|TABLE OF CONTENTS
by LLOYD DEMAUSE
THE FETAL ORIGINS
"The history of man for the nine months preceding his birth would, probably, be far more interesting and contain events of greater moment than all the three score and ten years that follow it."
- - Samuel Taylor Coleridge
I wish to present in this essay the evidence which has led me to the following three conclusions:
1. That mental life begins in the womb with a fetal drama which is remembered and elaborated upon by later childhood events,
2. That this fetal drama is the basis for the history and culture of each age, as modified by evolving childrearing styles, and
3. That the fetal drama is traumatic, so it must endlessly be repeated in cycles of dying and rebirth, as expressed in group-fantasies which even today continue to determine much of our national political life.
I will present my evidence for these three propositions in the following three major sections of this essay: the first by presenting obstetrical
evidence for the existence of fetal mental life, the second by surveying evidence on the form of the fetal drama in past historical periods, and the third by examining evidence on the form of the fetal drama in contemporary politics.
Before I proceed to this evidence, however, I would first like to summarize my previous writing on historical group-fantasies.
In five previous essays,(1) I examined evidence from historical material that a rebirth fantasy was shared by nations prior to deciding to go to war, that this group-fantasy derived from a desire to end a severe collapse of confidence in the nation and its leader, and that the leader often deflected the group's rage from himself to an "enemy," in order to restore national confidence. Beyond discovering that images of birth were always shared prior to the events which led to wars, I also found that there were four stages in the full political cycle which paralleled stages of fetal life. These four fetal stages I designated as follows:
FS1-STRONG: During the leader's first year, media fantasy language and cartoon body-images are full of group-fantasies of the great strength of the nation, and of the leader as grandiose, ruthless in defense of the group, and vitally necessary to its national life-blood. The leader, according to my evidence, is not primarily seen as an idealized parent, loved object, or superego figure, as most political theory assumes. Rather, he is more a "container" into which the group can evacuate their changing feelings, which he is expected to confirm and then discharge through actions which are fantasy- rather than reality-oriented. In other words, it is less important that the leader leads, loves or disciplines the group than that he is emotionally available to them and willing to embody their evolving fantasy needs. The group in this "strong" stage is felt to be safe in a "strong" womb-surround, so any external disorders which might occur are not seen as threatening enough to require a violent response.
FS2-CRACKING: The deification of the leader begins to fail, with an increase in scapegoating to deflect hostility from the leader. The group's boundaries are felt to be "cracking," with images of leaking water and crumbling walls predominating. The leader is seen as weakening and unable to control events. Complaints of being crowded, hungry and breathless multiply, and worries are increasingly voiced that collapse is imminent and enemies becoming more dangerous. This second stage also lasts about a year.
FS3-COLLAPSE: The group during this stage experiences extreme anxieties about its collapse of self-image and growing rage toward the
leader, who now seems impotent in ending the group's feeling of pollution, sinfulness and starvation. Group-fantasies of choking, falling, abandonment, disintegration, death and explosiveness proliferate in the media, feelings which the leader and certain delegate-groups are expected first to voice and then to take action to relieve. Free-floating paranoid fantasies of unnamed poisonous enemies multiply, as the group attempts to project its own rage outward and to account somehow for its inner feelings of turmoil. The "collapse" stage ends only after a "search for a humiliating other"(3)-an enemy who, in a moment of "group-psychotic insight," is identified as the concrete source of the group's distress. Because this search for a cooperative enemy takes time, this third stage can last from a few months to as long as two years.
F54-UPHEAVAL: The "group-psychotic insight" which identifies the delusional poisoner of the group can take one of several forms:
(1) Regicidal Solution-If the leader is self-destructive or if he fails to find an external enemy, the leader himself can be designated as the enemy, and a ritual slaying of a divine king is enacted, led by a new hero who purifies the group's polluted atmosphere through his sacrificial death. This regicidal ritual can be accomplished by assassination, revolution, impeachment, or even by a "landslide defeat" of the incumbent in an election.
(2) Martial Solution-If an external enemy can be located who will co-operate by humiliating the group, it then enters into a trance-like state of sado-masochistic enthrallment towards the enemy, whose totally evil nature makes every rage seem jus-tified and every sacrifice noble. Since the group's rage is now split off from the leader to the enemy, the leader's popularity is considerably enhanced. However, as this splitting is difficult to maintain, military action against the enemy by the now-heroic group leader appears imperative, in order to wipe out the hated "enemy," resolve the period of upheaval, clear up the pollution, and complete the rebirth which restores the group's strength and vitality.
(3) Suicidal Solution-Suicidal individuals often resolve internal ambivalences through a fantasy of a "Hidden Executioner" who helps them in their suicidal effort in killing the bad, polluted part of themselves so that the good purified part can be loved again.(4) Similarly, nations can provoke other nations to attack them, or can leave themselves defenseless and with-out allies, in suicidal group-fantasies designed to "burn out" the bad parts of the nation in order to "purify" it and give it a
"rebirth of national spirit." The "collapse" of France in the late 1930s is an example of such a suicidal solution. It is also true, of course, that all wars have their suicidal component in the death during combat of a portion of the nation's own population.
This psychogenic theory of recurring group-fantasy cycles was derived wholly from historical evidence, prior to my having examined obstetrical evidence for the possibility of a mental life prior to and during birth. In the next section, I will construct a fetal psychology based on contemporary obstetrical evidence and show its relation both to later childhood events and to adult individual and group psychology.
Virtually all contemporary psychoanalytic theory denies the possibility of mental life before or during birth. The newborn is believed to be without memory, ego, objects or mental structure. As one psychoanalyst puts it, "psychoanalysis does not really ask, 'When did it begin?' Instead, it asks a rather different question, 'When after birth did it begin!' "(5) Even though Freud sometimes called birth "the primal anxiety," "the precursor to anxiety," and similar phrases,(6) he nevertheless firmly believed that mental life began only after birth, that "birth still has no psychic content," and that "birth is not experienced subjectively as a separation from the mother since the foetus, being a completely narcissistic creature, is totally unaware of her existence as an object."(7) His opinion has been echoed by almost every psychoanalyst since he pronounced it over fifty years ago. The only time he was said to have deviated from this view was once when he was heard to have wondered if an infant born by Caesarian section might have a different pattern of anxiety,(8) but he never admitted such a notion anywhere in print. Greenacre, in fact, concluded that Freud linked birth to anxiety only through a sort of collective unconscious, rather like a Jungian archetype. And since Freud angrily threw Rank out of the psychoanalytic movement for writing in 1923 that there was actual mental life during birth,(9) there have been powerful reasons for psychoanalysts to accept Freud's opinion uncritically. (10)
This is not to say that there are no articles on birth in the psychoanalytic literature. Indeed, since birth images are ubiquitous in clinical practice,
there are scores of full articles and hundreds of clinical illustrations of fetal material in the literature. Yet almost always the therapists consider all birth material as pure fantasy, having no basis in early experience. As this is the only clinical evidence which is not treated as a combination of actual experience and fantasy, the anxiety produced in therapists by the patient's birth fantasies is obviously enormous. This anxiety is not as evident when the fetal material is positive - that is, when it can be interpreted as representing comforting fantasies of "regression to the womb." But when the patient produces frightening material with overt fetal content, it is either ignored or interpreted on later oral, anal or phallic levels.
Thus, when Abraham reported a patient who had lifelong nightmares of a blood-sucking spider which came out of an egg to crush him, he interpreted the blood sucking as "a castration symbol."(11) Likewise, when Ralph Little's patient had nightmares of a horrifying spider which crushed him, along with images of being connected to his mother by an umbilical cord so that "blood would have to flow to her or to him with the result that only one could live and the other die," he also called the spider a "castrating mother."(12) Rather than multiply examples, one can best judge just how much fetal content is overlooked all the time by therapists by reading a careful study by Calvin Hall of 590 unselected dreams, which showed that 370, or 60%, had overt images "from the fetal environment, of being born, and of returning to the womb."(13) Greenacre is surely on the right track when she wonders if "perhaps the struggle of birth is at once too terrifying and too inspiring for us to regard it readily with scientific dispassion."(14)
There are, however, a few pioneer psychoanalysts who have considered the possibility of a mental life at birth. Most, like Winnicott, were reluctantly convinced only after they had analyzed children who relived birth experiences in fantasy play in such concrete detail and with such emotional investment that the analyst felt they must have come from "memory traces of birth" rather than from later observation.(15) Yet even these few - including Greenacre, Winnicott, Melanie Klein, Karl Menninger, Roger Money-Kyrle, P.M. Ploye and others (16) - merely noted that birth material was present in dreams and fantasy life and asked whether others might not investigate whether mental life exists earlier than theory allows.
There are, however, a small group of psychologists, most of them psychoanalysts, who have seriously considered the possibility of the existence of mental life at birth: Otto Rank, Nandor Fodor, Francis Mott, Stanislav Grof, Elizabeth Fehr and other American rebirth therapists, Arnoldo Raskovsky and several other psychoanalysts in Argentina, and a group of psychotherapists who with Gustav Graber founded in Germany the International Society for the Study of Prenatal Psychology. All these therapists assume that mental life is present at birth, all emphasize the traumatic effects of the birth experience after what they consider as a com-
fortable uterine life, and most use only adult dreams and fantasies as evidence for their theory. I will briefly summarize their contributions to fetal psychology to date.
Otto Rank began his investigations into birth experiences in 1904, long before he had heard of Freud. The conclusions of his books, beginning with The Trauma of Birth in 1923 (17) - which caused Freud to say he was "through with him"-seem quite unexceptional today, emphasizing that the female genital is often a source of anxiety which must be overcome in order to experience sexual pleasure, and that this fact is often reflected in dreams and myth. Rank analyzed dreams, fantasies and myths quite soundly for their connections with separation anxiety from the mother, fears of being left alone in the dark, games of crawling into holes, and so on. He even touches on connections between rebirth rituals and other cultural and mythological material and birth experience-again, all in a straight-forward way which could easily be accepted today for publication in any psychoanalytic journal. The degree of Freud's own problems with the portrayal of the mother as the initial source of anxiety-problems which he only reluctantly overcame under the pressure of mainly female analysts later on-can be seen in his refusing to read more than the opening section of Rank's 1923 book, instead giving it to his patients to read and asking them to tell him their opinion of it. (18)
For the next quarter-century, Freud's anethema on birth material proved effective, and even so brilliant a psychoanalyst as Margaret Fries-whose forty-year "prenatal-to-parenthood" longitudinal studies showed basic personality patterns at birth that persisted and could accurately predict later development-nevertheless refrained from drawing any real conclusions from her results about prenatal mental life.(19)
Therefore, in 1949, a quarter century after Rank's work went out of print, when Nandor Fodor's book The Search for the Beloved: A Clinical Investigation of the Trauma of Birth and Prenatal Condition(20) was published in America, the therapeutic community was totally unprepared for what he said. That birth was traumatic and was remembered in dreams and fantasies, that birth was a source of the fear of death, that it lay at the base of nightmares of suffocation, claustrophobia and many other symptoms, all these conclusions were sensitively illustrated by Fodor with a wealth of clinical material-again, little of which would be considered startling today, although most therapists ignored his book at the time. Like Rank, Fodor assumed that "the physical environment within the womb is perfect" and that "after nine months of peaceful development, the human child is forced into a strange world by cataclysmic muscular convulsions which, like an earthquake, shake its abode to the very foundations."(21)
Like many of the later birth theorists, Fodor also believed in parapsychology, but his speculations on telepathy between the mother and fetus(22) could easily be separated from his clinical material on birth. Not so
with his follower, Francis J. Mott, an English psychologist who spent his entire life working on a system of fetal psychology. Mott's enormous output,(23) fearless speculations and unceasing devotions to the task of constructing a fetal psychology make his writings (if you can locate them in any library) a rich source of material, particularly his voluminous use of dreams and mythological material. But Mott's mystical task of connecting uterine life with an astral universal design of creation plus his often-stated avoidance of considering any obstetrical facts (as when he posits the ability of the fetus to "feel" the blood going out to the placenta, despite the fact that the umbilicus is without nerves), makes his vast body of work thoroughly unreliable.(24)
Stanislav Grof is a psychiatrist who began using LSD for psycho-therapeutic regression in 1956, in Czechoslovakia, and has conducted over 3,000 LSD therapy sessions in the past quarter century in Europe and the United States.(25) As he regularly found that patients relived their birth experiences, he posited four "Basic Perinatal Matrices" which he felt his patients regularly relived under LSD:
BPM 1 (Primal Union With Mother): In the womb, fantasies of Paradise, unity with God or Nature, sacredness, "oceanic" ecstasy, etc.
BPM 2 (Antagonism With Mother): Derived from the onset of labor, when the cervix is still closed, feelings of being trapped, of futility, of crushing head pressures and cardiac distress, of unbearable suffering and hellish horrors, of being sucked into a whirlpool or swallowed by a terrifying monster, dragon, octopus, python, etc.
BPM 3 (Synergism With Mother): When the cervix opens and propulsion through the birth canal occurs, fantasies of titanic fights, of sadomasochistic orgies, of explosive discharges of atom bombs and volcanoes and of brutal rapes and suicidal self-destruction, all part of an overwhelmingly violent death-rebirth struggle.
BPM 4 (Separation From Mother): Upon the termination of the birth struggle, after the first breath, feelings of liberation, salvation, love and forgiveness, along with fantasies of having been cleansed, unburdened and purged.
Although Grof, too, soon moved off into the paranormal sphere (an occupational hazard connected with fetal psychology), his original clinical work on the ability of adults to re-experience (or fantasize-he made no attempt to confirm his evidence as memory) birth feelings is detailed and valuable. Grof's work is paralleled in many ways by the similar experience of various "rebirthers," who feel that re-experiencing one's birth was
therapeutic. Beginning with the "natal therapy" of Elizabeth Fehr, and including the "birth primaling" of Arthur Janov and others,(26) many techniques of regression in place of LSD have been used to experience the same birth feelings felt by Grof's patients. Without commenting one way or the other on the therapeutic efficiency of re-birthing techniques, and leaving open for the moment the relationship between fantasy and memory, it must be acknowledged that a vast body of psychological material on birth feelings has accumulated in the past two decades-material, however, which remains wholly unintegrated into the mainstream of psychological thought, psychoanalytic or otherwise.
What characterizes all this work are two main assumptions:  It is all birth-centered, with life in the womb presented as comfortable, birth as traumatic, and re-birthing as the overcoming of separation anxiety, and  It is constructed from adult clinical material, and rarely examines the obstetrical literature, despite the fact that most of the researchers are medical doctors. These two assumptions are generally continued in the recent published work of those South American psychoanalysts who center their work around Arnaldo Rascovsky,(27) as well as those who contribute to the regular conferences in Germany of the International Society for the Study of Prenatal Psychology-although because Rascovsky and some of the German group began as pediatricians, some obstetrical observations of prenatal life are occasionally used.
The results, therefore, of sixty years of work on fetal psychology have been to reinforce Freud's initial feeling that birth is the prototype for all later anxiety, under the assumption that before birth there is no ego, no objects and no mental structure, only symbiotic oneness with the mother, and that birth is the rude shock from which later separation anxiety derives. It will be my purpose to demonstrate (a) that this theory equating birth with separation anxiety is wrong, (b) that the theory has been constructed as a defense against evidence that the experience of the fetus in the womb is actually individual and often traumatic rather than symbiotic and only peaceful, and (c) that birth is in fact a liberation from traumatic experiences in the womb rather than only a "separation trauma." in order to present the evidence which led me to these conclusions, I now turn to the obstetrical evidence for the conditions of mental life in the womb and during birth.
It is only in recent decades that medical science has begun to be interested in the study of the fetus. One doctor who wondered why the early interest was so negative said maybe it was because the fetus was so "inconveniently
tucked away in a most inaccessible situation. This area of medicine offered little opportunity for discovery, and did not attract much talent. Why study a creature which was so passive, so dull, so small, and technically so difficult? . . . Perhaps the fact that it was to some degree replaceable also entered into consideration."(29) Since medical study of other "inaccessible" organs dates back for centuries, it is likely the last sentence, perhaps reflecting infanticidal thought, has been most important. Whatever the reason, in any case, recent advances in fetal knowledge have been so rapid that "a student could compare the literature of today with that of twenty years ago and conclude that two different species were under study."(30)
The results of recent studies have been all in one direction: to push earlier and earlier the onset of all developmental stages and sensory abilities of the fetus.(31) This is particularly so in the development of the brain, nervous system and sensory apparatus, which all begin in the very first month of life after conception. By the end of the second month after conception, the one-inch-long fetus is astonishingly well equipped with a beating heart, a circulatory system, a digestive tract, graceful arms and legs, facial features, ears, fingers and toes, and-the crucial center of all fetal nutrition and breathing-a pulsing umbilicus, literally a fifth limb, containing two arteries and one vein through which blood is pumped to and from its placenta, which lies next to the mother's circulatory system. It is the placenta which provides oxygen and nutrients and removes carbon dioxide and waste products from the blood of the fetus. By the end of the first trimester (the first three months), the nervous system and sensory apparatus is so well developed that the fetus responds to the stroking of its palm by a light hair by grasping, of its lips by sucking and of its eyelids by squinting.(32) Doctors who perform amniocentesis at this time to sample the amniotic fluid can sometimes see the fetus jump and show an increased heart rate if the needle should touch it. Sight is so well developed that the heart rate increases when a bright light is shown on the mother's abdomen, and when the doctor in-troduces a brightly lit fetoscope, the fetus often turns its head away from the light.(33) Taste is developed by the 14th week, and the fetus is from this time on sensitive to the condition of its amniotic fluid.(34)
Hearing is even better developed during the first trimester: fetal activity goes up and the fetal heart rate increases when a loud sound is made near the mother's abdomen, and many experiments have been made which produce true fetal learning from sound stimuli. These include one experiment in which Debussy was played to four fetuses in utero during times when the mother and fetus were tranquil, with the result that after birth these four infants (and not others) responded to Debussy played in the nursery as a tran-quilizer or pacifier-only one of many experiments in the literature which clearly demonstrate prenatal memory and in utero learning.(35)
Despite the amount of evidence that has accumulated on the ability of the fetus by the second trimester to feel, see, smell, taste, hear and remember
fetal events, the bulk of medical and psychological writings continue to repeat the older view of a blind, deaf, pain-insensitive fetus.(36) Often those who take this negative view prove it by reference to a 1933 study by Langworthy(37) that suggested that "incomplete myelinization of sensory tracts" prevents the fetus from receiving messages from its sensory organs-although it has long been known that full myelinization is not necessary for functioning (it only increases the rapidity of conduction), and that well-organized activity in the brain is possible long before nerve fibers become completely myelinated.(38) This "incomplete myelinization" argument continues to be used to deny the ability of the fetus and newborn to feel pain in many areas of medicine, from the use of aborted fetuses as subjects in painful medical experiments to the denial of anaesthesia during circumcision and surgery of the newborn.(39)
During the second trimester, then, the fetus is seeing, hearing, testing, feeling and learning from its environment, and true mental life has begun-a concession easily granted babies born several months prematurely but denied those of the same age still in the womb, as though visibility somehow conferred sensibility. What kind of environment is it, then, that provides the sensory input for the beginning of psychic life? From all that happens to it during the last two trimesters, what lesson does the fetus learn about its first world?
Liley captures the difference between the old and the new views of the environment of the womb when he says: "Perhaps nowhere' does the notion of foetal life as a time of quiescence, of patient and blind development of structures in anticipation of a life and function to begin at birth, die harder than in the concept of the pregnant uterus as a dark and silent world... A pregnant abdomen is not silent, and the uterus and amniotic cavity... may be readily transilluminated with a torch in a darkened room."(40) The womb is in fact a very noisy, very changing, very active place in which to live, full of events and emotions both pleasant and painful.
The fetus during the second trimester, while the amniotic sac is still rather roomy, now floats peacefully, now kicks vigorously, turns somersaults, hiccoughs, sighs, urinates, swallows and breathes amniotic fluid and urine, sucks its thumb, fingers and toes, grabs its umbilicus, gets excited at sudden noises, calms down when the mother talks quietly, and gets rocked back to sleep as she walks about. Fetal activity patterns are now well studied, particularly since the development of ultrasound techniques. The normal fetus rarely goes 10 minutes without some gross activity, either with fetal breathing spurts during REM-sleep periods or with other movements.(41) It moves in regular exercise patterns, and one observer said it could be seen in ultrasound pictures "rolling from side to side [with] extension and then flexion of the back and neck, turning of the head and neck [and] waving of the arms and kicking of the legs. 'the feet were seen to flex and extend as the fetus kicked the side wall of the gestation sac. In one fetus the jaw was seen
to move up and down."(42) The fetus in fact has quite regular activity cycles averaging about 45 minutes, cycles which later in the third trimester can be felt quite accurately by the mother.(43) These fetal patterns become coordinated to some extent with the activity cycles of the mother-evidence that the fetus is quite sensitive to a wide range of the mother's activities and emotions .(44)
When the mother smokes a cigarette, the fetus smokes it too, and after the first few puffs its heart begins to beat faster, it feels a drop in oxygen (hypoxia) and an increase in carbon dioxide, and it stops moving and increases its fetal breathing rate to try to make up for the hypoxia-all responses which have a severe enough cumulative effect for heavy smokers to contribute to stillbirth, growth retardation, prematurity and later hyperactivity and behavioral problems.(46) When the mother takes a drink, the alcohol goes straight to the fetus, whose blood alcohol level quickly approaches that of the mother. Fetuses who drink alcohol daily end up growing slower, aborting more, are more often premature and have more physical abnormalities, mental retardation and hyperactivity - not to mention the extremely painful withdrawal symptoms associated with the fetal alcoholic syndrome.(46) The same principle holds, of course, for thousands of other drugs, including aspirin and caffeine, all of which go directly to the fetus across what used to be called "the placental barrier," and produce all kinds of harmful and painful effects, including hypoxia (low oxygen).(47) Equally important are various nutritional factors, with malnutrition among the poor (or among the well-to-do with poor eating habits) causing a wide range of harmful physical and behavioral defects.(48) So widespread, in fact, are all these uterine environmental hazards that few fetuses entirely escape harm from them. Even the medical director of Dow Chemical Corporation had to concede that of the "30 to 40 percent of all conceptions [which] usually end in spontaneous abortion, stillbirth, or live birth with congenital malformation, an undetermined number of these are probably the result of some environmental factors. "(49) Far from being a safe, cozy haven to which we all want to return, the womb is in fact a dangerous and often painful abode, where even today "more lives are lost during the nine gestational months than in the ensuing 50 years of postnatal life."(50)
But the fetus is not only in distress when the mother smokes, drinks or takes drugs. It is also affected both biologically and psychologically by the mother's fear, anger and depression. A large literature has been accumulating during the past three decades showing in considerable detail the many ways that the pregnant mother's emotions affect the physical and emotional development of the fetus.
It has long been known that laboratory animals fondled ten minutes a day during their pregnancy produce physically healthier and less neurotic offspring than those who did not get the fondling, and that mentally ill and depressed mothers give birth to many more undersized and behaviorally
disturbed babies than others.(51) Much more direct statistical evidence has recently shown that mothers who do not want to be pregnant, who feel hostility toward their fetuses, who are exceptionally anxious during pregnancy, or who are emotionally very immature all have lower weight babies with more mental retardation, more obstetrical problems and more behavioral nursery difficulties right after birth (as rated by independent observers) than those of control groups.(52) It is now often recognized that "maternal frights, fears, tensions, temper tantrums, frustrations, 'shocks,' 'stresses,' depressions and other mental states may harm the developing fetus."(53) The often lethal effects of maternal hostility toward the fetus are now so well accepted that habitual aborters are regularly and successfully treated by psychotherapy alone.(54)
The biological mechanisms for transmitting these maternal emotions to the fetus are many. When the mother feels anxiety, her tachycardia is followed within seconds by the fetus's tachycardia, and when she feels fear, within 50 seconds the fetus can be made hypoxic through altered uterine blood conditions. Alterations in adrenalin, plasma epinephrine and norepinephrine levels, higher levels of hydroxycortico-steriods, hyperventilation and many other products of maternal anxiety are also known to directly affect the fetus. That these effects are painful to the fetus is no longer in doubt-ultrasound and other modern techniques often show the fetus in terrible distress, writhing and kicking in pain during hypoxia. One mother whose husband had just threatened her verbally with violence came into the prenatal study center with her fetus thrashing about and kicking so violently as to be painful to her, and with an elevated fetal heart rate which continued for many hours after.(57) The same wild thrashing and kicking of the fetus has also been seen in several mothers whose spouses have died suddenly.(58)
Marital discord, in fact, is one of the best documented emotional causes of fetal distress, being associated in several careful statistical studies with later child morbidity, physical illness, physical defects, severe behavioral disturbances, hyperactivity, aggressivity, and early school failure.(59) Indeed, maternal fright alone can be so severe that it can actually cause the death of the fetus immediately afterwards.(60) In fact, severe emotional distress within the family during the mother's pregnancy has been found by Dennis Stott to have been associated with damage to the fetus "with almost 100 percent certainty" in large samples in both Scotland and Canada.(61)
Although most of these studies have been generally ignored by medicine and psychology alike, some obstetricians have recently begun to draw the same conclusions as I have drawn regarding the womb as a place full of pain as well as tranquility. Albert Liley, while filming with x-rays what he termed "frantic" movements of the fetus during uterine contractions, concluded that they "were characteristic of a human being in severe pain, as the fetus threw its arms and legs about and appeared to actively resist each contrac-
tion with various contortions of its body."(62) If the uterus were not filled with fluid, says obstetrician Robert Goodlin, and if there were air in the womb, the fetus would be heard "crying in utero" much of the time. ln fact, he says, for "obstetricians using air amniograms, it is often necessary to caution the mother to assume the sitting or upright position (post air amniogram) for several hours after the amniogram so that the air will be kept away from the fetal larynx; otherwise, the annoyance for the [mother] of hearing her unborn fetus cry. It therefore seems not unreasonable to assume that fetuses are often as uncomfortable (enough to cry) in utero as extra utero [for] it is the intrapartum, not the newborn period, which is filled with pain and stress for the infant."(63)
The distress of the fetus is increasingly felt during its third trimester in the womb. As the fetus during this period increases its length from 13 to 20 inches and nearly triples its weight, it is more crowded, more affected by stress including hypoxia, moves less and dreams more,(64) and begins to exhibit a definite "personality" which the mother can now recognize as its own, as it gets upset and vigorously kicks her in response to certain of her actions or positions-for instance, if she is sleeping in a position uncomfortable to the fetus. The crucial problems for the fetus in this new cramped womb lies in its outgrowing the ability of its placenta to feed it, provide it with oxygen, and clean its blood of carbon dioxide and wastes. The placenta not only stops growing during this period, it regresses in its efficiency, becoming tough and fibrous rather than spongy, as its cells and blood vessels degenerate and it becomes full of blood clots and calcified areas. As this happens, the effect on the fetus is to make it even more susceptible to hypoxia than previously.
Ever since the early research in the 1930s by Anselmino, Haselhorst, Bartels and others,(65) medical research has been puzzled by the low oxygen pressure of fetal blood, which continuously has such low oxygen levels that adults would black out in comparable conditions. This normal condition of low oxygen pressure was termed "Mt. Everest in utero, "with the suggestion that fetal development during the last trimester is analogous to a mountaineer climbing Mt. Everest and experiencing slowly decreasing oxygen levels as the fetus grew bigger and the placenta became less efficient. Although the discovery that this very low oxygen level is somewhat offset by an oxygen affinity of fetal red blood cells that is somewhat higher than adults, even so, it is now recognized by many researchers that this one factor is not enough to completely offset the growing insufficiency of oxygen supply to the brain cells. In fact, the late-term fetus is often "extremely hypoxic by adult standards." As one obstetrical researcher puts it, "the foetus in utero may be subject to great 02 and C02 pressure changes" which produce frequent hypoxia, "the most frequent cause of brain damage in the perinatal period."(66)
Recent medical literature is full of admissions of ignorance and calls for more research as to what is termed the "puzzling" ability of the fetus to live with such low oxygen levels and with such an "inefficient" placenta-the oxygen transfer efficiency of which Bartels calls the "worst" of all mammals.(67) Since "the asphyxiated fetus has no cerebral regulatory mechanism giving priority to the blood flow of the brain,"(68) and since the human fetal brain is many times the comparable size of other mammals of equal body weight, "the margin of safety of the fetal brain against hypoxia is probably smaller in man" than in other animals, so any reduction at all of the already very low oxygen level late in fetal life is felt as extremely stressful.(69)
Therefore, as the third trimester proceeds and birth approaches, as the placenta becomes less efficient and fetal needs much greater for oxygen, nutrition and the cleansing of its blood of carbon dioxide and wastes, the blood becomes more polluted, and every stress becomes magnified and is more painful to the fetus. At this low level of oxygen, even normal contractures" ("ractice contractions), which produce an increase in uterine pressure and a decrease in oxygen levels of up to 25%,(70) are painful to the fetus - as though the womb were giving it an hourly "squeeze" to get it used to the more violent contractions to come. fly two weeks prior to birth, the fetal oxygen level drops much further,(71) and the fetus's need for oxygen becomes so critical that when Barcroft postponed artificially the birth of a rabbit fetus, it quickly killed the mother by robbing her of oxygen.
During labor itself, oxygenation is decreased even further below critical levels, and carbon dioxide in the blood rises. Saling found a level of oxygen in fetal scalp blood at the onset of labor of 23% and just before delivery of 12% (in adults, the central nervous system fails below 63%,(72) findings which have led even the most cautious of obstetricians to conclude that "hypoxia of a certain degree and duration is a normal phenomenon in every delivery."(73) The effects on the fetus of this severe hypoxia are dramatic: normal fetal breathing stops, fetal heart rate accelerates, then decelerates, the fetus often thrashes about frantically in reaction to the pain of the contractions and the hypoxia, and soon the fetus enters into its life-and-death struggle to liberate itself from its terrifying condition.(74)
The many obstacles often thrown in the path of both mother and child in this liberation struggle are well known: the medication that induces one labor in five today makes contractions stronger and longer and causes more hypoxia; pain-relieving drugs likewise have the effect of prolonging hypoxia; and so on. These effects are now so well studied that even mild hypoxia far short of any brain damage has been proved to have measurable negative personality consequences later in childhood.(75) Whether these modern dangers to the fetus are any worse than the practices of the past-the violent tossing and shaking of the mother, the hanging upside down, the belly pummeling, the vulva punching and the multilating rusty forcep - - is doubtful.(76) But, past or present, it cannot be doubted any
longer that the facts of biology plus the policies of man combine to make the struggle for liberation from the painful womb a dangerous battle indeed.
Yet it is a liberation struggle for all of that, and not at all a "separation anxiety" from a comfortable womb. Those thousands of patients of Grof, Janov and others reliving their births might remember it as a cataclysmic, titanic struggle-but that it was a struggle for freedom from a hellish womb none doubted. Nor can these images any longer be considered "just fantasies," induced by transference suggestions of the therapist For even though neither Grof nor Janov were careful about verification from their patients' actual birth records, there are in fact other researchers, including obstetricians, who have hypnotized people whose birth they had attended years before, and then compared the hypnotized person's recall of remembered birth details with actual hospital records and with their own and mother's reports, and found significant details under hypnosis which could only be explained as actual memories.(77) Indeed, every piece of evidence, both obstetrical and clinical, which is added to the growing literature of fetal life confirms the concrete reality of these memories of feelings of pain, fear and rage as the fetus struggles for liberation from the asphyxiating womb. What the psychological effects are of these obstetrical facts, what it means to begin one's mental life with a fetal drama full of both pleasure and pain, I shall consider in the next section of the paper.
Contrary to the theory of "symbiotic oneness, "(78) the fetus in fact begins its mental life in active relationship with one vital object: its own placenta. Its dependence on the placenta for nutrition and constant cleansing of the blood is crucial to its existence, and, as we have seen, it responds to every decrease in placental functioning with visible anger, as shown by its thrashing movements and elevated heart rate. Over and over again during its early life in the womb, the fetus can be seen to experience cycles of peaceful activity, painful hypoxia, periods of thrashing about and then restored quiet periods as the placenta begins to pump newly-oxygenated bright red blood again. The placenta-umbilicus gestalt is the fetus's first object - as early as the second trimester the fetus has actually been filmed in endoscopic motion-pictures grabbing and holding its own umbilicus in a seeming effort to comfort itself when it is startled by the bright lights of the intrauterine camera.(79)
The pumping of polluted blood to the placenta, its processing by that organ, and the return of fresh new blood are such vital processes for fetal life that they becomes the physical prototypes for the later infantile mental mechanism of projection and introjection, whereby the baby fantasies the
mother as a "toilet" for its uncomfortable feelings-a placental "cleanser" who can process the baby's emotions and "return'' them in less dangerous form.(80) The nurturant placenta therefore slowly becomes the earliest object of fetal mental life, and the regular interruptions in this vital relationship produce the earliest feelings of anxiety in the fetus.
Slowly during the second and third trimesters the first structuring of fetal mental life takes place. When the blood coming from the placenta is bright red and full of nutrients and oxygen, it is felt to be coming from what I shall term a Nurturant Placenta and the fetus feels good, but when the blood becomes dark and polluted with carbon dioxide and wastes, it is imagined to be coming from a Poisonous Placenta, and the fetus feels bad and can be seen to kick out at the source of its pain. In the final months before birth, as the fetus outgrows the placenta, the womb gets more crowded and the blood more polluted, and the fetal drama steps up in intensity. I propose that just as the satisfying and grateful emotions associated with the Nurturant Placenta form a prototype for all later love relationships, so, too, the polluting-asphyxiating experiences produce an attitude of fear and rage toward the Poisonous Placenta, which is therefore the prototype for all later hate relationships-whether with the murderous mother, the castrating father, or ultimately, the punitive superego itself.
What I am proposing, then, is a basic model of fetal psychology wherein the fetal drama is the precursor for the oedipus complex, both having a cast of three, and both involving a relationship of the individual to a loved and to a feared object. That the fetus, like Oedipus, comes to feel it must actually battle with the Poisonous Placenta (Sphynx means "strangler" in Greek) to win back the Nurturant Placenta, I consider possible: repeated fetal experience, after all, teaches it that the outcome of its kicking the Poisonous Placenta is the restoration of the Nurturant Placenta. In any case, what is certain is that the fetal drama is set up long before birth, and the fetus learns that its good feelings are often interrupted by painful feelings which it is helpless to avert, and its once-peaceful womb slowly grows more crowded, less nurturant and more polluted, until it is finally liberated only by the battle which is the upheaval of birth itself.
It is one of the most basic principles of psychoanalysis that massive quantities of stimulation, particularly intensely painful experiences, result in a severe "trauma" for the individual, particularly when the ego is too immature to prevent itself from being overwhelmed by the affects. That fetal distress is traumatic can hardly be doubted, as the fetus has as yet none of the psychological defense mechanisms to handle massive anxiety and rage. Therefore, as psychoanalysts long ago found true of all traumatizations-from early enema-giving to war-time shocks or concentration camp experiences-the psyche then needs to endlessly re-experience the trauma in a specific "repetition compulsion" which, as Greenacre first pointed out, is similar to "imprinting" in lower animals.(81) As no psychic apparatus is as
open to trauma as that of the helpless fetus, no repetition compulsion is as strong as that which results from the "imprinting" of the fetal drama of repeated feelings of asphyxiation, blood pollution, and cleansing, climaxed by a cataclysmic battle and a liberation through a painful birth process. Although the form that this endlessly repeated death-and-rebirth fetal drama takes in later life is determined by the kind of childrearing which is experienced, the basic "imprinted" fetal drama can nevertheless always be discovered behind all the other overlays, pre-oedioal or oedipal.
The "imprinted" fetal drama, then, is the matrix into which is poured all later childhood experiences, as the child works over the basic questions posed by his experiences in the womb: Is the world hopelessly divided between nurturant and poisonous objects? Am I to be eternally helpless and dependent on the life-giving blood of others? Must all good feelings be interrupted by painful ones? Do I always have to battle for every pleasure? Will I have the support and room I need to grow? Can one ever really rely on another? Is entropy the law of my world, with everything doomed to get more crowded and polluted? Must I spend my life endlessly killing enemies?
The more loving and empathic the childrearing, the more the answers to these questions are positive and the more the stark elements of the fetal drama are modified. Every act of good childrearing contributes to the containing of the child's fears and mitigates the severity of the split between the idealized and poisonous primary object. On the contrary, every failure of parenting abandons the infant to the archaic fears and rages of the fetal drama and confirms its lesson that the world is full of dangerous objects, producing infantile fears which have seemed to psychoanalysts so exaggerated and unrealistic that they have posited inborn "death instincts" or "basic faults" to account for them.(82) The "death wish" and "basic fault" are real enough, and exist at birth-not because of genetic instinctual inheritance, but rather because of the very real frightening experiences of fetal life.
Thus the fetal psychology I propose has the same structure as that which Freud posited for psychoanalytic theory: that our lifelong search for love, pleasure and independence is opposed by an internal punitive agency, the superego. The superego, however, begins neither with the internal representation of the oedipal castrating father nor of the pre-oedipal devouring mother but with the image of the fetal Poisonous Placenta. All therapy-historical as well as individual-consists of reducing the severity of this frustrating internal agency, so that adult life can be based on the love and pleasure intrinsic to it rather than on the fear, hatred and dependencies of fetal and childhood life.(83) The better the childrearing, the less life will be dominated by the blood-sucking poisonous monsters imprinted during the fetal drama, and the less that processes of idealization, splitting, rage and passivity will impede one's search for love and happiness.
The addition of the fetal dimension to psychology will, I believe, have an important effect on psychotherapy. In the example earlier cited, psychoanalyst Lester Little only approximately understands his patient's repeated dreams of being a baby connected by a umbilicus to a blood-sucking spider when he thinks in terms of a "castrating mother."(84) My task in this essay, however, is to discuss the foundations for history and culture, not therapy. For the psychohistorian and psychoanalytic anthropologist, understanding the fetal dimensions of group life is a critical task, for their empirical material is permeated with overt imagery of the fetal drama. The ubiquity of fetal imagery of pollution fears, blood ties, nurturant and monstrous beings, rebirth rituals and cataclysmic upheavals in the group life of mankind from primitive religions to modern politics is simply too massive to ignore.
This is not just because individuals regress to fetal levels more easily in groups, but rather because individuals form groups in order to repeat and overcome the fetal drama. First one joins a group in order to be able to reestablish contact with this deepest part of one's self, and then one plays roles in the group in order to act out the various stages of the fetal drama. These group-fantasy tasks take precedence, and are the essence of all historical group formations. Only a small portion of group energy is therefore available for reality tasks rather than fantasy needs - a proportion which can be quickly estimated by comparing the total amount of fantasy-oriented religious and military activities of any group with its communal productive activities. Thus, Bion has defined a group accurately as "an aggregation of individuals all in the same state of regression,"(85) and I would only add that this state is a regression to the earliest memories of all: those of the fetal drama.
As previously mentioned, the elements of the fetal drama are modified by the events of childhood, with each uncaring act reinforcing the split between the Nurturant and the Poisonous Placenta and each loving act tending to heal that split and allow the child to mitigate the severity of its internal objects. Since mature, loving childrearing is a late historical achievement, the least modified version of the fetal drama can be found among early primitive and archaic groups who are still in the infanticidal mode of childrearing. In the next major section of this paper, I will examine in detail the evidence that early primitive and archaic groups acted out the fetal drama in such direct form that every minute of their waking and sleeping lives was dominated by concrete fetal imagery of hellish wombs, Poisonous Placentas, polluted blood and rebirth battles. But before I begin this de-
tailed empirical examination, an overview of the major fetal elements in group life of every historical period will prove useful.
Being emotionally part of a group may be defined as sharing a fantasy of being in a womb, connected to others by umbilicuses, that is, literally by "blood ties," organizing one's group role around fetal symbols, and acting out cycles of the fetal drama of growing pollution and purifying rebirth through a battle with a poisonous monster. Successive cycles of this group-fantasy of rebirth are then said to be the group's "history." Initiation into group life is always by means of a rebirth ordeal which establishes the shared fantasy and determines one's role within the fetal drama. Once one "becomes part of the group" by drinking the symbolic placental blood, every element of group-fantasy life acquires the halo of feral symbolism, spoken of as "the sacred," "the numinous," or "the charismatic." As Rudolf Otto first discovered and Mircea Eliade has since thoroughly documented,(86) one knows one is in the presence of the sacred by the feeling of awe and terror before an object which has the presence of mystery and overwhelming power, something "wholly other" (ganz andere) which is not really human but is intimately connected to one's essential self-a perfect description of the placenta. You can perhaps recapture this fetal feeling of awe before the original sacred object by trying to identify with the feelings of the fetus clinging to the placenta in Illustration 1. The umbilicus-placenta was once yours, a vital, pulsing "fifth limb" which you had even before you had arms or legs, and which you still feel exists-a "phantom placenta," rather like the "phantom limb" feeling that is often experienced by people who have had a limb cut off. If your empathy can carry you this far, you will perhaps then be able to recapture the aura of the placental prototype of every God "from whom all blessings flow" and every Leader "from whom all power flows." That Gods and Kings should be placentas seems, of course, even more bizarre than it once seemed that they should be parents. Yet if you examine the traits of sacredness and charisma dispassionately, you will see that divinity carries far more placental than parental qualities: self-sufficient, arbitrary, hidden, mysterious, omnipotent, unap-proachable, unknowable, asexual-all these are not qualities of any living parent but rather of a living all-powerful "thing" on which one wholly depends but whose arbitrary actions one cannot affect and with which one has constant silent exchanges.
Because all groups share this fantasy that their gods and leaders are placentas needed to pump life-giving blood into and to cleanse their own bad blood of pollution, all group space becomes "sacred" space, and the first act of every group is to establish this womb-surround by "founding" it, by designating a specific womb-hole or navel-stone (omphalos) or central umblical-post (axis mundi) that is the center of the womb, the place where sacrifices and other elements of the fetal drama are performed.(87)
Illustration 1 -The Poisonous Placenta in Antiquity
Clockwise from upper left corner: Back view of female statuette from Lespugue; Painted bull and placental sign from Lascaux; Bas relief of female with horn from Laussel; Earthmother votive with pubic triangle and swastika from Hissarlik; Leopard Goddess in childbirth from Catal Huyuk; Vulture Goddess with headless men from Catal Huyuk; Cylinder Seal with placental symbok from Ur; King's Placenta on Standard, Narmer's Palette, Egypt; Hum-baba/Huwawa mask, guardian of the cedar felled by Gilgamesh; Hecate and Scylla, Engraved gems, Rome; Italian dragon in its Labyrinth; Perseus slaying the Gorgon, with Hermes; Jason spewed up by the dragon; Danish Midgard serpent.
by: Lloyd deMause
The Institute for Psychohistory
140 Riverside Drive, NY NY 10024