feelings and no resolu tion. Life has lost its meaning; stuck in the agony, no w ay to feel better, no m ore chance for love, no reason to go on living.

AN GER AN D RAGE
H ere is how resonance w orks in the d om ain of anger. Something in the present m akes someone very angry; his w ife is d ivorcing him and trying to keep the kid s. Money is running out and she still w ants more. She refuses to see or talk to him. She turns the family against him. H e has been let go at his job d ue to injuries and has no prospects for a new job. All looks bleak and there is no alternative. All these are assau lts on d efenses. There is only so m uch that can be absorbed and integrated . And all this rests on a found ation alread y w eakened throu ghout child hood , as in the case of a m other w ho leaves home for someone else. Defenses w eaken so much that there is no barrier hold ing back d eeper compou nd ed pain. The p erson loses control and the consequ ences can be seriou s. Clinically, the low er leve ls burst throu gh to cortical levels so that perspective and critical jud gment d isappear; he is out of control becau se that is the central fu nction of the third line w hich is no longer op erational.
H ere the problem is on the feeling level w here there are po w erful em otions. Clearly, the treatm ent cannot be focu sed solely on cortical level. What has hap p ened is resonance. The current situ ation w ith the w ife resonates w ith d eeper anger w hich ultim ately tu rns to rage and fury. Thu s, the third -line gives w ay to the first-line reptilian brain w here killer feelings resid e. And for that m om ent the third -line, inhibitory brain is rep laced by the instinctive, primitive brain, and there might be murd er. The d eepest brain level becomes the highest operating one, temporarily. This may only last minutes. Once the rage is expressed the pain level d iminishes and some of the third -line thinking, reflective brain returns to fu nction. And the killer can now say, "I know w hat I d id ." At the moment of crisis he d id not know w hat he w as d oing; his rage took over and he came und er the control of the reptilian brain.
That is an extreme examp le, yet based on forty seven years of clinical practice. With less imprinted pain, resonance can also simp ly lead to im pulsive behavior where som eone actsout w ithout thinking. Inhibitory and d elaying cognitive processes give w ay to primitive impulses, and we get w hat I saw recently in therap y, a well-known football player who had exhibited himself in p ublic. H e need ed to even m ore prove he w as a m an. The origins here had tw o levels active, child hood traum a w here he w as d enigrated as a sissy by a m acho father, and d eeper pain from a m other w ho d rank d uring pregnancy; only one cocktail at night but it w as d evastating. Every time he asked for help his father w ou ld say, "Are you so helpless you can't d o anything for yourself?" The w hole affair w as channeled into the sexu al realm. N eed less to say, he masturbated d uring his act -out and finally fou nd relief. Instead he need ed to beg: "Love me, d ad d y, hold me, cherish me, d on't put me d own." This finally prod uced d efinitive relief.
I have seen rage over and over again w hen very d isturbed patients begin to relive on the emotional, feeling level and sud d enly are imp acted by the low er levels. They begin to p oun d the m attress and the pad d ed w alls w ith an enorm ous fury; they can scream for thirty m inu tes. In therap y, they can d irect the rage, connect w ith it. The p atient w ill not be overw helmed by it. Therapy is a controlled situ ation and is not acted ou t. It beco mes acted out w hen the person has no id ea that there are feelings d eep in the u nconscious, and is helpless to control them. H is u nconscious has taken over. And he may kill. Rage lies on the same level as terror; they are our prim ord ial ancestors, both surv ival mechanisms. If w e are going to fight for our life w e need to first have fear and then get angry -fu riou s.
Those w ho are about to kill are often engulfed by paranoia. Paranoia is often a sign of d eep feelings on the rise that impel id eas: "They w ant t o kill me." In any case, these id eas are fore-ru nners of first-line feelings, w hich have been triggered and are on the rise; bu t the killer never d rops into those memories/ feelings. For that he w ould need professional help. H e kills instead . H e acts-ou t those feelings. And he d oes so becau se m ost of his life is loveless and traum atic: father leaving home, mother an alcoholic. These are the d aily assaults in child hood that w eaken the d efense system. They become compou nd ed so that serious mental illness ensures.
Anti-psychotic med ication helps d ampen the low est brain levels from reacting. Med ication hold s d ow n response. It d oes this by enhancing the top level so that it is more active and effective; and at the same time there may be inhibitory med ications in it that block the low er level pain; thus, w e get a more active cortex and a less active brainstem and lim bic/ feeling brain. Often the content of this m ed ication inclu d es chem icals that w e shou ld prod uce ourselves. But we d on't because all that early traum a has exhausted supplies. We cannot m ake enou gh to blanket the p ain. So w hen our inner p harm acy cannot d o the job w e need help from the p harm acy arou nd the corner. We can call it anti-p sychotic m ed icine bu t all it is d oing is making up for w hat w e can no longer manufacture ourselves. It is a first-line blocker.
The lesson w e can take from this is that w hen d eprivation and severe trau ma exists w hile w e are being carried in the w omb and at birth, the first -line d efenses are alread y in a w eakened state. We are then born d am aged , w hich m ay not show up for years.
In the case of rage, the infant may have had uncontrolled temper tantru ms. These are the precursors. We can go a long w ay to avoid murd erou s rage by making sure there is as little trau ma as possible w hen w e live in the w omb. N o d rinking and d rug -taking by the mother. N o fights w ith her hu sband . N o crazy d iets w hile carrying. What w e can d o to change society and escape harm is to change our birth practices. N o m ore heavy d ru gs given to the mother at birth. Making su re the newborn is held and caressed right after birth. Much of this is d iscussed in m y book, Imprints. Gestation is our real child hood . What hap pens d uring those months affects us for a life-time, d etermines how w e behave and w hat d iseases w e w ill have, and ultim ately how long w e live.
So long as feelings remain alienated , w e m ay shorten our lives. Our hypothesis is that Prim als keep telomeres (one ind ex of longevity) from prem ature shortening. Generally, the longer the telomere the longer w e m ay expect to live. But that is a variable that remains to be measured .

ON LEVELS OF MEMORY
Too often w e consid er m emory as something w e can remember verbally. Bu t there are several kind s of memory; each level of consciou sness remembers in its ow n w ay. The emotional system remembers through feelings. Something makes u s cry and we have no id ea w hy. We rem em ber on non -verbal levels in non -verbal w ays and relive in that w ay.
Epileptic seizures can be another form of mem ory. As p atients relive first -line w e see that it is often an epilep tic equivalent. Later in therapy they w ill have first -line Prim als in lieu of a seizure. We have had su ccess w ith epilepsy because w e remove a level of pain that sometimes m akes the seizu re manifest.
There are third -line approaches to control first-line symptoms; avoid ing enclosed places, a "d oppelganger" of an oxygen -d eprived gestational life. Enclosed sp aces, for those w ho have that imprint, are avoid ed in ord er not to trigger off a panic attack. It can be caused by a mother w ho cou ld not open up easily for the birth of the baby or a m other w ho has been d rugged by the d octor at birth. It is not the enclosed space that is the d anger; it is the mem ory of w hat it provokes or resonates w ith. The level that it provokes can be d ee p. So even a room w ith no open w ind ow s can set off anxiety. ("I can't get out.") A Primal can m ake it consciou s bu t even w hen u nconsciou s, it is still an active m em ory. It still agitates. We can help this by opening w ind ow s, or better, by getting to the bo ttom of it w here the person can feel enclosed and imprisoned . In our w ork w e make all of those levels, over time, into consciou sly/ aw are experiences; not m ainly verbal experiences, but consciou s ones. We never try to transmute a non-verbal mem ory into som ething verbal and / or intellectual. In conventional therap y, "tell me how you feel," can be a d eceptive technique that confuses levels. It uses the third line to try to evoke the second ; but one level of brain tissu e cannot d o the w ork of another. The third line is a specialist in id eas and p hilosop hies. It can meticu lou sly analyze. It is a level of precision but not p red ominantly emotional.

THE CRITICAL PERIOD
I have not mentioned the critical period bu t the key imprint occurs d uring the time period w hen specific need s must be met. When not met at this time, the imprint becomes largely irreversible. (We can often reverse the imprint becau se patients ad d ress and live it again.) When need is at its zenith, it d emand s fulfillment; if not, there is pain. A nd the pain gets more forcefu l the earlier the need . We need a calm w omb -life. We need a baby immed iately in contact w ith the mother after birth. If he is not touched for eight w eeks after birth (the mother is sick) there is alread y great harm as the crit ical period for fulfillment is passed . We can im agine w hat harm has been d one to orp haned babies. Yes, touch is help ful after the critical period but the imprint of d eprivation m ay alread y have been set d ow n in the system.
During w om b-life d epression or chronic anxiety in the m other can be d eleterious. She must not d iet to keep trim and d eprive the baby of nourishment. When she d oes there m ay be an eating d isord er that lasts a lifetime. If there is a mem ory of starvation in the w omb then w hen the offspring is hungry later on she overeats; she eats for now and for the starvation experience w hich gives it a great and forceful compulsion. This is one of many checks in ou r clinical work; the force of the compulsion, w hether of food or d ru gs. It speaks of early s evere d eprivation of need . H ere again, there is a merger of levels and subsequent ad d iction. As alw ays, there are m any other factors. I only ask that w e consid er the factors I have ou tlined (Meaney & Seckl, 2008). First-line d riven behavior is often forceful and out of control as it provokes the third line to control, w hich it is not often up to the task.
In a recent stud y, Justin Feinstein at the University of Iow a City looked at subjects w ho had a d amaged am ygd ala, the hub of the emotional system. (Fein stein, 2013) They d id not have normal fear responses; that is, they failed to feel fear when they should have. But if oxygen su pplies w ere low ered and carbon d ioxid e supplies w ere increased , mimicking suffocation (increasing acid ity of the blood ), there w e re panic attacks. The causes? Certainly not from the usu al emotional structures. Researchers They believe it includ es the brainstem! Because the lowering of oxygen supplies and increasing of carbon d ioxid e provoked the low er structures to sense the d anger and react appropriately. Very much like w hat hap pens to a fetus when the mother smokes d uring pregnancy and prod uces those same effects.
Fear and terror are tw o d ifferent reactions involving d ifferent brain systems emanating from structures hund red s of millions of years ap art in evolution, as is anger and rage. H ow ever the emotional reactions have some similarities w hich allow s resonance; that is, enou gh sustained fear can m ove d eep in the brain and trigger off those primitive panic/ terror responses that I call first-line. It is not ord inary fear; it means a life-end angering cause and that comes from our time in the w om b and at birth w hen low ered oxygen w as lifeend angering and p anic ind u cing. If all this is ignored there can be no cu re becau se cu re involves the generating sou rce of behavior.
It is interesting that suffocation has such a great terror reaction associated w ith it. In the panic attack there is often a feeling of suffocation, one cannot catch one's breath, the heart beating so fast that it is about to ju mp out of the chest. And these breathing problem s are again brainstem originated (includ ed the med ulla of the brainstem). It is an ensemble of reactions originating d eep d ow n that later on set the stage for m any kind s of pulm onary problem s, asthm a, shallow breathing and other malfu nctions.
It is imp ortant to treat the nightmare, even to d rug or med icate it but w e cannot med icate/ erad icate an imp rint; that remains to go on causing d amage. So nightmares, p anic attacks, breathing problem s, pulm onary d ysfunction are all part of an ensem ble, a gestalt, if you w ill, that must be consid ered as one problem, not m any problems. There are m any symp toms, each symptom must be treated until w e arrive at the generating source w here it is all treated at once. The im print that is im mutable. N ow w e know w hat Freud w as getting at by the "id ." When w e note all of the d isparate aspects of a panic attack w e see that physiologic mem ory comes up intact w ith the w hole p anoply of related feelings. There is the breathing, the circu latory system, the muscu lature; all respond to a single imprint. -There is the racing heart, high blood pressure, breathing problems, shakes and d izziness.
There is often too m uch terror to feel all at once and integrate it. That is w hy it need s t o be revisited time and again in slow, ord ered fashion to prevent an overload .
Clearly it is so remote an experience that it can be experienced over time but not immed iately und erstood for what it is. We can experience it long before we und erstand it; exp eriencing it is cru cial for integration. The heart has to race again w hile the bod y tem p must again rise as it d id originally. And as I mentioned , the p hysiologic signs in a Prim al are the exact reactions originally; the same heart rate and bod y temperatu re. It is an exact reliving. The imprint d oes not change nor d oes the behavior based on it. Und erstand ing is the last evolu tionary step, w hen the feeling is on the first step. The re -birthers treat the tail w hile the cognitivists treat the head ; both miss the rest of us. The hu m an p art.
N on-verbal experiences can be relived and experienced on their ow n terms and in their ow n w ay, and can be integrated , nevertheless. There are times w hen a p atient can remember w hen his d og d ied after being hit by a car. Th at is top level cortical recall. What need s to be experienced and expressed is the repressed emotional aspect of the experience. The pain need s to be liberated and finally felt. It too need s to express how it feels.
Liberation is the goal. N ot as an exercise or a technique, but alw ays w ithin a context. The urgency of the recognition of d eep brain levels is brought home in a recent article by A. R. Brunoni and colleagues, "The Sertraline Vs. Electrical Current Therapy for Treating Depression." (Bru noni, Valiengo, Baccaro, & et al. 2013) By stim u lating the brain w ith lowlevel electrical stimu lation (trans-d irect cu rrent stimu lation), they claim to have had success w ith d epression d uring tests w ith 120 subjects. The p atients are und er anesthesia for tw enty to thirty minutes, w hile u nd ergoing continuou s stim ulation. It is a turn on ECT but much mild er. The results seem to w ork as w ell as low d oses of sertraline, commercially know n as Zoloft. So the conclusion is that the proced ure "could be used to avoid d rug t reatment." (N .Y.Tim es Feb 12, 2013). There is no d iscu ssion of cau se here. The assu m p tion is that w e have only tw o choices, none that inclu d es feeling.
To reiterate: becau se it is now established that low ered oxygen levels in the fetus creates panic in him , it shou ld be clear that a carrying m other w ho takes d rugs is d am aging the baby severely. Can he really feel terror? Anand d id an amniocentesis on fetuses and found as the probe invad ed fetal space all of his stress hormones rose; he also grim aced and sho w ed signs of d istress. (Anand , 2007) We have successfully treated panic attacks and u ncontrolled rage becau se w e ad d ress the first line. It is not a m ystery; it just belongs to an ancient brain system that w e have ignored for too long. If w e w ant to help those in d anger of acting out and to help those w ho suffer panic we must travel to a life hund red s of millions of years ago in phylogenetic history, d eep in the brain in our personal history, to find our answ ers. And they are there.