THE ORIGINS OF FETAL PSYCHOLOGY
After Freud initially proposed that mental life began after birth, he later admitted that he had come to believe he was wrong, saying that "the act of birth is the first experience of anxiety."44 Although most other psychoanalysts believed mental life began only with infancy, there were a number of exceptions, beginning with Otto Rank's The Trauma of Birth in 1923,45 which began the investigation of birth anxiety derivatives in adult life and culture. After Rank, David Winnicott wrote in the early 1940s a paper on "Birth Memories, Birth Trauma, and Anxiety,"46 which, however, was little noticed, since, as he said, "It is rare to find doctors who believe that the experience of birth is important to the baby, that it could have any significance in the emotional development of the individual, and that memory traces of the experience could persist and give rise to trouble even in the adult." While still a pediatrician, Winnicott saw that newborn babies varied enormously and that prolonged labor could be traumatic to the fetus, resulting in extreme anxiety--so much so that he thought "some babies are born paranoid, by which I mean in a state of expecting persecution."47 He was even able to conclude that "at full term, there is already a human being in the womb, one that is capable of having experiences and of accumulating body memories and even of organizing defensive measures to deal with traumata..." He sometimes would allow his child patients to work through birth anxiety directly, having one child sit in his lap and "get inside my coat and turn upside down and slide down to the ground between my legs; this he repeated over and over again....After this experience I was prepared to believe that memory traces of birth can persist."48 He also encouraged some adult patients to relive the breathing changes, constrictions of the body, head pressures, convulsive movements and fears of annihilation experienced during their births, with dramatic therapeutic results. 49
After Winnicott, psychotherapists such as Fodor, Mott, Raskovsky, Janov, Grof, Verny, Fedor-Freybergh, Janus and others published extensive work showing how their patients relived birth trauma in therapy and removed major blocks in their emotional lives.50 These traumatic birth feelings of being trapped, of crushing head pressures and cardiac distress, of being sucked into a whirlpool or swallowed by terrifying monsters, of explosive volcanoes and death-rebirth struggles-appear regularly in the 60 percent of our dreams that have been found to contain overt pre-and perinatal images,51 although most therapists continue to overlook their connections with actual birth memories.
Perhaps one of the most important results of clinical research by therapists sensitive to perinatal trauma--as described particularly in the work of Lynda Share52--is how regularly early trauma produces an overwhelming fear of all progress in life. It is as though the fetus concludes, "Going forward in life led to disaster; I must remain 'unborn' all my life to avoid a repetition of this horrible start."
Fetuses that experience injuries in the womb, premature births, birth complications, and many other medical conditions as newborn regularly live the rest of their lives in fear of all growth and individuation.53 For instance, one baby who was born with a congenital atresia of the esophagus, so that she choked on feedings, was seen to have multiple fears of dying all during a 30-year followup study into her life.54 Another, who often dreamed of lying in a refrigerator, asked his parents about the image, and they told him that as a newborn the window of his room had mistakenly been left open on an extremely cold winter night, and they "had thawed him out of his urine, feces and vomitus."55 Interpretation of this continuing fear led to a turning point in the treatment and in the patient's life. Another baby was born with an intestinal obstruction that prevented digestion, so she vomited up all her milk. Although the condition was repaired at one month, for the rest of her life she was concerned with disaster fantasies every time growth was imminent. As Share described her, "Each new opportunity for advancement stood for a metaphorical 'birth.' To be born in any kind of way meant to have to reexperience the disaster of her infancy: starvation, pain, surgery, and near-death. These, then, were the disasters she fantasized, the panic attacks each time she headed for something new and creative."56 As with all early trauma, any progress threatened repetition of disaster.
RECENT RESEARCH INTO FETAL MEMORY
Much has changed in our knowledge of the fetus during the decades since these early pioneering excursions into perinatal psychology. Neurobiologists have made startling advances in the understanding of how the brain develops in the womb, experimental psychologists have discovered a great deal about fetal learning, pediatricians have linked all kinds of later problems to fetal distress, and one psychoanalyst has even begun to compare thousands of hours of ultrasound observations of individual fetuses with their emotional problems during infancy in therapy with her. There are now thousands of books and articles on the subject, as well as two international associations of pre- and perinatal psychology, each with their own journal.57 I will here only be able to summarize some of the main trends of this extensive recent research.
Biologists used to think that because the fetus had incomplete myelination of neurons it couldn't have memories.58 This notion has been disproved, since impulses can be carried quite efficiently in the thinly myelinated nerves of fetuses, only at a somewhat slower velocity, which is offset by the shorter distances traveled.59 Indeed, far from being an unfeeling being, the fetus has been found to be exquisitely sensitive to its surroundings, and our earliest feelings have been found to be coded into our early emotional memory system centering in the amygdala, quite distinct from the declarative memory system centering in the hippocampus that becomes functional only in later childhood.60 These early emotional memories are usually unavailable to conscious, declarative memory recall, so early fears and even defenses against them are often only recaptured through body memories and by analyzing the consequences of the traumas.61
The fetus's nervous system is so well developed that by the end of the first trimester it responds to the stroking of its palm by a light hair by grasping, of its lips by sucking, and of its eyelids by squinting.62 It will jump if touched by the amniocentesis needle and turn away from the light when a doctor introduces a brightly lit fetoscope.63 By the second trimester, the fetus is not only seeing and hearing, it is actively tasting, feeling, exploring and learning from its environment, now floating peacefully, now kicking vigorously, turning somersaults, urinating, grabbing its umbilicus when frightened, stroking and even licking its placenta, conducting little boxing matches with its companion if it is a twin and responding to being touched or spoken to through the mother's abdomen.64 Each fetus develops its own pattern of activity, so that ultrasound technicians quickly learn to recognize each fetus as a distinct personality.65 Even sensual life begins in the womb; if a boy, the fetus has regular erections of his penis, coinciding with REM sleep phases, and baby girls have been seen masturbating during REM sleep.66
In addition to what we know about the disastrous effects on the fetus of prenatal exposure to drugs and alcohol,67 we now have considerable evidence on how maternal stress and other emotions are transmitted to the fetus. When a pregnant mother is offered a cigarette after having been deprived of smoking for 24 hours there is a significant acceleration in fetal heartbeat even before the cigarette is lit.68 The fetus has been found to be sensitive to a wide range of maternal emotions in addition to any drugs or other physical traumas she endures.69 When the mother feels anxiety, her increased heartbeat, frightened speech, and alterations in neurotransmitter levels are instantly communicated to the fetus, and her tachycardia is followed within seconds by the fetus's tachycardia; when she feels fear, within 50 seconds the fetus can be made hypoxic (low oxygen). Pregnant monkeys stressed by simulated threatening attack had such impaired blood circulation to their uteruses that their fetuses were severely asphyxiated.70 Alterations in adrenaline, plasma epinephrine and norepinephrine levels, high levels of hydroxycortico-steriods, hyperventilation and many other products of maternal anxiety are also known to directly affect the human fetus. Numerous other studies document sensory, hormonal and biochemical mechanisms by which the fetus is in communication with the mother's feelings and with the outside world.71 Even baby monkeys have been found to be hyperactive, with higher levels of the stress hormone, cortisol, after birth from a mother who was experimentally stressed during her pregnancy.72
While positive maternal emotions have been experimentally shown to increase later growth, alertness, calmness and intelligence--the fetus even benefits from the mother singing to it in the womb--and prenatal infant stimulation, particularly being bathed in pleasant music, improves fetal development compared to control groups,73 maternal distress and chemical toxins have been shown to produce low birth weights, increased infant mortality, respiratory infections, asthma and reduced cognitive development.74 Ultrasound studies record fetal distress clearly, as it thrashes about and kicks in pain during hypoxia and other conditions. One mother whose husband had just threatened her verbally with violence came into the doctor's office with the fetus thrashing and kicking so violently as to be painful to her, with an elevated heart rate that continued for hours.75 The same wild thrashing has been seen in mothers whose spouses have died suddenly. Maternal fright can actually cause the death of the fetus, and death of the husband and other severe emotional distress within the family during the mother's pregnancy has been associated with fetal damage in large samples in several countries.76 Marital discord between spouses has been correlated "with almost 100 per cent certainty...with child morbidity in the form of ill-health, neurological dysfunction, developmental lags and behavior disturbance."77
Margaret Fries has conducted 40-year longitudinal studies predicting emotional patterns that remain quite constant throughout the lives of those studied and correlated them to the mother's attitude toward the fetus during pregnancy."78 Maternal emotional stress, hostility toward the fetus and fetal distress have also been statistically correlated in various studies with more premature births, lower birth weights, more neonate neurotransmitter imbalances, more clinging infant patterns, more childhood psychopathology, more physical illness, higher rates of schizophrenia, lower IQ in early childhood, greater school failure, higher delinquency and greater propensity as an adult to use drugs, commit violent crimes and commit suicide.79 This increase in social violence due to pre-and perinatal conditions has recently been confirmed by a major Danish study showing that boys of mothers who do not want to have them (25 percent of pregnant mothers admit they do not want their babies)80 experience birth complications are four times as likely when they get to be teenagers to commit violent crimes than control groups.81 studies also show similar higher violent crime rates correlated with maternal rejection during pregnancy.82
THE NEUROBIOLOGY OF FETAL TRAUMA
There are sound neurobiological reasons for this correlation between fetal trauma and social violence. Early brain development is determined both by genes and by cellular selection and selforganizational processes that are crucially dependent upon the uterine environment."83 Since fetal traumas occur while the brain is still being formed, while cell adhesion molecules are still determining the brain's initial mapping processes and while synaptic connections are still undergoing major developmental changes, memories of fetal traumas cannot be handled as later in life and are coded in separate neural networks that retain their emotional power well into adulthood.84
Fetal abuse can be direct, either from drugs or from the pregnant mother being abused by her mate. According to the journal of the American Medical Association, "one in three pregnant women in America is slapped, kicked or punched by their mates."85 In addition, maternal emotional stress produces such biochemical imbalances as an overactivation of the pituitary-adrenal cortical and sympathetic-adrenal medullary systems with consequent increases of adrenocorticotrophic hormone (ACTH), cortisol, pituitary growth hormone, catecholamine and glucagon level. Maternal emotional stress has even been correlated with damage to the hippocampus, the center of conscious memory and self feelings.86 Furthermore, the emotions of the mother can be directly transmitted through the hormones in her blood to the fetal blood and then to DNA-binding receptors in the fetal cells that turn genes on and off, thus programming her stress directly into the developing fetal brain. This bath of maternal hormonal imbalances can produce severe fetal traumatic emotional dysfunctions.87 Baby rats, for instance, whose mothers had been frightened by loud noises during pregnancy were found to have copious supplies of stress hormones, plus fewer receptors for benzodiazepines and fewer GABA receptors, both needed for calming action during stress.88
Infants traumatized in utero and during birth are those Winnicott referred to as born paranoid," and can remain hypersensitive to stress, over fearful, withdrawn and angry all of their lives. Fetal traumas result in overstimulation of neurotransmitters, producing hypersensitivity and other imbalances in such important neurotransmitters as the catecholamines. The most important of these imbalances is low serotonin levels, which have been demonstrated to lead to persistent hyperarousal and compulsive reenactment in violent social behavior, both homicidal and suicidal.89 Because of this, reenactment in later life can be an even more potent source of violent behavior in the case of fetal trauma than it has been found to be in the case of childhood or war trauma.90
The same neurobiological factors have been found to be responsible for the increase in violence against self. Suicide patterns are so strongly linked to birth that epidemiologists have found higher suicide rates in areas of the country that a few decades earlier had had higher birth injuries.91 Other studies have shown that even the types of suicides were correlated with the kinds of perinatal traumas, asphyxia during birth leading to more suicides through strangulation, hanging and drowning, mechanical trauma during birth correlated with mechanical suicide elements, drugs given during birth being correlated to suicide by drugs, and so on. The rise in adolescent drug addiction and suicide recently, mainly connected with drug use, is believed to be at least partially due to the more frequent use of drugs by obstetricians during birth in recent decades.92
Far from being the safe, cozy haven to which we all supposedly want to return, the womb is in fact often a dangerous and often painful abode,93 where "more lives are lost during the
nine gestational months than in the ensuing 50 years of postnatal life."94 Few fetuses, for instance, escape experiencing painful drops in oxygen levels when the mother is emotionally upset, smokes, drinks alcohol or takes other drugs. As the placenta stops growing during the final months of pregnancy, it regresses in efficiency, becoming tough and fibrous, as its cells and blood vessels degenerate and it becomes full of blood clots and calcifications, making the fetus even more susceptible to hypoxia as it grows larger and making the late-term fetus "extremely hypoxlc by adult standards."95 Furthermore, the weight of the fetus pressing down into the pelvis can compress blood vessels supplying the placenta, producing additional placental failure.96 Practice contractions near birth give the fetus periodic "squeezes," decreasing oxygen level even further,97 while birth itself is so hypoxic that "hypoxia of a certain degree and duration is a normal phenomenon in every delivery," not just in more severe cases.98 The effects on the fetus of this extreme hypoxia are dramatic: normal fetal breathing stops, fetal heart rate accelerates, then decelerates, and the fetus thrashes about frantically in a life and-death struggle to liberate Itself from its terrifying asphyxiation.99
THE REALITY OF FETAL MEMORY
That the fetal memory system is sufficiently mature not only to learn in the womb but also to remember prenatal and birth experiences is confirmed by a growing body of experimental, observational and clinical data. Neonates can remember lullabies learned prenatally100 and can pick out at birth their mothers' voices from among other female voices and respond differently (with increasing sucking on a pacifier) to familiar melodies they had heard in utero.101 Sallenbach played simple melodies to the fetus in utera, based on four notes, and found it was able not only to move to the beat but continued to mark the beat when the notes were discontinued.102 As evidence of even more complex memories, DeCasper had 16 pregnant women read either The Cat in the Hat or a second poem with a different meter to their fetuses twice a day for the last six weeks of their pregnancy.103 When the babies were born, he hooked up their pacifiers to a mechanism that allowed them to chose one of two tape recordings by sucking slowly or quickly, choosing either the tape in which their mothers read the familiar poem or the tape where she read the unfamiliar poem. The babies soon were listening to the tape of their favorite poem, indicating their mastery of the task of remembering complex speech patterns learned in utero. Chamberlain sums up his extensive work on birth memories, which he found very reliable when comparing them with both the memories of the mother and hospital records, "They demonstrate the same clear awareness of violence, danger, and breech of trust which any of us adults might show in a similar situation...Even three-year-olds sometimes have explicit and accurate birth recall."104 Distress during birth is particularly able to be later remembered during dreams, when dissociated early neural emotional memory networks are more easily accessed. For instance, one child who had been a "blue baby" and near death while tangled in his umbilicus during birth and had had a forceps delivery had the following revealing nightmare during most of his childhood:
I would be kneeling down, all bent over. I am frantically trying to untie knots in some kind of rope. I am just starting to get free of the rope when I get punched in the face. 105
With the number of recent experiments demonstrating fetal competence, classical conditioning and more advanced learning ability,106 it is not surprising that some parents have recently begun to make the fetus a "member of the family," playing with them, massaging them and calming them down when they thought they had communicated distress by excessive movement and kicking, and trading light pokes in return for fetal kicks, in what they call "The Kicking Game."107 One father taught his baby to kick in a circle; a mother played a nightly game where she tapped her abdomen three times and bumped back three times.108 Another father who called out "Hoo hoo!" next to his pregnant wife's belly nightly found his child pushing with a foot into his cheek on whichever side he called; father and baby played this game for 15 weeks; he found his next baby was able to learn the same game.109 These parents tried to avoid maternal stress, loud arguments and loud noises-especially rock music--because they became aware it usually produced fetal distress.
Recent insights into fetal learning have led to some impressive research on fetal enrichment that demonstrates that prenatal stimulation produces advances in motoric abilities and intelligence that last for years. Experimental groups of pregnant women and their fetuses who participated in prenatal stimulation enrichment were investigated in parallel with carefully selected control groups not involved in any prenatal program. The postnatal evaluation of both groups on standard developmental tests shows highly significant enhancement from fetal sensory stimulation in motoric performance, visual skills, emotional expression and early speech.110 Even more impressive, when these prenatally induced enrichment effects are consolidated by immediate post-natal enrichment experiences, they produce improvements over the control group in Stanford Binet IQ tests at age three ranging from 38 percent for language and 47 percent for memory to 51 percent for social intelligence and 82 percent for reasoning, a fetal Head Start program of astonishing efficiency.
THE FINDINGS OF ULTRASOUND RESEARCH
Perhaps the most impressive observational work on the personality of the fetus is being done by the Italian psychoanalyst, Alessandra Piontelli, by combining thousands of hours of ultrasound observations and clinical psychoanalytic work with young children. Her research into pre- and perinatal memories began after she encountered an eighteen-month-old child who was reported by sensitive parents as being incessantly restless and unable to sleep:
I noted that he seemed to move about restlessly almost as if obsessed by a search for something in every possible corner of the limited space of my consulting room, looking for something which he never seemed able to find. His parents commented on this, saying that he acted like that all the time, day and night. Occasionally Jacob also tried to shake several of the objects inside my room, as if trying to bring them back to life. His parents then told me that any milestone in his development (such as sitting up, crawling, walking, or uttering his first words) all seemed to be accompanied by intense anxiety and pain as if he were afraid, as they put it,'to leave something behind him.' When I said very simply to him that he seemed to be looking for something that he had lost and could not find anywhere, Jacob stopped and looked at me very intently. I then commented on his trying to shake all the objects to life as if he were afraid that their stillness meant death. His parents almost burst into tears and told me that Jacob was, in fact, a twin, but that his co-twin, Tino, as they had already decided to call him, had died two weeks before birth. Jacob, therefore, had spent almost two weeks in utero with his dead and consequently unresponsive co-twin.111
Verbalization of his fears that each step forward in his development might be accompanied by the death of a loved one for whom he felt himself to be responsible "brought about an incredible change in his behavior," says Piontelli. Similarly, Leah La Goy, an American psychotherapist, has documented seventeen children who were her patients who had lost a twin in utero and who "consistently create enactments of fearing for their own life [which] can and often does weaken the parent-child bonding process" because they believe their mother might try to get rid of them too.112
Piontelli, like many other child therapists, began to be struck by the frequency and concreteness of children's "fantasies" about their life before birth. Unlike most therapists, who, however, Ignore their accurate observations because their training taught them the mind only begins after birth, she carefully recorded them and tried to confirm their reality, first by consultation with the family and eventually by her own extensive ultrasound observations of fetal life. The correlations and continuities between fetal experiences and childhood personality "were often so dramatic," she says, "that I was amazed that I had not been more aware of them at the time."113 One set of twins often stroked each others' heads in the womb through the dividing membrane; at the age of one, they could often be seen playing their favorite game of using a curtain as a kind of membrane through which they stroked each other's heads.114 Another set of twins---whose mother considered abortion because of her fear they might be jealous of each other---punched each other all the time in the womb and continued to do so after birth.
One fetus, who often buried his face in the placenta as if it were a pillow, as a child insisted that his mother get him a pencil case shaped like a pillow that he used similarly. Still other children played out various obstetrical distress problems in later life in dramatic detail, such as one child who had nearly died because her umbilical cord had been tightly knotted around her neck and who spent most of her early childhood wrapping ropes, strings and curtain cords around her head and neck, playing with them and licking them in a frenzy.115 The enormous importance of being able to use fetal insights such as these in the therapy of both children and adults for profound relief and personality change has been carefully documented by Piontelli and other therapists.116
44Sigmund Freud, "The Interpretation of Dreams," Standard Edition, Vol. 5. London: The Hogarth Press, 1959, p. 400.
45Otto Rank, The Trauma of Birth. New York: Richard Brunner, 1952; Otto Rank, The Myth of the Birth of the Hero and Other Writings. New York: Random House, 1932.
46In Collected Papers: Through Paediatrics to Psycho-analysis. New York: Basic Books, 1958,pp. 174-193.
47David W. Winnicott, Human Nature. London: Free Association Books, 1988, p. 149.
48Collected Papers, p. 177-8.
49Ibid, p. 249-250.
50Nandor Fodor, The Search for the Beloved: A Clinical Investigation of the Trauma of Birth and Prenatal Condition. New Hyde Park, N.Y.: University Books, 1949; Francis J. Mott, The Universal Design of Creation. Edenbridge: Mark Beech, 1964; Francis J. Mott, Mythology of the Prenatal Life. London: Integration Publishing Co., 1960; Amaldo Rascovsky, EI Psiquismo Fetal. Buenos Aires: Editorial Paidos, 1977; Stanislav Grof, Realms of the Human Unconsciousness: Observations from LSD Research. New York: Viking Press, 1975; Stanislav Grof, Beyond the Brain: Birth, Death and Transcendence in Psychotherapy. Albany: State University of New York, 1985; Arthur Janov, The Primal Scream: Primal Therapy--The Cure for Neurosis. New York: G. P. Putnam's Sons, 1970; Thomas R. Verny and John Kelley, The Secret Life of the Unborn Child. New York: Summit Books, 1981; Thomas R. Verny, Ed., Pre- and Perinatal Psychology: An Introduction. New York: Human Sciences Press, 1987; Peter Fedor-Freybergh and M. L. Vanessa Vogel, Eds., Prenatal and Peri-natal Psychology and Medicine: Encounter With the Unborn. Carnforth: the Parthenon Publishing Group, 1988; Ludwil: Janus, Wie die Seele entsteht: unserpsychisches Leben vor und nach der Geburt. Hamburg: Hoffman und Campe, 1991.
51Calvin S. Hall, "Prenatal and Birth Experiences in Dreams." Psychoanalytic Study of the Child 1(1967): 157-74.
52Lynda Share, If Someone Speaks, It Gets Lighter: Dreams and the Reconstruction of Infant Trauma. Hillsdale, N.J.: The Analytic Press, 1994.
53K. Mark Sossin, "Pre- and Postnatal Repercussions of Handicapping Conditions Upon the Narcissistic Line of Development." Pre- and Peri-natal Psychology Journal 7(1993): 197.
54G. Engel, et al, "Monica: Infant-feeding Behavior of a Mother Gastric Fistula-fed as an Infant: A Thirty-Year Longitudinal Study of Enduring Effects." In E. Anthony and G. Pollack, Eds. Parental Influences in Health and Disease. Boston: Little, Brown, 1985, pp. 30-89.
55William Niederland, "The Role of the Ego in the Recovery of Early Memories." Psychoanalytic Quarterly 34(1965): 568.
56Share, If Someone Speaks, It Gets Lighter, p. 191-196.
57The International Journal of Prenatal and Peri-natal Psychology and Medicine and Pre and Peri-Natal Psychology Journal. For excellent recent bibliographies, see M. Maiwald and L. Janus, "Development, Behavior and Psychic Experience in the Prenatal Period and the Consequences for Life History: A Bibliographic Survey." International Journal of Prenatal and Peri-natal Psychology and Medicine 5 (1993): 451-485 and M. Maiwald, "Development, Behavior and Psychic Experience in the Prenatal Period and the Consequences for Life History: A Bibliographic Survey." Int. J. Prenatal and Perinatal Psych. and Med. 6(1994): Suppl. 1-48. More extensive bibliography of pioneering fetal psychologists can be found in Lloyd deMause, Foundations of Psychohistory, "The Fetal Origins of History," pp. 244-332.
58Maggie Scarf, Body, Mind, Behavior. New York: Dell Publishing, 1976, pp. 23-40; Robert C. Goodlin, Care of the Fetus. New York: Masson Publishing, 1979, p. 192; Thomas R. Veny, Pre- and Peri-natal Psychology: An Introduction. New York: Human Sclences Press, 1987, p. 25.
59K. J. S. Anand and P. R. Hickey, "Pain and Its Effects in the Human Neonate and Fetus." The New England Journal of Medicine, 317 (1987): 1322.
60Joseph E. LeDoux, "Emotion, Memory and the Brain." Scientific American, June 1994, pp. 50-57; John P. Aggleton, Ed. The Amygdala: Neurobiological Aspects of Emotion, Memory, and Mental Dysfunction. New York: John Wiley Sons, 1992; Daniel Goleman, Emotional Intelligence. New York: Bantam Books, 1995.
61Bessel A. van der Kolk, "The Trauma Spectrum: The Interaction of Biological and Social Events in the Genesis of the Trauma Response." Journal of Traumatic Stress 1(1988): 273-290; Antonio R. Damasio, Descartes Error: Emotion, Reason, and the Human Brain. New York: G. P. Putnam's Sons, 1994, pp. 173-183.
62Robert M. Bradley and Charlotte M. Mistretta, "Fetal Sensory Receptors. Physiological Reviews 55(1975)i 358; Tryphena Humphrey, "Function of the Nervous System During Prenatal Life," In Uwe Stave, Ed. Physiology of the Peri-natal Period. Vol. 2. New York: Appleton-Century-Crofts, 1970, pp. 754-89.
63Robert Goodlin, Care of the Fetus, p. 1.
64A. W. Liley, "The Foetus as Personality." Australian and New Zealand Journal of Psychiatry 6(1972): 99-105; Alessandra Piontelli, From Fetus to Child: An Observational and Psychoanalytic Study. London: Tavistock/Routled, 1992; A. Ianniruberto and E. Tajani, "Ultrasonographic Study of Fetal Movements. Seminars in Perinatology 5 (1981): 175-181; T. B. Brazelton and B. G. Cramer, The Earliest Relationship. New York: Addison-Wesley Publishing Co., 1990.
65W. E. Rayburn, "Monitoring Fetal Body Movement." Clinical Obstetrics and Gynecology 3(1987): 889-911.
66P. H. Wolff, The Causes, Control and Organization of Behavior in the Neonate. (Psychological Issues Monographs No. 17). New York: International Universities Press, 1966, p. 22-23; Arthur Efron, "The Sexual Body: An Interdisciplinary Perspective." The Journal of Mind and Behavior. 6 (1985): 118-121.
67Jeanette M Soby, Prenatal Exposure to Drugs/Alcohol: Characteristics and Educational Implications of Fetal Alcohol Syndrome and Cocaine/Polydrug Effects. Springfield, IL: Charles C. Thomas, 1994.
68M. Lieberman, "Early Development of Stress and Later Behavior." Science 1141(1963):824.
69Bibliographic references can be found in Christopher Norwood, At Highest Risk: Environmental Hazards to Young and Unborn Children. New York: McGraw-Hill, 1980 and Child at Risk: A Report of the Standing Senate Committee on Health, Welfare and Science. Quebec: Canadian Government Publishing Center, 1980.
70R. E. Myers, "Production of Fetal Asphyxia by Maternal Psychological Stress." Pavlovian Journal of Biological Science 12(1977): 51-62.
71T. F. Anders and C. H. Zeanah. "Early Infant Development From a Biological Point of View." In J. D. Call, E. Galenson and R. L. Tyson, Eds., Frontiers of lnfant Psychiatry, Vol. II. New York: Basic Books, 1984; J. A. Connolly and J. H. Cullen, "Maternal Stress and the Origins of Health Status." ibid, Vol. I, 1983; B. R. H. van den Bergh, "The Influence of Maternal Emotions During Pregnancy on Fetal and Neonatal Behavior." Pre- and Peri-natal Psychology Journal (1990): 119-1 30; Thomas Blum, Ed. Prenatal Perception, Learning and Bonding. Berlin: Leonardo Publishers, 1993.
72New York Newsday, February 8, 1994, p. 69.
73Chairat Panthuraamphorn, "Prenatal Infant Stimulation Program" in Blum, Ed., Prenatal Perception, pp. 187-220.
74Thomas R. Verny, "Womb Ecology/World Ecology." Talk delivered at 2nd World Congress for Prenatal Education, Athens, Greece, May 14, 1994.
75Lester Sontag, "Implications of Fetal Behavior and Environment for Adult Personalities." Annals ofthe New York Academy of Sciences 134 (1965): 782-6.
76Robert Goodlin, Care ofthe Fehcs, p. 10; Dennis H. Stott, testimony, in Senate of Canada: Standing Senate Committee on Health, Welfare and Science. Third Session, Thirtieth Parliament, 1977, "Childhood Experiences of Criminal Behavior," Issue No. 1 Second Proceeding, Nov. 24, 1977.
77Child At Risk: A Report ofthe Standing Senate Committee on Health, Welfare and Science. Hull: Canadian Government Publishing Center, 1980, p. 16.
78 Margaret E. Fries, "Longitudinal Study: Prenatal Period to Parenthood." Journal of the American Psychoanalytic Association 25(1977): 115-140; Margaret E. Fries, Marie Coleman Nelson and Paul J. Woolf, "Developmental and Etiological Factors in the Treatment of Character Disorders with Archaic Ego Function." The Psychoanalytic Review 67(1980): 337-352.
79Lorraine Roth Herrenkohl, "The Anxiety-Prone Personality: Effects of Prenatal Stress on the Infant." In Roy J. Mathew, Ed. The Biology of Anxiety. New York: Brunner/Mazel, 1982, pp. 51-86; Antonio J. Ferreira "The Pregnant Woman's Emotional Attitude and Its Reflection on the Newborn." American Journal of Orthopsychiatry 30 (1960): 553-6; Child At Risk: A Report of the Standing Senate Committee on Health, Welfare and Science. Hull: Canadian Government Publishing Center, 1980; John H. W. Barrett, "Prenatal Influences on Adaptation in the Newborn." In Peter Stratton, Ed. Psychobiology of the Human Newborn. New York: John Wiley S. Sons, 1982, p. 270; Psychology Today ,4 (1971): 49;. Abram Blau, et al., "The Psychogenic Etiology of Premature Births." Psychosomatic Medicine 25 (1963): 201-11; A. J. Ward, "Prenatal stress and childhood pschopathology." Child Psychiatry and Human Development 22 (1991: 97-110; Lars Billing, et al, "The Influence of Environmental Factors on Behavioral Problems in 8 Year-Old Children Exposed to Amphetamine During Fetal Life." Child Abuse & Neglect 18 (1994): 3-9; D. H. Stott, "Follow-up Study from Birth of the Effects of Prenatal Stress." Developmental Medicine and Child Neurology 15 (1973): 770-87; Norman L. Corah, et al, "Effects of Perinatal Anoxia After Seven Years. Psychological Monongraphs 79 (1965): 1-32; Sarnoff A. Mednick, "Birth Defects and Schizophrenia, Psychology Today 4 (1971): 48-50; Sarnoff A. Mednick et al, Eds., Fetal Neural Development and Adult Schizophrenia. New York: Cambridge University Press, 1991; "Delinquents Said To Have Perinatal Injuries," Psychiatric News, September 1, 1978, p. 26; David B. Chamberlain, "Prenatal Intelligence." In Thomas Blum, Ed. Prenatal Perception, Learning and Bonding. Berlin: Leonardo Publishers, 1993, pp. 14-21; A. J. Ward, "Prenatal Stress and Childhood Psychopathology." Child Psychiatry and Human Development 22(1991): 97-110; Adrian Raine, The Psychopathology of Crime: Criminal Behavior as a Clinical Disorder. San Diego: Academic Press, 1993.
80Elaine Morgan, The Descent of the Child: Human Evolution from a New Perspective. New York: Oxford University Press, 1995, p. 78.
81Adrian Raine, Patricia Brennan, Sarnoff A. Mednick, "Birth Complications Combined With Early Maternal Reiection at Age 1 Year Predispose to Violent Crime at Age 18 Years." Archives of General Psychiatry 51(1994): 984-988; Henry P. David, Zilenek Dybrich, Zilenek Matejcek and Vratislav Schuller, Born Unwanted: Developmental Effects of Denied Abortion. New York: Springer, Publications, 1988.
82The New York Times October 3, 1995, pp. C1 and C10.
83Michael S. Gazzaniga, Nature's Mind: the Biological Roots of Thinking, Emotions, Sexuality, Language, and Intelligence. New York: Basic Books, 1992.
84Gerald M. Edelnan, The Remembered Present: A Biological Theory of Consciousness. New York: Basic Books, 1989, p. 44; Joseph E. LeDoux, "Emotion, Memory and the Brain." Scientific American, June 1994, pp. 50-57.
85 New York Daily News, June 17, 1992, p. 7.
86Lyle S. Joffe, et al, "Biobehavioral Antecedents in the Development of Infant-Mother Attachment." In Martin Reite and Tiffany Field, Eds., The Psychobiology of Attachment and Separation. New York: Academic Press, 1985, p. 334.
87Bruce S. McEwen and Harold M. Schmeck Jr., The Hostage Brain. New York: The Rockefeller University Press, 1994, p. 72.
88Ibid, p. 77.
89Bessel A. van der Kolk and Jose Saporta, "The Biological Response to Psychic Trauma: Mechanisms and Treatment of Intrusion and Numbing." Anxiety Research 4(1991): 199-212; Herbert Hendin, Suicide in America: New and Expanded Edition. New York: W. W. Norton & Co., 1995, p. f16.
90J,, Volavka, Neurobiology of Violence. Washington, D.C.: American Psychiatric Press, 1995; M. J. P. Kruesi, "Cruelty to Animals and CSF 5-HIAA." Psychiatry Research 28(1989): 115-116; Bessel A. van der Kolk, "The Trauma Spectrum: The Interaction of Biological and Social Events in the Genesis of the Trauma Response." Journal of Traumatic Stress 1(1988): 273-290.
91Bertil Jacobson, "Perinatal Origin of Eventual Self-Destructive Behavior." Pre- and Peri-Natal Psychology 2(1988): 227-241.
92Ibid, p. 240; Jude Roedding, "Birth Trauma and Suicide: A Study of the Relationship Between Near-Death Experiences at Birth and Later Suicidal Behavior." Pre- and Peri-Natal Psychology Journal 6 (1991): 145-169; L. Salk et al, "Relationship of maternal and perinatal conditions to eventual adolescent suicide. Lancet 1(1985): 624-627; Thomas R. Verny, "The Scientific Basis of Pre- and Peri-Natal Psychology: Part 1." Pre- and Perinratal Psychology 3 (1989): 166.
93Ernest M. Gruenberg, "On the Psychosomatics of the Not-So-Perfect Fetal Parasite." In Stephen A. Richardson and Alan F. Guttmacher, Eds. Childbearing: Its Social and Psychological Aspects. New York: Williams St Wilkins, 1967, p. 54.
94Roger E. Stevenson, The Fetal and Newly Born Infant: Influences of the Prenatal Environment. 2nd Ed. St. Louis: C. V. Mosby, 1977, p. 3.
95Heinz Bartels. Prenatal Respiration. New York: John Wiley and Sons, 1970, p. 47.
96A. Briend, "Fetal Malnutrition: The Price of Upright Posture?" British Medical Journal 2(1979): 317-319.
97Joseph Barcroft, Researches in Pre-Natal Life. Vol. 1. Springfield, Ill.: Charles Thomas, 1947, p. 209.
98Lubor Jilek et al., "Characteristic Metabolic and Functional Responses to Oxygen Deficiency in the Central Nervous System." In Uwe Stave, Ed. Physiology ofthe Perinatal Period, p. 1043.
99Peter Boylan and Peth J. Lewis, "Fetal Breathing in Labor." Obstetrics and Gynecology 56 (1980): 35-8; Peter Lewis, Peter Boylan, "Fetal Breathing: A Review. American Journal of Obstetrics and Gynecology 134 (1979): 270-5; Uwe Stave, Ed. Physiology ofthe Peri-natal Period. Vol. 2. New York: Appleton-Century-Crofts, 1970, 987-992; Carl Wood, Adrian Walker and Robert Yardley, "Acceleration of the Fetal Heart Rate. American Journal of Obstetrics and Gynecology 134 (1979) 523-7.
100R. A. Polverini-Rey, Intrauterine Musical Learning: The Soothing Effect on Newborns of a Lullaby Learned Prenatally. Doctoral Thesis, Los Angeles: California School of Professional Psychology, 1992.
101Anthony J. DeCasper & W. P. Fifer, "Of Human Bonding: Newborns Prefer Their Mother's Voices." Science 208 (1980): 1174-1176; P. G. Hepper and S. Shahidullah, "Newborn and Fetal Response to Maternal Voice." Journal of Reproductionn and Infant Psychology 11(1993): 147-153; Thomas R. Verny "The Scientific Basis of Pre- and Perinatal Psychology: Part 1." Pre- and Peri-Natal Psychology 3 (1989): 162-4; William P. Fifer, "Neonatal Preference for Mother's Voice." In Norman A. Krasnegor, et al, Eds., Perinatal Development: A Psychobiological Perspective. New York: Academic Press, 1987, pp. 111-115; Robert C. Goodlin, Cry of the Fetus. New York: Masson Publishing, 1979, p 11.
102William B. Sallenbach, "The Intelligent Prenate: Paradigms in Prenatal Learning and Bonding." In Thomas Blum, Ed., Prenatal Perception, Learning and Bonding. Berlin: Leonardo Publishers, 1993, p. 73.
103Anthony DeCasper, "Studying Learning in the Womb." Science, 225, (1984): pp. 384 "Human Fetuses Perceive Maternal Speech." Behavior Today. Feb. 4, 1985, pp. 1-7.
104David B. Chamberlain, "Prenatal Intelligence." In Thomas Blum, Ed., Prenatal Perception, pp. 20-21; David Chamberlain, Babies Remember Birth. Los Angeles: Jeremy P. Tarcher, 1988.
104Brad Steiger and Sherry Hansen Steiger, Children of the Light: Children's Near-Death Experiences. New York: Signet, 1995, p. 117.
106D. Spelt, "The Conditioning of the Human Fetus in Utero." Journal of Experimental Psychology 38(1948): 338-346; David B. Chamberlain, "Babies Are Not What We Thought: Call for a New Paradigm." International Journal of Prenatal and Peri-natal Studies 4 (1992): 168-169; Erna Osterwell, "A Psychoanalytic Exploration of Fetal Mental Development and Its Role in the Origin of Object Relations." Dissertation Submitted to the Faculty of the California Graduate Institute. 1990; Linda Carter Jessop and Barbara Keller, "Dearly Maternal Bonding." In Thomas R. Verny, Pre- and Peri-natal Psychology: An Introduction . New York: Human Sciences Press, 1987, pp. 107-127.
107M. Colleen Stainton, "The Fetus: A Growing Member of the Family." Family Relations 34 (1985): 321-326; R. Van DeCarr and M. Lehrer, The Prenatal Classroom: A Parent's Guide for Teaching Their Preborn Baby. Atlanta: Humanics Publishing Group, 1992.
108Ibid, p. 324.
109M. Freeman, "Is Infant Learning Egocentric or Duocentric? Was Piaget Wrong?" Pre- and Perinatal Psychology Journal 2 (1987): 25-42.
110A full bibliography is contained in Thomas Blum, "Early Proto-Developmental Enrichment Stimulations and Possible Changes in the Functional Morphology of the Brain." In Thomas Blum and David Yew, Eds. Human Prenatal Brain Development. Berlin: Leonardo Publishers, 1993.
111Alessandra Piontelli, From Fetus to Child: An Observational and Psychoanalytic Study. London: Tavistock/Routledge, 1992, p. 18.
112Leah LaGoy, "The Loss of a Twin In Utero's Affect on Pre-Natal and Post-Natal Bonding." International Journal of Pre-Natal and Peri-natal Psychology and Medicine 5(1993): 439-444.
113Piontelli, From Fetus to Child, p. 15.
114Ibid, p. 146.
115Alessandra Piontelli, "Pre-Natal Life and Birth as Reflected in the Analysis of a 2- Year-Old Psychotic Girl." International Review of Psycho-Analysis. 15(1988): 73-81.
116Nandor Fodor, The Search for the Beloved: A Clinical Investigation of the Trauma of Birth and Prenatal Condition. New Hyde Par, N.Y.: University Books, 1949; Stanislav Grof, Beyond the Brain: Birth, Death and Transcendence in Psychotherapy. Albany, N.Y.: State University of New York, 1985; Arthur Janov, The Feeling Child. New Yolk: Simon and Schuster, 1973; Amaldo Rascovsky, Fl psiquismo Fetal. Buenos Aires: Editorial Paidos, 1977; Lynda Share, If Someone Speaks, If Gets Lighter: Dreams and the Reconstruction of lnfant Trauma. Hillsdale, N.J.: The Analytic Press, 1994; E. V. Subbotsky, Foundations of the Mind: Children's Understanding of Reality. Cambridge, Mass.: Harvard University Press, 1993; Thomas R. Verny, Ed. Pre-and Peri-natal Psychology: An Introduction . New York: Human Sciences Press, 1987; David Chamberlain, Babies Remember Birth. Los Angeles: Jeremy P. Tarcher, 1988; Thomas Blum, Ed. Prenatal Perception Learning and Bonding. Berlin: Leonardo Publishers, 1993; K. Schier, "The Analysis of Appearance and Meaning of Prenatal and Perinatal Phantasies in the Psychoanalytically Oriented Psychotherapy of Children." International Journal of Prenatal and Perinatal Psychology and Medicine 5(1993): 433-438; Michael Maiwald and Ludwig Janus, "Development, Behavior and Psychic Experience in the Prenatal Period and the Consequences for Life History--A Bibliographic Survey." International Journal of Pre-natal and Peri-natal Psychology and Medicine 5(1993): 451-485.