Letters to the Editor 6,4

Dear Charlie,

G. Justus Hofmeyr's article "Fetal Education: A Lesson from the Past" (PPPJ, Winter 1990) raises several issues which I have either addressed previously or shall shortly-between these covers, Pre and Perinatal Psychology News, and the International Journal of Prenatal and Perinatal Studies. Even so, while abdominal decompression's intelligence claim has been discredited by one study, parallel concerns about prenatal stimulation should be answered.

An admitted obstacle confronted in our pilot study was that of selfselection: in offering families my Cardiac Curriculum (curricularized variations in the maternal blood pulse) versus classical music, all subjects opted for the former because for fairness the prelearning thesis was presented prior-they understood it and so chose; had a placebo sound been utilized as a control, the family-child psychodynamics stemming from this alternative were a potential ethical dilemma we did not wish to confront. Hofmeyr may have recognized this problem by admitting "such studies are difficult and often impossible to mount." Nonetheless, since the group had not been weighted toward higher income nor education, and represented some ethnic diversity, this sample was deemed sufficient for an impartial first investigation.

Obviously, clinical trials require greater diversity and numbers, matched with controls; such project expansion is proceeding in stages (currently with 50 prelearners and 50 nonstimulated subjects paired for key variables) by evaluators independent of Prelearning Institute, the definitive results to be reported at both 1992 ISPPPM and 1993 PPPANA congresses; initial outcomes already appear highly positive. Another prelearning assessment is being conducted by the Children's Rehabilitation Center in Moscow, directed by Mikhail Lazarev, M.D., employing a classical music comparison, while a Down's syndrome mitigative effort of 100 prenates will commence this autumn through the Department of Psychology at Queen's University of Belfast, under Peter Hepper, Ph.D. We are also preparing for an extensive replication through a major American state university.

As for parental expectations, my own elicitating of data from the pilot study families noted a decided reluctance to assign performance where unwarranted: if a child had not attained the developmental milestone in question, parents steadfastly held to their objection; at no time was any report of precocity coaxable-quite the reverse. Time and again the caveat was heard: "We do not want a prodigy!" Conversely, when giftedness appeared, both professional characterization and lay tracking showed close congruency. It should be underscored that most parents expect much of their offspring, yet that desire alone (certainly manifest among the prelearning families) hardly insures the high scoring achieved consistently by prenatally stimulated children; though complementary, at some point the effects of bonding-for all its desirable virtues-become clearly distinguished from those benefits evoked by pattern-specific enrichment exercised during neurogenesis, before that massive but normative fetal brain cell dieoff which concludes the third trimester.

Inflated parental demands upon youth is a negative factor wherever encountered, however, depressed expectations are the other extreme; although our pilot study families are quite supportive of their children, they do not appear slavishly so-but this raises the last Hofmeyr point I wish to discuss. Merely reinforcing norms does not allow for what Oliver Sacks calls hyperfunction: were only status quo and deficit situations possible, evolution would not have brought us where we are. Prelearning represents a patently progressive intervention . . . which my reading of civilization finds is the human hallmark; mediocrity has never sufficed for what our species does best-exceed ourselves.

I agree with Hofmeyr that caution and prudence are desirable qualities of the scientific process, but so are vision as well as risk; that interplay between is the rightful subject of inquisitive discourse such as his and mine. When thousands of mothers around the planet are subjecting their unborn to the widest range of stimuli-some insulting, much questionable, yet a portion consistently demonstrating substantial rewards from curricularized sounds-it seems timely to investigate the phenomenon, discern fact from fantasy, standardize the approach for safety's sake, and venture forth where promise beckons; not to heed this developmental call carries its own moral freight.

Very truly yours,

Brent Logan, Ph.D.

Prelearning Institute

Dear Dr. Laughlin,

I agree with Dr. Logan that the investigation of fetal stimulation techniques is timely. My concern is that investigations not based on meticulously administered randomized trials may be misleading.

Yours sincerely,

G.J. Hofmeyr

Coronation Hospital and the University of the Witwatersrand

Dear Editor:

I would like to make some comments relevant to Dr. Logan's article, published in Vol. 6, No. 1, issue of the Journal.

First, I think it important to acknowledge that Dr. Logan's techniques of prenatal stimulation are pioneering, and if his pilot data are substantiated through replication, his procedures offer major and revolutionary breakthroughs in the facilitation of human potential and development. In general, his results would substantiate a line of research starting in the 1960's, showing that stimulation enhances cognitive and intellectual development in children. Dr. Van de Carr extended this work and research to prenates, developing and researching prenatal curriculum, and there is little doubt that prenatal stimulation enhances cognitive and intellectual development. However, the results described by Dr. Logan are so impressive, so far "off the scale" in terms of what might be expected, that further and careful replication are vital. As the reader may be aware, Dr. Logan developed a series of audiocassettes called the cardiac curriculum, which involve a series of auditory tones played at high frequency levels. The technique requires that expectant mothers read some simple instructions, wear abdominal belts equipped with "earphones," and play auditory frequencies through these "earphones" for several hours each day. The power of the cardiac curriculum lies in it's availability and it's simplicity. The technique is readily available, with minimal training and at minimal cost, to anyone who wishes to enhance the developmental levels of their prenates. Dr. Logan's pilot study is a vital piece of research, with important social implications, and because the techniques are so accessible to the general public, the study needs to be replicated and the techniques evaluated before they are marketed to the general public.

Having stated the above, I would like to note that there are some serious shortcomings in the study, as there are in many pilot studies.

Before his findings can be accepted, there are some basic procedures that need to be incorporated into his scientific methodology.

First and foremost, he needs to replicate the study and utilize a control group. The results that he reports could have occurred for any number of reasons unrelated to his cardiac curriculum. He needs to randomly select and assign prenates to a prelearner and nonprelearner group, where both groups are treated the same except that one group receives the cardiac curriculum and the other group does not. This would help to scientifically control many variables that have proven to "contaminate" scientific data. It is possible, for example, that he inadvertently selected exceptional prenates for his study, and that his prenates were developmentally superior even without the cardiac curriculum. It is possible that high expectations associated with the cardiac curriculum translated into selective perception on the part of parents, biasing their reports or perceptions. An additional problem involves the test that Dr. Logan used to establish developmental levels of superiority. The test that he used is prone to subjective bias in that it relies on parental reports. Infant tests are notoriously unreliable as they are, but adding parental reporting exacerbates the problem, and increases the unreliability of developmental assessment. A simple answer is to utilize an independent researcher who has no investment in the research outcomes, who has no prior knowledge of which infants are in the treatment and control groups to observe and obtain developmental data on all infants.

In addition to following more extensive scientific procedures, there is an important question about his data. In his study, he reports that the mean developmental scores of his prelearners, i.e. those who participated in the cardiac curriculum, dropped from initial to later testing. In my mind, he did not sufficiently address this issue in his article, and a drop in developmental scores implies that positive impacts of the cardiac curriculum on intellectual development may only be temporary, without long range impacts. Certainly, further and long term evaluation needs to be done.

Some final concerns that I have involve the aesthetic, temperamental, and emotional implications of the cardiac curriculum. After listening to the cardiac curriculum for only a short period of time, I felt agitated. Since prenates are exposed to these frequencies and tones for up to two hours each day, I wondered about the emotional and temperamental impacts that the cardiac curriculum might have on prenates. I think it crucial that Dr. Logan investigate the impacts of his procedures on the long term, emotional health and well being of his prelearners. Dr. Logan does mention that he utilized the Vineland Social Maturity Scale, but does not report any data pertinent to this test. Results from this test might shed some initial light on the issue of emotional impacts, but more extensive evaluation needs to be done. In addition, the sounds are very mechanical, and not at all aesthetic or pleasing to the human ear. The aesthetic objections might be overcome by embedding the sounds in music, or in some other way making them palpable to the human spirit, to the human aesthetic sense.

Because of the necessity for more research, and because temperamental and emotional impacts need to be evaluated, I hope that Dr. Logan will take caution in marketing his procedures until further scientific verification can be accomplished.

Respectfully submitted,

William R. Emerson, Ph.D.

To the Editor:

I find it incongruous and inappropriate and just as schizophrenic as our 90's culture that your association would print an article such as "The Moon Hung on a Navelstring from the Dark . . ." by Joan Raphael-Leff [PPPJ 6(1):33-53]. On the one hand we talk about the "prenate," this living unborn child, and explore and praise the benefits of in-utero care and stimulation in Brent Logan's article [PPPJ 6(1):731]. On the other hand we have Ms. Raphael-Leff saying, ". . . efficient contraception and free access to abortion have liberated female sexuality from reproduction. . . ."

When abortion by its very nature has to mean killing this unborn child, this "prenate," what can we women have possibly be liberated from, and what are the implications of this transformation? Your printing of this article implies that we are evolving into some higher form of enlightened being as a result of this "liberation." I believe it is a sign of decay, of disintegration, and could be our emotional and spiritual undoing. How do you justify this contradiction?

Perplexed and increasingly indignant,

Lauren Sproul

Dear Charles:

In response to your letter of October 30,1991 requesting clarification on what the position of PPPANA ought to be with regard to abortion, I hope the following will prove helpful.

Our membership brochure clearly states that we are an educational organization with the intent of providing a forum for individuals from diverse backgrounds and disciplines to explore the psychological dimensions of human reproduction and the mental and emotional development of the unborn and newborn child. What the above means is that our Association is primarily educational in nature, education based on scientific findings.

What are the scientific data with regard to the presence of "human life" in utero? If you base your definition on the presence of mentation, in other words, higher neurological activity in the cerebral hemispheres you can reach the following "bottom line" conclusions:

1. There is no doubt that somewhere between the fifth and sixth month of post-conception life the unborn child changes from a sensitive to a sensible human being. This means that, during the last trimester the unborn child is a sensitive, feeling, thinking, aware and remembering human being.

2. During the second trimester the unborn child reacts differently to his/her environment eg. to sweet vs. bitter substances on its tongue, loud noises, etc. Is this a reflex reaction or does it imply some degree of volition and cognition? We do not know. This is a grey area at the moment.

3. We know very little of the mental functioning of the baby during the 1st trimester. All indications seem to be that it lives on a level of neurological development which does not allow for mental and emotional life.

There are investigators including myself who believe that in addition to the neurologically based system of mental functioning there is another system which I have called cellular memory and which may be present from conception on. However, let me hasten to add that at this time no convincing scientific proof exists to support this theoretical construct.

Some other research data need to be mentioned here. One concerns the long term effects of abortion on women. Though conflicting findings exist the majority of studies seem to show that women who have voluntarily aborted suffer of anxiety and depression for many years sometimes for as long as they live.

Studies on adopted children show conclusively that compared to nonadoptees they are more highly represented in every negative category you wish to put children and adults into, e.g., they have more behavior problems, do poorly academically, have a higher incidence of mental illness, criminality, etc.

I think a parent faced with the problem of an unwanted pregnancy should be able to receive all this and more information. As an organization PPPANA's role must be to provide up to date scientific information and non-judgmental counselling free of moral biases in this very difficult area. Because we are an umbrella association of divergent disciplines and philosophical concepts we must not become wedded to one point of view as opposed to another.

Who are we to say that the sanctity of the unborn's life is any more or less sacred than the sanctity of the parent's life? That would be playing God and I don't believe that PPPANA is ready to play that role yet.

Personally, I think we should do everything in our power to prevent unwanted pregnancies. Faced with the choice between abortions or adoption a pregnant mother should be able to receive information based on scientific research relevant to this question. She will then have the tools to enable her to make an informed decision which will be right for her.

I realize that there are many people who see this issue in terms of right and wrong, black and white and they will not be satisfied with my position. Unfortunately certain life situations do not lend themselves to solutions by Cartesian logic and I think this is one of them. Any attitude which is based on doctrinaire and extreme philosophical, religious or political considerations implies fanaticism to me. In the long history of this world, I don't know of any good that has ever come from fanaticism. So, let's stay reasonable, stick to what we know and allow people to live their own lives even if we disagree with the way they chose to do so.

Sincerely,

Thomas R. Verny, M.D.

Dear Charles,

Speaking for myself and not for PPPANA: (1) I do not think PPPANA should take sides, attempt to dictate, or presume to speak for its members on such a divisive issue.

(2) By publishing a Journal and Newsletter, the Association does not endorse authors and authors do not necessarily represent the view of the Association or speak for the membership.

(3) On the abortion issue, I think there is room for differences of belief. The person who complained to you about articles being "incongruous," "inappropriate," and "schizophrenic" apparently thinks there is no room for differences. In my view, our Journal policy should, at the least, respect differences, facilitate communication, and avoid orthodoxy.

(4) I find that the abortion debate inevitably becomes a spiritual debate calling forth divergent beliefs about the nature of body, mind, and spirit, and the uncertain relationship of spirit to body when it is only partially embodied. Given the diversity of metaphysical beliefs in our pluralistic society (and the constitutional safeguards established for religious beliefs) I think it is improper to enforce orthodoxy; it is also impractical, as experience shows.

(5) Prenatal and perinatal psychology does not focus on a baby in isolation but on the total environment which includes mothers, fathers, and many other cultural and global factors affecting personal choice and quality of life.

(6) In my view, abortion involves complex personal, moral, ethical, medical, legal, and constitutional decisions and does not lend itself to simplistic, dogmatic solutions, notwithstanding the attempt of some persons to treat it as such.

Yours,

David B. Chamberlain, Ph.D.

Dear Charles,

I received your letter and the copy of Lauren Sproul's letter. I welcome her comments and those of members who may wish to respond to her letter. There are many issues involved in the debate over abortion. I believe that both Ms. Sproul and Joan Raphael-Leff, author of "The Moon on a Navelstring from the Dark," are entitled to express their thoughts. I would encourage comments of any reader who wishes to challenge the positions presented by authors in PPPANA's journal. Authors' replies to those challenges also should be published. Certainly I believe that PPPANA was appropriate in publishing the original article.

While many members of PPPANA support the right to a legal abortion, other members do not. This issue came up at the Atlanta Congress this summer during the panel discussion on abortion. I thought that Barbara Findeisen did a skillful job of keeping the panel members and the audience on a discussion of issues surrounding abortion for the individuals involved, without debating whether abortions should or should not be conducted. While it would not address the issue of Ms. Sproul's letter, I think that an article in PPPANA addressing the issues discussed in that panel would be useful for the general readers of PPPANA. I have relistened to my tape of that workshop since receiving your letter and have again found it very enlightening.

I have several comments about the letter. The first is that abortion is a very complex issue; it is not black and white. I share some of Ms. Sproul's concerns. In fighting to assure the right to have an abortion in the first place (since many in this country would like to deny that opportunity), I think some have gone too far in the direction of abortion rights. As was mentioned in the panel discussion in Atlanta, when demonstrators outside a clinic stuff a 5 month old aborted fetus into the face of a woman who is entering the clinic contemplating an abortion, she becomes adamant that she will have the abortion. She is then making a decision based upon her right not to be told what to do by these angry people. The panelist who raised this point spoke of how she then must counsel the pregnant woman to make her decision based on what she truly wants for herself. The right to a legal abortion is still a relatively new thing. We need to continue to discuss our thoughts and feelings as we each decide where we stand on the issue.

Based on what we have learned from pre- and peri-natal psychology, there is a tiny person involved here. One of many points which I have not heard discussed, is that to force that person to evolve in the womb of a woman who does not want him or her and who would abort the child if allowed to do so, seems to me cruel and unusual punishment to that human being, a kind of life sentence of unwantedness. Even adoption into a loving family who sincerely wants a child cannot erase the pain which that fetus will endure.

Lastly, I believe that it is not our printing of the article which implies that we are "evolving into some higher form of enlightened being . .." as Ms. Sproul stated. The article itself may or may not imply such an idea. It is the article itself which is to be challenged, not the PPPANA journal. I do not consider it the job of the journal nor would I give it the authority to censor the presentation of ideas presented to conform to one ideology.

Thanks for your work, Charlie. I will be interested as this issue evolves.

Sincerely,

Karen A. Buck

Dear Charlie,

In response to your recent letter about an editorial policy concerning abortion issues, I'd like to say that I can understand the writer's confusion, expressed in the photocopied letter you sent. By her strictly limited criterion, which is that of the prenate's life or welfare, it is inconceivable that a publication can espouse both the welfare of the prenate and the liberation of the mother when that is at the cost of the prenate's very life. But this criterion ignores some basic facts of preand perinatal psychology that the writer, I would venture to guess, is not aware of or has not seriously considered. These facts have to do with the lifelong effects of being an unwanted fetus and the simple fact that a person can not be made to feel something (e.g., wanting one's child) that the person does not happen to feel.

The bottom line is that many of those who are trying to undo the damage of being unwanted often feel that the "gift" of life is anything but that. In my experience these are "borderline" people who very often seem to be only one step away from leaving this plane of existenceeither consciously by suicide or unconsciously in some dire selfdestructive pattern. One can not listen to their pain and their anguish, year after year, as they lament their very existence and not wonder if maybe they would have been better off not alive, as they claim.

In this respect, also, it is interesting that many of the "pro-life" folks, who espouse so much religiosity, have so little spiritual faith that they cannot imagine that being spiritual beings we would not enter by another "gate" if one were blocked.

I honestly don't know how you can respond to such a person as wrote this letter who is obviously perceiving out of so much intrauterine pain. The way I see these "pro-lifers" is that they are acting out a fight, for themselves alone, that they wish they could have had a long time ago in the womb. To that extent, they are not even seeing the fetuses that they are supposedly advocating, they are seeing merely reflections of their own pain.

I do feel strongly that any position of the journal should be careful to not exclude the very important insights that this psychology has given us concerning the supreme importance of a child's being wanted and planned for in that individual's chances for happiness in life. We cannot ignore the connection between being unwanted and trauma, nor that between trauma and later unhappiness-not to mention the dire consequences of that unhappiness to society as a result of the established connection of trauma to crime and psychopathology. Thus, I think the only thing you can do is to keep an "open" editorial policy in these matters. The ethical situation is no way as clear as the writer tries to make it seem. One could just as easily say that it is unconscionable and immoral to force a fetus to live in a situation where it is unwanted and where it is intolerable to live because it somehow satisfies the crazy controlling desires of some "pro-lifer" that it should do so.

Finally, where do you draw the line. My research/experience in preand perinatal realms has led me to the conviction that all is spirit and all is life . . . that the inanimate and the animal are also consciousness; as one example, that we are conscious on the cellular level of sperm and egg. Since there is, in my opinion, "spirit" and consciousness" at the sperm and egg level, do we require each of the 300 million sperm in each and every ejaculation of a male to come to full term? Also, do we require that of other species with their own brand of divinity and "spirit" in all of their infinite numbers of procreative attempts. The situation gets absurd!

Therefore, I believe the only reasonable response, within the biological parameters in which we find ourselves, is to seek to realize an ideal where children are loved from before conception onward, thus affording them a decent chance for a happy life, and where children are not born into situations where they are unwanted and are thus severely crippled in their ability to realize life's beauty.

Warm regards,

Michael Adzema