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Primal therapy is a trauma-based psychotherapy created by Arthur Janov, Ph.D.

Janov asserts that neurosis is caused by repressed emotional pain, deriving mainly from childhood. He claims that repressed pain can be brought to consciousness and resolved, by re-experiencing key traumatic childhood incidents and by fully expressing the resultant pain in a therapeutic setting. Janov believes that by re-experiencing such traumas and expressing long-buried painful feelings, permanent resolution of neurotic symptoms will be achieved.

Janov claims that in primal therapy, patients will be able identify their real needs and feelings in the process of experiencing all their Pain. The capitalized term "Pain" refers in primal theory to any general emotional distress and its purported long-lasting psychological effects.

According to Janov, therapeutic progress can only be made through direct emotional experience, which allows access to the source of psychological pain in the lower brain and nervous system. Janov argues that psychological therapies which involve only talking about the problem (referred to as "Talking Therapies") are of limited effectiveness because they mainly engage the cortex, or higher reasoning area of the brain, rather than these other areas. This is emphasized throughout Janov's writings.

Janov's first book, The Primal Scream, was published in 1970. Primal therapy received public attention after ex-Beatle John Lennon sought treatment from Arthur and Vivian Janov. Lennon's experience in the therapy heavily influenced his 1970 John Lennon/Plastic Ono Band solo album.

In spite of its initial high public profile, the absence of independent peer-reviewed outcome studies (or experimental clinical trials) to substantiate Janov's theories has contributed to a minimal level of acceptance for the therapy amongst mainstream psychologists. Today, almost forty years after its debut, primal therapy remains a fringe psychotherapy.

Concept
Janov claims that neurosis is the result of suppressed pain which derives from emotional trauma, usually from childhood and early life. He asserts that each individual has a "primal pool" of pain, and that by gradually re-experiencing those painful feelings which were repressed during childhood, the patient can eventually "drain the primal pool", thus ridding himself of anxiety and other symptoms of neurosis.

Janov believes that there is only one source of mental illness (besides genetic defects) - primal pain. Consequently, he asserts that the "cure" for neurosis is essentially the same for everyone - gradual cathartic release of this pain. In effect, Janov believes that primal therapy is the right therapy for almost everyone, no matter what form their neurosis takes.

Needs
Janov felt that much of the pain of childhood is the result of needs going unmet. Drawing from earlier psychologists, he described his take on the basic needs in his books. "Our first needs are solely physical ones for nourishment, safety and comfort. Later we have emotional needs for affection, understanding and respect for our feelings. Finally, intellectual needs to know and to understand emerge."

"Need is a total state of the human being - and at birth we are almost nothing but need." Janov argued that for the helpless newborn, survival is at stake in nearly every second of existence.

Janov claimed that when needs go unfilled for too long, Pain is the result (He capitalized Primal Pain in his early work, although in later works he dropped the capitalization).

Pain
In primal theory, "Primal Pain is deprivation or injury which threatens the developing child. A parent's warning is not necessarily a Primal Pain for the child. Utter humiliation is...An infant left to cry it out in the crib is in Pain...It is not hurt as such which defines Primal Pain but rather the context of the hurt or its meaning to the impressionable developing consciousness of the child."

Arthur Janov described Pain as the pain that doesn't hurt because, as soon as a patient drops into it, it becomes simply feeling. Most of the suffering component is in the blockage or repression.

Consciousness and repression
In primal theory, Janov claimed that consciousness is not simply awareness but refers to a state of the entire organism including the brain in which there is "fluid access" between the parts. Using the triune brain work by Paul D. MacLean, and adapting it to Primal Theory, three levels of consciousness are recognized in Primal Theory

The following table summarizes some of the fundamental ideas and terms Janov (J) has used as well as conventional terms used in general and scientific papers.
 * Janov described defenses as the agents of repression that consume energy while protecting the system from the catastrophic Pain of unfulfilled need. When referring to Pain or defense the word "line" is used instead of "level"; e.g. first line Pain = early trauma imprinted in the brainstem usually involving physical injury, third line defense = intellectual defense.
 * The brainstem has also often been referred to as the reptilian brain as it is the structure which mammals have in common with reptiles.
 * Janov claims that 1st line imprints occur before intellectual abilities such as the use of verbal language have developed, they are at the level of pure sensation and visceral (or gut) reaction. The brainstem is capable of processing the most primitive emotions of rage and terror and these can be experienced very early in life.

According to Janov, Primal Pains are imprinted in the lower brain first then later the limbic system and still later intellectual defenses are formed by the cortex simply because this is the sequence of neurological development. He therefore argues that the therapy should proceed in the reverse sequence: 'There is no way to go deep without first going shallow.' In primal therapy medication is prescribed for some "overloaded" patients so they don't overshoot into 1st line pains that they are not ready to feel, thereby allowing them to feel the more recent pains first.

Origins of neurosis
Primal theory posits that many or most people suffer from some degree of neurosis. This begins very early in life (especially in the "critical period" - the gestation period plus the first three years) as a result of needs not being met. There may be one or more isolated traumatic events but more often it's a case of daily neglect or abuse.

Janov argues that neurosis may begin to develop at birth, or even before, with "first line" Pains. He claims that neurosis can be reversed by reliving these pains in sequence, all the way back to birth trauma. Subsequent Pain is thought to be added on top of previous pain in what is called "compounding". Throughout childhood, more elaborate "defenses" develop as the early unmet needs keep pressing for satisfaction in symbolic and therefore inevitably unsatisfying ways.

Format and process
The overall strategy of primal therapy as practiced by Janov has changed little from the early days. The therapy begins with an intensive three weeks of fifteen open-ended sessions with one therapist. After this the patient joins group meetings with other patients and therapists once or twice a week for as long as is needed. Private sessions are still available, though not every day. The length of time needed in formal therapy varies from person to person.

Connected feeling
A connected feeling, according to Janov, is a "conscious" experience which connects the present to the past and connects emotion to meaning - there may also be a connection to sensations in the case of a physically traumatic experience such as physical or sexual abuse or painful birth.

The "primal"
Reliving of early painful feelings is referred in the therapy as "primalling" and a person who has relived such a feeling is said to have experienced "a primal". A complete primal has been found, according to Janov and Holden, to be marked by a "pre-primal" rise in vital signs such as pulse, core body temperature, and blood pressure leading up to the feeling experience and then a falling off of those vital signs to a more normal level than where they began. After the primal ("post-primal"), Janov claims the patient will be flooded with spontaneous insights.

Based on in-house studies, Janov and Holden claimed that the pre-primal rise in vital signs indicates the person's neurotic defenses are being stretched by the ascending Pain to the point of producing an "acute anxiety attack" (the conventional description), and the fall to lower levels afterwards indicates a degree of resolution of the Pain.

Janov asserts that a "primal" is qualitatively different from ordinary emotional catharsis or abreaction. Janov uses the terms "catharsis" and "abreaction" to refer to feelings that are not properly understood or accompanied by spontaneous insights on the part of the patient, ie "unconnected" feelings. A primal may be referred to as a "connected feeling" but a complete connected feeling may take months or even years to fully resolve, in many primals. (It should be noted that Janov's definition of abreaction/catharsis is unique to primal therapy; other psychologists do not use these terms to signify false or unconnected feelings).

Duration
Janov claims that after a year to a year and a half, patients are able to continue therapy on their own, with only sporadic follow up necessary. However, this duration is exceeded by many primal patients in practice.

Views
Primal therapy achieved a high public profile in its early years, to the extent that the very phrase "primal scream" became part of the English-speaking world's cultural lexicon. Since the 1980s however, the therapy has declined in popularity, leading some commentators to dismiss it as an ephemeral 1970s therapeutic fad.

Mainstream psychology
The therapy has failed to achieve broad acceptance in the psychological mainstream. A 1982 survey published in the journal Zeitschrift für Psychosomatische Medizin und Psychoanalyse, reported that "most psychotherapists in the Federal Republic of Germany believe [primal therapy] to be questionable in theory and dangerous in practice," leading the paper's authors to conclude that the therapy is not a valid therapeutic technique. In 1996, a group of 135 American psychologists were asked to evaluate the soundness of a number of different therapeutic approaches. Primal therapy was rated by the group as one of the therapies considered "most in question as to soundness. As of May 2008, neither primal therapy nor Arthur Janov were represented on the website of Psychology Today magazine, an absence described by one commentator as "symbolic of the therapy’s broader contemporary obscurity".

Alice Miller
One former advocate who later became critical of aspects of the therapy is German psychologist and child abuse expert Alice Miller. Miller practiced as a psychoanalyst for twenty years before becoming disillusioned with the discipline, and in the late 1970s she began painting as a means of accessing her unconscious. Through her painting, Miller began to experience traumatic memories of her own abuse as a child, and subsequently entered primal therapy at Janov's French primal centre.

Although Miller was initially enthusiastic about the therapy and the benefits she obtained from it, she later became critical of the three-week intensive aspect, stating that she felt it opened her up to more pain than she could initially cope with and that it could be potentially dangerous for some patients. She also felt that the helpless state into which some patients regress in this phase of the therapy could potentially be exploited by unscrupulous therapists. Miller also felt the therapy lacked a clear methodology, and she warned of the dangers of developing an "addictive dependency" to pain.

Miller later embraced a development of primal therapy by a German writer, J. Konrad Stettinger, who developed a four step process by which individuals could "self primal" at their own pace, without the aid of a therapist. Miller later repudiated her endorsement of self-primalling. She now believes that people wishing to explore early childhood feelings and experiences should find what she terms an "enlightened witness" - her term for a competent therapist.

In spite of her misgivings about certain aspects of primal therapy, Miller remains a strong proponent of the trauma-based psychotherapeutic model and believes that reliving and releasing such traumas is the only effective method of healing for victims of child abuse.

Other views
In a 1975 article, psychologist Herman Weiner argued that Janov's dismissal of transference could prevent a primal therapist from identifying problems of countertransference which might potentially keep a patient "stuck" and unable to make further progress. Wiener also warned that without a consideration of transference, therapists run the risk of establishing a culture of "dumb fetishism and cultism" where self criticism is lacking. While arguing that primal therapy "can be quicker and more profound in its therapeutic impact than any other known form of psychotherapy", Weiner also argued that "the expectation of a cure" for neurosis seemed "patently naive".

Theresa Sheppard Alexander, a trained primal therapist and author of Facing the Wolf, also argues that an understanding of transference is necessary to good therapy, and that a patient should seek to establish a relationship of trust with a particular therapist in order to consciously work through such issues.

Studies
As a non-mainstream therapy, primal therapy has been subject to few empirical studies, leading some critics to question its effectiveness. For example, in the book Let's Talk About Me, Dr. Anthony Clare claims that Janov has "no evidence" that childhood traumas cause adult neurosis, except for the "frenzied memories" of his patients. In the Gale Encyclopedia of Psychology, Timothy Moore wrote: "Truth be known, primal therapy cannot be defended on scientifically established principles. This is not surprising considering its questionable theoretical rationale."

Janov himself cites a number of studies which he asserts support the therapy's effectiveness, some of which have been carried out at his Primal Institute. He also cites a number of independent studies, but at least one critic has noted that Janov does not provide specific cites for these studies, making them difficult or sometimes impossible to verify. Janov's studies and those he cites have focussed largely on vital signs such as pulse, core body temperature, blood pressure and so on, which Janov asserts show significant long-term decreases in the post-primal person. He argues that this alleged lowering of vital signs is indicative of the patients' reduced stress levels after therapy.

In addition to the above, a number of independent small-scale studies have been carried out on primal patients which have attempted to ascertain the therapy's overall rate of success. A questionnaire carried out on 200 primal patients in 1979, for example, concluded that the therapy had a 79% success rate. A 1983 study surveyed thirteen primal patients both before entering the therapy and two years afterward. The study concluded that eight of the thirteen "were definitely improved on all outcome variables", while one patient had "an affective psychosis triggered by the treatment." The authors concluded that the overall outcome for patients was good and that "the systematic use of catharsis in psychotherapy should be explored further."

A slightly larger study of 26 patients was carried out at Janov's Primal Institute by Tomas Videgård in 1984. As with the earlier study, Videgård surveyed patients both before entering therapy and some twenty months later. Videgård concluded that the therapy had an overall success rate of 40 percent. He observed that patients who developed a good relationship with one or more therapists had much better results than those who did not, leading him to conclude that the patient-therapist relationship was much more important to the success of the therapy than Janov had realized.

Janov has summarized his own views in the following terms:


 * "Although there are scientific references and citations throughout this work, we should not lose track of the overarching truth--feelings are their own validation. We can quote and cite all day long, but the truth ultimately lies in the experience of human beings. Their feelings explain so much that statistical evidence is irrelevant."

Post-Janovian developments
Inevitably, many Janov-trained primal therapists, as well as some therapists who have experimented with Janov's ideas independently, have come up with variations on the original primal therapy as taught by Janov.

The birth trauma split
While primal therapy has sometimes been criticized for its assertion that human beings can recall birth trauma—which some researchers believe to be physically impossible —Janov was, ironically, originally a staunch opponent of the notion himself. The first major split in primal therapy occurred in the mid-1970s after Janov rejected claims that patients were reliving birth trauma. As a result of Janov's intransigence on the issue, a number of patients, together with about half of Janov's therapists, eventually left the Primal Institute to set up the Denver Primal Center. Only later did Janov himself come to accept that patients were capable of reliving birth experiences.

Graham Farrant's "cellular consciousness"
Some primal therapists have gone much further still in their claims regarding memory. The Australian psychiatrist Graham Farrant, who attended Janov's Primal Institute in the 1970s and later the Denver Primal Center, eventually set up his own private practice where he pioneered the notion that it is possible to recall experiences as far back as conception—and even beyond, to separate sperm and egg. Farrant proposed the idea of "cellular consciousness" to explain how such early memories could be formed prior to the development of the nervous system. It is not known what degree of support Farrant's ideas have amongst primal therapists generally, but his ideas have been published in various primal therapy journals and he was invited to give the keynote address at the International Primal Association's 14th Convention in 1986.

Farrant also claimed credit for the establishment of natural birthing centers in Australian hospitals.

Other variations
There have been numerous other variatons on the original therapy over the years. Some primal therapists have abandoned the three-week intensive period altogether, or retain it in a shorter form or else employ it only for certain individuals. Some have also discarded Janov's belief that transference and the therapist-patient relationship are relatively unimportant in primal therapy, and have instead emphasized the importance of establishing a good relationship with a trusted therapist in order to achieve the best possible outcome. Others emphasize the importance of developing life skills in addition to working with early feelings. Janov's materialist stance, which interprets religious experiences as merely symbolic of unfelt primal pain, has also been rejected by many therapists who accept the legitimacy of spiritual or transpersonal experiences. In order to differentiate themselves from classical primal therapy, such therapists sometimes employ unique labels for their particular variant, such as "primal integration therapy", "deep feeling therapy" and so on.

Additionally, some therapists with no direct connection to Janov at all have utilized aspects of his methodology to form their own versions of primal therapy. Janov continues to insist that only therapists trained at The Primal Institute or The Primal Foundation in Los Angeles are properly qualified, and that prospective patients should check the credentials of any person claiming to be a primal therapist at one of these institutes. Janov has repeatedly warned his readers to beware of those whom he labels "mock primal therapists" or simply "mock therapists" or "would-be practitioners."

Some individuals eschew a therapist altogether, and engage in what is known as "self primalling". Janov has also warned against this practice, arguing that the initial guidance of an experienced therapist is essential, but he accepts the idea of self-primalling or primalling with the assistance of a "buddy" for those who have already completed a full course of the therapy.

Antecedents
Although Janov has rejected standard psychological terms such as "catharsis" and "abreaction" to describe his therapy—arguing that "primalling" is a new and fundamentally different process—many commentators place primal therapy firmly in the cathartic tradition, which traces its origins back to the early work of Freud and Brauer. In catharsis, a patient experiences and releases his or her pent-up emotions, which is said by proponents of the method to lead to psychological insights which can be of considerable value to the patient.

Freud himself abandoned the cathartic approach fairly early in his career, but it was later taken up by one of Freud's disciples, Wilhelm Reich, and through Reich and others has found its way into several modern psychological theories. While the cathartic approach is strongly defended by its modern proponents, it remains a tradition which many psychologists regard with a degree of scepticism, which may to some degree account for primal therapy's poor reception amongst the psychological community in general.

The early work of one of Freud's closest colleagues, Otto Rank, also bears some relationship to primal therapy. In the 1920s, Rank became convinced that birth trauma was the cause of anxiety neurosis, and wrote a book, The Trauma of Birth, to express this view. Rank's book caused a rift between himself and Freud, and Rank's work was consequently ignored by the psychological mainstream for many years.

Related contemporary therapies and techniques
There are several modern therapies and approaches that are seen to share some similarities with primal therapy.

Perhaps one of the closest therapies in terms of theory is that of Stanislav Grof's Holotropic Breathwork. Grof began his career researching the potentialities of the hallucinogenic drug LSD as an aid to psychological healing and growth. After discovering that some of his clients were apparently re-experiencing birth trauma, Grof went on to develop a sophisticated model of neonatal experience and its alleged unconscious psychological effects. Following the banning of the drug LSD, Grof discovered that clients could continue recovering early memories simply by adopting certain breathing techniques, which he later developed into his holotropic breathwork technique. Grof himself has noted the similarities between his research and that of Arthur Janov.

Another technique that purports to have discovered the role of birth trauma memories in psychological healing is Rebirthing-Breathwork, pioneered by Leonard Orr. Janov himself has repudiated comparisons between primal therapy and rebirthing-breathwork, describing the latter as "dangerous".

Other established therapies which like primal therapy emphasize cathartic release include bioenergetics and various bodywork techniques.

Center for Feeling Therapy
One particular offshoot of primal therapy attracted some negative publicity in the 1970s. Two of Janov's trainee therapists, who disagreed with some of Janov's views, quit the Primal Institute to establish their own Center for Feeling Therapy nearby. The initial intention was to run a complete therapeutic community based partly on primal therapy, but the leaders soon abandoned the therapy altogether for a succession of alternatives. After a couple of years of operation, the Center was closed after a mass revolt by the clients who alleged persistent physical, emotional and sexual abuse by the Center's founders.

John Lennon and Yoko Ono
The musician John Lennon, and his wife, Yoko Ono, both went through Primal Therapy in 1970, and shortly afterward Lennon produced his raw, emotional album, John Lennon/Plastic Ono Band. (Ono recorded a parallel album, Yoko Ono/Plastic Ono Band from her experiences; both albums were released on the same day on the Apple record label.) Lennon's album featured a number of songs which were directly affected by his experience in therapy, including "Remember", "I Found Out", "Isolation", "God", "Mother", "My Mummy's Dead", and "Working Class Hero". After being forced to postpone his therapy for practical reasons, Lennon never returned to complete his treatment. For more on this subject, see the webpage, "John Lennon - Primal therapy," which includes excerpts of interviews of John Lennon, Arthur Janov and Vivian Janov, along with an account of one of John's therapy sessions written by Pauline Lennon.

Criticism
Primal therapy has not achieved broad acceptance in mainstream psychology. It has been frequently criticized as lacking outcome studies to prove its effectiveness. It is regarded as one of the least creditable forms of psychotherapy.

Primal therapy has sometimes been criticized as shallow, glib, simplistic, or trendy. It has also been criticized for not paying sufficient attention to transference. It has also been criticized for its claim that adults can recall infantile experiences, which some researchers believe is impossible. It has also been criticized as being dogmatic or overly reductionist.

In the book Let's Talk About Me, Dr. Anthony Clare criticizes primal therapy in several ways. He claims that Janov sees confirming evidence everywhere: "Everything is taken as evidence of [the truth of Janov's Pain Theory]." And he claims that Janov has "no evidence" that childhood traumas cause adult neurosis, except for the "frenzied memories" of his patients.

In a 1982 paper published in the journal Zeitschrift für Psychosomatische Medizin und Psychoanalyse, Ehebald and Werthmann report that, following a review of the scientific literature, they found "no on-going reports of primal therapy's therapeutic results, no statistical studies and no follow-up studies". Concluding that primal therapy is not a valid therapeutic technique, they stated that most psychotherapists in the Federal Republic of Germany believe it to be questionable in theory and dangerous in practice.

Alice Miller initially endorsed primal therapy. Later, however, she wrote a communication to her readers in which she expressed some reservations about it. In that communication, she stated that primal therapy could be dangerous when conducted by therapists who are not properly trained. She also stated that there was "too much faith" in cathartic discharge, claiming that the relief was sometimes temporary. She also voiced criticisms about the structure of the initial 3-week intensive phase, claiming that it could provide opportunities for unscrupulous therapists. And she warned of the dangers of developing an "addictive dependency" to pain.

In 1996, authors Starker and Pankratz published in Psychological reports a study of 300 randomly-sampled psychologists. Participants were asked for their views about the soundness of methods of mental health treatment. Primal therapy was identified as one of the approaches "most in question as to soundness".

The 1996 book "Crazy" Therapies discusses Janov's claim to have discovered the one cure for neurosis:
 * "Evidence that expressing angry, violent behaviour does not drain it away but increases the chances of its recurrence has been presented in the scientific psychology literature for years " (page 128).

In the 1998 book Insane Therapy sociologist Marybeth F. Ayella says that "what Frank (1974:424-25) describes as healing cults more closely resembles what I think occurs in Primal Therapy than does Janov's description".

Primal therapy is cited in the book The Death of Psychotherapy: From Freud to Alien Abductions. The author claims that all schools of psychotherapy, including primal therapy, cognitive behavioral therapy, and others, do not have scientific evidence of effectiveness beyond placebo.

In the Gale Encyclopedia of Psychology, Timothy Moore wrote: "Truth be known, primal therapy cannot be defended on scientifically established principles. This is not surprising considering its questionable theoretical rationale."

Martin Gardner wrote a critical article called "Primal Therapy: A Persistent New Age Therapy." in the Skeptical Inquirer. Gardner discussed some of what he sees as the problems with primal therapy, and also details a protest over the publication of the book The Biology of Love. (Janov, 2000)

The National Council Against Health Fraud (NCAHF) Newsletter listed primal therapy, among other treatments, in the article "Dubious Mental Health."

links

 * 39 Z Psychosom Med Psychoanal. 1982;28(4):407-21
 * 40 http://www.ncbi.nlm.nih.gov/pubmed/8839319
 * 41 Singer, Lalich, Crazy Therapies : What Are They? Do They Work?, pp 128
 * 42 Abrall, Soul Snatchers: The Mechanics of Cults not enough info.
 * 43 Eisner, The Death of Psychotherapy: From Freud to Alien Abductions, pp 51
 * 44 Moore, Gale Encyclopedia of Psychology
 * 45 Psychoanalytic Psychology (20:717-726, 2003) repeat of bornstein
 * 46 Cordon, Popular Psychology - An Encyclopedia, pp 133
 * 47 http://discovermagazine.com/2007/may/whatever-happened-to-primal-therapy repeat of moore/gale encyclopedia
 * 48 http://www.counselormagazine.com/content/view/338/1/ rehash of crazy therapies.
 * 49 Rosen, Psychobabble no qualifications in field
 * 51 Clare, Let's talk about me, pp 121
 * 52 http://tanadineen.com/media/NatPostMilstone.html unreliable attacks PTSD, calls gestalt a "fad".
 * 53 http://www.guardian.co.uk/music/2000/dec/21/thebeatles.johnlennon just a journalist and already mentioned above.
 * 54 New Age Blues (1979, ISBN 0-525-47532-X), Page 28 - rossman a mathematician, not a psychologist.
 * 55 http://www.primals.org/articles/weiner.html weiner already in.
 * 56 Ayella, Insane Therapy not referenced
 * 57 http://www.selfhelpfraud.com/uploads/3__Fringe_Psychotherapy.pdf
 * 59 Kirsch, Los Angeles Times, March 27, 1970 not enough info on source.
 * 60 Primal therapy - a clinically confirmed procedure? already in
 * 61 Alice Miller´s communication to her readers already in
 * 62 soundness of treatment repeat
 * 63 Skepdic entry about "Crazy Therapies" repetition
 * 64 Review of "Crazy" Therapies, 1997 repetition of previous link
 * 65 Insane Therapy ISBN 1-56639-601-8 ,page 39 appears to know little about primal therapy.
 * 66 The Death of Psychotherapy: From Freud to Alien Abductions. Donald A. Eisner ISBN 0275964132, 2000, Pages 51-52
 * 67 "Primal Therapy: A Persistent New Age Therapy." in the Skeptical Inquirer, May 1 2001.
 * 68 "Dubious Mental Health."
 * 68 "Dubious Mental Health."

links2

 * ALREADY IN


 * 19 a b c Ehebald U, Werthmann HV (1982). "[Primal therapy—a clinically confirmed procedure?]" (in German). Z Psychosom Med Psychoanal 28 (4): 407–21..
 * 20 a b Starker S, Pankratz L (February 1996). "Soundness of treatment: a survey of psychologists' opinions". Psychol Rep 78 (1): 288–90..
 * 23 Eisner, The Death of Psychotherapy: From Freud to Alien Abductions, pp 51
 * 24 Moore, Gale Encyclopedia of Psychology
 * 34 http://www.primals.org/articles/weiner.html
 * 36 http://www.selfhelpfraud.com/uploads/3__Fringe_Psychotherapy.pdf
 * 38 Alice Miller´s communication to her readers
 * 30 a b c Thompson, Sally Anne; Clare, Anthony W. (1981). Let's talk about me: a critical examination of the new psychotherapies. London: British Broadcasting Corp. p. 121. ISBN 0-563-17887-6.


 * possibles


 * 26 Cordon, Popular Psychology - An Encyclopedia, pp 133
 * 25 Bornstein RF (2003). "The Scientific Review of Mental Health Practice: Implications for Psychology and Psychoanalysis". Psychoanalytic Psychology 20 (4): 717–26. doi:10.1037/0736-9735.20.4.717. http://psycnet.apa.org/journals/pap/20/4/717/. if someone has access to this article, we could consider it


 * neutral
 * 32 http://www.guardian.co.uk/music/2000/dec/21/thebeatles.johnlennon fine to use re pt's sociological impact but not as a reliable source about efficacy of therapy


 * OUT


 * duplicate links to refs already included


 * 27 http://discovermagazine.com/2007/may/whatever-happened-to-primal-therapy - repeat of Gale
 * 43 Primal Therapy section from the Gale Encyclopedia of Psychology, 2nd ed. Gale Group, 2001, author Timothy Moore repeat of Gale
 * 42 Eisner, Donald A. (2000). The death of psychotherapy: from Freud to alien abductions. New York: Praeger. pp. 51–2. ISBN 0-275-96413-2. repeat


 * attacks on catharsis in general rather than PT in particular


 * 21 Singer, Lalich, Crazy Therapies : What Are They? Do They Work?, pp 128
 * 39 Skepdic entry about "Crazy Therapies" link to same material as above
 * 40 Review of "Crazy" Therapies, 1997 link to same
 * 28 http://www.counselormagazine.com/content/view/338/1/


 * no relevant qualifications


 * 29 Rosen, Psychobabble - no qualifications in field
 * 33 New Age Blues (1979, ISBN 0-525-47532-X), Page 28 no qualifications in field


 * dubious sources


 * 35 Ayella, Insane Therapy - about center for feeling therapy rather than PT
 * 41 Insane Therapy ISBN 1-56639-601-8 ,page 39 link to same
 * 31 http://tanadineen.com/media/NatPostMilstone.html attacks both gestalt therapy and PTSD as dubious along with PT, which makes this source highly questionable
 * 44 "Primal Therapy: A Persistent New Age Therapy." in the Skeptical Inquirer, May 1 2001. - secondhand source, and quite frankly, the writer of this article is so ill-informed about the therapy it simply doesn't merit inclusion
 * 45 "Dubious Mental Health." can't access, unknown provenance, only repeats info already included, so scarcely worth inclusion


 * unverifiable


 * 22 Abrall, Soul Snatchers: The Mechanics of Cults can't verify
 * 37 Kirsch, Los Angeles Times, March 27, 1970 - can't verify