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Concerned About Unconventional Mental Health Interventions?

Concerned About Unconventional Mental Health Interventions?
Alternative Psychotherapies: Evaluating Unconventional Mental Health Treatments
Showing posts with label prenatal life. Show all posts
Showing posts with label prenatal life. Show all posts

Friday, May 20, 2011

Looking Backward: Sources of the "Primal Wound" Belief

Very few ideas get created out of nothing, so it’s always interesting to look for the “ancestors” of beliefs that seem to appear suddenly and be spoken of by a small number of people. Ever since I first came across the “Primal Wound” (the belief that newborn babies who are relinquished for adoption thereby sustain a deep, lifelong psychological wound) , I’ve been wanting to find time to look for some historical background. I’ve found quite a bit-- all confirming the statement attributed to Gershon Scholem, that “Nonsense is always nonsense, but the history of nonsense is scholarship”.

In an earlier post, I pointed out the roles of the Czech psychiatrist Stanislav Grof and the British “clinical theologian” Frank Lake in arguing that unborn babies are aware, not just at 34 weeks, but all the way back to conception. Grof and Lake believed it was possible to know what unborn babies felt, by means of LSD experiences that they thought allowed them to recall their prenatal lives.

Just a little earlier than Grof’s and Lake’s work, a book called The search for the beloved (1949) was published by Nandor Fodor. Fodor had been a psychic researcher, “ghost-hunter”, and exorcist in England before training as a psychoanalyst. In an interview published in Psychoanalytic Review not long before his death in 1964, Fodor asserted that there was telepathic contact between a mother and her unborn child (Spraggett, A., “Nandor Fodor: Analyst of the unexplained”. Vol. 56, pp. 128-137). In a 1957 article (Fodor, N. “Prenatal foundations of psychotic development”. Samiksa Vol. 11, pp. 1-42), Fodor advised that all births should be by Caesarean section in order to avoid the shock of birth and possible resulting schizophrenia. In The search for the beloved, incidentally, Fodor advised that no psychotherapeutic treatment was complete until it reached memories at the fetal level. Emphasizing the influence of the mother on the unborn baby, he suggested that birthmarks are indeed caused by mothers’ experiences. He rejected the idea that most maternal shocks are not followed by birthmarks, saying “the cases in which the shock of the mother is not followed by a marking of the child’s body furnish no contrary argument. Negatives never prove anything “ (p. 330)-- an argument that has emerged a number of times in discussion of the “Primal Wound”.

A number of Fodor’s remarks in The search for the beloved foreshadow statements by Nancy Verrier and her followers. Here are some of them: “At first, the child is unable to realize that the mother’s breasts are not part of its own physical and psychic organism, that the mother is a being apart” (p. 174). “[F]oster parents and institutions cannot enter into the same psychic bond which the pre-natal community of life and immediate post-natal maternal care established “ (p. 165). “In the case of illegitimate birth the child’s reactions to life are bound to be completely abnormal” (p. 166).

Next question: where did Fodor get his belief system? Some answers to this question can be found by looking at the authors whom Fodor quotes in The search for the beloved. There are two major sources cited, one of whom in turn quotes the other. The first is the psychiatrist J.Sadger (I can find no first name for him, and assume that he is not the same person as Freud’s colleague I.I. Sadger). In 1927, at a psychoanalytic conference in Innsbruck, Sadger spoke of the need for analytic patients to go back to memories from infancy, birth, or earlier; if neurotic symptoms did not dissipate at that point, they need to focus on the embryonic period in earliest pregnancy, or even on their memories as sperm or the ovum. In a 1941 Psychoanalytic Review paper (“Preliminary study of the psychic life of the fetus and the primary germ”, Vol. 28, pp. 327-358), Sadger discussed whether the ovum consciously selects one or another sperm for fertilization purposes, and whether the zygote contains an inheritance of “the rejection or inclination of one [parent] toward the other at the time” (p. 330). He asserted that “I believe first of all that the embryo already feels plainly whether its mother loves it or not, whether she gives it much love, little love, or none at all, in many instances in fact in place of love sheer hate” (p. 336). Assuming that all events, physical and mental, are overdetermined by psychological factors, Sadger opined that “many a fall or other accident of a pregnant woman is nothing else than an attempt at abortion on the part of the unconscious” (p. 336).

Sadger in his turn seems to have owed some of his thinking to Georg Walther Groddeck, a second source frequently cited by Fodor. Groddeck was a physician whose ideas had some influence on Freud’s later work. In 1923, Groddeck published Das Buch vom Es (The Book of the It), a volume in the form of letters to a female friend signed by “Patrik Troll”. This volume was translated and re-published in 1947 as The Book of the It, with a preface by the British novelist Lawrence Durell. The “It” of this title had nothing to do with the Addams family, but was a vaguely-defined combination of a universal vital force and the learned anxieties and desires of an individual, working together through the unconscious mind to shape both physical and psychological characteristics of the person. Groddeck considered the primary motivations to be the desire of the child for the mother and the mother’s experience of sexuality while holding the child inside her body and while giving birth, an event that Groddeck seemed to perceive as a sort of reverse intercourse with the object being expelled rather than penetrating. Groddeck’s belief that all aspects of life can be influenced by the unconscious shows in his anecdote about telling a woman with a breech presentation that giving birth vaginally with a head presentation felt very good; he claimed that the fetus reversed positions within half an hour after this discussion. He attributed both infertility and impotence to unconscious rejection of relevant aspects of life-- and, by the way, claimed that a man could not penetrate a woman unless she “unconsciously” wanted this to happen.

Here we see some, though by no means all, of the precursors whose ideas are responsible for Nancy Verrier’s “Primal Wound” belief. Need I point out that none of them have any basis in systematic study of psychology, biology, or medicine? These claims date back to a time when few people asked for the evidence behind assertions like those of Fodor, Sadger, and Groddeck (but even Freud numbered Groddeck among the “wild psychoanalysts). We’d do well to think of these ideas, including the “Primal Wound”, in 2011 terms, not those of 1923.

Thursday, March 10, 2011

Understanding Prenatal Life: For Best Results, Choose Your Sources

Ideas about the experiences of babies before and during birth are a part of some ways of thinking about mental health and about psychotherapy. Some treatments, like regression therapies, focus on the belief that prenatal experiences help to determine individual development and may need to be recalled and processed so a person can move beyond lifelong difficulties. Practitioners of these treatments often claim that they know what prenatal life was like-- even back to conception (or before!)—and can help patients understand and recover from problems that result from that early part of life.

What makes anyone think that they know the experiences of an unborn child, particularly of one who is still constituted of a small number of cells? Major claims about this have come from people who believe that their experiences when taking LSD were accurate depictions of what they had experienced in the earliest parts of their lives. Frank Lake, the author of Clinical Theology, considered that experiences resulting from LSD represented the trauma of birth as well as of separation from the mother. His colleague Stanislav Grof , again using LSD revelations as sources, proposed that there were four stages of experience before birth. The first is at least potentially blissful, although it may be spoiled by the mother’s smoking, drinking, etc. This period lasts until the birth process itself begins, when the infant is said to feel stuck and under inescapable pressure as the uterus begins to contract rhythmically. Third, the passage through the vagina is experienced as a life-death struggle which may also be ecstatic. Finally, birth itself is experienced ecstatically, with a sense of release of pressure and radiant light (although paradoxically some of Grof’s followers have emphasized birth as involving a sense of loss as the physical connection with the mother is broken.)

Later in his career, Lake gave up the LSD method and depended on re-enactments of birth and deep breathing exercises to induce experiences that he believed were representations of prenatal life and the birth experience. His follower William Emerson ( 2002; Somatotropic therapy. Journal of Heart-Centered Therapies, Vol. 5, pp. 65-90) clarified some of this belief system when he stated that one “of the central concepts in this field is the notion that mind pre-exists the nervous system; that there is a level at which the conceptus is aware of essential qualities of feeling present in its inception; and that this awareness records its struggles to survive the hazards of implantation, the history of its gestation, and the detailed drama of its birth at an energetic and cellular level”.

Looking at these ideas, we see that the notion of distinct memories going back to conception is based not on scientific study of early development but on drug-induced experiences and fantasies during group re-enactments. We also see that such beliefs are related to the idea of a soul or nonmaterial animating entity that exists prior to, and separate from, the material body. In addition, we see that these beliefs reject the function of the nervous system as holder of memories and instead ascribe memory to a nonmaterial energy (perhaps the World Soul or some other form of “nonlocal mind”) and to properties of individual cells outside the nervous system.

Anyone considering prenatal experience from the psychological or other science-based viewpoint would reject the perspective I’ve just described. The experiences of adults, however vivid or interesting, would not be taken to indicate anything about the nature of prenatal experience. No nonmaterial entity would be included in a discussion of either prenatal or post-natal functioning, and it would be assumed that all such functioning has the potential to be understood from a materialist viewpoint, even if it is not presently well understood. Memory, in particular, would be thought of as a function of the nervous system and not of other body parts or of nonmaterial elements.

One particularly important assumption about the psychology of prenatal life would be that until injury, disease, or old age interfere, development goes from a less advanced to a more advanced state. In other words, adults have more capacities than children, older children more capacities than infants, and infants more capacities than unborn babies. As a consequence, if an infant does not have the capacity to remember an experience, an unborn baby, who is less advanced in development, will not have that ability either. So, for instance, as a young baby does not have the capacity to understand many adult motives and wishes (like the ones Emerson called “essential qualities of feeling present at its inception”), an unborn infant will also be unable to perceive or remember such adult mental states. Although the baby could be affected by the mother’s physical condition, by stress hormones, etc., it would not actually be able to respond to the mother’s pleasure or displeasure about the pregnancy.

The capacities of newborn babies to show some recognition of sounds they heard a few weeks before birth are of great interest, and no one who has an interest in early development would argue that the fetus is “anesthetized” in some way, or that sensation and memory suddenly and instantly emerge when the baby takes its first breath. But those early abilities are a far cry from the telepathic communication of adult emotion sometimes claimed, and the evidence for them is a far cry from descriptions of drugged states.

Friday, February 25, 2011

Attachment and "Bonding": The Mainstream and Some Eddies

Psychologists and clinical social workers will be surprised at my bothering to talk about the subject of this post, but if they look back over some recent comments they’ll see why this needs to be done. I’m going to review historical changes in ideas about emotional attachment and show where the mainstream is today.

Sigmund Freud’s discussion of attachment assumed that a child’s preference for a familiar caregiver depended on experiences of feeding-- a sort of “cupboard love”. He also considered that attachment could not begin until the end of the first year, when necessary cognitive abilities developed. While Freud considered early experiences essential in the shaping of personality, he focused on oral experiences rather than attachment per se as the important factor in early life.

A second generation of psychoanalysts in the 1930s included some whom Freud labeled “wild psychoanalysts”. These were people like Georg Groddeck and Sandor Ferenczi who emphasized the role of the body in emotional life. Ferenczi re-enacted parent-child caregiving actions with his patients, a method later advocated by the 1970s “antipsychiatrist” R.D. Laing. Without specifically discussing attachment, these therapists focused on early interactions that can be interpreted as related to attachment, and were concerned with earlier events than Freud usually focused on. One psychoanalyst, Otto Rank, pursued earlier and earlier causes of emotional problems and eventually held that birth itself was a traumatic event.

In the 1940s, therapists using hypnosis claimed that they could use a process of regression to return patients to early periods of development, and that this process could correct the impact of early problems. Within a few years, a popular book, The Search for Bridey Murphy, suggested to the public that hypnotic regression could return a person not just to an earlier stage of his or her development, but to a past life. Scientologists at about the same time contributed to this belief by stating that under their guidance it was possible to remember not only prenatal life but the moment of one’s conception. Popular acceptance of these ideas was not diminished by various studies like those of T.X. Barber, who showed that in fact age-regressed hypnotic subjects were no more accurate in their depiction of what they had been like at age 3 than they were when told they were now 90 (which they had not yet been). However, belief in memory of prenatal or pre-conception life was not part of mainstream psychological thinking about attachment or any other part of development.

With the publication of John Bowlby’s theory of attachment in the 1960s, ‘70s, and ‘80s , mainstream psychology developed an intense interest in attachment, and focused on the timing of this emotional process toward the end of the first year, as Bowlby suggested-- a schedule not very different from the one Freud had originally described. A small number of dissidents offered alternative claims about timing and causes of attachment. W. Ernst Freud (born Halberstadt; the son of Sigmund Freud’s daughter Sophie) published a chapter on “Prenatal Attachment” in a 1980 volume, The Course of Life, edited by Stanley Greenspan and George Pollock.

W.E. Freud’s claims were similar to those made by individuals such as William Emerson, a leader of the Association for Pre- and Perinatal Psychology and Health (APPPAH). Emerson has advocated the use of head and neck massage as a corrective for babies he considers to be influenced by their prenatal and birth circumstances. APPPAH was much influenced by the publications of Stanislav Grof, a psychiatrist, and Frank Lake, a psychiatrist and theologian, both of whom considered experiences induced by LSD to provide useful evidence about the nature of prenatal and birth experiences. These views, while considerably outside the mainstream of psychological thought, were treated with interest by the “psychohistory” school of historians. APPPAH also influenced the suggestion by Nancy Verrier that adopted children experience a “primal wound”.

In the 1970s, the “primal therapy” advocated by Arthur Janov contributed to this picture by its assumption that memory is not confined to the functioning of the nervous system, but is instead a biological function of all cells. Once again, this echoed some thinking of Scientologists and others outside the psychological mainstream.

In the early 1980s, work by M.H. Klaus and J.H.Kennell investigated maternal attitudes and referred to the strong preference of mothers for their babies, and their preoccupation with their babies, as “bonding”. This term was often confused with the term “attachment”, which is properly applied to babies and children, not to adults. Because in Klaus and Kennell’s original work “bonding” appeared to occur shortly after birth, lay readers may have come to believe that attachment occurs shortly after, or even before, birth. As a matter of fact, later work indicated that “bonding” often develops much more gradually than Klaus and Kennel originally reported--- and, to repeat the point, is in any case not an infant process, however much it may influence the infant.

Today, mainstream psychology continues to consider that emotional attachment arises as a result of experiences with a consistent, sensitive, responsive caregiver, and that this becomes evident only in the second half of the first year. For example, the University of Delaware clinician-researcher Mary Dozier, writing in Zero to Three for January 2011, refers to the new attachment concerns of foster children who are more than 10 or 11 months old when they are placed with a caregiver. Dozier and her co-authors also reject the biological factors suggested by Janov , Verrier, and others, stating that “the experience of loss is just as devastating when the infant is moved from a loving, committed foster parent as when he or she is moved from a committed biological parent… From an infant’s point of view, biological relatedness is inconsequential."

Sunday, January 16, 2011

Prenatal Listening: It's Complicated

A New Yorker “Annals of Psychology” article by the columnist-pundit David Brooks, entitled “Social Animal”, appeared in the Jan. 17, 2011 issue of that magazine. I have to say that it was a fairly feeble article, apparently drawn largely from a Psych 101 textbook of several years ago. However, Brooks” article contained a little discussion of a topic that deserves careful consideration-- whether unborn babies learn from the voices that penetrate the uterus and come to their ears. Brooks stated: “Even when he was in the womb, [the infant] was listening for his mother’s voice, and being molded by it. French babies cry differently from babies who’ve heard German in the womb, because they’ve absorbed French intonations before birth. Fetuses who have been read “The Cat in the Hat” while in the womb suck rhythmically when they hear it again after birth, because they recognize the rhythm of the poetry.”

I certainly do not want to say that none of this is true, but I believe that the important implications of such early learning make it essential for us to examine with care the research behind the claims Brooks is making. The research report stating that French and German babies cry differently is by B. Mampe, A.D. Friederici, A. Christophe, and K. Wermke (“Newborns’ cry melody is shaped by their native language”),and was published in Current Biology in 2009 (Vol.19, pp. 1994-1997). Mampe and her colleagues recorded cries from 60 babies 2-5 days of age (half born of French-speaking mothers, half born of German-speaking mothers) while they were interacting with their own mothers-- having their diapers changed, preparing for feeding, or being soothed when spontaneously fussing. The cries were not the characteristic high-pitched pain cry of the young infant and were not recorded at times when there was a clear reason for pain like a heel-stick for a blood sample.

Mampe and her colleagues analyzed the ways the sound frequencies of these cries changed over the brief period involved in one exhalation of breath. Like adults, infants change their sound production rapidly in ways that can produce a rising tone or a falling one. The researchers were able to analyze each cry and create a graph indicating its pattern, and later to statistically compare all the babies of French mothers and all the babies of German mothers on their cry “shapes”, whether rising or falling. This was of interest because sound production by French speakers involves more rising tones than do the sounds produced by German speakers.

Because there is no reason to suppose that French people have different vocal anatomy than German people, it appears that those different sound patterns must be learned through experience. But when does that experience begin to have an effect? Mampe and her colleagues suggest that the babies must have learned prenatally to use the sound pattern of their mother’s language.

Of course this is a possibility. However, there are some details about this study that need to be examined before rushing to a conclusion. Mampe’s group reported statistical comparisons between the French-background group and the German-background group’s cries, but it’s not quite clear how they did all the steps in their analysis. When there is more than one cry from each baby, and not necessarily the same number of cries from each, there are particular ways to do a statistical analysis; most statistical tests are designed to work on one score or reading from each participant. The Mampe paper does not make it clear how this problem was solved. In addition, the graphic display of the results shows a very considerable overlap between the sound patterns produced by the two groups, with some “German-listening” babies crying with the French-like rising tones. Whatever was happening here, it would seem that whether or not hearing experience made a difference, there were some unidentified factors at work too.

There is a more obvious issue as well, having to do with the basic research design. When the babies’ cries were recorded, they were interacting in some way with their own mothers. Each French-experienced baby was with a French-speaking mother, and each German-experienced baby was with a German-speaking mother. Whether the baby continued to cry or stopped depended in part on the mother’s response. It’s also possible that how the baby managed its rising or falling tone also depended on the mother’s response. Possibly (but of course we can’t tell on the basis of Mampe’s research), a French-speaking mother responded to “French-like” cries, with their rising tone, as if she recognized the sound as language, and to “German-like” cries, with their falling tone, as if this was a vocalization but not related to speech. German-speaking mothers would reverse this, but in both cases the mothers might become more attentive, change facial expression, and speak when they heard the sounds that resembled their own speech, thus rewarding and prolonging a particular sound pattern. To really know about this we would need to switch German-speaking mothers to briefly caring for French babies, and French-speaking mothers to briefly caring for German babies. We might find out that because of her interest in understanding a baby’s intentions, a mother does things that shape even very early sound production.

Let me switch back for a minute to Brooks’ New Yorker article and that final claim that babies suck rhythmically because they recognize the rhythm of the poetry. This statement is presumably based on the well-known study by DeCaspar and Spence in which unborn babies were allowed to hear either readings of the Dr. Seuss classic “The Cat in the Hat” or an alternative with simple but different rhymes. After they were born, the babies were given a nipple device, like a pacifier. If they sucked in one way (long rests between sucks) they would hear one of the readings; if they sucked another way (short rests between sucks), they would hear the other. The babies tended to suck in the way that would let them hear the familiar verse. But… it did not matter whether the person reading the verses was the baby’s mother or someone else. They sucked in a particular pattern in order to hear the familiar verse, not to hear their mother’s voice. And, contrary to what Brooks implies, the babies did not imitate the rhythm of the verse with their sucking rhythms; they just used sucking as a way to choose what they listened to.

The moral of this story, I suppose, is that year by year we learn more about how young humans develop. It’s not easy to find this out-- we have to discover clever ways to get babies to tell us about themselves. A study that seems very definite in its results can suddenly be seen to need substantial follow-up. Regrettably, much of what’s written about children (like Brooks’ New Yorker article) does not include the essential thinking that’s needed before conclusions are drawn. Caveat lector!