Birth Revisited

by Stephen K. Khamsi, Ph.D.

Several experiential psychotherapies have recently reported that it may be possible to reexperience birth. It has been suggested that the birth process may exert an important and lasting influence on personality development, and that reexperiencing birth in psychotherapy may contribute to positive outcomes. These reports contradict the traditional opinion that neonates are neurologically inadequate to register, code, and store perinatal experiences.

What follows is a review, organized in an historical fashion, of the most notable literature on birth material in psychotherapy. Included here are reviews of psychoanalytic work with "derivative" material, in the form of dream and transference interpretations; and of research involving hypnosis, LSD-assisted psycho therapy, primal therapy, and rebirthing, all of which claim to work directly with "birth material." This review is followed by a discussion of the theoretical an research implications.

Prior to reviewing these reports, though, we will do well to consider five central issues:

1. What is meant by reexperiencing or reliving birth? How is it significant of meaningful to the person who has such an experience? This issue concerns the subjective nature of purported birth reexperiences.

2. Are such experiences veridical? Can neonates actually register, code, and store the experience of birth? What, if any, is the degree of correspondence between an alleged birth reexperience and the original birth? Are such "reexperiences' memory, fantasy, or delusion? When does human memory begin? This is the problem of vericlicality.

3. Is it beneficial to reexperience birth? Is it harmful? When, for whom, under what circumstances, and in which ways? This is the problem of outcome evaluation.

4. Does the birth process have a general and lasting effect on human personality development? Is birth universally traumatic? Does a traumatic birth have lasting ill effects? This issue concerns the psychological reactivity of the birth experience.

5. If birth reexperiences are more than simply fantasy, how do they occur? Are the simple extensions of memory? Are there laws governing the recall of birth material. Why is the recollection of birth so rare? What is the relationship between birth reexperiences and other paranormal experiences? This is the problem of the mechanism by which purported birth reexperiences operate.

Psychoanalysis

Freud. Freud (1927/1959) never considered the birth process to be a major determinant of personality. Affected by the neurological opinion of his day, Freud held that a child lacks the physiological maturity for meaningful experience until the age of two or three. He did concede that the act of birth represents an individual's first experience of anxiety, and that there is some connection between the birth experience and the form of later anxiety; but aside from serving as the prototype of anxiety, birth was considered fairly unremarkable in its effect on psychological life. Freud always stopped short of believing that there was active mental life at this time, so he considered "birth material" from psychoanalysis to be fantasy rather than memory - a position held by a majority of psychotherapists to this day (Chamberlain, 1983, p. 26).

Freud's interest in the experience of birth was tied to his much greater interest in the experience of anxiety. According to Freud, the problem of anxiety "is a nodal point, linking up all kinds of most important questions; a riddle, of which the solutions must cast a flood of light upon our whole mental life" (Freud, 1920/1935, p. 401). Birth is important only because it "is the first experience of anxiety, and thus the source and prototype of the affect of anxiety" (Freud, in Strachey, 1959, p. 10).

While acknowledging the connection between the act of birth and the forms of subsequent anxiety, Freud cautioned that we must not attribute it "undue stress." The importance of birth to psychic development is eclipsed by the instincts of sexuality and aggression-, by a phylogenetically-inherited predisposition to anxiety, inescapable and deeply ingrained in the human psyche over countless generations; and by the castration and Oedipal complexes, which subsume the more peripheral experience of birth. Freud painstakingly pointed out that an outbreak of anxiety is not a reproduction of the birth situation going on in the mind. Deriving quite reasonably from such beliefs, Freud insisted that "there is no place for the abreaction of the birth-trauma" (Freud, 1927/1959, p. 64).

Most psychoanalysts have basically agreed with Freud's portrayal of the significance of birth. A few, however, have raised dissenting opinions - most notable are Rank, Winnicott, and Fodor.

Rank. Rank (1929/1952) is famous for postulating that birth is a universal trauma with lasting ill effects that are central to psychological life. The core of this trauma involves the shock to the psyche when it is thrust from the womb to the outside world. Rank developed the idea, originally Freud's, that the neonate's anxiety during the birth process is the prototype of all later anxiety. Rank concluded that not only anxiety, but the whole of psychic life can be fruitfully related to the traumas of birth.

Rank believed that the fetus enjoys a completely protected and pleasurable existence, and that this blissful primal state is interrupted by the act of birth wrenching, tumultuous, traumatic. The ego recoils from the primal anxiety of birth, and massive repression buries the memories of both the birth trauma and the blissful intrauterine state. The person seeks paradise in the world formed in the image of the mother, while repression prevents pathological regression which would make one unfit to go forward in life. The remainder of life is marked by an unconscious drive to restore paradise lost.

For Rank (1929/1952), "the nucleus of every neurotic disturbance ... lies in the birth trauma" (p. 46). The neuroses in all their forms are reproductions of, reactions to, and failed attempts to overcome the birth trauma and/or the prenatal state (p. 212). The Oedipus complex is dethroned with birth replacing castration as the nuclear psychogenic trauma because, according to Rank (1936), "the historical and genetic primacy of the birth fear as compared with castration fear ... seems undeniable" (p. 119). According to Rank, the birth trauma and the weaning trauma are both painfully-experienced actual traumata" they are massively repressed, and their effects are displaced onto the later castration fantasy.

In contradistinction to Freud, Rank believed that the patient's unconscious uses the analytic process to repeat the trauma of birth, thereby partially abreacting it (Rank, 1929/1952, p. 11). Successful analysis brings a belated mastery of the birth trauma and separation from the mother, represented by the analyst. There is always a great resistance on the part of the patient to sever the transference relationship, because it represents in some way the patient's physiological connection to the mother's womb.

The idea of abreacting the birth trauma was never comprehensible to Freud. While admitting that Rank's birth trauma theory was a legitimate endeavor to solve the problem of analysis, he objected to its "far-fetched character" (Freud, 1927/1959, p. 62). Freud criticized Rank for assuming that the neonate is capable of receiving visual impressions at the time of birth and for the arbitrary nature of his interpretations, focusing variably on natal agony and on prenatal ecstasy. His main criticism, however, was that while Rank's correlations between birth trauma and psychopathology could be verified with empirical research, no such attempt had been made. Freud's dismissal of Rank and his ideas about birth has affected the course of psychoanalysis ever since.

Winnicott. Winnicott (1958), the English pediatrician and psychoanalyst, insisted that the birth experience is significant and is held as memory material (p. 177). He believed that birth material was vitally important and pervasive, so he implored analysts to prepare themselves for such material. "Since the birth trauma is real it is a pity to be blind to it," declared Winnicott, "and in certain cases and at certain points the analysis absolutely needs acceptance of birth material in among all the other material" (p. 180).

In contrast to Rank, Winnicott (1958) denied that birth is always a traumatic affair. He insisted that a normal birth is constructive, non-traumatic, and leads to increase ego strength and stability (p. 181). In the memory trace of a normal birth there is no sense of helplessness. Instead, the birth can easily be felt by the neonate to be a successful outcome of personal effort (p. 186).

Normal birth aside, Winnicott (1958) noted that traumatic births leave a permanent mark on the individual. Presaging many later birth theorists, he believed that "when birth trauma is significant every detail of impingement and reaction is, as it were, etched on the patient's memory" (p. 183).

Winnicott (1958) was open as well to the possibilities of intrauterine trauma and to its later abreaction. He noted that "in the very close and detailed observation of one case I have been able to satisfy myself that the patient was able to bring to the analytic hour, under certain very specialized conditions, a regression of part of the self to an intra-uterine state" (p. 191, italics in the original). He distinguished this experience from common fantasies with similar themes. The psychosomatic continuum reaches back to before birth, says Winnicott, and should be properly investigated.

Fodor. Fodor (1949, 1951), the Hungarian analyst, believed that dreams often reflect natal and prenatal material. His therapeutic interventions were designed first to release the birth trauma and then to integrate prenatal material. Fodor echoed the earlier contributions of Rank, but placed greater emphasis on the prenatal origins of consciousness and trauma.

Fodor (1949) believed that the child's reactions to birth are always catastrophic (p. 383). After nine months of relatively peaceful development, the child is forced into a strange world by cataclysmic convulsions. The unwelcome changes come about in three violent stages: the loss of the waters, the beginnings of labor, and the actual birth (pp. 14-15). Fodor believed that the change from prenatal to postnatal life involves an ordeal as severe as dying (p.4), and that the agony of birth results in a complete dissociation of natal and prenatal experiences from consciousness (p. 190). The record of these experiences is preserved in the unconscious and emerges in dreams (1951, p. 17).

Fodor (1951) denied that life for the unborn child is always an idyllic existence, peaceful and serene. Prenatal trauma is common, if not the rule. Parental intercourse and failed attempts at abortion both impress the unborn as murderous attacks. The cutting of the cord, highly significant as the first postnatal trauma, comprises the foundation for later castration anxiety (p. x).

For Fodor (1949), analysis was complete only when it reached the fetal levels of the mind. His therapeutic approach was based largely on dream interpretation along the lines of natal and especially prenatal trauma. Regarding natal trauma, he reported that some of his patients, though very few in number, appeared to actually relive their births on the analytic couch (p. 193).

The release of the birth trauma, while of immense importance, was introductory to the more vital phase of prenatal integration. In order to release the shocks suffered prior to birth, patients had to gain an intellectual grasp of their existence and nature. By the power of understanding, these primitive fear reactions were thought to enter the conscious mind and gradually cease their pressure. Prenatal integration did not occur, though, if one were unwilling or unable to accept such "facts" (Fodor, 1949, p. 353). Unfortunately, Fodor did not explain how this process-which included verbalizing emotional experiences of a prelingual period-is beneficial or even possible.

Hypnosis

Cheek and LeCron. Working with hypnotic age regression, Cheek and LeCron (1968) found that some patients were able to retrieve extremely early memories. The recall of birth events seemed particularly significant (LeCron, 1963, p. 137). Patients reexperiencing birth often reported a relief of relevant symptoms, and portrayed their birth experience as a causal factor in their symptomatology.

Other occurrences indicated that hypnotic birth memories may sometimes be veridical. LeCron (1963) reported that certain details of the fetal position, such as tilting the head to one side, unknown to most lay person, occurred with subjects who entered a revivification type of regression and were taken to a time shortly before birth (p. 141). Similarly, Cheek (1974) found that obstetrically appropriate sequential head and shoulder movements occurred during age regression in light hypnosis for ten consecutive naive subjects (p. 266). Cheek (cf. Verny, 1981) also found that four naive subjects, under hypnosis, were able to accurately describe how their head and shoulders had been positioned during their actual births, as well as the ways they had been delivered (pp. 99-100).

These findings have led Cheek and LeCron to conclude that the birth experience may be a source of imprinting in humans. They believe that the birth imprint-a response that becomes fixed by stress and does not fade with subsequent experience-may be the causal stimulus in a wide variety of psychosomatic disorders.

Emerson. Emerson (1979) has worked extensively with perinatal phenomena in psychotherapy, His major research technique was hypnotic age regression, though it was sometimes supplemented with other techniques. Unfortunately, Emerson referred to his approach as "rebirthing," so care must be taken to avoid confusing it with Orr and Ray's (1983) approach of the same name.

Emerson's observations were collected over a period of 5 years and included approximately 2500 hours of one-to-one rebirthing. Like Cheek and LeCron before him, Emerson (1979) believes that the neonate is capable of accurately perceiving the objective surroundings at the time of birth, and of forming rather sophisticated (though often incorrect) subjective impressions that persist in the unconscious.

Beyond this basic finding, however, Emerson leaves us primarily with his clinical research impressions. Among them, Emerson discusses the "theory of recapitulation," the idea that individuals unconsciously arrange their lives in response to unconscious, incompleted residual primal experiences. Individuals unconsciously manipulate their environment in order to avoid or create the conditions that will lead to reexperience and release of incomplete primal feelings and trauma.

Emerson (1979) also discusses "osmotic experiencing," the notion that the fetus during birth (and at certain other prenatal stages) seems to osmotically infuse the experiences of the mother (p. 20). Osmotic experiencing suggests that a fetus could be vicariously traumatized by the mother's own birth trauma, even while the neonate's own birth may not be directly or objectively traumatic at all.

Emerson (1979) is clearly an advocate of reexperiencing birth in psychotherapy. He believes that birth is a traumatic and basic foundational experience that sets the tone for later life, and that certain difficulties in living can only be resolved through natal and/or perinatal primal work (p. 17). He recommends his form of rebirthing for both rectifying and preventing birth trauma; he believes rebirthing is a profoundly liberating growth experience for anyone, and is especially important for prospective mothers as a psychoprophylaxis against the osmotic transmission to their children.

Wambach. Wambach's (1978, 1979) hypnotic research of birth reexperiences took place in large group workshops. Following subjects' "regressions" into past lives, Wambach (1979) conducted what she calls the "Birth Trip." The "Birth Trip" began with a long and detailed hypnotic induction designed to stimulate memories of the between-life and birth. Subjects reportedly relived their births and between-lives while reacting to a series of questions, the answers of which were later recorded on self-reported questionnaires. Wambach has summarized the experiences of 750 subjects.

As is evident from the nature of her questions, Wambach (1979) contextual ized her study against a background of past-life and karmic philosophy. Her sample was not controlled, so generalizability is extremely limited. No attempt was made to correlate the findings from the Birth Trip with more objective procedures.

Methodological pitfalls aside, of particular interest is Wambach's (1979) observation that "the most striking response of all in my subjects was the depth of emotion expressed during the birth experience" (p. 178). These deep emotional expressions occurred even though Wambach had strongly emphasized that subjects would not experience pain. In spite of the instructions to not feel pain, there emerged experiential themes of urgency, struggling, pressure, panic, suffocation, vertigo, claustrophobia, blinding light, being stuck, and being expelled.

Chamberlain. Chamberlain (1980,1983) worked with hypnotized mother-and-child pairs to determine whether birth reexperiences were actual memories or simply creative fantasies. He compared the birth reports of 10 hypnotized children (who had no conscious memories of birth) with those of their mothers (who claimed never to have shared with these children the details of the birth).

In general, the independent mother-and-child accounts coincided. The independent narratives reportedly matched or dovetailed at many different points, while direct contradictions of fact were "quite rare" (Chamberlain, 1983, p. 34). Children's accounts of details of time of day, locale, persons present, instruments used (suction, forceps, incubators), type of delivery (head-first, breech), and feeding of water or formula usually corresponded with their mother's accounts. Neonates reportedly were well-tuned to their mother's emotional state, and found it painful when they were taken away from their mothers at birth (1983, p. 35).

How can we explain so many accurate memories? Chamberlain (1983), citing extensive empirical evidence in the scientific literature for support, argues in favor of consciousness at birth. After all, his young subjects reported that as neonates they had "learned" that life was dangerous, dull, or exciting, and on occasions had been profoundly affected by specific words or sentences spoken during delivery (p. 41). This suggests to Chamberlain that at the time of birth neonates are able to "ask themselves questions, make decisions, formulate plans" (p. 36).

Raikov. Raikov (1980,1982,1983-1984), a psychoneurologist working in the Soviet Union, has conducted research that suggests the recovery of authentic neonatal reflexes, behaviors, and EEG activities in subjects under hypnosis. Concerned with the problem of whether hypnotic regression is an actual revivification, Raikov used regression to early infancy in order to test for the authenticity of age regression.

Raikov suggested the state of early infancy to 10 normal, highly hypnotizable subjects-, subjects were then filmed and their reactions authenticated by independent neurologists. This neurological investigation was conducted to determine the degree of convergence between age-regressed adult and infant neurological indicators.

The emphasis was on revealing signs found in either newborn or very young infants. The results showed that all (100%) the subjects showed uncoordinated eye movements and sucking reflexes-, six (60%) showed the foot bending reflex; five (50%) showed the Babinski reflex and cried without tears; and four (40%) showed the grasping reflex and spontaneous movements of the extremities.

To further test such findings, Raikov (1983-1984) conducted a study in which the EEG's of high-hypnotizable subjects were monitored and later compared with those of control subjects. Four of the five high-hypnotizable subjects manifested 11 marked and repeated changes of electrical activity in the brain" (p. 121) which resemble the brainwaves of infants from one month to one year old (p. 125), along with infantile neurophysiological reflexes. Control subjects were able to produce only some of the infantile behaviors and none of the EEG changes.

Raikov (1983-1984) concludes that the EEG investigation and analysis of infantile reflexes can serve as "evidence for the objective illustration of the reproduction of early infant behaviors in hypnotic age regression" (p. 129). He believes that people have a long-lasting unconscious physiological memory which includes infantile reflexes, and suggests that a barrier is formed through ontogenesis of the brain which prevents "infantile information" from emerging in everyday life. This research may be taken as fairly strong evidence against the theory that age regression in hypnosis is invariably a form of role-playing or acting done to please the hypnotist.

LSD-Assisted Psychotherapy

Grof. Grof, the Czechoslovakian-born psychiatrist and medical researcher, has spent over 20 years in the clinical practice of LSD-assisted psychotherapy. Grof (1981) contends that most of the fundamental symptoms of psychopathology can be explained in a new and logical way by making specific reference to the birth process.

Early in his research, Grof, (1975) realized that many LSD generally resulted in a successive unfolding of deeper and deeper levels of the unconscious. Grof described three major levels of the unconscious: the psychodynarnic of "Freudian" unconscious, the perinatal or "Rankian" unconscious, and the transpersonal or "Jungian" unconscious. There seems to be a general tendency for subjects in LSD-assisted therapy to work through p.,ychodynamic, perinatal, and transpersonal issues in sequence. The major experiential foci reportedly change as personal issues are successfully resolved.

The primary concern here is with the perinatal or "Rankian" level of the unconscious. Perinatal experiences are those which seem to involve biological birth, physical pain and agony, aging, disease and decrepitude, and dying and death. The elements on this level of the unconscious often seem to appear in four experiential clusters. These "basic perinatal matrices" (BPM's), as they are called, are hypothetical governing systems that influence one's perceptions, emotions, attitudes, and values; the range of effects includes cosmic oceanic bliss (BPM 1), deep depression (BPM 11), a no-exit existential crisis (BPM 111), and tremendous feelings of release and relief (BPM IV). In searching for a simple and logical conceptualization of these observations, Grof (1975) was struck by the deep parallels between these patterns and the clinical stages of delivery.

Grof has found that the reliving of such perinatal sequences in the context of LSD-assisted psychotherapy-including birth, attempted abortions, maternal diseases or emotional crises during pregnancy, and fetal experiences of being unwanted-can be of great therapeutic value. The personality and character changes associated with therapeutic experiences on the perinatal level have been found to be far greater than those associated with experiences on the psycho-dynamic level.

Even more remote than perinatal experiences, Grof (1975) found that in LSD therapy "vivid, concrete episodes that appear to be memories of specific events from an individual's intrauterine development are rather common" (p. 159). Lilly (1972, p. 8) and Laing (1982, p. 98) have reported similar findings with respect to their own purported intrauterine experiences. Grof believes that many fetal and embryonic memories are manifestations of the deep unconscious, are unknown to contemporary science, and lie outside the scope of existing theoretical systems.

Grof has done an exemplary job of researching this formidable subject in a thoughtful and conscientious manner. His presentation suffers, however, from a lack of raw data. Conclusions are advanced in great detail while the raw material is offered unsystematically, if at all. Given the importance of such research, further studies and replication are warranted.

Lake. Lake (1978a, 1978b), the late English obstetrician and psychiatrist, worked extensively with primal therapy and LSD-assisted psychotherapy. Of particular interest here is his (1978a) claim to have found a direct association between the symptoms of claustrophobia and the sensations experienced by the fetus during the second stage of labor (p. 13).

In "Birth Trauma, Claustrophobia and LSD Therapy" Lake (1978a) described his study involving 68 patients over a period of 8 years. The study included a total of 386 sessions, ranging from one to 38 per patient (average 6.2). LSD was given to patients as an adjunct to therapy on some, but not all, occasions. Sessions lasted from four to six hours, and patients averaged 30 hours each under LSD.

Lake's (1978a) basic finding from a retrospective questionnaire was that "LSD releases 'memories' of earliest infancy" (p. 14). The questionnaire was completed by 58 of the 68 subjects, and revealed that 60% felt at some time during their LSD sessions that they were again a child; 64% that they were again a baby; 66% that they were again being born; and 21% that they were again in the womb. These figures suggest that a rather high percentage of subjects believing they had reexperienced some part of their birth process.

Virtually identical descriptions were given by patients of their LSD reexperiences of birth (Lake, 1978a). Subjects often spontaneously identifying aspects of the birth trauma as causal events in their claustrophobia. Lake believes these reports represent actual relivings. He conceptualizes claustrophobia as a repetition com-pulsion, touched off by the pain, pressure, and stress of life situations analogous to one's birth trauma (p. 25).

Like Cheek and LeCron, several of Lake's patients identified migraines as reenactments of the intracranial events of birth. And like Fodor, Lake found birth interpretations (those that relate symptoms to the distress of birth) to be of great value.

Despite Lake's sincere contribution, difficulties exist that call into question the validity of his findings. Serious problems exists with respect to demand character-istics, self-reports, and inadequate coverage of the methods used both in therapy and in research.

Primal Therapy

Janov. As early as 1970, Janov noted that some clients' primal therapy experiences seemed to include powerful early material including birth as well. Janov has paid increasing attention to "birth Primals" and to birth, and now believes that "the birth trauma ... is probably the most important event of our lives" (1983, p. 24).

Janov (1971) has reported a "remarkable similarity in birth Primals - the fetal position, hands turned in, eyes rolled back, the roll of the head and the lack of words during the experience; just grunts and groans, not even the baby cry" (p. 127). Patients say they know what they are undergoing, but feel powerless to stop it (p. 46). According to Janov (1983), many patients during birth primals feel what seems to be drugs entering their systems (p. 45); others have claimed to experience a burning sensation around their umbilicus. Not all patients go through birth primals (1971, p. 126), but those who do seem to experience them over a period of several months (1983, p. 94).

Neither are all births traumatic, according to Janov (1983, p. 35). While birth is always "overwhelming," it is considered traumatic only under adversities such as strangulation by the cord, breech birth, or excessive labor time. Like Winnicott, Janov insists that there are positive functions of a normal birth; but whereas Winnicott focuses on the psychological benefits of enhanced ego strength and stability, Janov focuses on the physiological need for priming the internal organs for activation and survival outside the womb, a thesis previously advanced by Montagu (1978).

What are the effects of a traumatic birth? Janov (1983) believes that the traumas surrounding birth are engraved as imprints in the neonate's developing nervous system. This "Prototypical Primal Trauma" and its "Prototypic Defense" are stored in the system and recapitulated throughout life in situations of stress or pain. The birth trauma "teaches" the neonate how to respond to later stress and sets the direction for life: "the birth imprint thus determines physiological and neurological response tendencies, shapes later pesonality and physiotype, and directs the type of pathology we eventually develop" (Janov, p. 14).

Other critical aspects of the birth process, according to Janov (1983), are the manner in which birth ends, and the first moments outside the womb. He has coined the term "trauma train" to explain his idea that the manner in which birth ends seems to be permanently fixed as a prototypic response to stressful situations (p 49). He also believes that the first minutes outside the womb are critical (p. 15). A particularly widespread, major trauma with lifelong consequences is the separation of the newborn from its mother immediately after delivery (p. 43).

To alleviate the effects of a traumatic birth, Janov (1983) suggests that patients reexperience their birth in the context of primal therapy. He insists that clients who may possibly undergo such experiences should be fully informed about birth primals. Nevertheless, he admits that his therapy may take a protracted period and even then may not be totally effective (p 248).

Janov should be credited with a bold attempt to explore, understand, describe, and explain purported birth reexperiences. This is no small task and, predictably, his ambitious project suffers on several counts. Like many others, Janov has published the end points of his thinking and little of the raw data; his research is highly susceptible to the problems of demand characteristics and self reports; and he is quite dogmatic in his assertions without providing adequate supporting data. Janov's therapeutic and research methods have not been adequately explicated, so his findings and conclusions remain highly questionable to outside evaluation.

Verny. In reference to his practice of "holistic primal therapy," Verny (1978) claimed that "about 80% of these patients eventually work on some feeling, body sensation or memory that reaches back to the perinatal period" (p. 384). Findings from perinatal primal work, in tandem with an exhaustive study of the research literature, have led Verny (1981) to conclude that "birth and prenatal experiences form the foundations of human personality" (1981, p. 118).

Verny (1981) believes there is "hard, incontestable physiological evidence that the fetus is a hearing, sensing, feeling being" (p. 36). Consciousness is said to start between the 28th and 32nd week in utero (p 41), and memory is said to begin at some point in the third trimester (p. 42). Birth makes an indelible impression on the child and sensitizes it in terms of which stimuli it will later seek out and which it will avoid (p. 54). Verny (1981) believes oxytocin is largely responsible for the dissociation of perinatal events (p. 99), and that our ability to retrieve such memories may depend on ACTH (adrenocorticotropin hormone).

Verny (1981) has concluded that the personality of the unborn child is largely a function of the quality of mother-child communication (p. 27). He believes that the fetus may be able to tune into the feelings (p. 106), thoughts, and dreams of the mother (p. 42); that a strong intrauterine bond largely determines the future of the mother-child relationship (p. 81); and that maternal love forms a "protective shield" around the fetus that decreases the impact of outside tensions (p. 46). Nevertheless, the child suffers physically and emotionally (1984, p. 50). "Birth," says Verny "is like death to the newborn" (p. 48).

Verny is to be credited for his disciplined study and sensible conclusions about psychotherapy, birth, and fetal consciousness. His hypotheses are generally well conceived and grounded with respect to research findings. Even speculations are well-reasoned, plausible, and clearly presented as hypothetical. Nevertheless, his research has shortcomings. Verny has neglected to provide systematic pheno-menological data. He has also failed to substantiate the claim that 80% of his clients have experienced some sort of perinatal phenomenon. This is a remarkable finding which, if accurate, holds revolutionary implications.

Rebirthing

Orr and Ray. Rebirthing is intended to aid people in learning to breathe properly; this is done by "physiologically, psychologically, and spiritually" reliving the moment of one's first breath and by releasing its trauma. This supposedly leads to a variety of positive effects including freer breathing, conversion of pain into pleasure, reversal of the aging process, and total fulfillment in life.

Orr and Ray believe that preverbal thought and intelligence begin before birth. The birth trauma is thought to lead to the formation of sophisticated conclusions mostly negative-that generalize and then unconsciously control the person. These impressions may include "the universe is against me," "I can't trust people," "I can't get enough," or "people are out to get me." The birth trauma is also thought to result in a persistent inability to breathe freely.

It is difficult to separate the actual attributes of rebirthing from the eccentricities of its promoters. Orr and Ray (1983) have presented rebirthing in so casual a fashion that it is difficult to evaluate. This has led Rosen (1977), for instance, to characterize rebirthing as "a revival of infantile ritualistic magic" (p. 143). On the other hand rebirthing has many proponents, and preliminary research has suggested that rebirthing may comprise a unique breathing pattern that leads to positive therapeutic outcomes (Rubin, Yates, & Decker, 1984).

Feher. Natal theory and therapy have been presented as modifications and extensions of Freudian thought. Natal theory retains Freudian theory but also includes the experiences of prebirth, birth, and the cutting of the umbilical cord. This, according to Feher (1980), is because "birth and womb experience have until recently been the great unknowns in human psychology" (p. 203).

Feher conceives of the umbilical unit of cord and placenta as literally an extension of the fetal body; it is a major organ, the source of food and oxygen, a total life support system. When the umbilical unit is suddenly separated from thefetus,there ensues the "crisis umbilicus" in which the neonate must for the first time become dependent upon the external environment. The cutting of the cord-considered the first object of security-represents the infant's first loss, and all later losses recapitulate this severance. Feher agrees with Fodor that the cutting of the cord forms the foundation for later castration fears.

The birth trauma, according to natal theory, lies beyond the reach of analytic methods. Not only does birth predate language, thereby making the birth trauma largely inaccessible under normal conditions, but traumatic birth anxiety leads to a dissociation of birth memory. Only reexperiencing the trauma can stimulate the memory and, by breaking through the blocked emotion, relieve the anxieties surrounding it.

Fetal therapy is an attempt to wed the intense emotional approach of a group rebirth-which is considered the key to the natal approach-with individual psychoanalytic sessions. Members may be rebirthed on three or more occasions, supposedly with deepening experiences.

Although Feher's presentation seems thoughtful and sincere, her research suffers from common pitfalls. Feher needs to explicate her research methods; to provide the raw data behind her conclusions-, and to address the problems of self-reports and demand characteristics.

Implications for Theory and Research

Theory. These notions about birth reexperiences and early consciousness may warrant a examination of some of our most basic presuppositions about human consciousness. Taken collectively, these reports represent specific challenges to widespread philosophical and psychological doctrines.

The axial implications is that the perennial mind-body problem may be in need of review. The primary structures of consciousness-including perception, cognition, and emotional ity-may in some ways be affected by natal and/or prenatal events. These reports suggest that an expanded model may be warranted, one that includes the possibilities of natal and prenatal experience.

Also called into question is Locke's empirical theory of tabula rasa, the notion that the mind of a child at birth is like a blank tablet. Perhaps etchings on that blank tablet begin during or even before the time of birth. Similarly, Descartes' "innate ideas" may somehow derive from intrauterine or perinatal experiences.

With respect to Freudian thought, it may be that intrauterine andlor perinatal elements underlie and are recapitulated in the arenas of sexuality and aggression. Perhaps these so-called instinctual drives actually have natal andlor prenatal origins,

Research. Unfortunately, researchers in this area have generally been quick to spin theories while providing little of substance to support their contentions. Many have offered comprehensive explanations of the mysteries of natal and prenatal influence on later experience and behavior. While there are important functions in hypothesis formation and warranted extrapolations, no service occurs when an undifferentiated hodgepodge of assumptions, findings, and speculations are presented. Researchers should clarify their preconceptions and accurately report their findings, with a clear demarcation between observations and extrapolation.

Implications for future research followed from the five central issues stated in the introduction to this paper:

1. There is a pressing need for systematic research of a phenomenological, descriptive variety. We need individuals' accounts of their experiences, both from retrospective interviews and from personal documents such as diaries or personal journals. Such research is fundamental, since it forms the foundation for theory and therapeutic technique.
2. We would do well to follow the suggestions of Freud and LeCron to perform rigorously controlled, detailed longitudinal research correlating actual birth experiences with later personality development and birth reexperience claims. Information along these lines would help us to chart the degree of correspondence between original births and alleged relivings, and help us establish whether birth reexperiences are essentially fantasy or memory Since longitudinal research would be a major production that would take at least a generation to complete, an acceptable-albeit less definitive-alternative would be to conduct carefully controlled, systematic follow-up research on as relatively large number of alleged birth relivings.
3. Clinical judgments and subjective testimonials regarding the value of re-experiencing birth need to be balanced with objective measures, including pre- and post-testing. Outcome evaluation is important, yet formidable.
4. Studies are needed correlating original birth experiences with later physical and psycho!ogical measures. These findings would be of interest not only to psycho-logical theoreticians but also to those who govern obstetrical procedures. Obviously, if particular birthing procedures consistently lead to better development, these methods should be used.
5. At our present state of knowledge we can only guess as to the possible mechanism(s) involved in reexperiencing birth. Verny has offered plausible initial hypotheses which should be investigated, and other research pathways will arise in time.

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