This theory paper, published in the International Journal of Psychotherapy
(Volume 9, Number 2, July 2005) is reproduced here (with modifications) by permission.

Joaquin F. Sousa-Poza of Galiano Island BC Canada

Ex-Professeur Agrégé de Psychiatrie, Université de Sherbrooke, Sherbrooke, Québec, Canada

Text

In 1897, in a momentous decision, Sigmund Freud repudiated the seduction theory of neurosis (1) (Miller, 1981/1984) and embraced instead the drive theory (term used in Alice Miller's general sense), which gave rise to psychoanalysis. Miller, who felt it was incongruous to speak of "[sexual] seduction" when dealing with a child, refers to the seduction theory using the more appropriate, inclusive label of "trauma theory." I have extended that term to emotional trauma theory.

The actual or perceived failure of psychoanalysis gave rise to the tacit consensus that psychotherapy at large had failed, thus by sheer default supporting the rise of the "biological revolution" in psychiatry (Kaplan & Sadock, 1991). The latter's impressive advances led to the newly minted psychiatric mantra that neurotic patients so often hear today, "You're suffering from a biochemical disorder of your brain," or to the media-propagated notion, "It's all in your genes." Almost simultaneously, psychiatric diagnosis was overtaken by the -symptom-driven systematization of clinical pictures as outlined in the Diagnostic and statisticalmanual of mental disorders (DSM-IV-TR [4th edition, text revision]; American Psychiatric Association [APA1, 2000). The self, the legitimate subject of psychological psychiatric study and the presumptive sufferer of such disorders, was effectively banished. Finally, spiraling medical costs and American for-profit, "evidence-based" medicine favored the swiftness with which biological treatments could suppress certain neurotic symptomatology, as compared to the long and laborious task of psychotherapy.

The countermove, in psychological psychiatry, was to de-emphasize the search for new therapies and initiate a trend towards the integration of standing practices (Beutler, Consoli & Williams, 1995; Fisch, 2001; Lampropoulos, 2001; Wachtel, 1997). Though some schools of thought advocating different types of theories based on emotional trauma had emerged in the 20th century (Adler, 1927; Rank, 1929; Sullivan, 1953), only a few eventually made the link between adult emotional pathology and parental-induced emotional trauma during childhood: the so-called Palo Alto Group (Bateson, 1972; Watzlawick, Beavin, & Jackson, 1967) which studied pathological patterns of communication; those schools focusing on failures of early attachment (Bowlby, 1969,1973,1980; Mahler, Pine & Bergman, 1975; Spitz, 1965); as well as the work of Janov (1970), Casriel (1972), and Miller (1979/1981). None of these views however became prominent in the field of psychotherapy.

In the past, any theory of neurosis centered on childhood emotional trauma was doomed to fail because of an understandable, sociocultural reluctance to face the unpalatable notion, already encountered by Freud, that neurotic psychopathology essentially stems from deficient, improper, and/or abusive parenting rather than predestined instinctual clashes or biological derangements of brain physiology. That rejection was largely based on ingrained, tacit cultural prejudices that may be subsumed under the rubric of "parental infallibility" whereby parents supposedly always love their children—or at least "as best they can." This notion is hard for the child to contest since, power-wise, the parent-child relationship is perhaps the most asymmetrical ever known.

Emotional Trauma Theory

Emotional trauma theory posits that humans often lack the necessary self-knowledge to raise emotionally healthy offspring, thereby derailing the development of the individual and our societies. Furthermore, it suggests "software bugs" ("viruses") of the self are as transmissible or inheritable as genetic defects in a family, inasmuch as parents provide the genetic material to build the body as well as the information to build up a self. Parental injury to the child's emotional self is considered the core neurotogenic trauma, by no means excluding that such dynamic interacts with many other factors since development is a complex matter. Nevertheless, under usual conditions it is the parents who mold the core developmental premise termed the lovability principle (see later).

Thou Shall Not Be Aware

Few observers seem to have noticed the voices of the 1960s and 1970s that tried to revive Freud's trauma theory. These authors included Arthur Janov (1970) in Los Angeles, Daniel Casriel (1972) in New York, and Alice Miller (2) (1979/1981) in Switzerland (for this section subheading, I find it appropriate to borrow one of her book titles,Miller, 1981/1984). Also contributing indirectly to the development of emotional trauma theory was the work of the late Dr. Hassan Azima at McGill University on anaclitic therapy (Azima, 1963; Azima, Vispo, &McKenna, 1961; Azima &Warnes, 1963; Azima &Wittkover,1957).(3) Only Miller, however, seemed to be aware of the lineage of her work.

Casriel, Janov, and to a lesser extent Miller, belonged to what could be called the "feel the feelings" school. After decades of talking therapy, psychotherapists in the 1960s began to realize that patients harbored powerful feelings, mostly of anger and hurt. The notion was so new and radical that Janov (1970), for one, concluded that feeling the feelings (repressed emotional pain in his view) was "the cure for neurosis" Although that was not to be, it was still a considerable, positive step. Feeling the feelings does open up the self's wounds; it does not, however, heal them.

Daniel Casriel.
My serendipitous initiation to trauma theory occurred as I worked with Dr. Daniel Casriel during the late 1960s in New York City. Casriel challenged conventionality by permitting his patients to express fully and naturally, without suggestion of any kind, the painful feelings inflicted on the self by a lack of love during its developmental years. Like Janov, but not Miller, Casriel discerned a cause-effect chain of events between the neurosis of the adult and the patient's childhood perception and/or experience of not having been loved. Furthermore, Casriel, in a rudimentary fashion, developed Azima's concept of gratification (Azima & Warnes, 1963). Unfortunately, despite his writings, of which A Scream Away From Happiness (Casriel, 1972) was the most popular, as a pioneer in the field he did not leave a significant imprint in the literature.

Arthur Janov.
After experimenting for nearly a decade with successive modifications of Casriel's method at the University of Sherbrooke's Department of Psychiatry (in Quebec, Canada), I took an extended sabbatical leave in the late 1970s to study and undergo Primal Therapy (4) at Arthur Janov's Primal Institute in Los Angeles. I believed that Janov had overcome a major obstacle to putting Freud's trauma theory into practice; namely, how to induce systematic regression of the mind to the traumatic episode without suggestion or invasive methods. The term regression is used, not as returning to earlier modes of ego functioning, but as defined by Drs. Azima and Warnes, 1963, p.62, "...the evoked events are more than 'as if’ or 'instead’ experiences, and ARE identical in their intensity and lived quality with their genetic origins." And, indeed, Janov had mastered the technique of natural regression using a modified form of spontaneous and guided imagery. However, although Primal Therapy was the most advanced approach I had encountered to that point, it nonetheless presented several limitations and severe risks.

1. Excessive regression.

The patient, working in the recumbent position with dimmed lighting, had no means of controlling the depth of regression, resulting in premature overreaching. Too many damaged emotional files were opened at once for the process to be therapeutic.

2. Erroneous regression to pain.

The regression was towards emotional pain, for Janov gave primary causal status to pain, rather than to the anger associated with emotional aggression. Primal work consisted mainly of sorrowful appeals by the "child" (via the adult in regression) for love—and to a parent who had already proved to be dysfunctional. That the course of regression towards pain can be naturally spontaneous does not necessarily mean it is therapeutic. Decades of experimenting with the clinical results of pain versus anger have led me to conclude that anger, counterattacking in self-defense, is the primary response to aggression. Yet because the power imbalance in the parent-child relationship keeps the child from fighting back, emotional pain does arise. That pain sterns mostly from the derangement of the development of the self, but also from having to repress the anger itself—a "toxic" feeling.

3. Lack of supportive gratification.

Relying only on his regression technique to constantly reexperience the pain of the emotional trauma, Janov never realized that the repetitious, if hopeless, pleading was a de facto retraumatizing of the self.

Detachment From the Introject and the Late Separation Syndrome (LSS)

On my return from Los Angeles in 1980 to the University of Sherbrooke, as part of my continuing investigation of Freud's trauma theory I established what was, to my knowledge, the first experimental clinic of anaclitic psychotherapy (the precursor to emotional trauma psychotherapy), as part of the Outpatient Department of Psychiatry. There, I conducted preliminary clinical work with several collaborators, as well as solitudinal research or self-experimentation. After about one year, I realized that the most severe risk associated with Primal Therapy was a repeated regression to the grieving of childhood emotional pain, which leads to substantial detachment from, but not dislodgement of, the dysfunctional parental introjects.(5) Dislodgement of the dysfunctional introjects requires the deployment of the infantile anger provoked, but also suppressed, when the emotional aggression took place. Indeed, as explained later, anger is, in feeling (analogic) language, the equivalent of the verbal (digital) negation "no." Thus the end product of Primal Therapy, if carried to term, is a self unsupported by attachment to the introjects, a destabilized self; it thus risks the dreadful proposition of precipitating an anaclitic state in an adult.

This excruciatingly painful and dangerous state, described as the late anaclitic syndrome (LAS) in ,Sousa-Poza, Eagle, Rohrberg & Steinberg (1986) but now termed the" late separation syndrome" (LSS),(6) is characterized by a semantic collapse whereby "nothing means anything anymore.” The self is isolated in the mind,(7) [literaly floating, isolated in the vastness of the mind] detached from others and from the world; as the only extant event in the universe, it exists in a state of continuous fright [a sort of ultimate panic attack]. It is the near total lack of contact with the introject that precipitates the dangerous LSS in the adult. The self panics to the point that any negative outcome, from psychotic break to suicide, becomes a possibility. Needless to say, the psychophysiological response is brutal, with intriguing parallels to the dark night of the soul described by the grand mystics (John of the Cross, n.d./1979). It is a harrowing state, fraught with risk and of dubious therapeutic value for the psychiatric patient. [In my own case while doing solitudinal research, this state was nerardeled by a repetitive, "lucid" nightmare, where I was an astronaut walking in space and tether to the mothership would snap.] The above observation led me to realize that the anaclitic reaction (Bowlby, 1969, 1973, 1980; Spitz & Wolf, 1946)—referred to henceforth as the separation reaction, because it denotes how young children react when separated from the mother figure—is the subjacent emotional layer of neurosis. This conclusion paved the way to creating the first framework for both a clinical (the separation reaction) and theoretical (information and attachment theory) basis to the field of emotional trauma theory. I postulated that whereas regression towards anger is the "incision" that opens the wound and excises the dysfunctional introject, systematic nurturing/restitution is the necessary form of gratification to heal and close it (procedures fully described in the method paper, 2005).

The Emotional Trauma of Separation as the Core Pathogenesis of Neurotic States

Watzlawick et al. (1967) defined disconfirmation as the negation of the existence of one self by another. In reference to the separation reaction disconfirmation actually triggers subclinical, mother-child separation events without actual physical separation. Severing the bond is not an "all or nothing" affair; cumulative disconfirmatory messages can achieve the same effect by gradually severing sections of the bond. Thus, treating neurosis via the systematic retrieval and experiencing of past emotionally traumatic events, in the absence of appropriate gratification, can lead to the well-known pathology of the anaclitic reaction [seperation], which unfolds in the following classic stages:

1. Protest (anger in psychodynamic terms).
2. Depression (emotional pain in psychodynamic terms).
3. Despair (if no nurturing bond is provided to rebuild a healthy [confirmatory] introject, there is always the risk of reaching, at least partially, this stage and the following last, dangerous, one).
4. Detachment (by this time the child is highly disturbed and may not rebond even if the mother returns).

Given that lack of proper gratification can propel a patient to the two last stages, which in turn lead to the LSS, I immediately introduced nurturing/restitution with the help of some of the senior female nurses from the Department of Psychiatry. My therapeutic goal was to forestall a patient's progress beyond the first stage of anger. I permitted a limited expression of pain, but only during the patient's nurturing/restitution sessions.

Outline of Previous Work and Current Thinking

What is Disconfirmed; The Lovability Principle and its Homologous, Parental Deification

Over thirty years [going on forty right now]of clinical observations in hundreds of patients have permitted my early colleagues and I to confirm and amplify Casriel (1972) and Janovs (1970) notion that the emotional trauma of love deprivation during the developmental years is indeed the basic emotional metatrauma. This led to a more precise notion of what it is in the self that is disconfirmed. Clinically, emotional traumas of a seemingly different nature are all ultimately reducible to a simple, subjective metapremise: "I was not loved." We therefore inferred the existence of a metaphysical "hard core" (Lakatos, 1970), or basic informational premise of the primeval self, which we termed the lovability principle ( Sousa-Poza et al. 1986). It is a probabilistic concept, characterized by an exceedingly high level of certainty (100%) on the part of the child that he or she will be mirrored back, unconditionally, as a "right" (unblemished) self, by the parental figures. Indeed, the subjective sense of being lovable rests upon such recognition. Not only is the child's entitlement to love total, but there is also no record in the psychiatric literature of a child (with an undamaged organism) not needing and wanting to be loved. To understand the powerful pathogenic role of love deprivation, it must be taken into account that not only does the child assign the same level of lovability that he or she possesses to the parents, but also, as Carl Jung (1938/1960) and the theologian Hans Urs Von Balthasar (1988/1991) observed, the child is in love with (devoid of any libidinous, sexual connotation), and in awe of, the parents as if they were God in person. In the process, however, the child becomes an extraordinarily vulnerable target for what one patient has expressively termed "karmic hijacking." An excerpt from one of her sessions (speaking as the child she was) highlights these psychodynamics: "I love you [her parents] as God, you are supposed to love me back, that’s how it works! I'm SO MAD, you broke the deal and I could not take my love back; I was stuck loving you!"

The Self as an Information System and the Psychopathological Consequences of the Entropy Law

There is perhaps no better scientific conceptualization of the self than that of an information system that is liable to error. Granted, to conceive of "me" as an error is not as easy to grasp as recognizing that the corrupted software of a computer is spewing out nonsense. Yet neurotics spew out such "nonsense" mostly in their intimate relationships, to the point of making them problematic if not unworkable, because their perception of themselves and others is subject to erroneous distortions.

Most important, such a conceptualization implies that the self is subject to the second law of thermodynamics, or the popular law of entropy (Rifkin, 1980). This law rules much of the universe and, in information systems (Szilard, 1929), dictates the need for a supply of "redundancy" (in the sense of "backup" or reinforcing information) if the information system is not to reach untenable levels of entropy (disorganization, dedifferentiation, etc., eventually leading to dissolution of the self). In humans, such redundancy is provided by parental confirmation of the child's lovability during development and by the parental introjects and relationships with others during adult life. The metapsychological antecedents of this conceptualization lie in the concept of mirroring (Winnicott, 1971).

"Like the eye, the self cannot see itself". Children need a source of information confirming that they in fact exist; that their parents recognize them. Confirmation is tantamount to the statement "Yes, I see and recognize you as lovable" being subjectively experienced as "I am (exist)." In effect, confirmation is "redundant" because it adds nothing that is not already in the primeval self. It is, however, the necessary catalyst that kindles the self to develop. We need that confirmatory backup much as computers use "failover" systems in case a CPU fails or needs repair, or nature gave us two kidneys in case one fails. Thus, this notion of redundancy does not carry the usual meaning of useless repetitious information.

These parental backup messages, reflecting how the parents see the child, ultimately crystallize into the subsystem of information known as the introject. The enormous power the introject wields upon the self rests on the fact that the former constitutes the latter's structural pillar. Counterintuitive as this may sound, the self cannot stand on its own. As a building rests upon its foundations or a bridge is held in place by its suspended cables, the informational structure that is the self is sustained by the introjects. That is to say, the lovability principle is a necessary, but insufficient, condition to attain selfhood.

Much as only nutritious food is assimilated into the body tissues, only parental lovability-confirming information can be assimilated by the self. Thus a positive introject is by definition introjected; that is, it is almost totally assimilated, becoming part of the self proper. A negative introject, in contrast, is rejected, much as the immune system rejects a foreign body. Parental disconfirmation, then, evolves into an encapsulated, dysfunctional information subsystem that attaches to the self's periphery, perpetuating the wronging process via innumerable injunctions that remind individuals that they are "not good enough," "don't deserve," ''should try harder," and so on. Speaking as her maternal introject, a patient of mine succinctly defined the basic paradigm of disconfirmation: "To be yourself is not good enough for me."

By seeking confirmation for itself (I’m better, that is 'more lovable,' than you"), the negative introject sucks redundancy from the self, increasing the latter's entropy. Clinically, it is an angry, parasitic information system running parallel and attached to, the self—much as a sea lamprey attaches itself to, and lives off, a bigger fish or a computer virus attaches itself to key executable files. Yet even if sick, the introject must be retained to provide structural support for the self. Better to be the hostage of an angry, wronging introject ("wrong-self state") than to have no introject at all (akin to a catastrophic "no-self state"), which leads to the late separation syndrome. A substantial lack of positive introject means a frayed self in a high degree of instability (high entropy), thereby generating the first psychopathological consequence of disconfirmation: a state of fear, anxiety, and tension.

A second psychopathological consequence of disconfirmation stems from the state of the self-introject relationship since it is a major determinant of the default mood. If the relationship is on "good terms" (i.e. loving), the basic mood is euthymic. If it is on "bad terms" (i.e. aggressive), the default mood is mostly dysthymic. The relationship thus affects not only the experience of the moment, but also, ultimately, the individual's perception of the feeling tone of the world or Weltanschauung. By definition, neurotics cannot maintain their mind in the "love mode" (the only state of peace and contentment). The sadness of the unloved child evolves into the "dysthymic disorder" of the adult. Both exogenous and endogenous events can exacerbate these conditions, but it is the biological changes that reflect the precarious information state of the self, rather than vice versa. Obviously, there is room to postulate that the brain pathology that induces neurotransmitter and other neuropsychological changes may also be mimicking the neuropsychological condition generated by high self-entropy.

Primal Anger and the Primary Fault or Fragmentation of the Self

Primal anger is a profound, no-holds-barred type of anger, not unlike the anger harbored by borderline personality disorders (Kernberg 1968, 1975; Linehan 1993). Such extreme anger is provoked only when the child's self-development is aborted by persistent parental disconfirmation [physical, sexual, mental and other forms of abuse included]. In the epitome of self-sacrifice, the child negates his or her own existence to uphold that of a false parental self. The ensuing anger, recoverable during treatment, is often of murderous proportions because the child's emotions function according to the "eye for an eye" rule. Since in children the mental self is not highly developed, they are unable to muffle their anger with rationalizations. But dependency needs aside, the anger must be automatically repressed to yield "right of being" to the perceived parental godliness. To spare the parent then, the child turns that anger against the self, becoming, consciously or not, "no good." In effect, although children cannot counterattack, they are outraged. At a deeper level, they know they have been egregiously trespassed.

In consequence, a primary fragmentation occurs, and the self splits into two fundamental or "tectonic" files. One file, with a "no access" (unconscious) label, knows the self has been trespassed and is enraged. The second file, however, the conscious part, "does not know" that the malaise the self suffers is rooted in anger. Thereafter, any further disconfirmation only adds to that primary fault, resulting in the third psychopathological consequence of disconfirmation: fragmentation of the self. Anger levels, suppressed or not, keep rising. And even when anger is to some degree consciously felt, the link to its tabooed origins is mostly lost. Moreover, in adult life, primal anger is usually displaced ("dumped") onto targets of opportunity. Even when the disconfirmation has been carried out by brutal, naked, physical or sexual abuse, and the child, as an adult, is aware that she or he is angry with the parent, the full extent of the outrage is seldom, if ever, fully experienced. Thus the verboten parricide is transmuted later into homicide, suicide, or, under nefarious historical circumstances, genocide. [It's chilling for mankind to realise that a man as utterly deranged like Adolph Hitler could have climbed to absolute supreme command that was at the time the jewel of the western civilisation.]

Becoming "A Nobody." The Introjects Angry Injunctions as Silent Hallucinations of LowSelf-Worth

A fourth psychopathological consequence of disconfirmation is low self-worth. As an extension of the parental self, the dysfunctional introject perpetuates the disconfirmatory process via negative injunctions. The basic objective of defensive exclusion, as explained later, is to prevent the self from gaining awareness of this existential ruse and, in particular, from daring to target primal anger against the parental introject. Having learned as children to repress the anger and to yield right of being to the parents' existence over their own, wounded adults may continue in this vein by yielding such a right to others. Or, in numerous compensatory maneuvers to become "somebody" they may attempt [As Hitler and "great leaders" did in modern history] to gain the lost terrain by trampling over other selves. Yet they never feel genuinely entitled, no matter the magnitude of their worldly achievements, because the silent introject's voices constantly remind them of how bad and worthless they are.

How's the water fish?

The introject's disconfirmatory voices have not been considered severe psychopathology for two reasons. First, the situation is pandemic. Most people suffer from their effects, hence the predicament has become "normal." Second, the "voices" unlike auditory hallucinations are not audibly vocalized—although it is not unusual for the self to run strings of such abusive thoughts. They are silent hallucinations, and most people are unaware of their presence. Yet although no sound is heard, the emotional consequences of the injunctions are constantly felt as negatively biasing certain fundamental aspects of intrapersonal perception, thought, and behavior. Heard aloud or not, it is hardly a sane state of affairs for the self to confuse "them" (introjects) with "me" (self proper). [Yet must of us do.]

Cultures as Prescriptions for Being and the Loss of "The Right to Be Right"

Neurosis implies a loss of the innate, elemental right to be a right self. Without thedisconfirmation that deprives the child of the right to be a right self in relation to the self of the parental figures, there would be no neurosis. In effect, the child would be incapable of doubting her or his innate sense of lovability. The near sacredness to which parenting, and family life in general, has been indiscriminately elevated in most cultures since ancestral times guarantees that the deck is stacked against the child. Succinctly stated, the basic cultural neurotogenic premise grants right of being to the parent by affirming, "the self of the parent is always righter than that of the child."[ fifth patological consequence{

Cultures preclude awareness of the human wound because, aside from dictating customs and mores, they also contain "prescriptions for being"(8) (the cultural self), that "rub salt on the wound" by siding with the introject's dictates rather than with the wounded self of the child. They do so by feedback and feedforward mechanisms, whereby the (mostly male) self imprints the culture which, in turn, imprints the self. That is why the introject tends to contain the same dysfunctional premises as those of the culture from which it stems, and vice versa.


Confirmation and Disconfirmation. Information about the Message (Content) versus Information about the Messenger (Command)

Communication theorists (Watzlawick et al., 1967) have accorded great clinical relevance to the confirmatory-disconfirmatory value of a message. They discern two parts to a message; the content and the command. At the command (self-data) level, the message is always personal and never neutral. It carries an emotional, usually nonverbal (tone of voice, setting, gesture, etc.) valence that, I propose, confirms or disconfirms the lovability principle. The fact that a message is communicated mostly nonverbally accounts for the surreptitious psychopathology of disconfirmation. That is, what we don't say leaves no trace and has little legalistic value. The command can, of course, also be directly verbalized. [Be it as it may all leads to the tacit acceptance of the psychopathology of everyn day life "bening" when in fact history shows, it has been castrotephic for humanity.]

The content usually expressed verbally, refers simply to what the information is about, without further interpretations. For instance, if a friend tells you "I own a Porsche," at the content level it means just that; he owns such a car (neutral, impersonal information). At the command level, however, the statement could have one-upmanship connotations in a competitive relationship ("I'm ahead of you on the social scale"). In effect, the command belongs to a more abstract order called metainformation; that is, information about information.

Neurosis as an Informational Injury

Updating the nature of the mother-child bond that was originally outlined in Sousa-Poza et al. (1986), I can state that what circulates through that bond is information. I therefore conclude that neurosis radically deviates from all preexisting molds of disease by being an informational injury. Hence, neurosis resembles more of a "software" (informational), rather than a "hardware" (biological), malfunction. However, persistent software malfunction can induce hardware damage. Take the instance of a computer software system beginning to overwrite core system libraries or memory areas, thereby causing the system to "crash," often with irreparable hardware damage.

It is highly plausible that beyond a certain threshold of psychodynamic damage, and consequent emotional suffering, the particular psychobiological makeup of the individual, genetics included, is what dictates the type of symptomatological clusters described in the DSM-IV-TR (APA, 2000). It is also possible that individual differences in sensitivity to disconfirmation are biologically determined. But the fact that appropriate medication can alleviate such symptoms does not mean that the causative state of this misinformation of the self has been corrected. In other words, lack of symptomatology does not mean sanity, vitality, wisdom, happiness, or emotional health.(9)

The Psychopathology of Self-Doubting: The Neurotic Riddle or Informational Impasse

Disconfirmation is a necessary, but insufficient, condition for inducing neurosis. The second element is the immutability of the lovability principle. This latter seems to be so critical to survival that it is very deeply "hardwired" - to the point of being seldom overridden, albeit often doubted. This doubting, however, is pathogenic enough that patients will require external therapeutic input if they are to recover the notion that they are as lovable as ever. This is not an easy task. Persistent disconfirmation shatters Ericksons sense of "basic trust" (1959). And the damaged, unworthy self learns to discount its own lovability—never mind that it can never completely accept that state of affairs. Much of interpersonal human behavior is geared to seeking confirmation of one's lovability while a lot of dysfunctional behavior is about squelching the thirst for confirmation, often with culturally sanctioned substitutes (drinking, smoking, overeating, shopping, overworking). The goal is always to get rid of the distressful instability induced by lack of full selfhood.

Unlike adult patients who, when guided and supported by a therapist, can face the conclusion: "I don't feel well, not because I'm bad, but because my parents did not love me," children, whose emotional and physical survival are at stake, cannot. In fact, children transmute that reality into the basic alogical premise that wrongs the self; they auto-declare their self de facto unworthy: "If they treat me badly, it must be because I'm not lovable; there must be something wrong with me." This erroneous conclusion arises because children cannot conceive of being hurt by, and being angry at, the deified parental figure. But nor can they ignore the insult. And it is here that the doubting arises. A child's cognitive capacities cannot resolve the riddle posited by the hardwired cognition "I'm lovable" and the messages from the deified parental figures that contradict it: "No, you are not!" And even if later as an adult the problem is figured out at the mental level, this does not change how he or she feels. This unsolvable discrepancy constitutes a Russellian paradox (Russell, 1961), whereby the only way to "win" is to step out of the game. Yet that entails either ignoring the parental message—impossible for the child—or, in the case of the adult, getting rid of the dysfunctional introject—again impossible even for the most intellectually gifted of individuals to accomplish without therapeutic help.

Inheriting the Human Wound: The Sacrilegious Taboo and Transmission of the Virus

The "disconfirmatory virus" is transmitted when wounded adults, who have not achieved full selfhood because of lack of parental confirmation, become parents themselves. Their overriding psychic need to surmount the love deprivation state that prevents self-completion leads them to reverse the flow of redundancy. Hence, they seek unconditional confirmation of their own defiled lovability from the best and most readily available source: their children. Even if, at the core, children are aware of the travesty, parental deification makes them the ideal propitiatory victims. Indeed, such deification gives rise to the sacrilegious taboo that prevents that awareness from prevailing. This taboo is so powerful that it silences primal anger by labeling it "blasphemous." In the end, such children never achieve full selfhood; as adults, they will likely end up seeking the confirmation they missed from their parents from their own children. It is a never-ending, vicious cycle.

[Over the centuries, this "benign" psychopathology of everyday life has become a tacit monstrosity that will eventualy derail the human mind to the brink of destruction, if it has not already done so .]

The Architecture of the Self and the Coding of Self-Knowledge

In the past models of both the brain and the mind were often based on linear processing devices such as computers. Recent belief is that the brain in fact generates the mind (which in turn generates the self), and that the whole system operates more like the Internet – constantly reprocessing information that is stored in a very distributed fashion. Current trends in cognitive neuroscience are to thus base models of the mind on the brain, such as parallel distributing processes, modal models, and connectionist models.

However, since nowadays elemental computer concepts are familiar to the majority of readers, it is conceptually and heuristically useful to use computer analogies as clay models ("as if" constructs) to illustrate the flow and storage of the information making up the self. Although our initial data seems to support such conceptualization of this particular function of the self, the terms "folders/ files" or "software/hardware" are not used here to represent physically locatable constructs (memories—both recall and encoding—exist as potentials or processes) but are used solely in metaphorical terms.

Following thus the computer constructs, the information making up the self is stored in three "folders" depending on how such information is coded. And that, perhaps guided by evolutionary processes, happens to correspond to the evolution of three coding modalities: the iconic, the analogical, and the more popularized digital coding of the computer era. According to coding modality, these folders of the self (from the most archaic to the phylogenetically more advanced) are the somatoself, the emotional self, and the mental self.

Thinking versus being:
The emotional self, the male-mind bias,and it's psychiatric and socio-cultural consequences .

The term somatoself coined in Sousa-Poza et al. (1986), denotes that folder of the self that contains iconically coded information; The body is the iconic representation of the self, the "me" I see when I look at myself in a mirror. My name "Joaquin" is my personal digital label, which is, to a large extent, arbitrary. In the spectrum of similarity, a portrait of myself bearing more or less a resemblance to me would be my analogical representation. the emotional self, the male-mind bias, and its psychiatric and socio-cultural consequences. The emotional self the only folder not explicitly described in Sousa-Poza et al. (1986), is at the forefront of neurotic suffering and psychodynamics, if only because neurotics are to a large extent emotional orphans. It is in this folder that primal anger has been stored with a "no access" label. The information carried by emotions is expressed and encoded in the typical more or less continuum (feelings are not a yes-no proposition; they arise, peak, and slowly abate) of the analogical code, as opposed to the all-or-nothing, 1-0 representation that characterizes digital encoding.

The sixth major psychopathological consequence of disconfirmation is that it stunts the development of the emotional self which, because of a lack of backup redundancy, never achieves autonomy. Children, not having differentiated from the parental selves (represented later in life by the introjects), remain in a symbiotic state with them. Predominant male-mind cultural values, however, preclude awareness of that problem. It is possible to obtain a university degree while being emotionally stunted. [And that, as the Spanish physician and humanist Gregorio Maranon, said : "The danger of our times is that the barbarians (aliens to self-knowledge) master the techniques.]

What I call the male-mind bias arises from a peculiar distortion of the self, based on the fact that a great part of a young boy's emotional self must be silenced to fit into the mostly narcissistic notion of "being a man". Women, historically perceived by men as de facto lesser selves, can retain more of their emotional expression, although they have long been penalized in matters of power, status, and social rank. Preferentially silenced in men, therefore, are the constructive (anabolic or "feminine") aspects of selfhood, such as compassion, tenderness, [nurturing],and other soft and "unmanly" feelings. Favored are the hyper-developing, destructive (catabolic), "manly" attributes, such as competitive aggression and dominance to acquire power over others. Indeed, men soon learn that crying is viewed as "breaking down," whereas "taking it on the chin" or "biting the bullet" with "a stiff upper lip" becomes, incongruously, highly commendable. [In one word narcissism.]

This crippling practice, as nefarious as the old Asian custom of foot binding women, creates a severe emotional handicap in the male self. In effect, it generates a contrived, contra natura false self that is corrupted by the fact that many of its emotional subfolders read, "no access permitted" These deforming male-mind emotional values, which have had a negative effect in psychiatry and psychotherapy, are, I believe, at the root of Freud's abstinence principle of nongratification in psychoanalysis, as well as the current penchant to attribute biological roots to all psychiatric disorders.

The status of the emotional self is downgraded. Male-mind thinking exalts mental abilities (which bring power but not necessarily peace of mind) to the point that, socioculturally, the mental self has become synonymous with the self. It is understandable, therefore, that male-mind psychiatry was destined to feel more comfortable with impersonal techno/scientific solutions (to know how "to do," as in prescribing medication) than with self-knowledge (to know how "to be," as in practicing psychotherapy). In consequence, the current psychiatric fashion is to ignore the biographically rooted psychodynamics of the patient (informationalevents), focusing instead almost exclusively on neurophysiological factors. Eventually, however, for both scientific and clinical reasons, biological and psychological psychiatry must converge so that psychiatrists can understand how informational and neuropsychological events interact. Besides, it may prove highly dangerous to tamper with the hardware, particularly when, as James Watson noted: "How the mind works... is still a mystery. We understand the hardware, but we don't have a clue about the operating system" (Watson & Lemonick, February 17 2003, p. 52). [Emphasis Mine].

The mental self and the false self. The mental self (Sousa-poza et al., 1986) is basically digitally coded and expressed in thoughts, words, and ideas. Yet the digital code is detached in similarity [ and from ordinary reality] from whatever it represents. For example, as Bateson and Jackson (1964) have noted, names of objects have little in common with the objects themselves; the word "dog" for instance does not bark nor fetch sticks. In effect, digital information, although extremely efficient in intellectual and/or material problem solving and in understanding the outer world, is, in matters of the self, the most removed from reality. To build upon the concepts of Bateson (1972), we can say that the mental self stands to the self as the map stands to the territory. [This , I believe, is why reason and computers alone will never figure out the stock market. Investing has a too strong emotional component.]

To understand the contribution of the mental self to the psychodynamics of neurosis, three fundamental considerations must be kept in mind:
1. While the emotional self functions strictly by the lex talion (Judaic law of an eye for an eye) the mental self is above all a "reasonable" entity because it usually functions via inductive or deductive logic.
2. Whereas the emotional self is transcultural, the mental self is not; rather than being hardwired, the mental self is formed by the particular culture in which the child is raised.
3. The mental self is also the selfsubfolder that can be, and often is, consciously manipulated to the point that references to a false self, a well-known concept in the literature (Kohut, 1971; Masterson & Klein, 1989; Winnicott, 1989), usually mean a falsified mental self.

The unquestionable supremacy of the mental self was summed up in the famous Cartesian dictum: Cogito ergo sum (I think, therefore I exist; Descartes, 1637/1985). In pure male-mind mode, thinking is confused with being. In fact, however, the former is just one of thefunctions of the latter, whereas being requires the full participation of all components of the operational system: mental, emotional, and somatic.

In my opinion, this view of the mental self has been a formidable obstacle to understanding the self and the sciences of the mind in general. A better dictum would be: "I am loved therefore I exist." As it is, the role of the mental self in the treatment of neurosis, necessary as it is, has been substantially overestimated. Unfortunately, too, the dysfunctional introject yields not to reason but to the brute force of anger (as outlined in the method section, Sousa-Poza 2005).

All neuroses unavoidably result in a form of aggression. Simply put, the individual is forced to exact confirmation of a false self from others. If the mirror (introject) is crooked, the reflection (the self) cannot be straight. To spare the parent, children turn their "badness" against themselves, concocting a falsehood so as to uphold the assumed parental goodness: "After all, they did love me the best way they could." But whereas true love is unconditional, what usually passes for love is highly conditional on fulfilling neurotic parental needs. Ending up saddled with a false self is the sixth psychopathological consequence of disconfirmation.

The Mind's Firewall: Defensive Exclusion. Protection from Emotional Trauma by Fragmentation of the Self

Like water and oil, differently coded information does not mix freely but has to be translated or converted from one code modality into another, much as a converter permits Microsoft Word to work with documents originally written with WordPerfect. A crucial characteristic of neurotic states is that they interfere with the intercode free flow of information (analogical-digital-iconic translations) and, insofar as all files pertaining to a particular message cannot be integrated, its contents cannot reach correct meaning within the screen of consciousness.

For a message to be thoroughly processed and to generate adequate meaning, the experiential triad—so named by Ahsen (1968) and composed of elements similar to the three coding modalities defined here—has to remain intact. Such is not the case when the message severely affronts the lovability principle. At that point, the defense mechanism known as defensive exclusion is deployed to intercept and neutralize the message by preventing full processing into its conscious meaning. Defensive exclusion fragments the self.

The information payload is scrambled into "packages" according to their coding modality. For instance, anger is stored in the emotional self with a "no access" label attached and, if the destructive potential is high enough, another file is stored in the somatoself. This latter induces psychosomatic symptoms, as is often the case with the pelvic area pain experienced by sexually abused women. Unable to access the information, the mental self arrives at an erroneous meaning about the event. Thus the child is spared the full impact of the trauma, although at the cost of fragmenting the awareness or informational integrity of the self, as well as falsifying ("corrupting") the indexing of self-knowledge by misclassifying the disconfirmatory message. To quote another book title from Alice Miller (1980/1983), the child logs the insult in the "for your own good" index.

Contamination of the Present by Automatic Downloading

Given that biographical information stashed away in the emotional self is analogically coded, its files are indexed by "look-alike" similarities; that is, similar files of biographical events are indexed closer to each other than to dissimilar ones. In clinical practice, whenever individuals encounter a situation in life analogous to the infantile one, the contents of the historical "no access" files are triggered, provoking an automatic, involuntary download into the experience of the moment; thus the mind is tricked into believing that the anger-triggering aggression stems, not from the introject, but from the "outside," from the person(s) being related to. This contamination, the seventh psychopathological consequence of disconfirmation, leads to misinterpreting the intentions of others which, in turn, severely interferes with relationships of any type. This also lies at the root of the iatrogenic "transference” phenomena provoked by the psychoanalytic treatment setting itselfBecause of corrupted indexing, neurotics tend to misread the command. It is pathognomonic of neurosis, in fact, to confuse the target (parental figure) with the trigger (hapless human being in the present), and to expect different results from consistently repetitive behavior. Indeed, we remain, as Alice Miller so accurately termed the phenomenon, "prisoners of childhood" (1979/1981).

Footnotes:
1 The term neurosis is no longer in use in the Diagnostic and statistical manual of mental disorders (DSM-IV-TR [4th edition, text revision]; American Psychiatric Association [APA], 2000). Psychopathology formerly known as neurosis has been grouped under different "disorders." In this paper, however, the classic generic term shall be retained.
2 Miller never developed a method of her own, for a while advocating that of J. Konrad Stettbacherr (1990/1991)
3 The contributions of Dr. Azima are discussed in the previous paper (Eagle, Rohrberg & Steinberg, 1986).
4 Arthur Janov registered Ihe term "Primal Therapy" as a service trademark.
5 The introjects are the characteristics and values of the parental figures that are incorporated unconsciously into the child's psyche, perpetuating parental dictates in the adult self. Although technically there is a paternal and a maternal introject which, as outlined in the method paper (Sousa-Poza, 2005), serve different functions, they can be referred to in the singular only.
6 I owe the coining of this term to Dr. Jacques Bradwejn.
7 In the previous paper (Sousa-Poza et al.1986) we had erroneously stated that the self is the seat of all experience. That is, in fact, the function of the mind.
8. I owe the elaboration of this notion in part to conversations with the eminent American anthropologist Edward T. Hall.
9 There is incipient evidence that early emotional trauma carries with it negative neuropsychological changes (Bremner, 1999).

Joaquin F Sousa-Poza, M.D., D.(M.)Sc. F.R.C.P. (C)
Ex-Professeur Agrégé de Psychiatrie Université de Sherbrooke, Sherbrooke, Québec, Canada. Currently working in Victoria, British Columbia, Canada.

Reprints of the original background paper "Anaclitic Etiology and Treatment of Neurosis: An In formation-Attachment Model" (Sousa-Poza, Eagle, Rohrberg & Steinberg, 1986) are available directly from me at the address listed below. The early groundwork for this research was supported by Grant MA-5661 from the Medical Research Council of Canada (currently the Canadian Institutes of Health Research).

I thank the following persons for their contributions; Daphne H. Fontaine, Suzanne Frenette, Jose Luis Gonzalez De Rivera, Ali Hemani, Lisette D. Jolicoeur, and Kenneth Lilley.

Joaquin F. Sousa-Poza, M.D., D.(M.)Sc, F.R.C.P.(C)