1995 International Congress of APPPAH
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II. Birth and Obstetrical Challenges III. Impact on Postnatal Relationships IV. Forum on Birth and Its Consequences for Society V. Breaking the Cycle of Violence |
The ConferenceUntil recently, neither psychology nor medicine has given adequate attention to very early development, in the false belief that prenates and neonates could not feel, remember, learn, or be influenced by these experiences. This was a tragic miscalculation that made guinea pigs of us all. For the last two decades we should have known better. A wave of studies revealed the sensitivity, awareness, and intelligence of newborn behavior. Over the same period, studies of the baby in the womb also revealed the same qualities.
The ability of prenates and newborns to learn from experience is a sobering discovery calling for immediate changes in the experiences we are providing for them in our technological approach to birth. Babies are capable of learning the wrong things about violence, danger, fear, hate, rejection, as well as the right things about love, acceptance, trust, and joy. Waiting for birth to commence active parenting is too late. Early parenthood--starting at conception, not birth--is a reality, whether we are ready or not.
Insights like these led to the choice of themes for panels of experts followed by interactive forums which allowed participants to interact with all speakers.
The keynote speaker Lloyd de Mause of the City University of New York, addressed the conference on "Restaging Fetal Traumas in War and Social Violence." His address was published in Vol. 10(4) (Summer) of our Journal and in Vol 23(4) (Spring) in the Journal of Psychohistory. The complete address in four parts is available on the net.
Two 3-hour post-conference workshops were offered: (1) Resolving Birth Trauma Within Families, led by William Emerson, Ph.D. and Ray Castellino, D.C., and (2) Attachment Disorder Therapy for Children, Adolescents, and Families led by Terry Levy, Ph.D.
Following is an outline of the major themes for panels, and the names of the presenters.
I. The Vulnerable PrenateResearch and clinical data reveal the impact of uterine life on personality. How to correct the damage and prevent future harm. Moderator: William Emerson, Ph.D., with Bruce Lipton, Ph.D., Jay Hathaway, Elizabeth Noble, P.T., and Barbara Findeisen, M.F.C.C.
II. Birth and Obstetrical ChallengesBirth from the perspective of the mother and newborn. Assessing the long-term psychological impact of birth trauma and current obstetrical practices on mothers and babies. Moderator: Robbie Davis-Floyd, Ph.D. with Suzanne Arms, Elizabeth Davis, William Emerson, and Bethany Hays.
III. Forum on the Impact of Postnatal Experiences
Barbara Reid Findeisen, M.A., M.F.C.C., ModeratorAbstract of Presentations
Marshall Klaus, M.D., Pediatrician, author, pioneering researcher on bonding
Title: The First Hours and Days of Life: A Special TimeThe fascinating question on how parental attachment progresses during the early postpartum period can be answered only by minutely examining what happens between parents and their newborn during this crucial time. What pulls them together, ensuring their proximity through the many months during which infants are unable to satisfy their own needs? When they are together in the first hours of life, multiple interactions simultaneously occur between mother and child. Each is intimately involved with the other on a number of levels, which lock the pair together.
The mother and baby elicit behaviors in each other that are naturally rewarding. For example, the infant's crying is likely to trigger the mother to pick him up. When she picks him up, he is likely to quiet, open his eyes, and follow her movements. When the mother starts the communication by touching the infant's cheek, he is likely to turn his head, bringing him into contact with her nipple, on which he will suck. His sucking in turn is pleasurable to both of them. This is a necessarily oversimplified description of these interactions; the behaviors do not occur in a chain-like sequence, but rather each event triggers several others. When we look closely, we see a fail-safe system that ensures the proximity of mother and child.
The renewed interest in this early period after birth has been stimulated by several provocative observations of both mother and infants. Perhaps the most dramatic example of these observations is the ability of newborns, if left quietly on the mother's abdomen after birth, to crawl from abdomen gradually up to her breast, find the nipple, and start to suckle.
Investigators have also noted that if the lips of the infant touch the nipple in the first hour of life, a mother will decide to keep her baby longer in her own room during her hospital stay than another mother who did not have contact until later.
Other researchers have shown that the normal infant, when dried and placed nude on the mother's chest and then covered with a blanket will maintain his or her body temperature as well as the elaborate, high-tech healing devices that usually separate the mother and baby. The same researchers found that when the infants are skin-to-skin with their mothers for the first ninety minutes, they cry hardly at all, compared to infants who were dried and wrapped in a towel and placed in a bassinet. It seems likely that each of these features--the crawling ability of the infant, the sensitivity of the mother's nipple, the decreased crying when close to their mother, and the warming capabilities of the mother's chest--are adaptive and were built into human beings several hundred thousand years ago during much more stressful times, to help preserve the infant's life.
In addition, when the infant suckles from the breast, there is a large outpouring of twenty different gastrointestinal hormones in both the mother and the infant, including cholecystokinens, which stimulate growth of the baby's and mother's intestines and increase the absorption of calories with each feeding. The stimuli for this release are the mother's nipple and the inside of the infant's mouth. These responses were essential for survival thousands of years ago when periods of famine were more common before the development of modem agriculture. This presentation describes these new findings and why all mothers should receive early contact with suckling in the first hour and rooming-in (two components of the UNICEF Baby Friendly Initiative). New observations in the area of parent-to-infant bonding will be shared with implications for changes needed in the care of the family in the perinatal period.
Terry M. Levy, Ph.D., Psychologist, President, Association for Treatment and Training in the Attachment of Children (ATTACh)
Title: Effects of Attachment TraumaAttachment theory focuses on the most primary of relationships, the infant-mother bond, and on the ways in which this bond serves as a foundation for growth and development. Attachment-related issues are especially relevant in today's society. Professionals from the fields of mental health, child protective services, and the judicial system struggle with difficult questions that affect the lives of children, families, and society. How do children learn to perceive the world in a positive way, develop a sense of worth, become capable of developing healthy relationships and manage adversity effectively? How do multiple placements in the foster care system affect attachment? How do we prepare adoptive parents to deal with a child's traumatic past? How do we manage the realities of modem family life (day care, poverty, violence, teen pregnancy, single-parent families) and the influences on parent-child attachment?
Attachment is an instinctually-based mechanism which develops in the original parent-child relationship as a results of the parent's response to the child's expression of need, as well as the ongoing, reciprocal parent-child interaction. Children with anxious attachment are at-risk for developing an array of psycho-social difficulties due to their lack of a secure base and other subsequent complications (e.g. multiple placements, abuse). These children lack the "protective factors" which ameliorate responses to stress and increase resiliency.
Severe childhood trauma is correlated with a wide variety of symptoms which include difficulties with sense of self, modulating affect and relating to others. Attachment trauma often produces symptoms in the following DSM IV categories: Disruptive Behavior Disorders (Oppositional Defiant Disorder, Conduct Disorder, Attention-Deficit Hyperactivity Disorder). Separation Anxiety Disorder, Reactive Attachment Disorder of Infancy and Early Childhood, Post-Traumatic Stress Disorder and Depression. Dissociative and characterological symptoms may emerge as the child develops. Behavioral acting-out includes aggression, destruction of property, lying, stealing and self-destructive behaviors. Extreme oppositional and defiant behaviors are common.
Children who have been sexually abused manifest inappropriate sexual behavior, attitudes and concerns. Cause-and-effect thinking is deficient with a failure to recognize the relationship between actions and consequences. They rarely take responsibility for their own actions, they blame others, and feel no remorse for hurtful actions. They perceive themselves as unwanted, worthless, and "bad," caretakers as unavailable, untrustworthy and threatening, and the world as unsafe and hostile. Learning and language disorders are common, often a result of neurological damage early in life (e.g., fetal alcohol syndrome, failure to thrive, physical abuse). Core emotions include extreme anger, fear and pain associated with unresolved loss, as well as shame, guilt and self-blame. Temper tantrums and rage reactions are common. Chronic non-compliance is manifested as control battles, defiance of rules and authority, and inability to tolerate external limits. Lacking trust in others, they often overcompensate with pseudo-independence. They are superficially engaging and charming, lack long term relationships, and adhere to typical social roles of victim and/or victimizer.
James W. Prescott, Ph.D., Developmental Neuropsychologist, pioneer in recognizing the origins of violence in early separation of infants and mothers which damages developing brain structures and processes.
Title: The Origins of Love and ViolenceLove and violence have their roots in the failure of (1) the first foundation of life, the maternal-infant affectional bond which includes prenatal and perinatal life experiences; (2) the second foundation of life in the paternal-infant affectional bond; (3) the third foundation of life in the sexual affectional bond; and (4) the fourth foundation of life, of transcendental consciousness.
Scientific research was reviewed documenting that failure of "mother love" results in developmental brain dysfunction and damage which causes depression, social alienation, violence and substance abuse. Certain prenatal and perinatal traumas are linked to adult violence and substance abuse. Cross cultural studies show that the failure of physical affectional bonding in the maternal-infant relationship, and repressed adolescent sexual relationships are causative of later adult violence.
The author's SAD (Somatosensory Affectional Deprivation) theory of depression helps explain social alienation, violence, and substance abuse in terms of the damaging effects which sensory deprivation of body touch and movement has upon the developing emotional-social-sexual brain (Limbic brain-cerebellum and frontal/prefrontal and somatosensory cortex). Human societies can be transformed from cultures of violence to cultures of peace through physical affectional bonding in human relationships.
The author explains how certain moral philosophies of good and evil, and moral theologies of pain and pleasure in human relationships influences those sensory processes which encode the developing brain for peaceful or violent behaviors.
The presentation was illustrated with films and slides. A background document "The Origins of Human Love and Violence" containing the scientific and cultural data, is available from Touch the Future at: www.TTFuture.org. The scientific paper was published in the Pre- and Perinatal Psychology Journal, 10(3), 143-188, Spring 1996.
Nancy Verrier, M.A., M.F.C.C., Psychotherapist, adoptive mother, and author, The Primal Wound: Understanding the Adopted Child.
Title: How Separation From the Birth Mother Leads to ViolenceSociety has had an altruistic view of adoption: it was about rescuing children from a terrible fate. Incorporated into that myth has been the belief that we could substitute one mother for another and the baby would be none the wiser. In my research into the subject of adoption, in talking to myriad adoptees, birth mothers, and adoptive parents, and in my work with adoptees in psychotherapy, I know that this is not true.
Babies know that they are being handed over to a stranger, and they don't like it. It is a violence against their sense of well-being and against the natural order of things. However, as infants they are helpless to do anything about it. The rage they feel at this unnatural act and the helplessness they felt at the time continues to fester in many adoptees.
The rage goes deeper than that, however. It is about the rage an infant feels in waiting, and waiting, and waiting for his mother to return, and she never does. Adoptees greatly fear this rage, because they feel as if they could blow up the world with it. Some keep themselves tightly controlled by becoming numb to any feelings, while others act out their rage in acts of violence by saying things, breaking things, hitting things, committing crimes, and turning that rage against themselves in acts of suicide.
Adoptees are over-represented in special schools, treatment centers, juvenile halls, and prisons (See B.J. Lifton, Journey of the Adopted Self.) A number of serial killers are adopted. Even adoptees who have been models of control know that rage lies just below the surface waiting to be triggered. Because this rage is a result of early trauma, it is difficult to control unless everything is controlled. This is only one of many issues which results from the unnatural manipulation of children's lives.
IV. Forum on Birth and Its Consequences for Society
Thomas R. Verny, M.D., D. Psych., Moderator
Abstracts of Presentations MadeMichael Trout, Director, The Infant-Parent Institute, Champaign, ILL
Title: The Traumatic Consequences of AdoptionThat we once insulated adoptees with our self-serving presumption that they were quite incapable of any inklings about their past now seems absurd. That we continue these self-serving ways by denying adoptees access to the facts of their heritage, through sealed adoption records, is abusive. Now we must appreciate yet more possibilities: that the twin whose sibling dies in utero has knowledge of the loss and has feelings about it; that a prenate might hold in her body the memory of her mother's attempt to abort her, or even the mother's attempt to kill herself; that an adoptee may actually integrate into her character the memory of psychological rejection by her birthmother during the pregnancy, and the loss of her mother at birth. All this is a new and profound challenge to clinicians and adoption workers.
This paper considered the possibility that adoption, almost by definition, represents a perinatal trauma. The specific nature of this trauma was discussed, as were methods of healing this trauma. A case example of such healing was offered on videotape.
Ann L. Coker,, M.P.H., Ph.D., Epidemiologist and Professor, University of South Carolina.
Title: Pregnancy Wantedness and Subsequent Risk of Neonatal Death, Violence in Childhood, and Self-Esteem in AdolescenceBeing unwanted puts children at increased risk of a range of adverse health outcomes including neonatal mortality, child abuse, delayed cognitive and social-emotional development and perhaps puts children at increased risk of becoming violent adolescents.
This research used the cohort of pregnant patients enrolled from 1959 - 1966 in the Child Health and Development Studies, Oakland, CA. All women were interviewed early in their pregnancy and asked about their attitudes toward their own pregnancy. The sub-samples of this cohort of women and their children were followed forward in time. The short and longer term consequences of being unwanted (or mis-timed) were evaluated in this cohort. Women reporting that the pregnancy was unwanted were more than two times more likely to deliver infants who died within the first 28 days of life compared with women reporting accepted pregnancies.
Pregnancy wantedness was not associated with fetal death or with post-neonatal death. Pregnancy wantedness was inversely associated with aggression in children age 9-11 yet pregnancy wantedness was not consistently associated with low self-esteem or an external locus of control in adolescence. The literature on the health consequences of being unwanted was presented.
Ludwig Janus, M.D., Psychoanalyst, author, editor, and President, ISPPM, Heidelberg, Germany
Title: Birth and Violence: The Example of European HistoryPsychoanalytical psychology of culture assumes that cultural forms are essentially determined by our early feelings towards our parents and ourselves. In this sense society's leaders and institutions can be regarded on the one hand as childhood illusions of power made concrete, and on the other as protective parental objects. The form such projections of the self and of objects take is determined by our actual childhood experiences with our parents. In his book "Childhood and Society," Erik Erikson used the example of Red Indian tribal societies to convincingly show how the way in which a tribe deals with babies and infants is reflected in its rites, myths and values.
In this context, prenatal psychology has developed the decisive new viewpoint that one of the important basic constituents of these projections of the self and of objects is the way in which we experience ourselves and relationships before birth; in other words, the idealized leaders and institutions are to some extent a reflection of the fetal experience of power and relationships. In the macrocosm of the historical group, individuals seek the living-space and the security that characterized the microcosm of their prenatal stage of life. Human culture, with its kings and empires, can essentially be understood as a collective re-enactment of prenatal experience. As prenatal "heavyweights," the kings hover in their sacred uterine chambers. According to this way of looking at things, wars are re-enactments of birth when the illusion of uterine omnipotence is disturbed and cannot be sustained. In this context too, actual experiences before, during and after birth play an essential part in determining the nature of these re-enactments.
These basic considerations are illustrated in historical developments in Europe from the Middle Ages to the present. The author highlighted the creative potential of the collective re-enactments seen in the historical process. To a great extent the historical process appears to creatively shape and restructure human identity, making new forms of social existence possible. This can be seen in the transformation of identity from dependency in the Middle Ages to one of autonomy in modem times.
V. Breaking the Cycle of Violence
Preventive solutions to violence: Preparation for conception and birth, positive interaction with the baby in the womb, arranging a nourishing environment for birth, and nuturing the newborn in the family. Moderator: David B. Chamberlain, Ph.D. with Carista Luminare-Rosen, Ph.D., Phyllis Klaus, M.F.C.C., Beatriz Manrique, Ph.D., and John Travis, M.D., M.P.H.
Carista Luminare-Rosen, Ph.D. is Founder and Co-Director of The Center for Creative Parenting, Larkspur, CA. For a decade, she has been a pioneer in creating curricula for preconception, prenatal and postnatal education and health care.
Title: Prebirth Education as a Solution to Post-Natal ViolenceBased on the conviction that parenthood actually begins before conception (and long before birth), a successful holistic curriculum has been developed to educate parents about the benefits of preconception and prenatal health care. From over a decade of experimentation, a series of courses have emerged. These are shared, including results with parents and their newborns. This model may be useful to other educators, and is an basic key to reducing violence in families and in society.
Phyllis Klaus, C.S.W, M.F.C.C. practicess psychotherapy in Berkeley, CA. and teaches and practices at the Erickson Institute in Santa Rosa, CA. She is co-author of The Amazing Newborn, Mothering the Mother, and Bonding: Building the Foundations of Secure Attachment and Independence.
Title: How the Doula Can Reduce Trauma at BirthSeven randomized trials of the effect of doula support at birth have documented profound reductions in stress and negative interventions at birth. Clinical cases from the speaker's work with clients will illustrate how the nurturing care given to mothers during labor significantly changes her view of and her care of her infant--factors which raise and lower the potential for bonding. When childbirth is not a humane experience for the mother, and her extremely open state during labor and delivery is not respected, the seeds of domestic and societal violence may be planted. The doula at birth fills a void that has existed in our maternity care system.
Beatriz Manrique, Ph.D., family psychotherapist, author, and researcher, is President of CEDIHAC-CEDI and is a psychology professor at Central University of Venezuela, in Caracas. She directs the world's largest experiment in prenatal stimulation and bonding.
Title: Love Effaces Violence
For ten years we have been studying 684 families from poor ghettos of Caracas, from the prenatal age of five months gestation with follow up to six years of age. Systematic and comprehensive measurements evaluate the development of the child, the relationship with parents, family and friends, and language development. We especially emphasize the attention and affection, caresses, sensory stimulation, and communication in utero through auditory, visual, and tactile stimuli. We are convinced that prenatal interaction reaches the baby's psyche This presentation will summarize the very positive results found from periodic testing, our observations of how the children have benefited, and the important effects which the program has had on the parents. We did not find violence in the members of the families that participated in this program, and conclude that love can be taught. We believe that such a program, begun in the prenatal stage of life, undermines several of the causes of later violence and continues to pay dividends year after year of life.
John Travis, M.D., M.P.H. launched the nation's first wellness center--the Wellness Resource Center--in Marin, CA in 1975. As author and co-author he has published The Wellness Workbook, Wellness for Helping Professionals, A Change of Heart: The Global Wellness Inventory. He edits the quarterly Wellness Associates Journal.
Title: The Hidden Holocaust: Early Child MaltreatmentA holocaust is sweeping the world, largely unnoticed, as homo sapiens brings destruction on all living things, a destruction which is largely the result of damage done to infants at and around birth--something that has happened to almost everyone born in the last hundred years. Parents have commonly given up their birthing responsibilities and rights to medical authorities, and the result is severe damage to the normal infant/mother bonding process. The resulting inhumane births, mostly in hospitals, lead infants to feel disconnected and abandoned. After birth, failure of breastfeeding and failure to hold infants in-arms, contributes further to estrangement and alienation of the next generation, increasing the potential for denial, addiction, materialism and violence. Common myths about the early years will be disputed and recommendations given for a healthier and more natural childhood.