Saturday, November 22, 2008

Life before birth (revised):

How Experience in the Womb can Affect Our Lives Forever

When I first wrote about how the birth trauma and prenatal experience affect adult behavior it was considered “New Agey.” Now, there are literally hundreds of studies verifying this proposition. There seems to be little question now that a pregnant woman’s mood and physiology can produce long-term effects on the offspring. That means us.

Let’s start with a simple bit of research; Dr. Daniel Schacter, psychologist of Harvard University has reported on a study where subjects watched bits of a TV series and then had their brainwaves measured. (see: Science, Sept. 2008).

They found when the subject remembered the event, the single brain cell signature was the same as in the first viewing. They reported that it seemed like a reliving; which of course, has been my position. What do you call it when a memory brings up one’s exact history with its precise early physiology? This happens to our patients every day. When there are certain triggers, the brain conjures up its history, intact. That is why our behavior is so compulsive and unwavering; our history motivates us all of the time. We are largely victims of our deep unconscious brain.

In Schacter’s research on epileptic surgery patients, they threaded fine electrodes down in the brain of the subject. These electrodes could pinpoint small brain storms at their origins. And they could make minute measurements during recall. The lesson? We can relive past events in their entirety, precisely as they occurred. What is very new in all of this is how early an experience can affect our later life. Think of the implications: that old memories reside in the same neurons (nerve cells) as were involved originally. That is why the neurotic cannot distinguish between past and present and sees reality through the prism of the past.

Let’s go back to the notion I discussed earlier of epigenetics. One genotype, a single genetic predisposition, can give rise to many phenotypes depending on what happens to those genes during gestation. So what we might imagine is genetic is genetic-plus what happens to us in the womb. So much happens to us in the womb; so much as been ignored in terms of their long-term effects that many diseases remain a mystery because we are looking at the wrong place at the wrong time with the wrong tools.

What I am learning is that events in the womb explain so much about later life. If you bend an emerging twig you are bound to get a distorted tree. The question has always been, “how early is early?”

There is increasing interest in epigenetics. A group at Washington State University (led by Matthew Amway) found that gestational experience in animals that sways the genetic unfolding can show effects for three generations. They found that exposing pregnant adult rats to stress resulted in defective sperm in the offspring. Some resulting effects included cancer in adult animals. Females avoided mating with other rats who were also exposed during gestation. And this went on, not only for the life of the adult, but also with their offspring, as well. It seems that the system itself knows how to behave given certain biologic deficiencies, and it is always in terms of what is best for heredity; what gives us the best shot of succeeding in life. So when we cannot explain some trait in adults by heredity we may have to reach back several generations to explain it. This gives us a new perspective on so-called psychological problems in adults. We are, of course, extrapolating from animal experiments but it can well be predictive of human behavior, as well.

We can now only guess as to what traumas occurring to the pregnant mother continue their effects on grandchildren. It isn’t just that the mothers underwent trauma but that trauma alters her basic physiology, and that alteration may have lifetime effects. And so when a grandchild develops heart problems or cancer in his twenties we may have to rethink the probable causes; seeing what kind of pregnancy his grandmother underwent. Was it wartime? Or were the prospective (grand) parents fighting all the time? Was grandma depressed? Was she a heavy smoker or drinker during her pregnancy? There is a whole host of new variables to consider. It all looks like the discarded theory of the inheritance of acquired characteristics, but if we look closely it is not based on heredity but of epigenetics; of what happened to the unfolding of those genes when trauma inserted itself.

Here is the way one patient reported it. It is almost a duplicate of how many patients state the same thing: In my very last session I felt myself totally helpless. I could not move or speak. I felt stuck and weak. I could not breathe, something heavy pressing on my chest. I cannot do anything and no one can help me. I don’t think that the idea of hope even existed back then. It seems like nobody exists during that time. There were no words, scenes, no people and no parents. All alone. Extremely uncomfortable.

Another example which includes reliving of the birth trauma:

My knowledge of any correlation between my prenatal life and my life in general is limited to my mom’s diet at that time which was almost completely based on the consumption of peanuts as this was her only source of food. I always crave for peanuts.

My earliest sensation in the course of re experiencing my birth primal was of “its time to go “sensation which expresses it self also in a physical sensation of a “kick” in my lower back. At this stage there was only a sense of my self-arching forward without any other feeling attached to it. In the process of moving forward towards an opening I felt my self resting a few times until the same “kick” in my lower back drove me to keep on moving.

My next sensations are of my self feeling crushed from all sides in which I make a great effort to move forward, a sense of urgency followed by brief periods of hopelessness manifest its self in a “Doom day” sensation. At this stage I panic, there is no way out, every thing is against me, and in addition to that my mother was given anesthesia that caused me to be physically lethargic (its smell and taste are coming up in every very early primal I have). At the same time amplified my panic. I was very close to really completely give up but I made one last effort.

I was all alone in my experience; no one could help me. My imprint from birth, first of all, is: I do not trust woman, I have to do everything by my self, I am lonely, in extreme circumstances I function very well, but it does not feel good to be alive. Here again are the feelings of helplessness and helplessness. In ineffable sense of gloom and doom.

An example: Someone is born with all kinds of allergies from birth on. A history of emergency clinic visits for all kinds of infections, asthma, breathing problems due to allergies, and in general, a very deficient immune system. Here is where we need to push back the envelope and direct our attention to those early months in the womb. When we do, we often find out that the mother was quite anxious and/or depressed. Or often, the marriage is falling apart. Or in one case, as her belly got big the husband was turned off and sought out an affair. The mother was crestfallen, fell into a depression, and we had a baby that was impacted by all this and was born with a diminished immune system, something that got its start early on in the pregnancy. Don’t forget that the immune system, in some respects, is our first inchoate nervous system, sussing out dangers and menaces and organizing defenses against them. This includes secreting some of the pain-killing neurotransmitters we know about today. What starts out to defend us ends up hurting us. If the immune system is compromised there is a good chance that natural killers cells will be, as well.

That fact that we normalize this basic physiologic system means that patients do indeed relive very early origins. I believe that no cognitive/insight therapy could ever alter the natural killer cell system.

Huot and colleagues have shown that a mother’s depression when pregnant negatively impacts the baby. (R.L Huot, et al. “Negative Affect in Offspring of Depressed Mothers is Predicted by Infant Levels at 6 Months, and Maternal Depression during Pregnancy but Not Post-Partum.” N.Y. Academy of Science 1032, 2004. 234-236).

This is not the case of a mother who is depressed when she gives birth. They could predict behavior later on depending on whether the pregnant woman was depressed. The investigators found that stress hormone levels reacting to a minor stress stimulus (arm restraint) predicted negative responses in infants. There was a particularly negative effect if the woman was depressed during the first two trimesters. In short, the effects on in utero life endure. And it is predictive, given certain kinds of adverse events that impact the fetus. And, it seems the earlier the trauma, the more devastating. Here again we see how important events that happen during womb-life are more important than post-birth experience. It has been a saying of mine for decades: The more devastating the trauma, the more devastating the symptom. In order to understand the possible origins of a symptom is to see how overwhelming it is; how completely it blocks functioning. This often tells us how early and how hurtful the imprint is. Its depth in the physical system is another indictor of how early the trauma, i.e., colitis.

Because the baby can be born with higher than normal stress hormone levels, and because the immune system works in seesaw fashion with cortisol (high stress—low immune function) the fetus has possibly set the stage for a lifetime of immune problems. Here is where genetics plays a role; high stress in the fetus will affect those areas with genetic vulnerabilities. After all, what is the meaning of high levels of stress hormone during fetal life? It means an input that agitates the system to be chronically alert. And when the system can shut off that input longer, we have the makings of an enduring primal imprint. That input is maternally induced. So we have a newborn with a high level of agitation already set in place many weeks earlier. Here is ADDHD (attention deficit disorder) waiting to happen. Over time, the deleterious results can range from impulsive tendencies to migraine and high blood pressure (to hold down the imprinted input). It is then no mystery when the child cannot concentrate or sit still. It is not enough to know that there are high levels of stress hormones in the baby, but what causes it, in the first place?

We change natural killer cells after one year of our therapy into normal levels. These cells’ key function is to watch out for cancer-developing cells and pounce on them in an effort to contain them. So a mother’s distress while pregnant can spell life-endangering effects on her baby, not the least of which is later cancer. The earlier the trauma occurs during womb life, the more disastrous the effects. That is our important secret life.

What can be done about this? Treating it first and foremost, then make sure it will not come back? How do we do the latter? By reliving the earliest womb-life events. How do we do that? Well, luckily, each new harmful or adverse experience that remains un-integrated is re-represented later on in a higher level of the nervous system and is noted as the outsider or enemy. It is indeed a threat to the organism. I believe that there are specific frequencies that tie these events together. When we explore these ramified events and begin to relive them, we are also reliving deeper and earlier aspects of the feeling and/or pain. And that is how we relive pure physiologic brain-stem responses without ever acknowledging it.

When there are certain kinds of triggers, the brain conjures up its related history, intact. That is why our behavior is so compulsive and unwavering; our history motivates us all of the time. We are largely victims of our deep unconscious brain. We can only reach deeper into the remote past as we gain more and more access to deeper levels of brain activity. We need to have real good access to our feelings first; then very early brainstem events. That takes time but it can be done.

And what about cancer? The beginning deformity of cells can well begin in the womb with mother’s anxiety due to her own history or due to her marital circumstances. In any case, the fetal system needs to gather its resources to shut down excessive input. Here is where many cells are evolving and gathering their identity, but instead there is massive repression and, ultimately, physiologic deviation, even at the cellular level.

One patient had three siblings all “messed up” and depressed. It remained a mystery why all of them were so disturbed (her parents were indeed loving), until she had very early primals (a systematic reliving of early trauma). She learned that there was a civil war in South America, which lasted many years. The father left the family to go and fight, coming home occasionally to make babies. The mother was in desperate straits with no money, no one to turn to, and fearful of the constant raids into her village. The children, even in fetal life, suffered. She was a loving mother whom the children adored, but with a neglected womb-life, which should not be ignored. It had far-reaching effects. It therefore is an indicator of what went on during fetal life. Can we imagine a doctor learning about a stroke with her patient and then examining his fetal life?

Low birth weight is associated with slow fetal growth and lack of development of various physical systems. If the newborn is abnormal in any respect, even birth weight, we may assume that something abnormal may have happened during gestation. Babies of depressed mothers are more often of low birth weight. At least, let’s consider it. Babies with low birth weight lack muscle, something that follows her into adulthood. Here is a quote from the Helsinki Birth Cohort Study: “(we) have shown that the risk for coronary heart disease and type 2-diabetes or impaired glucose tolerance is further increased in 60- to 70-year-olds who were small at birth, thin or short in infancy, but put on weight rapidly between 2 and 11 years of age. A similar growth trajectory has been shown to predispose to type-2 diabetes or impaired glucose tolerance.”

People who suffer stroke tend to be thin or short at 2 years. There is evidence that these early events can lead to hypertension later on, which is an important risk factor for both coronary heart disease and stroke. The point is that when a child is born out of the curve of normalcy (too fat or too thin), it may be an indication of some abnormality during gestation. I will discuss in a moment the now-significant amount of research on high stress levels in the pregnant woman and its effect on the heart of the baby whose physiology closely adheres to the mother.

We need to study Alzheimer’s disease as it relates to gestational trauma as well as birth difficulties.

Certain height and weight problems at 2 years of age are a well accepted indicator of childhood emotional problems. Why is this so? There are a number of answers. Growth of the fetus relies heavily on adequate oxygen supplies. Because of the large brain, which uses a good deal of oxygen, there is a physiologic demand for more and more. If these supplies become limited for any number of reasons, the body growth will slow down so that the brain can be left intact. Hence, lower fetal weight. Let us keep in mind that cancer can develop and live without oxygen, and maybe that adapting to lower levels of oxygen in the womb is part of an explanation for later cancer. Deprive a cell of a majority of what oxygen it requires and you have one key element in the origin of some cancers. This can only be a hypothesis.

In experimental animals it was found that anything, which increased fetal stress hormone levels, could result later on in elevated blood pressure, anxiety and hyperglycemia. And when we fiddle with stress hormone levels, we increase the likelihood of later cardiac crises. And cortisol levels are also heavily implicated in signaling the birth process to begin.

Cortisol is a stress hormone because it sets in motion the alarm signals to combat too much and too strong an input. When it goes on for a long time it accelerates the possibility of dementia and a whole host of other diseases. Primal imprints do exactly that; maintain a high level of cortisol for a lifetime.

In nearly every study of prenatal life, there is the implication that high stress hormone levels in the pregnant woman can result in hypertension and cardiac problems later on in the offspring. Infants of mothers, who were diagnosed as anxious before pregnancy, had significantly higher stress hormone levels. Neuro-psychologist Paula Thomson explains: “Prenatal stress responses are dependent on the mother’s stress level. But how babies show it is through a limited physiologic vocabulary.” She believes that the fetal stress response is already skewed and, given later stress, the earlier stress response does not change. It can be blocked, diverted, covered over, but it remains pristine clear.

She believes that stress states in the pre-nate and neonate can be recognized by elevated heart rate, and greater activity levels (gross body, single and multiple limbs with higher reflex activation). The pre-nate and neonate may show mistimed diffuse movement and overt grimacing; and will be rather clumsy and have a lack of coordination. All this can be a predictor of later heart disease. That is only if we look at the problem in a gestalt overview.

Thomson: “One overarching goal of this article is to help clinicians understand the potential deleterious effects of prenatal stress. (See Thomson. “Down Will Come Baby.” Journal of Trauma and Dissociation. Vol. 8(3) 2007).

She adds: “It is hoped that increased knowledge of prenatal stress will inform psychotherapeutic treatment protocols, especially when treating severely traumatized and dissociative patients who may themselves have suffered early pre-nate stress. Further, when these patients become pregnant, appropriate treatment for the mother may benefit the offspring. When clinicians provide therapeutic intervention to a pregnant woman the pre-nate may also be affected.” (Field, 2001; Ponirakis, Susman & Stifer, 1998.) (My emphasis)

Let us not forget that (Thomson): One of the most dramatic changes occurs in the first moment of conception. The primitive cell carries the blueprint for an individual who has never existed before and will never exist again. While in the womb, he is having the most important experiences in his life, because nearly all of it is of life-and-death significance. This is what Freud should have addressed when he was developing his theory of psychoanalysis. Here lies the deep unconscious; a dark place with no exit and no words. Biologic responses dominate. In order to relive, we have to include all of our physiologic processes, not just cerebral memory. The first step is to acknowledge these facts; a much more difficult step is to fashion a therapy for them. I think we have done that.

One of the key factors in high levels of maternal cortisol is the increase in the chances of a lost baby; or at the least some kind of prematurity. Again, those levels descend into the fetal system and change the baby in ways we are still learning about. Babies born to depressed mothers have higher levels of cortisol than normal. Here was what Lauren Kaplan and colleagues have to say about this: “In utero environment sculpts the uniquely plastic fetal brain resulting in long-term maladaptive patterns of behavior and physiology.”

(Lauren Kaplan, et al, “Effects of Mother’s Prenatal Psychiatric Status and Postnatal Caregiving on Infant Biobehavioral Regulation.” Early Human Dev. 2008 April; 84 (4) 249-256)

What researchers are now saying over and over again is that womb-life can inalterably affect the lifetime of the offspring. And, it is not only behavior that is altered but the physiology, as well. Does this mean a change in Primal Theory? Absolutely, it pushes the envelope much earlier for when imprints start and for their widespread enduring effects. It means that how the birth trauma is played out, and reacted to, depends on earlier life circumstances.

Information is now amassing as research continues into a heretofore unexplored area. There is an article in the November 14, 1998 of BMJ by Marc Bygdeman and B. Jacobson entitled “Obstetric Care and Proneness of Offspring to Suicide as Adults (Case-control study. Pages 1346-49. See: BMJ Vol. 317. Website: that suggests that “through a process of imprinting certain individuals might subconsciously create a traumatic situation during the act of suicide that produces a sensation similar to that experienced during birth.” (Page 1346) This could be a quote from one of my books (and indeed, one of the scientific contributors was a student of mine). What they found was that those who committed suicide violently were more often exposed to complications during birth. Strangely, those mothers who were drugged did not result in suicide by the offspring. But there is the implication that the adult may be more likely to be addicted to drugs. The implication seems to be that opiates given during birth reduce the impact of the trauma and are, hence, less likely to produce suicide-prone individuals.

What my theory states is that when provoked by a certain hopelessness in the present, which is not overwhelming in itself, it can trigger off—resonate—with earlier imprinted hopelessness during birth and sets off an attempted suicide; because it not only triggers the original traumatic feeling but all of the circumstances around it. Thus, suicide, to try to put an end to the agony. And when drugs were given to the mother to ease her pain it also at the same time eased the suffering of the baby. Thus, later on, one turns to drugs to ease pain; a replication of the earlier event. It worked when it was a matter of

The reason that current psychotherapy has been such a failure is the factors that produce current behavior are far, far earlier than we might have imagined. To ignore all of this research is dangerous for the patient because it means she stands little chance of resolving suicidal feelings (and perhaps suicide) without this understanding. So, it can again mean life-and-death for the patient.

I want to emphasize the role of serotonin production in the fetus. For the first few months of gestation, the fetus does not fulfill its quota of serotonin. (This neuro-juice often acts like a pain-killing drug.) It must "borrow" some from the mother. That is assuming she has adequate supplies, which is not always the case in chronically depressed and anxious mothers. If she doesn't, the fetus cannot go to a pharmacy and take out a loan. The mother may be low on stock if she is chronically affected by depression or anxiety or if the circumstance around her pregnancy is unhappy or worrisome. The system stamps-in this event and then permanently alters any number of set-points, including serotonin. A low level of it remains fixed as memory; it is an aspect of the overall memory experience. This is partly the basis for a later free-floating anxiety or depression—a seemingly mysterious state that befalls one without any seeming cause. These afflictions occur because there is a systemic lack of proper repression (serotonin is basically a pain/feeling suppressor). No one can see this; and indeed no one will see it until the constant grinding pain produces a serious symptom. Then the person will be treated for the symptom while he remains basically the same. The system is always ready to spew out another symptom. There is a big difference between the treatment of the human being and the treatment of a symptom. Symptoms are idiosyncratic; underlying pain is just that—underlying. Lack of touch produces similar pain among those who were not touched; where that pain alights is an individual matter; some in behavior, others in physical symptoms. So a person may always sense a feeling of gloom and doom in growing up but never know how early that feeling began or what caused it. To reiterate: womb-life leaves a trace memory of uncontained pain (assuming there was any). The person seems to have been born with fragile defenses, and we may wonder how that happened because there was a loving, caring family around him. Yet even the slightest physical insult can produce a damaging effect in the person. The imprint is of a non-contained fear that leaves one with panic or anxiety attacks later in life. There may be inadequate physical development because chronically low serotonin is known to affect physical progress. Serotonin is as essential as food; it is food for the fetus. We often see, what in the early days of psychiatry was called hysteria, in these individuals. They are easily hurt because they have insufficient defenses; and they exaggerate reactions because there is a seething caldron of fear and pain surging toward the surface. Their reactions are inordinate because they always sit on top of a heavy, dense load of pain.

We now know that a difficult birth can deplete the baby of adequate serotonin/inhibition levels. Later, all kinds of impulse neurotics—criminals—addicts, are low in serotonin, and obviously, low in inhibition. I don’t think we need to stop at birth for adverse effects on serotonin. It can happen as serotonin begins to function adequately, even in the last few months of pregnancy. Again, many of my patients are low in serotonin at the start of therapy but normalize after a year; therefore, it is a reversible phenomenon. (See a full discussion of this in my Primal Healing). It isn’t only serotonin; there is ample research now to show that the neocortical inhibitory prefrontal neurons are low in number due to a trauma at or before birth. These are poor inhibitors from the time of birth on. These individuals cannot wait, lose patience, have attention deficit disorder lash out with little provocation and want what they want NOW! They will interrupt because they cannot wait their turn to speak. All this means that we can be born with a tendency to ADD. It is not heredity but the experiences during womb-life that impacted that heredity. It seems like we are born with it but mostly we are not.

Now let’s push the envelope even further back.

In a recent experiment, a scientist raised some rats after knocking out some of the building blocks for serotonin (the key element in Prozac), which is key for gating or repression; the animal did not have the wherewithal to construct a serotonin structure. (We call that gating; which is no more than blocking pain chemically so that the message of suffering does not reach full conscious/awareness.) He then let the females mature, get pregnant and have babies. Of the 43 mouse embryos tested, 37 displayed abnormalities and brain malfunction. This indicates that the animal mother’s state affects the development of the baby’s brain. Her levels of serotonin can determine how her offspring mature. So, when a pregnant woman is chronically depressed, and hence low on serotonin, the baby’s entire life may be adversely affected. And the changes in her as a result of “heredity” will determine what kind of mothers the offspring will be. Later childhood environment does count a lot but not as much as when the baby’s brain is rapidly evolving. In gestation, it is essential that the mother be normal in every way possible. Otherwise, she cannot fulfill the needs of her baby in the womb. And one definition of love is helping to fulfill the needs of the child. No fulfilling needs—no love.

What is very important for us to realize was that a mouse fetus does not make her own serotonin until the third trimester. It seems like the mother supplies what is needed until the baby can take over. But when the mother is low on supplies, she cannot fulfill what the developing baby lacks. Therefore, the baby carries around a load of pain. Now if we apply that to humans, there seems to be a time in gestation when pain or noxious stimuli impinge, but we are not yet able to produce enough of our own gating chemicals, leading to un-gated pain. This residue will continue and may lead to bouts of anxiety later on in life. It becomes free-floating fear or terror. This is not due to heredity but rather to experience in the womb. This is why we should never neglect womb-life when addressing neurosis. Part of our in utero life, therefore, takes on hurt at a time when our system can do nothing about it. Nevertheless, it affects all later development. At 30, we may suffer from panic attacks (as excessive agitation) that began its life in the very early months of our mother’s pregnancy. It is pristine and free-floating, ready to spring forth whenever we are vulnerable or our defenses are weak. No talk therapy can make a dent in it. It leaves us fragile for a lifetime so that any insult in infancy and childhood weakens us all the more. Demanding and/or aloof parents can easily compound an allergic tendency, for example.

Catherine Monk and her associates studied anxiety in pregnant mothers. (Monk, C. et al.“Effects of Women’s Stress-Elicited Physiological Activity and Chronic Anxiety on Fetal Heart Rate.” Developmental and Behavioral Pediatrics, 2003. Lippincott Publishers. Their conclusion was: “Women’s emotion-based physiological activity can affect the fetus and may be important to fetal development.” To think that there is a significant physiologic change but no later psychological one would be to ignore the human brain.

Now as to the enduring effects of pre-birth and birth trauma: Alyx Taylor has shown that the baby’s stress response to an inoculation at eight weeks was largely determined by the “mode of delivery” of the newborn. Those who reacted the most were birthed by assisted delivery. Cesarean showed the least response. The central finding was that the stress-response circuits (HPA circuit) in the brain help to determine how a baby will respond to future stress.

I am not going to cite any number of relevant studies but one such article is a review of many related ones. Nicole Talge and her colleagues reviewed the data on what happens to the babies of stressed mothers. (“Antenatal Maternal Stress and Long-Term Effects on Child Neurodevelopment. How and Why.” Journal of Child Psychology and Psychiatry. 48:3/4 4 (2007) pp 245-261.)

Nearly all studies claim an effect of the mother on the fetus. I suppose the real question is, “What can we do about it?”. Years later, it seems an impossible task, but it is not. Once there is an imprinted trauma during womb-life, the brain system closes down on the pain through inhibition/gating. Thereafter the effects are life-long.

The best that anyone can do after that is treat the symptom. In order to treat the cause we must go back to the originating source and undo the trauma. The way we do that is to relive the trauma and open the gates. It can be done, as I have explained elsewhere, by reliving emotional trauma during childhood, which has at its roots the pre-birth event. When we fully relive the childhood event it incorporates the earlier trauma; each new related trauma is re-represented on higher levels. And when these later traumas are relived, we see the disappearance (or reduction in the severity) of the symptom, as for example: high blood pressure. That is because the earlier trauma may only be expressed through specific physiologic reactions such as blood pressure or heart rate. To relive the physiologic responses can be enough given other variables. If we connect to the related childhood feeling in our therapy it automatically (given the person having deeper access), includes the earlier physiologic component of the feeling. I want to reiterate that there is a timetable of needs that must be fulfilled at that time and no other. Once the fetus has been impacted due to a high level of stress hormones that is it; the system gates it as best as it can and no other mode of treatment except reliving can change it.

This is a change in our paradigm. It means that trauma that has life-long effects can occur during womb-life, and thereafter has profound effects on our later behavior and symptoms. How, therefore, can we possibly attack allergies, migraine and high blood pressure without an acknowledgment of the deep and remote origins of the problem? I have been writing about this for decades. The difference is that research has now caught up and begins to confirm our theory. And now we see why after one year of our therapy there is a normalization of natural killer cells; as I pointed out, these are cells on the lookout for newly forming cancer cells, and attacks them. So we might say that one way to help forestall cancer is to make sure that our immune system is intact and strong. Although I have written extensively about the value and efficacy of reliving in many books, research is now bolstering this position. From News In Science (June 4, 2008) comes this statement: “The Archives of General Psychiatry is the latest to show the value of using so-called prolonged exposure therapy (reliving) for post-traumatic stress disorder (PTSD).” The study was of individuals classified as PTSD who received three different kinds of therapy. One was cognitive restructuring (altering thinking patterns). The second was Reliving. The last third getting neither form of therapy. Reliving here is defined as being exposed over time to the problem that originally caused the condition. The results were that one-third of long-exposure group developed PTSD. Almost two-thirds of the cognitive group became PTSD, while almost 80 percent of the no-therapy group was diagnosed as PTSD. Six months after therapy again one-third of the Reliving group were still PTSD while the cognitive group was at 63 percent. The researchers summarized as follows: “The current findings suggest that direct activation of trauma memories is particularly useful for prevention of PTSD symptoms.” They point out that PTSD usually does not set in for some several months after the originating trauma. The only difference with my theory is that the traumas occurred far earlier than expected. Meanwhile they point out that there is a “growing trend” toward exposure therapy. Maybe all our efforts for the past 40 years have not been in vain.

Here is what Alexander Jones and colleagues have said about his research on prenatal life: (“Fetal Growth and the Adrenocortical Respnse to Psychological Stress.” Jones, et al. J. Clin. Endoc. Metabolism. Feb. 7, 2006 10:1210/jc. 2005-7.)

I paraphrase to make scientific lingo a bit more understandable: Animal studies show that the stress response changes the set-points of several hormone systems; and that will impact later in terms of how we respond later to harsh environment. A report by K.L. Thornburg and S. Louey (“Fetal Roots of Cardiac Disease.” Heart 2005; 91:867-868.), discusses how stress to the fetus can result in heart disease later in life. When the newborn is underweight (often indicating adverse events in the womb), there is a greater tendency for problems in the endothelium (the lining of the heart) later on in life. There is an indication that lower oxygen during gestation is yet another traumatic factor affecting the heart. Whenever we compromise the endothelium, we run a risk of heart problems, this is obviously true for damage during gestation. It stands to reason that pre-natal traumas are generally all encompassing; we should find damage almost everywhere we look. The problem is that without an all-encompassing theory that directs us where to look we would never put together heart attacks at 50 with a trauma at minus six weeks. I arrived there years ago from observation, which is also a valid part of the scientific method. Research now helps to confirm.

There are several studies that have looked into fetal hypoxia (reduced oxygen) and the results systematically seem to be severe emotional illness later in life. (See: “Behavioral Alterations in Rats Following Neonatal Hypoxia and Effects of Clozapine.” Fendt.M., et al., Pharmacopsychiatry Jul, 2008; 41 (4) 138-45) (Also see: “Decreased Neurotrophic Response to Birth Hypozia in the Etiology of Schizophrenia.” T.D. Cannon, et al., Biological Psychiatry. Vol 64, Issue 9 Nov, 2008. Pgs. 797-802.) There is more and more information about the later ill effects of traumas at birth and before. It behooves us to look into this as those entrusted to heal mentally ill patients. Without this understanding we will not know where to look in order to heal patients. The information is out there; it is up to us in the healing professions to seek it out.

The question is, “Why hypoxia in schizophrenia?” There are several explanations. What I have witnessed over and again is that the fetus is in danger of dying from lack of oxygen and then does not have the wherewithal to combat the trauma (a mother smoking, for example). Lack of sufficient oxygen is a terrible stressor. If it continues, death is in the offing. Further, it leaves the fetus and baby with insufficient resources to combat future stress. The danger remains as a substrate so that any later trauma can set it off; hence breathing problems. So anxiety reactions to seemingly non-toxic situation are inordinate and out of keeping with the gravity of the current situation. They have simply reawakened the almost dying while in the womb. It is never a matter of changing attitudes, as the cognitivists would have it; it is a matter of what shaped those attitudes, in the first place.

I have discussed the notion of the “critical window” in my other works; it simply is that time in life when needs must be fulfilled, and at no other time. We can hug a child all day at age ten but it will not erase the lack of touch for the first four months of life which seriously deregulated the whole system and left a legacy of internally imprinted pain; a pain for which one must constantly take painkillers. And it remains a mystery to the loving adoptive parents who took the child from an orphanage at the age of 12 weeks.

There is no way to make up for that loss except when going back to relive the original trauma. There is no way to “make up for” this deficit as much as we might want to. It is set in altered biologic set-points. We can treat the damage this does (kidney disease) but not its causes. The whole nervous system must retreat to the time when the trauma occurred; it can never be a matter of “remembering.” It has to be organic and systemic memory. That is, part of the precise memory lies in those new set-points. And they are wedded to how they first developed, in the first place.

There is a critical window for healthy functioning kidneys. It is sometime in the last trimester of gestation that most kidney cells (nephrons) are developing (up to the 36thweek). Nephron development begins just after the eighth week. Trauma here, however subtle, may result in later kidney disease, with no apparent immediate cause. Once that damage is done we can only treat its symptoms (unless and until we address origins).

Physiologic reactions are the base for later feelings. What distorts those physiologic responses will ultimately distort psychological reactions, as well. If the system is highly activated due to early trauma, chances are we will have a hyperactive individual who will search out projects to keep herself active and busy. If dopamine and other alerting chemicals are in short supply, we may later have so meone who is phlegmatic, concocts reasons for not doing anything, for not following through. It is not a one-to-one relationship, but we can see how the platform of physiology will eventually direct our psychology. If we don’t have all of the mobilizing chemicals we need, it stands to reason that the adult, in order to keep matters ego-syntonic (comfortable to the person), will rationalize why he doesn’t try and doesn’t persist.

One may rightly question how anyone can relive events in the womb with no scenes or words. Luckily, that part of the imprint is totally physiological. We don’t need verbal acknowledgment. That deep brainstem is also a very important part of our central nervous system and gives the oomph or push to a feeling. A single feeling will encompass all three levels of brain function. Again, there is no exit here except entering into the most profound of unconscious states, which, dialectically, automatically transmutes into consciousness. Remember, each level has its own consciousness, and its own contribution to make. When we arrive down there we are communicating with a level that has an identity all of its own. One level is pure instinct, another pure feelings and still another pure thought. Put them all together and we get pure feeling. A therapy of feeling must take into account all levels of consciousness. And any proper psychotherapy must understand that addressing the most recent top thinking brain level alone must eventually fail. It is overwhelming feelings/pain that caused the problems (say, of addiction), in the first place.
If we strip feelings away from thoughts we get someone who might be a psychopath; going through the motions of being human but without the humanity. The deeper we go into the unconscious the more conscious we become. In a curious dialectic when in therapy we descend to other levels of consciousness (deemed the unconscious) we are both unconscious and conscious at the same time. As we descend down, the unconscious automatically becomes conscious-- at that point we can finally meet our maker—us.


  1. Your description of ADD as a form of in-utero hypoxia was a real eye-opener for me! When my mother was pregnant with me, she feared giving birth. She was small (1.53m) and was discomforted at the thought of going in labour while her baby could be of average size. She heard that smoking would keep the fetus small, so she temporarily increased her smoking habit.

    Right now, I'm on Concerta and I'm looking for alternatives. There's nothing like primal healing in my neighbourhood. I'm considering biofeedback - I'd like to know what your take is on this method.'
    Having read your book 'Primal Healing', I'm very happy to now understand better how the brain works, but I cannot form an opinion about biofeedback on the basis of this book.

    I also have schizoid traits, might this be due to the same reason? Again, because there is no primal healing therapy in my surroundings here in Holland, I chose bioenergetic analysis therapy. After reading dr.Lowen's 'The Betrayal of the Body' I felt confident that this therapy might also be a good and effective choice.
    I hope you will blog some more on ADD and schizoid PD in the future, I value your opinion.

  2. Mahdiya. I don't believe in biofeedback at all. It is trying to impose a notion of normal on a brain that is definitely not normal and should not be given its previous experiences. Anything that does not have a "why" in it will not work!! What is wrong with Primal Therapy? Where are you? People hesitate to come to the Primal Center in Santa Monica, yet it is their one and only life they are gambling on. Do it right! dr. janov

  3. hi, I live very far away from Santa Monica, in the south of Holland. And I am not aware of any primal therapy here.

    But what would primal therapy, as ADD treatment, encompass in a nutshell?
    Overcoming the initial sensory trauma of asphyxiation (in case of in utero hypoxia) is the key, right? Well, choking (in a social sense) definitely seems to be a red hot lead in my life, but I attributed that already to some schizoid comorbidity.

    But what are you saying? If you overcome your pre-birth trauma, you could also overcome ADD in the sense that the levels of secretion of dopamine and norepinephrine would rise to normal?

  4. Mahdiya. Yes it helps enormously to root out gestation and birth traumas, but first you must address and feel later childhood events. We have had very good luck with ADD. It is very understandable. dr. janov

  5. Dear mister Janov,

    I do not «believe» that Primal Therapy works; I know it from practical experience. I have learned to circumvent the repressing action of my cognitive brain and follow the emotional and physical route to relive (in fact, to live really for the first time) hundred of traumatic events of my life to heal from the emotional wounds these events had caused. I learned the primal at your New York Primal Institute in the early ’80, used it extensively in the first few years and then on an «as needed» basis ever since.

    There is no doubt in my mind that Primal Therapy is revolutionary tool that has a great potential to help heal our deeply sick Humanity. I have discovered recently, that while Primal Therapy does a great job of «repairing» damaged individual, some other people are doing a fantastic job in promoting ways to help preventing these damages to occur in the first place. Everyone concerned about the future of Humanity will probably be interested in visiting the and the web sites. Information found on these sites corroborates what you are saying about the Primal theory and the disastrous effects of very early (from conception, on) traumas, and this, from a scientific perspective.

    Charles-Gilles Massé

  6. Dr Janov,
    I have always believed intuitively that the pregnancy and childbirth experience has been drastically underappreciated in it's effect on humans. When my children were born in the 80's and early 90's there seemed to be a growing trend toward childbirth preparedness and natural childbirth. Sadly it seems to have fallen by the wayside for most in favor of "scheduled c-sections"epidurals, and induced labors often for the sole purpose of convenience to peoples schedules. Although breastfeeding is encouraged, so are women encouraged or forced by financial necessity, to return to work at anywhere from 6 weeks to 3 months. They are encouraged to pump their breastmilk, which completely overlooks the nurturing and bonding that is the most beautiful part of nursing a baby. I truly hope more people become aware of the importance of bonding, even before birth but until people start looking beyond the immediate it seems unlikely. All I can do is to pass the word to those who would listen, which I do every chance I get!
    Jenny H

  7. Dr. Janov,
    Congratulations on your book and work. It is very interesting. I have been also treating patinents since last 10 years and ofcarse the base of every disease is a mother´s womb. I have taken my patients to sperms consciousness and beyond that which cannot be explained. My therapy is based on the investigation done by my professor Werner Meinhold ( in Meersburg, Germany and which has helped me to treat almost everything in my patients and the results are astonishing. It has not only changed my patients life but my life too. I am also finishing a book on the same topic which is expected sometime in January 2012. I am a putting your website on Facebook so that others can also get benefited. Please allow me to be in touch with you for furhter sharing and discussion...atul


Review of "Beyond Belief"

This thought-provoking and important book shows how people are drawn toward dangerous beliefs.
“Belief can manifest itself in world-changing ways—and did, in some of history’s ugliest moments, from the rise of Adolf Hitler to the Jonestown mass suicide in 1979. Arthur Janov, a renowned psychologist who penned The Primal Scream, fearlessly tackles the subject of why and how strong believers willingly embrace even the most deranged leaders.
Beyond Belief begins with a lucid explanation of belief systems that, writes Janov, “are maps, something to help us navigate through life more effectively.” While belief systems are not presented as inherently bad, the author concentrates not just on why people adopt belief systems, but why “alienated individuals” in particular seek out “belief systems on the fringes.” The result is a book that is both illuminating and sobering. It explores, for example, how a strongly-held belief can lead radical Islamist jihadists to murder others in suicide acts. Janov writes, “I believe if people had more love in this life, they would not be so anxious to end it in favor of some imaginary existence.”
One of the most compelling aspects of Beyond Belief is the author’s liberal use of case studies, most of which are related in the first person by individuals whose lives were dramatically affected by their involvement in cults. These stories offer an exceptional perspective on the manner in which belief systems can take hold and shape one’s experiences. Joan’s tale, for instance, both engaging and disturbing, describes what it was like to join the Hare Krishnas. Even though she left the sect, observing that participants “are stunted in spiritual awareness,” Joan considers returning someday because “there’s a certain protection there.”
Janov’s great insight into cultish leaders is particularly interesting; he believes such people have had childhoods in which they were “rejected and unloved,” because “only unloved people want to become the wise man or woman (although it is usually male) imparting words of wisdom to others.” This is just one reason why Beyond Belief is such a thought-provoking, important book.”
Barry Silverstein, Freelance Writer

Quotes for "Life Before Birth"

“Life Before Birth is a thrilling journey of discovery, a real joy to read. Janov writes like no one else on the human mind—engaging, brilliant, passionate, and honest.
He is the best writer today on what makes us human—he shows us how the mind works, how it goes wrong, and how to put it right . . . He presents a brand-new approach to dealing with depression, emotional pain, anxiety, and addiction.”
Paul Thompson, PhD, Professor of Neurology, UCLA School of Medicine

Art Janov, one of the pioneers of fetal and early infant experiences and future mental health issues, offers a robust vision of how the earliest traumas of life can percolate through the brains, minds and lives of individuals. He focuses on both the shifting tides of brain emotional systems and the life-long consequences that can result, as well as the novel interventions, and clinical understanding, that need to be implemented in order to bring about the brain-mind changes that can restore affective equanimity. The transitions from feelings of persistent affective turmoil to psychological wholeness, requires both an understanding of the brain changes and a therapist that can work with the affective mind at primary-process levels. Life Before Birth, is a manifesto that provides a robust argument for increasing attention to the neuro-mental lives of fetuses and infants, and the widespread ramifications on mental health if we do not. Without an accurate developmental history of troubled minds, coordinated with a recognition of the primal emotional powers of the lowest ancestral regions of the human brain, therapists will be lost in their attempt to restore psychological balance.
Jaak Panksepp, Ph.D.
Bailey Endowed Chair of Animal Well Being Science
Washington State University

Dr. Janov’s essential insight—that our earliest experiences strongly influence later well being—is no longer in doubt. Thanks to advances in neuroscience, immunology, and epigenetics, we can now see some of the mechanisms of action at the heart of these developmental processes. His long-held belief that the brain, human development, and psychological well being need to studied in the context of evolution—from the brainstem up—now lies at the heart of the integration of neuroscience and psychotherapy.
Grounded in these two principles, Dr. Janov continues to explore the lifelong impact of prenatal, birth, and early experiences on our brains and minds. Simultaneously “old school” and revolutionary, he synthesizes traditional psychodynamic theories with cutting-edge science while consistently highlighting the limitations of a strict, “top-down” talking cure. Whether or not you agree with his philosophical assumptions, therapeutic practices, or theoretical conclusions, I promise you an interesting and thought-provoking journey.
Lou Cozolino, PsyD, Professor of Psychology, Pepperdine University

In Life Before Birth Dr. Arthur Janov illuminates the sources of much that happens during life after birth. Lucidly, the pioneer of primal therapy provides the scientific rationale for treatments that take us through our original, non-verbal memories—to essential depths of experience that the superficial cognitive-behavioral modalities currently in fashion cannot possibly touch, let alone transform.
Gabor Maté MD, author of In The Realm of Hungry Ghosts: Close Encounters With Addiction

An expansive analysis! This book attempts to explain the impact of critical developmental windows in the past, implores us to improve the lives of pregnant women in the present, and has implications for understanding our children, ourselves, and our collective future. I’m not sure whether primal therapy works or not, but it certainly deserves systematic testing in well-designed, assessor-blinded, randomized controlled clinical trials.
K.J.S. Anand, MBBS, D. Phil, FAACP, FCCM, FRCPCH, Professor of Pediatrics, Anesthesiology, Anatomy & Neurobiology, Senior Scholar, Center for Excellence in Faith and Health, Methodist Le Bonheur Healthcare System

A baby's brain grows more while in the womb than at any time in a child's life. Life Before Birth: The Hidden Script That Rules Our Lives is a valuable guide to creating healthier babies and offers insight into healing our early primal wounds. Dr. Janov integrates the most recent scientific research about prenatal development with the psychobiological reality that these early experiences do cast a long shadow over our entire lifespan. With a wealth of experience and a history of successful psychotherapeutic treatment, Dr. Janov is well positioned to speak with clarity and precision on a topic that remains critically important.
Paula Thomson, PsyD, Associate Professor, California State University, Northridge & Professor Emeritus, York University

"I am enthralled.
Dr. Janov has crafted a compelling and prophetic opus that could rightly dictate
PhD thesis topics for decades to come. Devoid of any "New Age" pseudoscience,
this work never strays from scientific orthodoxy and yet is perfectly accessible and
downright fascinating to any lay person interested in the mysteries of the human psyche."
Dr. Bernard Park, MD, MPH

His new book “Life Before Birth: The Hidden Script that Rules Our Lives” shows that primal therapy, the lower-brain therapeutic method popularized in the 1970’s international bestseller “Primal Scream” and his early work with John Lennon, may help alleviate depression and anxiety disorders, normalize blood pressure and serotonin levels, and improve the functioning of the immune system.
One of the book’s most intriguing theories is that fetal imprinting, an evolutionary strategy to prepare children to cope with life, establishes a permanent set-point in a child's physiology. Baby's born to mothers highly anxious during pregnancy, whether from war, natural disasters, failed marriages, or other stressful life conditions, may thus be prone to mental illness and brain dysfunction later in life. Early traumatic events such as low oxygen at birth, painkillers and antidepressants administered to the mother during pregnancy, poor maternal nutrition, and a lack of parental affection in the first years of life may compound the effect.
In making the case for a brand-new, unified field theory of psychotherapy, Dr. Janov weaves together the evolutionary theories of Jean Baptiste Larmarck, the fetal development studies of Vivette Glover and K.J.S. Anand, and fascinating new research by the psychiatrist Elissa Epel suggesting that telomeres—a region of repetitive DNA critical in predicting life expectancy—may be significantly altered during pregnancy.
After explaining how hormonal and neurologic processes in the womb provide a blueprint for later mental illness and disease, Dr. Janov charts a revolutionary new course for psychotherapy. He provides a sharp critique of cognitive behavioral therapy, psychoanalysis, and other popular “talk therapy” models for treating addiction and mental illness, which he argues do not reach the limbic system and brainstem, where the effects of early trauma are registered in the nervous system.
“Life Before Birth: The Hidden Script that Rules Our Lives” is scheduled to be published by NTI Upstream in October 2011, and has tremendous implications for the future of modern psychology, pediatrics, pregnancy, and women’s health.