SHARING SPACE II: The Pre- and Perinatal Development of a Sense of Self

Publication Date: 
12/1998

Under consideration are the remembrances of several pre- and perinatal experiences by Jessica (pseudonym), during the course of her therapy as an adult. While these events are significant in their own right in terms of their specific effect on her developing humanness, their combined effect constituted a continual assault on her developing sense of a self, and which eventually resulted in a dissociation that caused her to not experience herself as a needing, wanting person; or in her words, as not having a me.

She was terrified that she had been born, or even made wp,with a flaw in the basic structure of her humanness. In her therapy Jessica experienced this dissociative process at a conscious level. Her descriptions of how the traumatic experiences threatened the existence of her self, and of the process of dissociation itself, provide information of theoretical significance into the formative stages of a self and of the mechanism that played an active role in protecting her embryonic self from threatening events.

RECALLS: A BY-PRODUCT OF THERAPEUTIC PROCESS*

These pre- and perinatal remembrances are viewed as a by-product of a more fundamental reparative process, and were not the direct goal of intervention. Therapy was based on the following assumptions: (1) psychological development can be interfered with only by external events; (2) the human psyche (a combination of brain and body) has the ability to deny to consciousness any interference that is too threatening; (3) there exists a reparative process for psychological injuries (interference) that is manifested by a variety of cathartic responses, and that operates at maximum effectiveness when allowed to proceed under its own internal mechanisms.

In Jessica's therapy empathie listening was used to facilitate the emergence of deeper material into her awareness and, to promote a therapeutic cathartic release. When such a reaction was not forthcoming, more active interventions were used-primarily role-plays (approximations of the distressful event), to amplify the emerging affect, but not to the point of overload, to attempt a therapeutic cathartic release. A differentiation, explained later, is made between a therapeutic and non-therapeutic cathartic reaction (Von Glahn, 1993). Other commonly used methods for promoting catharsis (or abreaction) such as deeper breathing, hypnosis, massage, guided imagery, screaming, pounding, and music were not used.

The recalls presented here occurred over a two year period, during which time there were four sessions a week, with each lasting three to four hours. In general, the earlier hi therapy a recall occurred, the more intense and prolonged was the anxiety that preceded it. More technically, a response was mediated by the sympathetic mode of the ANS (Janov & Holden, 1975). These anxiety attacks were triggered by simply listening to Jessica. In the later stages of her therapy, the sympathetic reaction was markedly reduced when it preceded a cathartic response. Independent verification for some of Jessica's descriptions, such as her birth, was confirmed in a separate consultation with her mother, whose feedback also provided other details that Jessica could not have known.

BIOGRAPHICAL SKETCH

When Jessica was born, her parents, the K's, had a one-and-a-half year old daughter, and were in a difficult marriage. Mrs. K. resented her second pregnancy from the start and at the same time there were frequent and heated arguments with Mr. K. Mrs. K. was in partial labor for about 15 hours before being given a shot late in the evening to help her sleep. Within minutes, labor began hi earnest. With a nurse's assistance, Mrs. K. had to walk to the delivery room. When she was ready to let the baby come, she was asked if she could hold for a few minutes. Jessica started coming out face-down. The doctor pushed her back in, and turned her face-up. When she came back out, face-up, Mrs. K. emitted sharp cries of pain because she was tearing (an episiotomy had not been done). Sharp orders and hurried movements mingled with Jessica's cries. The doctor pulled on her limbs to get her out. He quickly scrutinized her, then held her up for a quick look by Mrs. K., who didn't (or wasn't able) to say a word. Jessica was laid on a cloth covered table. Two attendants rubbed her with towels, while chatting and joking with each other. Jessica cried lustily from when she was first born until she was taken to the nursery.

At home Mrs. K. had little time for her newborn. There were three other adult relatives to shop, cook, do laundry for, a big house to clean, and Mr. K. worked long hours, often coming home late and drunk. The other relatives had \"spoiled\" the K.'s first child, who cried constantly whenever she was not being held. Mrs. K. finally solved that problem by blistering the others with her anger, and letting her daughter \"cry it out\" for several days while not being held. When Mrs. K came home with Jessica, the others kept their distance.

Mrs. K. was Jessica's whole world. During recall, She described her mother's attention:

When my mom got up, she'd stand there and shake her head, and have this really mean look on her face. She was grumbling and complaining because everything was a mess and I was hungry. She looked all upset because her problem didn't go away during the night. All I had to do was wake up in the morning and I knew what to expect: the mean, ugly look in the morning, all the bitching and grumbling all day. I just knew I'd make someone hurt! I knew I'd make somebody sick! I knew somebody would walk around feeling bad because of me!\"

During one episode shortly after her birth, Jessica's crying (asking to be changed, fed, and comforted) woke Mrs. K. in the middle of the night. With her usual angry countenance, she quickly fed and changed Jessica. When Mrs. K. started to leave, Jessica started to cry. There followed a series of Mrs. K. picking her up and putting her back down, with not crying and crying associated with each. When placing her hand over Jessica's mouth didn't stop the piercing cries, Mrs. K. finally snatched her up, held her face right in front of hers, snarled at her in a scolding voice, blamed her for being \"bad,\" and abruptly put her back in bed. The crying suddenly stopped.

When asked by this author to describe Jessica as an infant, Mrs. K. spontaneously responded: \"Jessica was the perfect baby. She never cried, and she never wanted anything!\" Jessica was a model child. She always acted responsibly, and tried not to make anyone upset. Inwardly, she had no experiential understanding of herself as a needing, wanting person, no felt internal source for pursuing any psychological needs.

Jessica was sexually molested at age six by a teen-age boy. She always remembered this event, but did not reveal it to anyone until her mid-twenties after over a year of therapy. During her senior year in high school she had her first panic attack of \"something\" coming after her. It happened in a windowless bathroom, the same setting as the sexual assault. Constantly fearful of another attack, Jessica felt safe only with her boy friend and her mother.

Toward the end of her senior year of high school, her mother was in an auto accident, hospitalized for ten days, and finished recuperating at home. She was fiercely independent and refused to follow the medical regimen, primarily staying in bed. Jessica's anxiety was skyhigh. While staying keenly aware of everything her mother did, she faked preparing for her final exams. Her performance on them was so poor (also partly due to anxiety over knowing others were expecting a decision about what she wanted to do after graduation), that all her teachers had the same reaction: It seemed like she hadn't been in class all year. When the principal learned about Mrs. K.'s accident, he ascribed Jessica's exam failures to that and let her graduate as she had always been an excellent student. Jessica married two years later, and a year after that adopted her infant niece. When her husband began working the night shift, her panic attacks started again. In the early years of her marriage she did day-care in her home.

When Jessica contacted this author for therapy at age 23, she stated her concern as, \"When my husband works nights, I have to go to my mother's with my daughter [now three] to spend the night.\" She did not state that she was having panic attacks and pacing the floor for most of the night, or how she felt about having to go to her mother's, or that she wanted to be able to stay at home-that was only implied. After her opening statement, she did not volunteer any further information (the sexual assault) for many months, only responded to questions, and eventually began sessions with, \"Well, what would you like me to talk about?\"

PRE-BIRTH

This is Jessica's reaction to her overall pre-birth experience, covering from sometime after conception to before birth. While this was her first pre-birth recall, it occurred after over a year of therapy and after she had remembered other perinatal experiences. Edited for readability, the version presented here is a composite from two sessions a few days apart.

Session 1

The first thing I ever 'thought' about was surviving. This is just when my mind started 'thinking.' It's the very spark, or the very second, it all started, and I knew I had to do everything to make sure I survived. I wasn't certain if I would. Those were my first 'thoughts,' doing what I had to do to survive. It was like all that was here was my mind. Everything was black and empty. It was before I was a person. There was just life trying to survive and it didn't have a body yet. Everything was in the present. There was no past. There was no memory and no meaning. I can actually get to the point where there's no memory. The more my body grew, then it became a past. There was more of me so there could be a past. There was a time when I wasn't what I was then. There was a time when I was less and I knew it. Then I was acquiring a past. Then I had a memory. I didn't worry about needs. There wasn't any of that there. It was all like stages. Every second was important. Every second something was changing. Every minute there was more to me. Every minute I was growing. I can remember first moving. It was all so new. It was all on automatic. I couldn't alter any of it or change any of it. I didn't want to. The next stage was feelings about me, about my 'human being.' That's when I started wondering who I was and trying to 'figure out' what I was. I stopped just being amazed at how I was growing and settling for that. Something in me knew I had to understand it and 'figure' it out.You know what things you get last before you're born? Your needs. You have feelings before then, but you start recognizing your needs and what they are, and you start knowing how you have to get them. The first need must have been trying to 'figure out' who or what I was.

And I knew in order to survive I had to be born. I knew that I couldn't get what I needed here; they involved another environment. I had gotten all I could out of that dimension. I knew what I needed to survive and I knew that I had to have more to keep growing. I was eager and I was happy to move-this feels so real. This amazes me.

Session 2

Do you know though, before I was born I can remember feeling hesitant and scared, and not certain about what was out there, not certain how the world would feel about me. A part of me became aware that something was wrong. I was 'wondering\" something about my mom and dad-Oh, but that shouldn't be there! You're going to think I'm crazy! Let's not do this any more! Before I was born, things were bad. I can remember my awareness of me, and a part ofthat was the feeling that they didn't want me. I knew I was a human being and that I needed things, and one of the things I needed was somebody to want me. Somehow I knew-Oh, I was scared of them already. I wasn't certain if somewhere somebody didn't want me to survive.

I never knew what was going to happen from one minute to the next. I never knew when they were going to have a fight. I'd wake up and hear them screaming. Whatever was happening to her, was happening to me. When she was upset, it scared me. There was never any quiet. I never, ever felt safe. There was nowhere to go to get away from that. Where did she think I was going to go? Get up and walk out!

I must have heard her screaming this was all a 'mistake.' Or that it was all an 'accident' when she got pregnant with me. Those two words stick in my mind. It left me with the feeling that it was just an accident that I lived through it all. I feel like Fm really not supposed to be here. I was a mistake! I came into being and I wasn't supposed to!

The feeling that they didn't want me-It wasn't all that big of a feeling, but it was there. I knew that I was fighting then because they didn't want me-No! It can't be, can it? It's not possible, is it, for me to know that then? You'd better not let anybody hear this until I get it sorted out. You don't think I'm cuckoo?

\"That feeling that they were giving me-Right there is where things really started going wrong! This is where it got scary. Suddenly things were in a way that I couldn't 'figure' out. I knew it shouldn't be there and it was affecting how I was reacting to everything. I was not growing the way I should. They had altered how I was to grow.

Listen! This is really starting to scare me! I feel like you're tampering with the central essence of me!

Parts of me that were supposed to grow couldn't because of this. Some part of me had to stop growing. I was not moving forward the way I should. Some part of me was being altered and I didn't know how to fix it. I was afraid I wouldn't survive, that I wouldn't get what I needed if my environment changed-NO! Nothing's broke, is it? ... You aren't going to get me this far-Listen! They didn't miss something putting me together, did they?

BIRTH

Session 1

I remember 'thinking' before I was born all that was happening seemed to be in preparation for a different dimension in my life. I was going to be born so somebody could love me and touch me; so I could be enough; so I could be a part of the world and I could have an effect upon the world.

The world was a good place and I was going to be a part of it! The world was going to be better because I was here; because there was nothing like me. Nowhere could the world get what it was going to get from me. I was important, as important as anything. Even the tiniest speck!

During labor I felt squeezed. I wasn't frightened. I was going along with the process of being born. I was starting to get out when somebody pushed me back in. Gosh darn it!

I was not in charge of my birth any more. They were pushing my head in and I couldn't breath. I was very frightened and confused. I thought that I was going to die before I could get out.

Somebody was jerking and pulling and turning and me. It scared me, and it hurt everywhere on my body. I was dizzy. I wanted to go back to where it was quiet.\"

Then Jessica suddenly switched to talking in the first person.

\"Make them stop! Leave me alone! Everyone leave me alone and I'll be just fine. Let me do it!\"

Just as quickly, she returned to a third-person description.

The doctor simply plucked me out of my mother and said, 'Here's the little trouble-maker. I can tell she's going to be a stubborn one.' My mom hurt, and she hurt physically because of me. There was a lot of confusion. The lights were bright and the room was noisy. The medical team was in a panic and everyone was yelling.

It seemed like the whole world was a mess. Things weren't going right. And it was all because of me. Because I was ready to be born and I wasn't doing it right! Everyone was frightened and scared and they didn't understand.

Two nurses took me and washed me roughly. They were talking and laughing with each other, and were unaware of how they were treating me, or how I felt. I remember one of them saying, \"Who do you think you are? You're just another person to take care of.'

I was hungry and screaming and scared. It didn't matter. Nobody wanted to touch me and hold me and smile at me. There was a whole room full of people. I just had to wait! I wasn't any more important than anybody else! Everybody was doing the best they could and I have to just behave and stop crying.

And I'd learn, I'd learn that I was a nobody, that I was just like everybody else. It didn't matter what I wanted or expected. I was in the real world and I'd just have to wait. I was nobody special and I didn't deserve anything any more than anybody else. It didn't make any difference who I was. I was just one more person to take care of. It all made me feel like I wasn't what they were looking for, like I was a nobody. Who the hell was I?

They weren't concerned about me. They were just concerned with what I had done, with how hard I had made it for everybody. Like I had any control over it! All I had done was be born. And it was no big deal! I came out thinking, 'Ta, ta, I'm here!' and everybody goes, 'Big deal!'

Everybody felt like I had to prove myself. It was like everybody thought it was a tough, mean, crummy world and welcome to it kid. You're no different than the rest of us. It's all crummy and rotten and look at what you're a part of. They must have had a lot of bad attitudes.

I felt like going and hiding. What did I do good? I was just born! It didn't matter what I had to offer. Nobody saw any good in me. I was waiting for someone to be so delighted and happy I was here, that I was out and now the world was a better place because there was one more good thing. Nobody felt I had contributed something only I could. I thought something unique had just happened, and never in the space of time would anything like that happen again because I was different. I was one of a kind and I could contribute things nobody else could.

I do feel like I've committed a grave transgression because I was born. Because of me I added more hurt to this world. I didn't add good things. I wasn't good and special and one of a kind. I felt so awful, like I didn't have a right to live.

Everybody thought the world was crummy and a mess, and that I added to the awfulness and the crumminess. I felt so disappointed. Yuk. This was what I had waited for?

After being cleaned up, I went to sleep. When I woke up, I decided to give the world another chance. It was tough being born. It was.

Do you remember all this stuff? Do you think I'm cuckoo? I know all this happened.

ANESTHESIA

The next significant psychological event, Jessica's reaction to the medications given to her mother, happened within minutes of the above event. Even so, she recalled this event six months after her birth recall, but in-between the two pre-birth recalls. It seems logical to assume that there was more of a connection between the effect of the anesthesia and the second pre-birth recall. This experienced announced itself by Jessica lying on the floor and breathing laboriously, which continued throughout her description.

I could feel my face and my hands go numb. Then I couldn't feel my skin any more. Then my whole body felt numb. I kept trying to wake up my body and I couldn't. I couldn't 'figure out' why my mind was saying 'move' and my body didn't!

I couldn't breathe on my own. I could hear this breathing in my ears, and I had to keep listening to it and make sure I could hear breathing. I had to listen very hard because I couldn't feel my body any more. As long as I could hear breathing, I knew I was alive.

I feel like I'm sleeping with my eyes open. It's like being alive but not being able to feel alive. Tell me! How do you understand that you have no feeling about your physical existence when you look down and see it there? It was like time just suddenly stopped, like I stopped being but I could see. When you cross into that feeling of just seeing, it's like you're not human any more. I felt that everything I had known as human being had left me.

Somewhere something was in me that shouldn't have been-something crazy! It was more powerful and stronger than I was. It just did what it wanted. It felt like something was breaking down in me, that something in my human being was going wrong! I didn't understand that it was a drug that was doing that to me. I didn't know that it was happening from the outside, that somebody had done something. I 'thought' I had given up. I 'thought' I had done something wrong.

I was afraid I had lost the ability to react, to feel, to 'think' for myself, to 'understand' things. If you can't feel and 'think' and 'understand,' what good are you? What use do you have? What are we here for? Why do you live?

It left me with the feeling that 'something' is going to take over that I won't have any control over-that 'something\" is going to get me! That's where that feeling comes from. There's 'something\" that's going to get me!

Since this remembrance occurred a few days before the second prebirth recall, it was natural for her to think that this event was the cause of her panic attacks.

DISSOCIATION

The dissociative experience that caused Jessica to feel that she had lost her me was the result of the middle-of-the-night encounter with her mother. A description of her reaction to that experience, minus the dissociative aspect, was Jessica's first very early recall, and is presented here.

\"When she threw me down, I was afraid to move.\"

However Jessica was put back down in her crib, she experienced it as being \"thrown down.\"

I realized that I was right. She hated caring for me. I had destroyed her life when I was born! I was a terrible, awful person and responsible for making her life so unhappy. I felt that I was so unimportant that no one could ever love me. I knew that I could never trust her again. She would never be there when I needed her. I stopped expecting anything from anyone!

I couldn't handle all those feelings. I knew I was all alone. I saw no hope that anything would ever be right. I decided not to live!

At the age of three months Jessica had radiation therapy for a tumor in her throat that was causing her to dehydrate. Jessica's conscious experience of the dissociation occurred about two years after the above recall. The core of the dissociation was her feeling that the part of her that was causing the problem, the needing part of her, and that she described as the bad in the world, had been sent away.

The recall began with:

\"She wanted me to go away! Ill go where it doesn't hurt her!\"

Then Jessica suddenly switched to talking to the other part of herself as if it were a separate person.

J: You' have to go away! They don't love \"you\" here. No one wants 'you.' There's no room. Get out of here! Can't 'you' see? They're going to kill 'you'! Make 'her' get out! 'She's' got to leave!

I couldn't help 'her' any more. So I had to let 'her' go. I didn't want to. I didn't! But something in me knew I had to or 'she'd' die. \"We'd\" all die!

It was like there was something grown up in me that wanted to pick 'her' up and love 'her' and tell 'her' it wasn't 'her.'

VG: What did you want to tell 'her'?

J: That it wasn't 'her.' That 'she' was a good bahy! A good \"human heing\"! I told 'her' that 'she' was a good baby and that I loved 'her,' but that 'she' would have to die!

\"Do you hear me? I killed 'her' so 'she'd' never have to be a no one again, to hurt like that again, be so alone again. I promised 'her.'

VG: \"Why did you think that making that promise was a good thing\"?

J: Because I cared too much about 'her.' Because I loved 'her' and I didn't want anyone to hurt 'her.' I promised this little, itty, bitty baby that no one loved or wanted, that I'd never let 'her' hurt again. I promised 'her' that 'she'd' never have to feel those feelings again. I believed in 'her' and I loved 'her'; but I couldn't do too much for 'her.' I'd send 'her' away though. I could do that!

You see, I had to give me up. I had to or no one will get through it. This part of me that cared about anything, that loved and needed and wanted, the real human being in me, I had to send \"her\" away.

\"Did you hear what 'she' is? I feel like there's two people in me now. Does it make sense to you? I'm two things. A second or two ago I sent my me away because I loved 'her,' because I didn't want anyone to hurt 'her,' and I knew I wasn't enough for 'her.' I had to scrape my 'human being\" out of me and let 'her' float off.

\"But before that I sent away the baby they hated and didn't love and didn't want. I sent 'her1 away because 'she's' bad and no good. They wanted me to take the bad-but it's me! see, it doesn't make any sense. It's two things.

After a few minutes of restful silence, Jessica spoke in a more reflective manner.

J: This is the only way to keep me alive. It's to not remember who I really am to the world. It seems all very critical, and it seems like a real finely worked out plan that had to be executed successfully to get through it all. It was like it was my whole life-everything in me working to get it all where it should be. It seemed real detailed and important that every single step take place the way it did. My life depended on me doing all that and it's very hard for me to understand it now. It was all so rigid and there was no room for mistakes.

I could take a million smacks. I could be thrown down a hundred times. But I couldn't take the thought that they couldn't love me. I couldn't live with that information. I couldn't take it in and remain the same. I couldn't live and be a human being in the manner I knew.

My sole reason for being a human being, to be loved and wanted, I couldn't get from people. You can't substitute anything else in the world for that. You can survive without everything else, without people touching you, or smiling at you. They can hit you and throw you down and break your bones. But the absolute most necessary ingredient in a human being is that some-body loves you and wants you.

\"This is like chopping you off in your center. This alters the most crucial part of you. The part that just can't be damaged. There's no room for mistakes there, for wrongdoings there, for injury there. It's a deeper notch in me than just fear or hurt. It's gnawed into a part of me that shouldn't have been gnawed into, that should never have been touched. It simply can't happen! Once you've been wronged there, there's no fixing it. You just can't take that. It means death.

Listen to this stuff! I knew it had to be something big. I had to be so careful. They were trying to damage the part of me that couldn't take it all. They were getting so close to destroying me. That's what I couldn't think about. That's what gave me the feeling of running, and not recognizing that there was a part of me like that.

\"That's a beautiful thing to exist in a human being. Everybody has to be in touch with that part of them. But my first thought was that it terrified me to know that that part existed. My defense against them doing that to me was to not recognize that that existed, and that they could take it from me because the alternative was death. All of the depths of the real humanness to me I had to give up, to become oblivious to that part of me existing. It left me with the feeling that that part of me was dangerous.

This therapeutic experience of talking to the you did not completely resolve the dissociation and give her back her me. . . . It was, however, the start of that journey.

REFLECTIONS ON THE DEVELOPMENT OF A SELF

A short time after the above recall, Jessica gave a final reflection on her thoughts about how a self develops.

You're not born with a real centered feeling. You know how that develops? That only comes from people always considering who you are in everything you do.

None of the things I needed were ever considered, or nurtured. People just did what they wanted when they wanted, and they never involved me, what I really needed. And when I operated based on who I really was no one held me, no one loved me, no one wanted me.

I didn't know how to recognize needs as something that came from within me. I didn't know how to rely on what I really needed because I'd never been allowed to figure that out. It got squelched in me before it even got started. It's like somebody gave me this being without a set of directions. So I had to act like I had a 'me' even though I knew I didn't.

OTHER GUIDANCE FROM JESSICA'S THERAPY

Chaos

Jessica believed that infants have an instinctual need for their experience to make sense, and that this need is as important as any other. Her word for experience not making sense is chaos, meaning that there is no order or predictability to one's basic sense about life. For Jessica the feeling of chaos was the most painful of all the upsetting emotions she experienced, and the most difficult emotion for her to make a conscious decision to face. Since in her words \"a human mind cannot exist in chaos,\" Jessica asserts that the psyche will construct any reason or explanation as a defense against the feeling of chaos. A symptom suggesting that an infant or very small child is dealing with chaos is head-banging, which Jessica did later in her infancy. It is soothing because it allows the infant to know the source of the pain.

Immediately after Jessica experienced the dissociative event about her lost me, she refused to take her back. Her reason was that after she had lost the me, \"meaning that she stopped needing and crying,\" that her mother would then love her. All that was left for her mother to love was her body. When that part of her was ignored, it became the cause of her mother's unhappiness as perceived by Jessica. The tumor in her throat seems a likely consequence.

The issue of her bad body announced its readiness by her insisting that I not touch her. Up to this point she had always wanted me to hold her when she cried. When her discussion about this insistence upon non touch led nowhere, I decided on a more active intervention, and lightly stroked her face with my finger. Her immediate response was to emphatically slap my hand away. My action contradicted her sense of the world as an infant-that she was the bad in the world, the problem-causer, the destroyer of her mother's life, and not deserving of love. That was her sense of who she was. It was the only way her world made sense to her. My touching her cheek was the opposite of this reality and threatened to plunge her mind into chaos. She reacted instinctively.

As I persisted with stroking her cheek, she banged her head against the back of the wooden frame of the couch we were sitting on. I placed my hand to prevent that, and stroked her face with the other, which was an ordeal in itself as she tried to prevent it with both of her hands. When I was able to touch her cheek, her immediate reaction was to bang her head, and when it hit the relative softness of my hand she impulsively grabbed her head and her body writhed in the agony of chaos. It was necessary to repeat this scenario a number of times over several sessions. Jessica's description of chaos seems remarkably similar to the intense reaction of children, both autistic and normal, in Martha Welch's holding therapy (HT) (Welch, 1987, 1988). In HT the mother suddenly places or holds her child in a face-to-face position. Initially, or within a few minutes, the child usually struggles quite intensely to break the contact, and if the mother persists with holding, the child eventually has an intense cathartic release. Jessica's account suggests that the children might be dealing with what she calls chaos.

Sleep

After Jessica resolved the trauma of chaos, and which came after all of the above recalls, she started to abruptly fall asleep during sessions. The first sign was my asking a rather simple question about a present concern she was talking about, within seconds she was sound asleep, and she later reported dreaming within minutes. This happened every session for several months. At first she slept for three to four hours, gradually decreasing to 45 minutes.

In a personal communication, E. Michael Holden, (neurologist, formerly research director at The Primal Institute in the mid- to late-1970s, and co-author with Janov of Primal Man: The New Consciousness) commented that infants have a need for rational sleep, and if it does not happen because of psychological overload, the result is a \"brain pain,\" or a \"body pain.\" In Holden's view the only remedy is sleep, which occurs when this trauma is ready for resolution and facultative conditions are present.

SUMMARY

Several pre- and perinatal experiences remembered by an adult during her therapy have been presented. While each event had its own specific effect, the accumulated result was interference with Jessica's development of a sense of self, a center or a core to her personality, or, in her words, her me. In Jessica's view, the basis of a sense of self is dependent on the nature of interaction with others. Jessica's account of her experience suggests that just having needs met is not sufficient for the full development of a sense of self. What is more critical is that the individual's needs are met in a way that allows the developing person to integrate the information, to be allowed sufficient time to make sense of their experience, of their interaction with the environment.

In the formative stages of Jessica's psychological development, exactly the opposite happened. Her pre-birth account strongly suggests that her sense of her self (her interaction with her environment being based on what she needed) began before birth. Jessica's attempt to \"figure out\" the frightening aspect of her pre-birth experience was, perhaps, an attempt to understand what seems to have been her most prominent need at the time: to feel that she was wanted, that the world wanted her to survive. Physiological disturbances in her (triggered by her mother being emotionally upset) could certainly have made her feel that her life was in danger. Certainly by the time of her birth, it was obvious that the interactions of her mother and others with her were not based on her needs. This type of interaction dominated her life at home, and culminated in the dissociation experience when she felt that the needing part of her was the bad in the world. How does this case report compare with current knowledge about the development of a self? In a special issue devoted to the concept of self (Developmental Review, vol. 11, 1991), Brownell & Kopp, in summarizing the contributions to this issue, raised the question, \"Out of what does self-awareness arise?\" The conclusion was that a presymbolic or primitive self had to be a logical postulate in understanding early selfdevelopment.

However, the discussants placed limitations on the characteristics of a presymbolic self. A presymbolic self was viewed as essentially the experience of self as opposed to awareness of self, which was thought to emerge from the former. The consensus among the theorists was that only the presymbolic self operates in the \"opening months of life,\" and it is only sometime after this period that the infant obtains selfawareness, the ability to view itself as an object. Jessica's remembrances, as well as those found in, for example, Chamberlain (1988), Janov (1983), and others are in direct conflict with this limitation.

There was one theoretical conclusion in Brownell and Kopp (1991) that was in strong agreement with Jessica's descriptions. They write that, \"the essential function of {self} is to organize and integrate the infant's experiences in the world. {Self} serves as a frame of reference, as a locus from which to discern who and where we are, what we do, and what we want or intend\" (292), and \"the function of {self} might be said to be the location of or imposition of order in the world from a single consistent vantage point, and the definition of the world from that vantage point\" (297).

While this description is certainly supportive of the viewpoint of this journal, the above contributors limited this organizing ability in the \"immature infant\" to a definition of the physical boundaries between the infant and its environment. Practitioners of (or believers in) preand perinatal psychology are faced with a difficulty in convincing others, particularly professional colleagues. My suggestion is that we be cautious in stating what may seem so obvious to us. For example, practically any recall of a pre- or perinatal experience immediately arrests practically anyone's curiosity. It is easy to claim, as with Jessica's recalls, that the remembrances represent exactly how the preverbal person felt and/or \"thought\" at the time. This may or may not be completely true. In fact, there may be no possible way of ever determining the absolute veracity of any such recall. Perhaps, as in Jessica's case, her description of feeling \"not wanted\" before birth may very well be an adult's conception of a preverbal feeling of intense physiological stimulation. In Jessica's case it was enough to make her feel that \"something\" was coming from out of nowhere to greatly upset her. Perhaps that is enough for an unborn child to sense that its environment is not a friendly place, that its presence is an irritant, or an unwelcomed intrusion.

* The most significant recalls will be presented in chronological order, not necessarily in the order that Jessica remembered them. Jeffrey Von Glahn, Ph.D. practices psychology in Michigan and may be contacted at 3816 Sparrow Wood Ann Arbor MI, 48108.

";"

Brownell, E. A. & Kopp, C. B. (1991). Common threads, diverse solutions: Concluding commentary. Developmental Review, 11, 288-303.

Chamberlain, D. B. (1988). Babies remember birth. New York: Ballantine.

_____. (1990). The expanding boundaries of memory. Pre- and Peri-Natal Psychology, 4(3), 171-189.

Developmental Review, vol. 11, 1991.

Holden, E. M. (1977). A quantitative index of pain resolution in primals with discussion of probable relevant biological mechanisms. Journal of Primal Therapy, IV(1), 37-52.

Janov, A. & Holden, E. M. (1975). Primal man: The new consciousness. New York: Crowell.

Janov. A. (1983). Imprints: The lifelong effects of the birth experience. New York: Coward-McCann.

Von Glahn, J. (1993). Toward a psychophysiological model for understanding the effectiveness of catharsis as a psychological change agent. Unpublished Ph.D. Dissertation. The Union Institute.

Welch, M. (1987). Toward prevention of developmental disorders. Pennsylvania Medicine, 90, 47-52.

_____. (1988). Holding time. New York: Simon & Shuster.

Jeffrey Von Glahn, Ph.D.