With respect to primal therapy, Janov (1970, 1971, 1973, 1983) and Verny (1978, 1984) have made important contributions regarding the so-called birth primal. These clinical observers have called attention to the phenomenon. Now there is a need for systematic phenomenological-descriptive research from the view points of those who have actually lived such experiences. Such qualitative research is of fundamental importance in that it should form the foundation of later theory and therapeutic technique.
The present study is an attempt to examine purported birth reexperiences-those that occur in primal therapy-in a critical and systematic manner.
Thorough studies always begin with an analysis and critique of the most important research, opinion, and theory relating to a topic. The analysis for this particular study revealed that while "birth primal" is the term that has been used by clinical observers, "birth feelings" is the term most commonly used by those who have actually had such experiences in primal therapy. This is evident in the written protocols of Janov's (1983) patients, in Videgard's (1984) recent outcome study of primal therapy, and in the verbal reports of my own research subjects (Khamsi, 1985) and clients.
This study had three main objectives. First, there was an attempt to elicit subjects' descriptions of birth feelings. Second, an attempt was made to elicit information relating to specific questions about the experience which were derived from the related psychological literature. Finally, attempts were made to generate hypotheses for subsequent investigation.
Subjects. Thirteen subjects participated in this study, eight women and five men. The age range was 27 to 55, and the average age was 41. Subjects were referred by their primal therapists upon request by the chief researcher and author of this report.
Subjects were selected with respect to the logic of exemplary cases. Two primary criteria guided the selection of subjects: (1) they must have experienced birth feelings on one or more occasions in the course of primal therapy, and (2) they must be able to articulate these experiences (cf. Colaizzi, 1978).
Procedures. An intensive, semi-structured dialogal interview was conducted with each subject. All interviews took place in the San Francisco Bay Area between 10-8-84 and 11-26-84. These open-ended interviews lasted from one to two hours and were audio-recorded for later verbatim transcription.
Two interviewers were used. The first (male) is a professional psychotherapist and the author of this report, and conducted eight ofthe interviews; the second (female) is a registered nurse and professional medical history interviewer, and conducted five of the interviews, The interviewers had each experienced primal therapy, and were informed about the birth psychology literature and about qualitative inter- viewing (cf., Kruger, 1979; Kvale, 1983).
Subjects were also involved in two post-interview contacts. They were asked to add to, correct, and/or validate, first the verbatim transcription and later an initial treatment of the data.
Treatment of the data. Treatment of the data involved delineating "natural meaning units" (Giorgi, 1975, p. 74), explicating "significant statements" (Colaizzi, 1978, p. 59), producing "formulated meanings" (Colaizzi, p. 59), and assembling a general data base by which to address the research questions (Giorgi, p.87-88). For each of eight research question headings, a specific data base was derived from the general data base; the central themes of each specific data base were articulated and then organized into"categories" (Kruger, 1979, p. 130). Each research heading was then descriptively addressed with respect to its specific data base and categories.
One question posed tothedata,forexample, was "What isthe quality of experience of birth feelings?" This question was addressed by interrogating the validated formulated meanings from all 13 protocols and extracting those that related to the quality of experience of birth feelings. This produced a long list of significant and relevant statements, and comprised the specific data base for this particular question. The central themes of this particular specific data base were then extracted and organized into categories, and a description of the quality of experience was generated. Each research question heading, in turn, was so addressed,
1. Circumstances leading to birth feelings. Several subjects in this study had undergone some form of psychotherapy prior to their primal therapy. By and large, subjects were not attracted to primal therapy because of birth-related issues; they were far more likely to enter primal therapy because of certain personal and interpersonal problems which they hoped and thought would be alleviated. Subjects were often following the recommendation of a spouse or friend as to the specific modality of the therapy.
Most subjects' sessions began with present feelings which sometimes led to .'primal feelings" (i.e., core emotions seemingly rooted in past experience). Generally there was a sense of continuity between present and primal feelings.
Birth feelings, when present, reportedly came from "deep within." The body seemed to "take over" and led to birth feelings.
A wide variety of therapeutic techniques eventuated in birth feelings. Most central was simply becoming more aware of inner experience and relinquishing conscious control of the body and breath. Relaxation, deep breathing, expression of emotions, making sounds, pushing with one's body, and touching or being touched by one's therapist were common. In most cases birth feelings occurred without conscious direction or focus toward birth material, although three subjects had been directed into "birth regressions."
Subjects also reported events in life that seemed to be "triggers" of birth feelings, Although too vast to catalog here, triggers included feeling overwhelmed, changing one's job or living situation, engaging in sexual intercourse, experiencing therapeutic techniques), listening to music, receiving a massage, taking personal or interpersonal risks, and watching films.
The person and technique of the therapist were clearly of importance to the subjects. Several subjects mentioned that working with a certain-sexed therapist or being touched were almost prerequisites to attaining deep feelings, including birth feelings. The quality of the therapists' voice and touch was felt by most to be a particularly important aspect of the therapeutic relationship, and seemed to affect access to birth feelings.
The needs for safety with, trust in, and connection to the therapist were almost universal. Most subjects felt that some sense of nurturance, permission, reassurance, and/or support were critical in their exploration of birth and other deep feelings. Subjects apparently found it easier to feel deeply, then, when they trusted their therapist to be beneficent, present, and supportive.
Therapists considered effective were perceived as interested, kind, loving, sympathetic, trustworthy, and validating. They were perceived as allowing subjects to proceed at their own pace, and as intervening only carefully and appropriately so as not to interrupt the experiential flow. Therapy seemed difficult or unsuccessful when subjects felt they were being directed with little regard for their feelings.
2. Recognition, conceptualization,and labeling of birth feelings. Most subjects had read something by Janov prior to their therapy. This seemed to have two main effects. First, it suggested to some subjects that the birth process contains a psychological factor and/or can possibly be reexperienced. Second, somes ubjects acquired expectations and in some cases waited to have similar experiences; in every such case, however, subjects' actual experiences differed markedly from their expectations. In retrospect, most subjects felt that they were only slightly affected by these publications.
Explicit labeling of experiences as birth-related was usually made by the subject, but in several cases was made by the therapist. Not atypical was the comment by Kelly (all names have been changed) that her therapist "made very little comment on what was going on, and very little if any discussion of birth feelings or anything else for that matter. We just didn't talk much about what the therapy meant." There seemed to be a general tendency for therapists to wait for subjects to arrive at their own meanings and conclusions.
Somewhat surprisingly, most subjects had rarely discussed their birth feelings prior to participation in this study. Except for "birth interpretations" (i.e., those in which a therapist interprets a client's current behavior and experience in relation to their birth), discussions even with one's therapist were all but extraordinary, and even then usually occurred only long after the fact.
For subjects who had discussed their birth feelings, however, positive outcomes were reported. Commenting on his discussions of birth feelings with others in primal therapy, Fred explained that "it seemed important to me. I guess it helped me to talk about it, it helped me to have the feelings, helped me to go with my own process of reexperiencing my birth." These subjects reported that discussion helped them to feel freer and remember more, and to better understand themselves. Many subjects spontaneously reported that their research interview was itself a positive experience, for all these same reasons.
Subjects were usually skeptical at first about the possibility of reliving birth. These experiences, however, were sufficiently powerful and realistic to convince subjects of their reality. John, for example, claimed to have been highly skeptical about birth feelings, "but as I went deeper into them and experienced them more and more over time, it became clear to me-as clear as that the nose is on my face, that I can feel with my fingers-that I was reexperiencing my own birth." And as Hannah declared, "I don't doubt that my birth experiences were real, that I was actually reexperiencing and having memories of things I had earlier experienced." Birth feelings, in short, were almost always believed to be veridical relivings of subjects' original births.
3. Cognitive aspects of birth feelings. In examining what subjects think about birth feelings, it should be remembered that these experiences are unique, esssentially nonverbal, and difficult to describe. In this light, it should come as no surprise that subjects expressed extreme difficulty in stating their thoughts about birth feelings, and in explaining how they arrived at their conclusions. For example, Jill explained early in her interview that "I'm having a real hard time because I'm trying to describe something that's so physical . . . I'm running into all these problems finding words."
Nevertheless, two themes emerged that offer insight into the cognitive aspects of birth feelings. The first of these consists of similes offered by subjects. Although clearly unlike any other experience in most respects, the most common comparison of birth feelings was to sex, and was offered by six subjects. As Martin said, "it's like sex, but not at all sexual."And as Marie added, "there's some similarity with orgasm . I . [but] they certainly aren't that lovely feeling of an orgasm at all, or we'd be primaling all the time." It was like sex in its all-encompassing, intensely physical, transcendental quality; and for many there was an aftermath of relief and release. Birth feelings were also likened to being out of conscious control and to physical and transcendental experiences.
The second theme offering insight into the cognitive aspects of birth feelings involves subjects' global, pervasive impressions about existence. These "lessons" were allegedly recognized during birth feelings and ostensibly learned at birth. The lessons included feeling held back, held down, helpless, unloved, or unwanted. Subjects claimed to learn that they don't have enough "space" in life, that they always have to "push like hell," or can't "get anywhere" without being rescued. Self-concepts seemed tarnished as well, with subjects reportedly learning at birth that they were stupid, inadequate, or a failure.
Breathing often seemed pivotal in this regard. When breathing seemed free and easy during birth feelings, subjects often claimed to have felt ecstatic, to have sensed that the world is a safe and nurturing place, and to have believed that life is good. When breathing was problematic, however, subjects claimed to feel that they were in danger, to sense that they "weren't going to make it," and to believe that life is a struggle with which they can get no help.
4. The subjective effects of birth feelings. Birth feelings were generally considered both beneficial and central to therapy, and said to result in deep insights into the nature of the personality. "I'm becoming aware that everything in my life connects to birth experience," stated Charles, "that the patterns are there." Most widely reported among the perceived benefits were greatly expanded capacities for self-acceptance and self-understanding.
After experiencing birth feelings, subjects reported heightened sensation in their bodies. Frequent were reports of feeling physically freer and looser. Feelings of a pain vanishing or a load lifting were also common. Subjects also claimed to be better able to interpret their "body messages" and to understand their personal rhythms and character.
Subjects also reported heightened contact with their emotions. They felt more "centered" and "integrated" with their "real selves," as well as stronger and more self-confident, Anxiety, attachment, defeat, demoralization, depression, irritability, jealousy, pressure, shame, and tension often disappeared. Often things seemed to "fall into place." Feelings of being inadequate, self-conscious, and shy seemed notably relieved. Subjects claimed to be more "clear," efficient, energetic, optimistic, relaxed, and satisfied, and to have improved abilities to appreciate and create. Birth feelings often seemed important as somehow comprising the root-though not the whole-of a disconnection between the body and the emotions.
Relinquishing control was also a common theme. Some subjects claimed a greater trust in natural processes, and to feel more spontaneous and "flowing." They typically claimed to be in greater contact with their own and others' emotions, and better able to be close, intimate, open, and vulnerable with others. Several claimed a new understanding and sensitivity with children, especially neonates. Three subjects stated that having birth feelings had lessened their suicidal feelings, perhaps saving their lives, and three others reported a distinct lessening of their fear of death.
Birth feelings, however, were not universally considered beneficial or even central to therapy. Several subjects stated that birth feelings were not the most important feelings they encountered, or even the central focus of their therapy. Two subjects felt ambivalent about the benefits, and two insisted that having birth feelings could be harmful. None of the subjects, however, believed they had been permanently damaged.
When harmful, birth feelings were an exhausting and debilitating ordeal. "I really thought I was nuts," stated Barbara, "I thought I was never going to get better, ever. I mean, I wouldn't want anybody to go through what I went through. [Birth feelings] were harmful in a sense that there wasn't enough structure in my life, I was nothing but a mass of feelings and that's all I did."
At times, present thoughts became distorted and even minor obstacles seemed overwhelming; perspective became diminished and birth feelings became one's sole focus. "I found the stronger it got," noted Hannah, "the more it pervaded my everyday life. That just being blocked in small ways in my life would just be terrifying, would feel like life and death." Some alleged that they came to think that there was"only pain without resolution,"or that they were going crazy. Sometimes subjects felt helpless, isolated themselves, and/or believed that "life is hell."
Physical pain was often present, typically in the head or chest. The body would sometimes vibrate or contract against one's will, in everyday life as well as during sessions. Some felt "pulled back" into birth feelings and had to "get into them" almost constantly to relieve bodily discomfort, frustration,and tension. Sometimes conscious and concerted efforts were made to stop such feelings from emerging. Optimism and spirituality sometimes seemed temporarily lost, and sessions sometimes left subjects feelings hopeless, sore, tired, and/or vulnerable.
While relinquishing control was usually considered a positive change, it sometimes seemed harmful. When occurring in the extreme,subjects felt overwhelmed by pain and unable to cope. "I guess I'd say that the dose was too large," said Barbara. "It seems like this feeling stuff is necesssary but it really has to be part of a real life in the world, something that feeds your soul as well as something that gets rid of your shit."
5. The personal significance of birth feelings. Whether deemed positive or negative, birth feelings were usually considered outstanding and profound by virtue of their power and intensity. "It's very encompassing," stated Hannah. "I don't know that there's anything that you experience later in your life that is as total as the birth experience. I mean, you're just in it and nothing else is happening."
Some subjects reported that birth feelings led to a variety of behavioral, emotional, mental, and spiritual changes in their lives. For some, having birth feelings was a journey to the deepest or ultimate place in themselves, to the center of existential identity. According to Jill, "when I experience birth feelings it's like I go to the core of myself, and that everything else starts from there. And that when I'm in touch with that core of myself, I have a heightened sense of awareness and that that core is connected to a whole lot of other feelings and of really just who I am, that's where it all started."
For many, birth feelings seemed to hold a special significance. Some reported a new perspective of their body, their children, their emotions, human existence, or even the nature of reality. Sometimes it seemed to be a "turning point" or something sacred. "I remember twelve years ago," said John, "when this was first happening... realizing that this was sort of my sacred experience and I wanted to have that for myself and not piss it away by talking to other people about it."
Some came to feel, understand, and accept themselves inclusive of their birth experience. and things seemed less "mysterious" or to "fall into place." Hillery, a twin, claimed that birth reexperiences helped her understand current feelings in terms of her birth; these feelings then seemed less mysterious and frightening. "You know, like of having no space," she recalled. "Well of course I didn't have any space in the womb. And feeling pushed around and crowded a lot-it was my sister that was pushing me around."
Some experienced a newfound freedom in relation to anger, their body, or relationships. Some felt a heightened ability to move forward in life. As noted above, death sometimes became less fearful.In somecases, however, birth feelings were regarded as simply one among several notable occurrences in therapy. Many had difficulty separating the effects of birth feelings from othe raspects of therapy. Some described birth feelings as continuous with other experiences or as components of a much larger process. While generally considered powerful and profound, the particular meaning and significance of birth feelings clearly showed a wide range of individual variation.
5. The quality of experience of birth feelings. Central to birth feelings is their ineffability. In addition, some had difficulties simply talking about them because even this seemed to stimulate their re-occurrence. Birth feelings, then, were both difficult to describe and difficult to discuss.
Birth feelings seemed to constitute a unique type of awareness. Common were reports of a qualitative shift away from ordinaryconsciousness; sometimes this felt like entering a different dimension or a deeper realm of experience. Common was the sense of the body "taking over," or of "letting go" or "surrendering" to the feeling orto the deeper self. Paradoxically, subjects claimed to be totally involved with their internal experience while simultaneously registering the presence of others, the perceived safety of the situation, or even a self-awareness by way of an "observing self."
Some subjects reported not understanding what was happening throughout their experience of birth feelings. Others, however, reported that they "knew" their survival was in jeopardy or that their mother was not there. As Kelly explained, "there's not much thought, but a sense of knowing."
Birth feelings were described as intensely physical-an all-encompassing, pervasive, totally-involving body experience. As Hannah explained, "They're very total, they're very physical, they're very self-directed, they're very encompassing, they're very intense." More than simply physical, however, they were experienced as intensely emotional, mental, and spiritual as well.
Subjects' sense of time and especially of space sometimes changed dramatically. Typically there was a sense of "going back in time." Time often seemed to slow down and sometimes to stop altogether.
Spatial orientation as typically reported on the axes of in-out, up-down, back-forth, and open-close. Quite common were the feelings of "being in," "dropped into," and/or "going into" a birth feeling. Similarly, subjects often felt that they were in an enclosed space, and/or that something was "closing in" on them. Subjects sometimes felt"lost in the feeling," or struggled to "get out." Likewise, birth feelings seemed to "come up," or subjects would "get down into" them. Birth feelings sometimes seemed "a going back" or to take one back, and some had "gone back into" or "gone back and forth" with such feelings. Some also felt themselves "open up"to such feelings, that they were sinking or"going under," or that they must "shut them off."
Cycles of movement, elements of rhythm, and patterns of experience were often reported. Some subjects experienced themselves rhythmically thrusting their bodies, and/or a rhythm being imposed upon them. "I go through stages of being real tense and it's very rhythmic," noted Jill. "It's like push push push, and there's a real rhythm to it, and it goes and goes, and then I stop and rest; and then it starts up again," These cycles often consisted of sequential periods of activity and rest; the active periods seemed to include anger and/or frustration, while the restful periods seemed to include fear and/or sadness, respectively.
Many subjects' bodies had quivered, shaken, or vibrated during birth feelings. Common were reports of an over all sense of contraction, pain, pressure, tension, and tightness; concentrations of such were reported in the face, fingers, head, jaws, neck, shoulders, and throat. According to Barbara, "a continuous kind of thing that happens to me is that my body goes into contractions ... I spent a lot of time in therapy in a little ball, just contracting." John reported his feelings coming in "strong waves."
Subjects often reported having felt crunched, crushed, or squished. Voluntary control of movement seemed lost at times; sometimes they felt unable to move or stretch, and at other times their bodies would arch or pull into certain positions. Common while lying on the back was the raising or curling up of the head, shoulders, arms, hands, legs, and/or knees toward the chest.
Some became hot and sweaty, experienced numbness or shriveling, and/or reported excessive mucous. Sometimes the lips would pucker and suck, or the eyes would ache.
There was great individual variation relative to the presence of physical pain. When present, physical pain was reported in the head, neck, chest, back, diaphragm, colon, and legs. Surprisingly, some subjects reported no physical pain,
Though typically nonverbal, birth feelings were not necessarily silent. Many subjects underwent periods of crying and screaming, and making sounds which were characterized as "like an animal," "like a baby," high-pitched, horrible and weird. A few subjects mentioned a sense of being in darkness, and some reported some sort of color. Two reported instances of extremely bright light.
Breathing difficulties were almost universal; 10 of the 13 subjects, in fact, provided unsolicited and explicit reports of breathing problems. Several subjects considered their breathing difficulties to be quite painful. There were reports of not getting enough air, of choking or feeling suffocated, or desperately attempting to get more air, and of becoming terrified when such attempts failed. Often breathing was shallow, came in jerks, and spasms, or stopped for long periods.
Pushing, too, was almost universal. Subjects often pushed and struggled, sometimes with persistence, sometimes with desperation. Unexpected was the finding that subjects wanted not only to "get out," but also wanted to "get somewhere." Common during birth feelings was the sense that the subject was just where he or she needed to be, that they had a job to do and/or a goal they were working toward; that they "knew" what they are doing; that they would use all their resources to complete the task; and that they felt some positive sense of satisfaction when moving toward or completing the experience.
Several emotions were common during birth feelings. Most widespread were variations to fear (e.g.. fear of death, inability to breathe, lack of control, sense of danger), and anger (e.g., frustration, irritability). Also common were feelings of anxiety, desperation, discomfort, helplessness, hopelessness, loneliness, neediness, powerlessness, sadness, and vulnerability, and impressions of being abandoned, unloved, and unwanted.
Some subjects reported emotional pain. For Marie, in fact, "it's the emotional pain that initiates the primal." Crying, hurting, and unhappiness were quite common. Barbara, however, the only known cesarian-born subject, reported no pain. "[Birth feelings] would be painful if you didn't go through the movements, go through the sounds you need to make, I don't think it's pain unless you don't do it."
Many subjects described aspects of their birth feelings as somewhat pleasurable in a sensual way. Some reported periods of feelings energetic, "grounded," peaceful, powerful, relieved, safe, secure, wonderful, and even ecstatic. Two subjects were emphatic that they experienced no pleasure during birth feelings, and a third experienced pleasure only when it was over.
No simple pattern emerged with respect to aggression. A few subjects reported little or no aggression, while the majority reported a good deal of anger, aggression, or rage toward their mother or their surroundings.
Needing help and having to struggle unassisted were common themes. Several subjects spoke explicitly about their mother's being out of contact or uncooperative with them, or of doing nothing at all to help. There is an indication that aggression may have become stronger when cooperation with the environment (i.e., the mother) seemed lacking. Several subjects reported feeling that they had a job to do, and aggression seems to have mounted when this mission was blocked.
Predictably, many subjects felt exhausted after completing a cycle of birth feelings, which lasted anywhere from several minutes to many hours or even days. Subjects had a range of experiences from pleasure and relief, on the one hand, to feeling angry, dazed, dead, helpless, or hopeless, on the other. There was usually a strong sense of relief-sometimes but not always pleasurable-for those who did experience a sense of emergence and completion.
7. Birth, birth feelings, and personality. No single or dramatic pattern emerged with respect to the subjects' biological births. Five knew relatively little about the circumstances of their birth. At least three were born substantially post-term.
As noted above, virtually all subjects believed their birth feelings to be intimately connected to the circumstances of their original birth. Most subjects were skeptical at first, but over time came to consider the "reexperiences" to be sufficiently plausible and realistic to consider them actual relivings. "All my primaling feelings seem related to actual experiences I had," said Hannah. "They were so physical that it would be hard to think of them as anything but coming from an actual physical experience." Birth feelings were generally experienced as clear, involving, powerful, and real.
The most common patterns attributed to birth were pervasive, formerly-unconscious "programs" that seemed to determine experience, behavior, and self-concept. The feeling components of these "birth programs" included but were not limited to: "I have to do things by myself," "everything's a struggle," "I'm not good enough," "there's something wrong with me," and "no one wants me." Some programs seemed to occur in polarities and included feeling pushed/pushing; feeling held back/holding back; having to get out/not wanting or knowing how to get out; feeling helpless or out of control/feeling powerful; and sensing that one isn't "making it"/sensing that one can do what is necessary to survive.
Many subjects blamed their births for a variety of feelings and characterological traits (e.g., feeling crowded, fearful, frustrated, helpless, isolated, jealous, panicky, pressured, and vulnerable). Most common were disturbed relationships with mothers, and subjects generally believed this had originated during or even before birth, Subjects often felt their mothers did not help, love, reassure, support, or want them adequately. They reported a lack or loss of cooperation and contact, and sometimes became furious or contemptuous toward their mothers.
8. Consciousness and memory. Obviously, all of these subjects' "memories" extended at least as far back as birth. The vast majority of subjects felt they were born with feelings, some sense of self, and an ability to think. Some felt they were born with the capacity to reason or draw mental conclusions.
Almost all subjects had experiences which they believed were intrauterine memories. These "memories" were often vague, however, and a sense of uncertainty was common. There were two basic physical sensations; one was of floating comfortably or even blissfully, while the other of being "squished" and of wanting to "get out," Three subjects claimed to have experienced conception and/or implantation under hypnosis.
Four subjects claimed to have "known" in utero something about the state of their mothers' emotions, usually that their mother was unhappy and/or did not want them. For Kelly, "I was actually given up for adoption ... my feeling sense of all that is that I knew that she was gone before I was born, I knew real clearly that she didn't want me and that she was leaving." For Stella, "I sensed that before I was born my mother did not want me ... and that is almost a ground of being for me, I never believe anybody really wants me. It runs through everything in my life."
While it was generally accepted that one's identity was etched upon at birth, an incipient character structure was generally thought to predate even this experience. Most subjects reported some rudiment of consciousness in utero prior to delivery. A handful of subjects reported an awareness of their mothers or some necessary outside system. Jill, for example, claimed to have "an awareness of need, an awareness of being connected to something else, and needing that." Most of the subjects reporting intrauterine consciousness felt that natal and prenatal events wielded some sort of lasting influence.
Six subjects reported instances or some sense of between- or past-lives at some point in their lives. These rarely if ever seemed to occur, however, from primal therapy alone-subjects claimed to have experienced between- and past-lives usually as a result of hypnotic, psychedelic, or visualization techniques.
The imaginary composite subject in this study would have undergone some form of psychotherapy prior to beginning primal therapy. The attraction to primal therapy would have been due to a hope and an expectation of resolving personal and interpersonal difficulties-not due to birth issues.
Probably skeptical at first, the subject would first have had birth feelings in the course of a primal session. This would have occurred after becoming more aware of inner experience and after relinquishing personal control. Some current Iife event may have seemed to"trigger"the experience, and the presence of an encouraging and supportive therapist may well have seemed important.
Alarm and resistance were probably present when birth feelings first occurred, as the body may have begun to shake in response to "waves" of feeling. The subject was probably lying on his/her back when an overall sense of contraction occurred; the body may have curled upand/or stretched out, possibly while sensing a loss of control over various voluntary movements. Breathing probably became labored, and a sense of desperation or panic may have occurred.
The birth feelings would have seemed almost totally pervasive and all-encompassing, simultaneously, however, one may have assessed the safety of the situation. This inward journey to the deepest self, while fascinating and powerful, mayat times may have seemed excruciating or even debilitating. These experiences probably occurred on more than one occasion over a period of weeks, months, or even years; and may have intruded to some degree into everyday life.
Birth feelings probably seemed unique, essentially unlike other life experiences. Rhythm. space, and time would have changed dramatically in a struggle to get out or to get somewhere. There probably were periods of anger and aggressive pushing, perhaps with a sense of needing but not receiving help, alternating with periods of rest marked by fear and/or hopelessness. Eventually the body, breath, and emotions may have led to a surrender or letting go. Exhaustion and relief were probable as the experience, ended. A sense of completion, even elation, may at times have been evident.
The subject was likely at some point to label the experiences as birth-related. Lessons ostensibly learned at birth, which long affected the subject subconsciously, would seem to be revealed to the subject. Such insights were likely to provide a deeper sense of self-understanding and self-acceptance. A heightened sense of contact with the body and the emotions would also have been likely. Birth feelings were most likely regarded as veridical reexperiences of the original birth event.
Birth feelings would have seemed strengthening as something accomplished and survived. The subject probably discussed them only rarely, in part because the experience seemed almost impossible to put into words. Certain aspects of everyday life may have taken on a new meaning or perspective as they were reevaluated in the light of this new learning. One's identity would likely seem to extend far back in ontogenetic time, and one's memory at least to intrauterine existence. It may paradoxically seem like an old self with a new identity.
All research designs have strengths and weaknesses, and conclusions and generalizations should always be made accordingly. The boundaries of the current study are defined by its exploratory, qualitative design. The findings and conclusions are based on retrospective, self-reported data which is qualitative and impressionistic. The following conclusions, therefore, should be interpreted accordingly.
1. Birth feelings seem not to be discrete, encapsulated feelings, simply about birth. When consciously experienced, birth feelings seem inextricably interwoven with prenatal, childhood, and present events.
2. Primal therapy does not seem to cause birth feelings. Rather, primal therapy seems to provide a therapeutic environment that is conducive for the emergence of birth feelings.
3. Once in primal therapy, two conditions seem crucial in arriving at birth feelings. First, it seems necessary that the therapeutic relationship provide a sense of safety and acceptance, to allow each client to proceed at his/her own pace. Second, clients must somehow "let go" control of their bodies and emotions.
4. Subjects during birth feelings seem to have a dual consciousness consisting of the outer/present and inner/past environments. When the outer/present situation satisfies a client's needs for safety and support, as discussed above, they then may be able to let go of the outer/present situation and enter the deeper inner/past realm.
5. For those who experience them, birth feelings represent an important avenue of therapeutic change. Even subjects reporting primarily negative birth feeling experiences believed their therapy could have been handled better and could have yielded better results. With adequate research, and with proper therapeutic guidance and support, most such experiences should produce at least moderately beneficial results.
6. Birth feelings are clearly distinct from psychotic states and other mental disorders. Birth feelings are usually disintegrative only when they are blocked, so these clients should not be prematurely medicated. Despite the widespread fear of unbridled emotional outbursts, and despite our training to be "helpers," it is probably best to trust nature to take its own course. Therapists should be forewarned that birth feelings may produce deeply disquieting effects upon others (including veteran clinicians), and are inappropriate to the traditional 50-minute hour.
7. Birth feelings can help or harm. Consequently, psychotherapists should be particularly sensitive with alleged birth material. Clients should neither be pushed nor invalidated with respect to birth material. Clients need to feel safe in order to relinquish control and complete the experience; birth feelings seem to emerge and be integrated only under such conditions. It is imperative that such clients be allowed to move at their own pace, and to verbalize their experiences in their own ways.
8. Few clinicians have been trained to work with birth material. It is inadvisable, inappropriate and unethical to work with clients who present such material when this ties beyond the scope of one's professional competence. In these cases, therapists should referto other clinicians with the proper training and experience. It is prudent to refer these clients to clinicians who have themselves undergone primal therapy or a closely-related experiential psychotherapy.
The current study examined birth feelings, or"birth primals," as experienced by 13 subjects in psychotherapy. Attempts were made to first elicit the phenomenology of the experience, and then to address specific questions that were formulated with respect to the literature.
Birth feelings were characterized by subjects as ineffable and all-encompassing reexperiences of birth and before. Subjects' ordinary senses of rhythmicity, spatiality, and temporality changed dramatically. Breathing difficulties, pushing, and a sense of struggling to get out or to get somewhere were common. A dual consciousness was usually present: one level was cognizant of the present situation while the other was totally absorbed in the inner experiential moment, out of conscious control, and attempting to complete a necessary task.
Birth feelings were usually considered highly beneficial, providing heightened insight and self-acceptance. For some, however, birth feelings seemed exhausting and debilitating; these subjects seemed to lose perspective and become overwhelmed with pain.
The emphasis here has been on describing birth feelings in order to orient the clinician to their existence and parameters. Several practical suggestions have been offered with regard to understanding, working with, and referring clients immersed in birth material.
Stephen Khamsi is a psychotherapist in private practice in Sonoma and Marin counties in Northern California. In addition to his work at the Primal Center of California, which he co-founded in 1979, Stephen teaches psychology part-time at Napa Valley College and is a consultant in marriage and family therapy. Stephen received his doctorate in psychology from the Saybrook Institute in San Francisco for his research on primal therapy.