ABSTRACT:  For almost seventy years, birth trauma has been considered a real and important factor in human personality, with a flurry of new research and information substantiating its effects coming out in the last few decades.  In general, researchers and theorists have proposed a pretraumatic and undisturbed state, associated frequently with our time in the womb, that—one way or the other, at some time or other, but oftentimes at birth—gets disrupted.  This disruption is often severe and traumatic, resulting in a split.  In a primitive and almost instinctual way, we dissociate into a hurt and vulnerable self that is hidden away and a less sensitive self that is pushed forward.  This process is called the primal split, and it may in fact be that this is the crucial move that differentiates us from the animals.  Once this split has occurred, its effects usually continue for a lifetime, as it pushes the individual to re-create repeatedly, in a myriad of ways, the original trauma, in failed attempts to master it.  The way that birth or early trauma occurs, persists, and is repeated indefinitely shows the same logic and pattern as that characterizing adult post-traumatic stress disorder (PTSD).  The trauma of birth for the baby and of war for the soldier affects them similarly.  Hence PTSD and primal theory have much to learn from each other and are ripe for integration.
 

Pre- and Perinatal Pioneers

Otto Rank, in 1929, was the first person to deal seriously with the trauma of birth as possibly important for psychotherapy.  His ideas (Rank 1929/1952) were welcomed by Freud at first but were later discarded as a potential threat to the pre-eminence of the Oedipus complex.

One of Rank’s patients was Nandor Fodor (1949), who himself became a psychiatrist and focused his clinical attention on the formative experiences of birth.  Francis Mott (1959), a British psychiatrist and a patient of Fodor, wrote extensively on the mythological and dream content of prenatal and perinatal life, writing several books on this between 1948 and 1964.

Frank Lake (1980) was influenced by Mott’s work and was one of the first British psychiatrists to emphasize the effects of intrauterine life, as well as the trauma of birth.  Donald Winnicott (1958) also recognized and worked with the impact of birth on his patients when circumstances warranted, and he suggested that the body retained these impingements as memories.

Bill Swartley (Rowan, 1988) was one of the founders of the International Primal Association; he introduced primal integration to Britain in the late Seventies.  Winnicott supervised Ronald Laing (1976, 1982), who explored the fundamental significance of pre- and perinatal psychology in the structure of the personality.

One of the most important experimenters and theorists in this area is Stanislav Grof (1992), who is still alive and active, although his first work in this field started in the 1950s.  It was Stan Grof who discovered the four basic perinatal matrices, or BPMs.
 

Out of Eden

The first of these BPMs, which is called BPM I, is related to the prenatal state and is often experienced as undisturbed, "oceanic," or blissful.  Obviously it is possible for many bad experiences to be had in the womb, through accident, illness, drugs and so forth; but let us assume that none of these have occurred.  It is a good womb rather than a bad womb.  At this stage the person is, and feels, OK.

It seems quite possible to regard this stage as a myth, in the sense of an unverifiable story that somehow makes sense of things.  The essential thing is that this is a state before trauma.  Somehow we all seem to have memories of such a state, and the sense of it has regularly been projected in the form of myths of a Golden Age, the Garden of Eden, the Primordial Paradise, and so on.  I only postulate it because none of the rest seems to make sense unless we do start here.

At this stage there is nothing wrong.  Whatever is needed is given, without the need to ask.  The self is OK, and the world is OK, and there is no need to differentiate between the two.  I do not need to be able to communicate my needs as all that is needed is immediately provided.  It is peaceful and quiet (who ever heard of a noisy utopia?), and when I do become aware of lights or sounds, they are filtered and muffled before they get to me.  There is one sound which may become symbolic of this whole state of being—my mother’s heartbeat.

My body is relaxed and energy can easily flow in and flow out again.  The energy is not trapped . . . I am open to the world.  But it also indicates that I have no protection against harsh events which occur.  I assume that I am free and even perhaps omnipotent.  I am totally identified with myself.  I am whole.  This stage may be very far back, because the fetus is a very active creature and events may, sooner than we would think, "conspire" to disrupt this sublime peacefulness.

Ken Wilber (1980) calls this the pleroma stage and points out how important it is not confuse it with the later, more spiritual stages of psychospiritual development.  Many people have made this mistake, including Freud, Rank, and others.  Such lack of distinction Wilber calls the pre/trans fallacy, because it confuses what is prepersonal with what is transpersonal.

At the beginning we do not distinguish ourselves very well from our mothers.  We are not quite sure where our mother ends and we begin; there seems to be an overlap, which is quite large at first.  We are not even sure that we want to be separate or have the right to exist as separate.

"It is an ‘oceanic’ state without any boundaries where we do not differentiate between ourselves and the maternal organism or ourselves and the external world" (Grof, 1992, p. 38).  All the strength, all the power, seems to be in relation with the mother, the identity with the mother.  Perhaps the mother and I are one.  There may even be a feeling of omnipotence, of being all-powerful, because of this.  Everything we do is right.

In order to move out of this unity and become a separate body, something is necessary; and it is going to have to be something which threatens this power, this omnipotence.  Harsh reality is going to have to tell us that we are not all-powerful, that we are not the mother, that we are little, and weak, and wrong.

Sometimes this is the trauma of birth (Janov, 1983).  Sometimes it is an earlier trauma, or a later one.  Sometimes it is just the experience of not getting what we want, when we want it.  Sometimes it is the feeling of being abandoned.  It may be actual insult or injury.  But whatever it is, and however violent it may seem, the broad effect is the same.  We somehow split, in a primitive and almost instinctive way, into a hurt and vulnerable self that is hidden away and a less sensitive self that is pushed forward.  Winnicott (1958) has a good description of this, but many other people have described it quite independently.

At the same time, a notice is put up, as it were, which says, "Do not enter; here be pain." And so we carry on, improving the false self, and maybe even developing other false selves on the same model, to satisfy other, newer, situations.  We do not go back.

It may be that this is the crucial move that made us different from the animals.  There is no evidence at all that the consciousness of an animal splits in this way.  Poets and other writers down the ages have told us that the appealing thing about animals is that they are simpler than we are, more direct, less tortured.  Perhaps it is this fatal split that makes us the complex creatures that we are—creatures with an inner life that is just as important as our outer life, and often harder to cope with.

Let us just go back to the trauma of birth.  It is important to understand this, and in recent years much new information has come from research and clinical experience.  The basic point is that the fetus is well developed and quite experienced before the birth process begins, as Verny (1982) has well described.  It is a person who is being born, not a ball of flesh that later becomes a person.

One of the curious things is that even a person who has brought some quite fresh thinking to the question of the early origins of neurosis, Daniel Stern (1985), has nothing to say about birth or fetal experience.  Like the psychoanalysts he is mainly addressing, he simply assumes that life starts at birth and carries on from there.  This could be regarded by some as quite extraordinary.

One of the best books to emerge about this is by David Chamberlain (1998), an excellent researcher who has had papers published in some of the best journals in the field.  He writes,

Perhaps the last big scientific barrier to full recognition of infants as persons will fall with acceptance of the possibility of complex personal memory at birth.  Skeptical parents sometimes come to accept birth memory when they hear their two-year-olds spontaneously talking about it.  Once we know that newborns are good at learning and that learning and memory go hand in hand, it is easier to accept birth memory.  Some need no further convincing because they have discovered their own birth memories by one method or another.  Others have discovered these memories under hypnosis or in a psychological breakthrough in therapy.  (pp. xx-xxi)

One of Chamberlain’s research projects was to correlate children’s accounts of their births with their mothers’ accounts of them.  The mothers had to assure him that they had not spoken of their experiences to their children.  The children were aged between nine and twenty-three.  He used open-ended questions and allowed the people to speak freely.  Although there were one or two discrepancies, the vast majority of the descriptions tallied closely.  In other words, the memories were on the whole extremely accurate.

The only reason more doctors, psychologists, counselors, and psychotherapists do not take this on board is that they are not aware of the burgeoning literature on infancy.  I will come back to this shortly.
 

The Primal Split

At some point—maybe prebirth, maybe during birth, maybe some while after birth—an event happens that indicates that I am not in control of my world.  My assumption of freedom—and perhaps of omnipotence—is contradicted, and my total identification with myself is split.

The event that happens must be one that produces panic.  I seem to be invaded by some aggressive force.  It could objectively be said that I am being abused.  But the way I take it—whether as fetus, neonate, infant, or child—usually seems to be that I am "wrong," and am being punished.  How could I be hurt if I were perfect?  But I am being hurt, therefore I am not perfect.

In a state of panic, I resort to some kind of defensive tactic.  At this stage I have no resources for dealing with trauma.  I cannot cobble together any complicated defense.  It seems as if I am faced with extinction, annihilation.  In desperation, I split into two.  I turn against my original OK self, and I put in its place a self that has lost the notion of being perfect and whole.  So now there is an OK-me (distanced and disowned) and a not-OK-me (fostered and put forward as the answer to the insult).  This is the basic split, and of course splitting is a much more drastic defense than repression.

The not-OK-me, in order to repair itself and feel better about itself, may instantly adopt something salient from the invading and punishing entity, and incorporate it.  After all, that is where the power is, and power is what it needs or lacks.

It is sometimes objected, in relation to this account, that something as early as the birth trauma cannot possibly be remembered, never mind events even earlier still.  The answer to this is that there is more and more evidence each year, pushing back the limits further and further each time, that more is possible than we thought.  For example, Janov (1977) has published photographs showing how bruises made in preverbal experiences may actually come to the surface as visible marks during psychotherapy.  I have seen a video shot with a heat camera by a gestalt therapist that shows very clearly the marks of early trauma becoming visible as the client relives the experience.  It seems clear from all the evidence that we have to accept the possibility of muscular memory and cellular memory as well as the more common kinds of memory using the cerebral cortex.

This is not really very hard to understand.  The great psychologist Jerome Bruner (1967) suggested that we actually have three distinct information processing systems: the enactive—having to do with physical memories; the iconic—having to do with imagery; and the symbolic—which has to do with language.  The enactive and iconic systems (which of course we still have as adults) come before language and cannot be reduced to it.

Now this experience of trauma and splitting is a particularly powerful one, because it is only in this experience that I first become conscious that there is a "me" at all, as distinguished from the world.  My very first experience of being me is tied in with the first experience of being not-OK.  We do not fully understand yet how this can happen with the fetus or with very young babies—it becomes more obvious around the three-year-old stage, as Duvall and Wicklund (1972) have described in detail—but somehow it does seem to occur.  There may be a whole chain of such events, one of which may be more dramatic than the rest, and may come to symbolize the rest.  Grof has been clearer about this than most.

What Grof says is that there are four main stages of birth, four basic perinatal matrices.  I have already mentioned the first one, BPM I, undisturbed life in the womb.  BPM II begins when the uterus starts contracting and the cervix has not yet opened.  This is for the baby about to be born a situation of great pressure and no way out.  If it is prolonged or if the baby is already anxious for one reason or another, this can be a traumatic scene.

I want to make it clear that some birth processes are quite all right and may well induce a feeling of triumph at having made it into the world through all obstacles.  It is not at all suggested that birth is always a trauma, but rather that there is always some kind of a trauma which starts this process going.  Balint (1968) calls this the "basic fault."

Frank Lake (1980) has been very specific about different levels of trauma and exactly how that makes a difference to how the trauma is taken and experienced.  Partly it is a matter of how the mother and the other close and important figures react to various situations, for the very young infant seems to be able to pick up emotional reactions very quickly.

Once this split has been established, it has effects which continue long afterwards.  The trauma a psychotherapist is pitted against is often no longer the trauma of childhood but the cumulative traumata of a lifetime of repetition of the original in an attempt to master it.  If the trauma is repeated indefinitely and mastery fails to evolve, it is like a series of reinoculations which come to exceed the original dose and thus serve to restore the original disease in chronic and even more virulent forms.

This links with the work of Alice Miller (1987), who has highlighted the importance of early trauma and the way in which many analysts in the past have downplayed it and failed to do it justice.  But if it is important, it must continue to be important, because the way of dealing with this first trauma will set the pattern for the way in which the person deals with the next trauma, and the next, and the next.
 

Infancy

The word infant comes from a Latin word meaning "unable to speak," so strictly speaking we should save the term for the preverbal period of life.  But of course in ordinary speech it is often used more widely.  What are the facts about what kinds of experiences infants are capable of?  In psychotherapy and counseling we often find clients going back to these early times, and we sometimes wonder if babies so young can have such complex experiences as seem to be revealed in the therapeutic relivings of our clients.

In the last two decades there has been a tremendous amount of research on infants, and much more is now known than ever before.  Goren and coworkers (1975) found that infants with an average age of nine minutes attended most closely to a schematic face compared with a blank head shape, or one with scrambled features.  Dziurawiec and Ellis (1986) found this hard to believe and so repeated the experiment with improved methodology.  They got the same results.  It seems that the purpose of this early visual acuity is to aid in bonding.

Wertheimer (1961) studied newborn babies actually in the delivery room, as soon as they were born.  He worked only with those where there was no anesthesia and no apparent trauma.  He found that if he presented a series of sounds, placed randomly to the left and to the right, the baby looked in the direction of the sound source.  There was no random looking about, just a direct look in the right direction.

Lipsitt (1969) did an experiment where newborn babies, just a few hours old, had to turn their heads to the right at the sound of a tone and to the left at the sound of a buzzer.  If they turned their heads the correct way, they got a reward—a sweet taste in the mouth.  It took the newborns only a few trials to learn which way to turn their heads.  Then the signals were reversed, and it took them only about ten trials to unlearn the old task and learn the new one.  Tom Bower (1977) concludes,

The newborn can localize sounds.  He can locate objects visually.  He seems to know that when he hears a sound, there probably will be something for him to look at, and that when an object approaches him, it probably will be hard or tangible.  (p. 24)

Visually, the baby has size constancy from birth onwards . . . but also shape constancy, form and color perception, movement detection, and three-dimensional and depth perception (Slater et al., 1983; Slater, 1990).  After two days a baby will show a preference for the mother’s face when this is shown side-by-side with a stranger’s face (Bushnell, 1987).

The same things can be shown with the infant’s ability to smell.  Engen et al. (1963) found that infants only a few hours old will turn away from an unpleasant odor.  And Macfarlane (1975) placed three-day-olds on their backs and then placed breast pads from their mothers on one side of their heads.  On the other side he placed breast pads from other nursing mothers.  The newborns reliably turned their heads toward their own mothers’ pads, regardless of which side the pads were.

Several investigators in the 1970s found that babies less than a week old will imitate other people.  If we stick our tongue out at the baby, the baby will begin to stick the tongue out too.  If we stop this and begin to flutter our eyelashes, the baby will flutter the eyelashes back.  If we then open and shut our mouths, the baby will match us at the same speed.  If we use a TV split-screen technique showing the adult face and the baby’s face side by side, we find close matching of one to the other, which by five weeks old becomes very accurate and very quick, so that real two-way communication is taking place.  Even in babies only forty-two minutes old, Meltzoff found the beginnings of this kind of response (Meltzoff and Moore, 1983).

Smiling is an interesting area.  Bower (1977) writes that babies smile at a conceptual age of forty-six weeks, regardless of their age since birth.  (Most babies are born forty weeks after conception, but a range of thirty-eight to forty-two weeks is normal.) It very quickly becomes possible to see that there are actually four different smiles: the relief smile, when the baby realizes that an unexpected noise or movement is not threatening; the "I want you to like me" social smile for strangers; the special smile for mother or other very close person; and the "got it, I’ve solved the problem" smile.

This last is the most surprising to many people.  Papousek (1969) found that if he fixed it up in such a way that certain specific movements of a baby could make things happen, babies smiled when they worked out how to make it happen.  The smiling, in other words, showed an intellectual pleasure in discovery and control.  The actual characteristics of the event the baby was producing were quite unimportant.  What was important was that there be a relationship between a given action and a given event in the external world.  At this point there was vigorous smiling and cooing, which was not directed at the event in particular but rather seemed to reflect some internal pleasure.
 

Trauma

When something traumatic happens to the infant, therefore, whether during or after birth, there is a person there to experience and register it, and react to it.

Frank Lake (1980) argued that there are four levels of stress or pain and resulting trauma, and that what happens inside the individual depends very much on exactly what degree of pain is involved.  He made no distinction between different causes of trauma.  The first level is pain-free and involves no trauma.  It is the ideal state.  The second level of stress can be coped with.  This is where the stimulation is bearable and even perhaps strengthening, because it evokes effective and mostly non-neurotic defenses.  The third level involves opposition to the pain.  But the pain is so strong it cannot be coped with, and repression takes place.  If this trauma happens in infancy or earlier, the defense will be splitting rather than repression, consequently some degree of dissociation will occur.  The fourth level Lake calls transmarginal stress.  It is so powerful or so early, or both, that the person cuts off completely from the real self and may even turn against the self, wanting to die.

Some recent work by Southgate and others suggests that many child accidents are in fact unconscious attempts at suicide, based on this fourth level of trauma (Southgate and Whiting, 1987).  And if the trauma was actually a case of sexual or other abuse, and if the abuse was repeated or re-created somehow in later life, a real adult suicide may result, again possibly disguised as an accident.

Grof (1992) makes it abundantly clear that early trauma can be quite real and crucially important, and he relates it particularly to the process of birth.  As I have mentioned already, he distinguishes four stages of birth—the first two of which I have discussed; and he says that adult neurosis is very frequently based upon traumas suffered at one or other of these stages.  Lake (1980), in one of his charts, presents the way in which his four levels of trauma can be related to Grof’s four stages of birth to make a matrix of sixteen cells which account between them for the origins of many of the neuroses.  Again, of course, the drastic things which happen in the lives of adults may result from repetitions of the original trauma in some direct or disguised form.

Recent research has shown that strict diagnostic criteria of post-traumatic stress disorder (PTSD) can be applied to very young children—in their first, second, and third years.  Concerning PTSD it has been written

The clinical importance of these findings is that a post-traumatic syndrome does appear to exist in infants and children exposed to traumatic events.  The sequelae can be severely debilitating and last for years if untreated.  Any lingering notion that infants cannot be affected by trauma because of their limited perceptual or cognitive capacities ought to be dispelled by these empirical findings.  (Scheeringa et al., 1995, p. 199)

What we learn from all this is that there is a logic of trauma, originating in the earliest times of our lives, which can be understood and applied to sexual and other forms of abuse later in childhood and can also be applied to adult trauma occurring as a result of earthquakes, floods, war, and so on.  Thus, there is a direct link between the traumatic experience of the baby during birth and the traumatic experience of the soldier in battle.  This whole field of trauma is ripe for integration, and the primal and other deep experiential psychotherapeutic work that has been going on can help a great deal in understanding the phenomena of trauma in general.

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References

Balint, Michael. (1968). The Basic Fault: Therapeutic Aspects of Regression. London: Tavistock.

Bower, Tom. (1977). A Primer of Infant Development. San Francisco: W. H. Freeman.

Bruner, Jerome S. (1967). Education as a social invention. In R. M. Jones (Ed.), Contemporary Educational Psychology: Selected Essays. New York: Harper & Row.

Bushnell, I. W. R. (1987). Neonatal recognition of the mother’s face. Paper presented at the Annual Conference of the Developmental Psychology Section of the British Psychological Society. York, England.

Chamberlain, David. (1998). The Mind of Your Newborn Baby. Berkeley: North Atlantic Books.

Duvall, S., and Wicklund, R. A. (1972). A Theory of Objective Self-Awareness. New York: Academic Press.

Dziurawiec, S., and Ellis, A. (1986). Neonates’ attention to face-like stimuli: Goren, Sarty, and Wu revisited. Paper presented at the Annual Conference of the Developmental Psychology Department of the British Psychological Society. Exeter, England.

Engen, T.; Lipsitt, L. P.; and Kaye, H. (1963). Olfactory responses and adaptation in the human neonate. Journal of Comparative Physiology and Psychology, 56, 73-77.

Fodor, Nandor. (1949). The Search for the Beloved. New York: University Books.

Goren, C.; Sarty, M.; and Wu, P. (1975). Visual following and pattern discrimination of face-like stimuli by newborn infants. Pediatrics, 56, 544-549.

Grof, Stanislav. (1992). The Holotropic Mind. San Francisco: Harper.

Janov, Arthur. (1977). The Feeling Child. London: Abacus.

Janov, Arthur. (1983). Imprints: The Lifelong Effects of the Birth Experience. New York: Coward-McCann.

Lake, Frank. (1980). Constricted Confusion. Oxford: Clinical Theology Association.

Laing, Ronald D. (1976). The Facts of Life. London: Penguin.

Laing, Ronald D. (1982). The Voice of Experience. London: Penguin.

Lipsitt, L. (1969). Learning capacities of the human infant. In R. J. Robinson (Ed.), Brain and Early Behavior. London: Academic Press.

Macfarlane, A. (1975). Olfaction in the development of social preferences in the human neonate. In Parent-Infant Interaction (CIBA Foundation Symposium 33). Amsterdam: Elsevier.

Meltzoff, A. N., and Moore, M. K. (1983). The origins of imitation in infancy: Paradigm, phenomena, and theories. In L. P. Lipsitt (Ed.), Advances in Infancy Research; Vol. 2. Norwood, New Jersey: Ablex.

Miller, Alice. (1987). The Drama of Being a Child. London: Virago Press.

Mott, Francis. (1959). The Nature of the Self. London: Allen Wingate.

Papousek, H. (1969). Individual variability in learned responses in human infants. In R. J. Robinson (Ed.), Brain and Early Behavior. London: Academic Press.

Rank, Otto. (1952). The Trauma of Birth. New York: Robert Brunner. (Originally published, 1929.)

Rowan, John. (1988). Primal integration. In J. Rowan and W. Dryden (Eds.), Innovative Therapy in Britain (pp. 12-38). Buckingham, England: Open University Press.

Scheeringa, Michael S.; Zeanah, Charles H.; Drell, Martin J.; and Larrieu, Julie A. (1995). Two approaches to the diagnosis of post-traumatic stress disorder in infancy and early childhood. American Academy of Child and Adolescent Psychiatry, 34(2), 191-200.

Slater, A.M.; Morrison, V.; and Rose, D. (1983). Perception of shape by the new-born baby. British Journal of Developmental Psychology, 1, 135-142.

Slater, A. (1990). Infant development: The origins of competence. The Psychologist, 3(3), 109-113.

Southgate, John, and Whiting, Liz (Eds.). (1987). Journal of the Institute for Self-Analysis, 1(1).

Stern, Daniel. (1985). The Interpersonal World of the Infant. New York: Basic Books.

Swartley, William. (See Rowan, 1988.)

Verny, Thomas. (1982). The Secret Life of the Unborn Child. London: Sphere.

Wertheimer, M. (1961). Psycho-motor coordination of auditory-visual space at birth. Science, 134, 1692.

Wilber, Ken. (1980). The Atman Project. Wheaton, IL: Theosophical Publishing House.

Winnicott, Donald. (1958). Collected Papers: From Pediatrics to Psychoanalysis. London: Tavistock.

Copyright © 1996 by John Rowan

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^{*  This article was originally published in Primal Renaissance: The Journal of Primal Psychology, Vol. 2, No. 1, Spring 1996, pp. 36-44.  Reprinted with permission.}

 

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JOHN ROWAN is a psychologist and psychotherapist who has been working in the field of primal integration since 1977, having trained in and taught in the course led by Dr. William Swartley from 1977 until Dr. Swartley’s unfortunate death in 1979.  He has a private practice in London and teaches at the Minster Centre.  He has written several books, including The Transpersonal in Psychotherapy and Counselling (Routledge, 1993).  He is on the editorial boards of Primal Renaissance: The Journal of Primal Psychology, Self & Society, the Journal of Humanistic Psychology, the Transpersonal Review, and Masculinities: Interdisciplinary Studies on Gender.  He is a founding member of the Association of Humanistic Psychology Practitioners.  He is a Fellow of the British Psychological Society and is a member of the International Primal Association.  His particular workshop interests are creativity, body languages (with Sue Mickleburgh), sexuality and sex roles (with Sue Mickleburgh), subpersonalities, and the transpersonal.  He lives with Sue Mickleburgh in Walthamstow, England, and has four children and three grandchildren from a previous marriage.  He can be contacted by e-mail at JohnRowan@compuserve.com

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