The Primal Institute
Patricia Leis Nicholas, M.A., Assistant Director
E. Michael Holden, M.D., Medical Director
Leslie A. Pam, Ph.D., Associate Director
Rosemary: Would you recommend that parents choose not to have their infant sons circumcised specifically because it causes psychological damage?
Ms. Nicholas: Yes, and also it’s going to hurt the baby!
R. But isn’t pain inevitable in life? Even if the child is born by the Leboyer method and never circumcised, there’s no way he can live in this world and not get hurt. He’s going to fall down and skin his knee or clunk his head.
Dr. Holden: It makes a difference whether a person is going to have trauma a few days after he’s born, compared to having trauma when he’s a little older. The younger a child is, the closer he is to conception, the more open and vulnerable that child is to hurt. So the goal of the parent should be to minimize hurt during infancy. It is correct, of course, that in later childhood, some bumps and bruises are inevitable. But it is not inevitable for an infant.
R: This is part of why infant circumcision is such a scandal! If you were going to circumcise a three-year-old, nobody would strap him down and let him scream and do it to him without anesthesia. Yet, that’s the way it is done to newborns! People have thought that newborn babies have no feelings!
H: Actually the opposite is true. Newborn babies have that much more feeling, more sensitivity, and are more vulnerable to pain than older children.
N: Most parents are not aware of what actually goes on during the circumcision procedure.
R: Can you explain what primal therapy is in a few words? What does it do, or prove, or solve?
H: There’s a premise for primal therapy which is that neurosis and psychosomatic illnesses in adults are based on pain in childhood.
R: Physical pain and psychological pain?
H: We don’t make a distinction between the two because suffering is suffering. Psychological pain is a representation of emotional and physical pain from childhood. Primal therapy is a system devised by Dr. Janov for reversing neurosis. It allows people to complete their total biological healing responses to traumas that happened when they were little, and too vulnerable to finish these healing responses. For example, if a child was very badly hurt and needs to cry for 40 hours, an infant may only be strong enough to cry for an hour. After that he will shut down to that pain. So there’s 39 more hours of crying still to go. Primal therapy is the completion of the response to early traumas. It is the completion of the healing sequence.
“The younger a child is, the closer he is to conception, the more open and vulnerable that child is to hurt. Newborn babies have that much more feelings, more sensitivity, and are more vulnerable to pain than older children.”
R: So sometimes you get people that cry for 40 hours?
H: Yes, about a single feeling. It is desperately hard, agonized crying.
Dr. Pam: But it’s not 40 hours of crying in one sitting!
H: Whether one is a baby or an adult, there is just so much pain that one can tolerate in a given unit of time. Primal therapy is a sequential re-experiencing of hurts to complete these healing sequences in response to early traumas.
P: That’s not only in infancy.
H: That’s right. It can be a trauma from childhood and even teenage years and early adulthood. It can be anything that you have repressed.
R: It’s fascinating that a person can go back and find these things when only rarely can one consciously remember one’s birth, infancy or prenatal days.
H: There’s a reason why the typical person does not remember before age 3 or 4. It’s because there’s so much pain during that time that it’s part of repression.
R: Then if someone had a particularly comfortable birth and infancy they would remember it?
H: That is basically true. If a person had an extremely good birth and a great infancy, they’d tend to remember from about age one or one-and-a-half, rather than from age 4 on. We see patients who will say that they remember nothing before age 12. So the amount of repression varies with the amount of pain.
R: I’ve had therapy myself, but it was more conventional. Much of it was based on A Guide to Rational Living by Ellis and Your Erroneous Zones by Dyer. I’ve also had assertiveness training. The basic message of my therapy was “Don’t wallow around blaming your parents or blaming the past for your problems. Deal with your life in the present and future.”
What you do would contradict that?
P: It’s just another approach.
R: Then according to primal therapy a person can’t just forget past traumas. One has to go back and resolve it.
N: That’s right. It’s a “resolving” experience rather than a “wallowing” experience.
H: Dr. Janov often makes the point that primal therapy is not for everyone. It is for people who are suffering a great deal. Perhaps other types of therapy have not worked for them. Some people will benefit greatly from other types of therapy. But if a person is really open to their pain of childhood, then primal therapy will be good for them.
P: Primal therapy deals with the causes of neurosis. If you don’t have the kind of pain that requires you to go back to the cause, you can patch yourself up.
N: I think anyone can benefit from primal therapy. We get average neurotic people who feel that something’s wrong with their life. They have families and successful jobs. They find that our therapy fulfills them. They find something that they lost along the way and then they can experience life more fully.
R: The way I understand it, usually one cannot derive ones neurosis from one isolated instance of trauma.
N: There is prototypic pain. People will have a certain type of pain and it’s compounded by many different experiences that reinforce a particular trauma. When they get the other traumas out of the way, they can focus on the original trauma.
R: It’s like something way back that they can’t quite reach? That “forgotten” trauma is what causes a certain type of behavior.
H: It can be reached ultimately through primal therapy. There is a sequence of laying down the pain which starts with severe prototypic pain in an individual who is very open. This is continually added to throughout childhood. Primal therapy is that whole process in reverse.
R: What is the difference between a child born by the Leboyer method and one born to bright lights and typical traumatizing hospital procedures? It’s a neat type of birth experience to have. But what is the ultimate difference?
H: Have you seen children that were born by the Leboyer method?
R: I gave birth to my own baby that way. He was circumcised 8 days later. I don’t know if that “undid” the whole thing. He’s a sweet, happy, loving child. So are my other two sons and they were born in typical hospital settings.
N: If you give birth by the Leboyer method, you are eliminating at least some of the trauma that the child would have experienced with bright lights and other circumstances.
R: Have any differences in Leboyer-born children been objectively observed?
H: There is one study that followed 104 children born by the Leboyer method for 9 years. Of those 104, 100 of them were truly ambidextrous. Also, they were not afraid to try new things. That [fear of new experiences] is something quite characteristic of children born conventionally. Thus the transition from in utero to outside appears to have some long-lasting learning value for the child. If that first transition was easy to take, then later transitions are apparently easier to take. Also, one gets the subjective impression that Leboyer-born children are more serene and tranquil than children born by the conventional method. I can see it by the relaxation muscles. They have a placid, almost beatific look to their faces.
P: Being ambidextrous is important because it has to do with brain functions.
H: The left hemisphere for 92% of people becomes the hemisphere in which one is dominant for speech and handedness. But the left hemisphere is also recruited as part of the defense against pain. Thus verbal cognitive defenses against pain are very common. That is related to the prominant right-handedness in people. In primal therapy people become more bidextrous. They don’t become truly ambidextrous because it is many years later. The implication of true ambidexterity [in Leboyer- born children] is that the left hemisphere did not need to be recruited as a specialized, repressing portion of the brain, in the service of neurosis.. .in the service of keeping one unaware of pain.
R: I can’t say that I fully understand that!
N: The first time he explained it to me, I had no idea what he meant!
H: A three-year-old born by the conventional method would be predominantly right-handed, would be extremely verbal, and would be using words to defend against pain. Whereas a Leboyer-born child would be using both hands and would be speaking in a much more feeling way, not to repress pain but to express need. The brain is utilized differently in a person who has been hurt a lot in infancy.
P: You understand that the left side of the brain controls the right side of the body, and vice versa. So when a person is right-handed, the left side of the brain has a lot of power, energy, and strength, and it’s used to repress feelings. Neurologically that’s a known fact. That’s why people who stutter don’t stutter when they sing. Singing and feeling come from the right side of the brain. If someone is ambidextrous there’s an equal power on both sides of the brain. Then the person could use his or her left hand equally well.
H: Which is related to feelings, emotions and expressions.
R: What would cause someone to be left-handed?
H: That’s not well understood. 85% of people are left-hemisphere dominant for speech and right-handed. 7 1/2 % of people are left-hemisphere dominant for speech and left-handed. That means 92 1/2 % of people are left-hemisphere dominant for speech. Another 1/2 % of people are left-handed and right-hemisphere dominant for speech. There are anatomical differences between the left and right hemispheres. Embryologically the left hemisphere has many more neurons in it than the right hemisphere. Left-handedness can be genetic. It can also evolve in an individual who had impairment early in development, so that the right hemisphere becomes the dominant one.
R: My oldest son is left-handed. My youngest* who was born with Leboyer techniques appears to be solely right-handed. Maybe the circumcision took the other side away from him?
H: It is an important neurological finding that Leboyer-born children tend to be ambidextrous. But I’m not sure that because a person is right-handed or left-handed that they necessarily had a certain kind of pain in childhood. There are other factors which determine handedness.
R: There is a feeling, especially among those of us who espouse such things as natural births, bonding, breastfeeding and such … kind of a prevailing attitude of “You do it exactly this way or you don’t quite measure up!” Sometimes pursuing a certain method takes priority over the actual needs of the infant. What is resulting is feelings of guilt and failure. Some parents feel “I didn’t do right by my child. I have an inferior child because something went wrong.” This can result from a Caesarian birth, or medication during birth, or a baby that needed surgery, or the decision to circumcise.
* This interview took place in 1978 after my third child was born. I later gave birth to 3 more children, 2 daughters and another son. Interestingly, my fourth son, born in 1985 and left intact happens to be left handed. Of additional interest, one of my right handed children is left foot dominant. Another one is left eye dominant. Apparently this is a genetic trait from my husband’s side of the family.
H: Our point of view is not that the child is “inferior” but that a child who has had trauma is different than he or she would have been without the trauma. ..
N: I’m a parent too. It’s important for parents to realize that the intent is not to hurt the child. Sometimes people don’t know the information because nothing has been published. It’s like when nobody knew that smoking was harmful.
R: 20 to 30 years ago parents were led to believe that the baby wouldn’t breathe right away unless the doctor spanked him!
N: Circumcision is the same kind of thing.
H: You can’t change what has already happened. But you can allow them to react to pains in the present by letting them express their feelings. Parents can allow their children to express their concern, their upset, their frustration, their anger.
N: It’s important that parents not allow themselves to get too hung up with guilt feelings because that will affect how they relate to that child.
R: What about the baby that has to have necessary traumatic medical procedures? I have spoken to mothers who have had badly jaundiced babies who have had to have several heel sticks. The mothers are worried about the trauma that the baby went through. Should parents seek to avoid procedures such as vitamin K shots, PKU heel sticks, or silver nitrate in the eyes in order to spare the baby the trauma?
H: Some things are medically necessary. In the case of a very jaundiced child, it’s important to know the bilirubin count. But circumcision is elective.
N: Severe jaundice can result in permanent brain damage and so can PKU. Circumcision certainly does not fall into the same category.
R: What if parents have a Leboyer birth and have a boy and later have him circumcised? Some people just aren’t thinking. Leboyer births have become the latest fad. People are asking for Leboyer births and signing circumcision papers at the same time. Does the latter “undo” the former?
H: If the birth is benevolent it is a great favor to the child. This has helped the child for a lifetime. But any subsequent trauma is traumatic whether it happens at 8 days, 8 years, or 18 years. It is better to have a Leboyer birth followed by circumcision than to have a conventional birth followed by circumcision. You don’t “undo” a good experience.
R: What are the long-range detrimental effect of circumcision during infancy?
H: In general there has been an increase in the total burden of pain.
P: It has a completely different meaning and outcome for each person. I’m Jewish and I had the Bris at 8 days. Someone who had it done in the hospital by a doctor shortly after birth would experience it differently.
R: What can you tell me about your recollection of circumcision through primal therapy?
P: I remember being strapped down. I remember the Mohel. I remember several men. They’re wearing dark clothes and some of the guys had beards. I see it as a bunch of evil leering monsters who are going to devour me. The feeling was that they were taking something from me. I had something they wanted and they took it from me, and I was totally helpless!!
R: Did you feel pain during the memory?
P: Oh sure! It really wasn’t as much physical pain as it was pure abject terror! I mean…you’re this big, you’re being strapped down!! The physical sensation isn’t as bad as the psychological effect. The mental image I have is a lot more painful than the actual cutting. They sort of converge on me and the terror is so great that I almost…I can’t feel the physical pain because the mental pain is so great!!
H: The meaning of the trauma is the most painful thing, not the trauma per se.
R: So if you had gotten stuck on your diaper pin, that would have hurt, but it wouldn’t have been the same.
P: I think human beings are capable of tolerating a certain amount of physical pain. Like you said, the kid falls down and scrapes his knee. I don’t think those things are traumas. It’s the meaning that’s attached to it that’s important. If your father deliberately stuck you with a pin that would be different than if you accidentally got stuck by a pin.
N: However, so many people think that babies don’t experience pain when they’re circumcised. When I watch people having the re-experience of circumcision, there is physical pain.
P: The pain that I experienced was afterwards. Initially I was petrified. When they did it to me I could feel the moment and I was completely numb with fear. But as my fear subsided the feeling went right back down here. It just hurt for days until it healed. During the time I was constantly aware that I was hurting, but my feeling is that it has to do with them hurting me and taking something from me. Every time I was aware of that pain, the throbbing and the healing process, I kept seeing this scene, and my body kept going into it! I was just terrified until the pain went away. As long as it took to heal I was in absolute terror and agony … for days.
There are two different parts to the feeling for me. One is the scene of having it happen and one is the aftermath. And the aftermath is just as bad! I could feel something trying to turn me off. Since the pain is there I cannot tolerate the terror in the same intensity that it was first initiated upon me. If it’s 100% terror when it’s happening, the body cannot tolerate that amount of pain. The only thing I could do was to turn off and shut down because the healing process is so painful.
N: But, Leslie, after you experienced and relived this by having the primal, how did you find that insight that what had happened affected your life?
P: Basically I understood why. I had a very strange birth. Then I had the Bris. Later I had my tonsils out. Then I had a hernia operation when I was three. So most of my life I was numb to feelings. I didn’t know what the word “feelings” meant. I felt like I went into shock. I’ve also relived the hernia operation. I can relive the incision but that’s not really the pain of it. The part that freaked me out is that my mother took me to the hospital and told me that she wouldn’t leave me and that everything would be all right. Then when they went to put me under with the gas, I thought “she sent me here to be killed!”
H: I had a similar experience at age 10. Even for a ten-year-old your mind is not developed enough to realize that this is a service of a medical operation. The child feels that he’s being assaulted. A child does not make sense out of a surgical procedure the way an adult would. One of the most important things that the parent can do is to stay with the child during the procedure if he is to remain conscious, or until the anesthesia has taken effect, if he is being put under.
R: I’m glad to hear you say this. When my second son Jason was two he had to have some stitches taken in his forehead. The doctor made me leave during the stitching. He said if I stayed there Jason would associate the trauma with me and get mad at me since he wouldn’t know why I wasn’t rescuing him.
H: That’s just bullshit!!
R: Does an isolated physically painful experience really cause psychological maladjustment? Is a circumcision during infancy really going to screw somebody up for life?
H: What is relevant is whether a person was able to fully experience and respond to that trauma at any age. If there’s some part of the healing reaction left over, it contributes to neurosis. What’s relevant is whether a person could react to it fully and integrate it.
R: We have raised goats and we have their horn buds removed by disbudding them. The procedure is horrible. They’re encased in this little box with just their heads sticking out. You take this hot electric iron and you burn into the animal’s skull to kill the horn bud. Our friends who do this have observed that if the animal has been a pet and has had a lot of stroking then they almost always scream during the procedure. But if the animal has not been made into a pet, then they just stand there and take it.
H: That’s closely related to a human counterpart which is that if a child goes to a hospital himself for an operation, he’s likely not to cry during the whole hospitalization. But if the mother is there, the child will cry incessantly. Until about 1952 this was interpreted as meaning that parents should not be with children in hospitals. Finally people became more enlightened and realized that the children were crying because it was safe to cry in the presence of their parents.
R: To the doctors and nurses I’m sure it is a lot easier if the child isn’t making any noise.
H: It’s at the expense of the child. The child has to hold on to pain in a neurotic way which means pushing pain back which is later expressed in other ways.
R: Sometimes when babies are being circumcised they don’t appear to respond to it. They don’t cry. They shrink within themselves and don’t react to it openly.
H: It’s like the example of the baby goats. Is it safe for that child to cry? I would guess that if a mother is holding the child during circumcision the child would cry in agony…but why circumcise? When a kid is eight days old and he’s strapped to a board, it’s not safe to utter a peep! The whole body has to draw within and clamp down on that experience.
R: Is this what you see people do when they’re reliving circumcision?
N: When they relive it they cry and express their feelings… the fear, the agony.
R: So evidently if a person is circumcised as a newborn he undergoes a severe trauma and as a result he is “not what he could have been” had he not had that , experience. Some of our greatest spiritual leaders in ancient times… Jesus and the prophets and the apostles…all would have been circumcised as infants. Are you saying that these men would have all been better people had they never been circumcised?!!
H: It doesn’t make a value judgment about whether a person is good, bad, or indifferent. It just means that they still have some pain to express from their childhood. In the absence of that expression it will tend to come out in other ways…insomnia, psychosomatic symptoms. If a child has been circumcised, that child has been traumatized. The child is a different sort of person than he would have been had he never had that pain.
R: But Jesus was circumcised as an infant, and He’s supposed to be the most perfect person that there ever was.
H: I don’t want to get into a…
P: No comment!
N: You are placing a value judgment on Jesus and…we really can’t answer that!!
R: In some hospitals they do immediate circumcision right there in the delivery room. In other hospitals they wait a day or two. Do you find a difference in the person who was circumcised immediately compared to the individual who was circumcised a few days later, as to what he would re-experience?
H: In general the earlier the trauma, the more vulnerable the child.
R: My basic feeling is that if you have to have it done, you should wait a few days. I think the worst thing would be to have it be his very first sensation in life.
P: At birth you are in so much shock and agony, you’re shut down already. Maybe that s the time to have it.
H: I think it just should not be done. It’s an avoidable trauma.
R: I agree. But do you find a difference?
N: No. It’s totally individual. Both seem to be equally as bad.
P: What’s worse, a crack on the hand with a hammer today or tomorrow? When you’re that little those kinds of things are about 20 times more painful than you could tolerate to begin with. Whether it’s done on the same day that you’re born, or two days later, or eight days later… if it’s traumatic, it’s traumatic. If we could absorb all the pain…and the meaning that it has, that you’re taking something from me…that I feel unloved…that I’m not getting what I need…if we had tolerance for the entire amount of pain, the trauma would be resolved. Unfortunately we can’t do that.
H: What I said about the timing of pain should be considered more in relation to months. If the child were circumcised at six months of age, it would be quite different than if it happened within the first month.
P: In terms of the development of the brain and the way that it can handle pain, that makes perfect sense.
H: The older the child the greater his ability to defend against pain.
R: Yet at six months parents and doctors would pay more attention to the child’s reaction. At this age the child would look more like he’s afraid and scream louder. They have more of a “personality” by then.
P: Right. They get them while they’re helpless. They think they’re not feeling anything right after birth and when they’re six months old they can.
H: One newborn baby is extremely similar in behavior patterns to another newborn ~ baby. When individual personal past experience begins to be reflected In a child’s behavior you see the development of “personality.” “Personality” in the individual characteristics derives almost entirely from maturation of the cerebral cortex which is virtually non-functional in the newborn. So that euphemism about the child’s developing personality is just talking about a neural schedule, a maturation of the cortex. But the baby can feel pain at any age.
R: We just haven’t thought of newborn babies as being people.
P: The way they protest is meaningless. If your mother called us now and said Michael, you’re going to be circumcised.
H: Well, I certainly would react differently than I would have at that age!!!
P: In those days they could just pick you up and do it to you. Today they’d have to work to convince you. They’d have to bribe you…
H: Extort me!! Kill me!!
R: There are different types of circumcision devices. There are clamps. The Plasti-bell is a ring of plastic that stays in place for about a week. If a person relives his circumcision, is he aware of which device was used?
N: No. It hurts regardless.
R: My gut feeling is to tell my sons not to ever go through primal therapy because they would have to relive that pain of having been circumcised.
P: Well, I’m glad I did because of the meaning that it had for me. There’s always been a certain kind of person that has terrified me during my whole life, based on that experience. There’s a certain smell that I associate with that time. There’s a certain look that I associate with the people involved. Before I had the therapy those kind of experiences used to bring up that same feeling. I had absolutely no idea why I disliked certain kinds of people. There was a certain religious overtone to this thing that I’ve always disliked.
R: Did you perceive it as a spiritual or religious experience?
P: No. But later on going to temple, there was always a certain uneasy feeling about meeting the Rabbi and the other men. They all had black hats and beards and they had a certain smell. Those were the guys that did it to me and I always shied away from them.
H: One has irrational fears until you know where the fear came from.
P: That memory remained with me my whole life. In some way I was responding to people in a certain way based on that experience. Whenever anybody tried to take something away from me it made me feel utterly helpless, and panicked and tense. Anybody who wanted to do something similar to that.. .it would bring up that feeling. It’s not very pleasant going through life being afraid of people. ,
R: How do your parents feel about that? Do they know? Do they feel guilty?
H: He went through primal therapy because he wanted to. It had nothing to do with his parents.
P: I haven’t ever discussed that particular issue with my parents. My mother is pretty open about how she wiped me out when I was a kid. But she was a child herself when I was born. At that time people didn’t know any better.
N: When people go through primal therapy and relive their infancy, they don’t blame and judge their parents.
R: The books about primal therapy gave me that impression. I felt “This is fascinating, but these parents are real villains!”
H: No. That’s not true. Parents do painful things to their children by accident or out of ignorance. But when you go through primal therapy you don’t call your mother or father on the telephone and bawl them out.
N: Often it’s just the reverse. Many people come into this therapy feeling hostile toward their parents. After understanding the isolated experiences that caused their traumas, sometimes they can have a relationship with their parents in the present that they didn’t have previously.
H: Whether your children ultimately want primal therapy should be their decision, not yours or your husband’s.
R: I agree. That was just my “gut” reaction! Finally, is primal therapy the same thing as rebirthing or natal therapy?
N: There’s an enormous difference. .
H: Rebirthing is age-regressing back to the ideas or visual impressions of one’s birth. It’s not a complete re-experience. It is mock primal therapy. It is dangerous because if a person had an extremely painful birth and they start to re-experience that in a swimming pool in the presence of someone who knows nothing about primal pain, then they’re on the verge of psychosis! Primal pain comes up very hard for people. It produces incredible anxiety. Part of the goal of primal therapy is opening a person up to just so much pain, to give them time, and integrate it in a sequential, systematic way.
P: If they understood the way the brain was constructed they would realize that people could not connect birth experience consciousness and have its full meaning without second-line access which we call reliving other experiences that are less painful.
H: One has to go down to those painful experiences in a sequence over a long period of time. To go from the present to birth is like walking into a volcano. It’s too much. It’s impossible to integrate it.