Frank Lake's Maternal-Fetal Distress Syndrome:
- An Analysis -

By Stephen M. Maret, Ph.D.
Professor of Psychology
Caldwell University


CHAPTER 5

Conclusions

C. Final Conclusions

Frank Lake can be critiqued for some of his excesses and failings and these have been presented. But Lake also can be praised for a significant contribution to pastoral counseling and pastoral theology. His impact upon these fields in the United Kingdom was extensive, not only through the C.T.A., but also through his books, articles, sermons, and lectures. while this dissertation has not concerned itself with the primal therapy that Lake proscribes as the "cure" for the M-FDS, it is certainly a significant component of his overall project.

Alastair Campbell, in a somewhat critical review published in 1982, described Lake as "one of the most important figures in the contemporary pastoral care scene."323 He continues:

It is obvious that Dr. Lake's ability to synthesize apparently disparate bodies of knowledge makes his work essential reading for anyone interested in pastoral theology.324
This is indeed one component of Lake's genius. While at times he tended to synthesize in a simplistic and superficial manner, he nevertheless attempted and at times succeeded in drawing analogies and correlations which were valid and quite helpful for pastoral care. One significant example would be his Dynamic Cycle", described in chapter
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323CampbeII, "Review of Tight Corners in Pastoral Counselling," 26.

324ibid.


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one of this work. Lake's use of the Gospel of John to construct an anthropology based upon the only "normal" specimen of humanity that has ever existed is simple and yet profound. His exegesis is not strained and the model is truly an integration of the psychological and theological realms.325 The "input" phases of "acceptance" and "sustenance" coupled with the "output" phases of "status" and "achievement" together give a well-rounded paradigm of explanation of physiological, psychological and theological development. Indeed, the analogy of the "womb" with the "womb of the spirit" is an apt one.

In some ways, this dissertation has critiqued Lake for failing at an impossible task. It is unreasonable to expect anyone to conceptualize an all-embracing theory which somehow accounts for every facet of human experience, and then which correlates these with each other. While Lake did not attempt to theorize a conceptual scheme which explained everything, he did latch on to the M-FDS as a theory which could explain quite a lot. His over-emphasis upon the pre-natal was perhaps a result of what he perceived as an almost total neglect of this phase. In this he is certainly correct.

How is the M-FDS to be evaluated? Certainly it cannot be summarily dismissed. The evidence presented in this work certainly allows for a M-FDS to exist, certainly with some qualifications. That embryological and fetal life may not be "just like" Lake described them does not change the emerging research evidence descriptive of a prenatal organism that is quite sophisticated.

Apart from some of the more extreme affirmations that Lake makes regarding the perceptual and memory capabilities of fetuses and embryos, and even sperm and ova, the M­FDS does have significant evidence to warrant it's acceptance as a paradigm in the sense of "a generally accepted system of ideas which defines the legitimate problems and methods of a research field."

The parameters of the "research field" that Lake is defining are those of the beginning and end of intra-uterine life. The problems, restrictions and methods of the study of the human prenatal organism have already been noted, and indeed, the continuing advance of technology may make some of these moot. The research evidence that has emerged has bolstered some of Lake's contentions regarding intra-uterine life.
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325Lee Eliason, in an Th.M. thesis, evaluated the Dynamic Cycle as an "unusually deep interpretation of a Christocentric model for the understanding of human dynamics in health and in emotional sickness. It seems to integrate a number of valid concepts from secular psychology so thoroughly, they have few contradictions with his theological affirmations." (Lee Eliason, quoted by Peters, Frank Lake, 165).

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For instance, the field of psychoneuroendocrinology is providing evidence regarding the extent to which "umbilical affect exchange" can and does affect the immediate and long- term morphology and psychology of behavior. Domer's previously mentioned second rule of ontogenetic organization.326 clearly delineates the effect that extra-uterine events can have on the embryo/fetus and how these effects can cause long-term changes. Likewise, Dorner's proposal of a "functional teratology" or a "teratopsychophysiology" to complement the widely accepted "structural teratology" or teratomorphology" would certainly be consonant with Lake's M-FDS.

The emergence of psychoneuroendocrinology and psychoneuroimmunology lays the groundwork for the discussion of an issue elicited by Lake's M-FDS, that of "prenatal psychology." Referring to the research done in these fields, Fedor-Freybergh and Vogel write:

Psychoneuroendocrinologists have already elicited useful data from the preliminary theoretical research in recording fetal response to and retention of outside environmental stimuli (touch, sound, and light stimuli for the most part). Various highly specific biochemical structures (hormones, neurotransmitters and other polypeptide structures) are needed, in direct connection with input phenomena, for the transformation and storage of both sensorial and sensible types of information. Crucial to the formation of the primary central nervous system on the hypothalamic-pituitary-adrenal level, some of these functions are detectable in the very beginning of development of the human being. Thus the embryo successively develops a high sensibility and competency for the potential ability for perception .327

To speak of a prenatal psychology is to emphasize the developmental continuity between the prenatal, neonatal and post-natal human organism. It is also to emphasize that
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326"During the pre and/or early post-natal life. systemic hormones and neurotransmitters are capable of acting as organizers of the brain, which is the controller of the neuro-endocrine-immune system. Thus, the quantity of the systemic hormones and neurotransmitters co-determines during a critical period of brain development, the quality, ie. the responsiveness, of their own central nervous system controllers and hence the functional and tolerance ranges of their own feedback systems throughout life . . . Abnormal levels of systemic hormones and neurotransmitters, which can be induced by abnormal conditions in the psychosocial and/or natural envlronment. can act as teratogens and lead to permanent physiological and/or psychological dysfunctions in later life. Thus many malfunctions of reproduction. metabolism, information processing, and immunity called up to now idiopathic, essential, cryptogenic, primary or genuine can be explained by pre­and/or early postnatal psycho-and/or physiological processes. (G. Dorner, "Die mogliche Bedeutung der pra­unloder perinatalen Ernahrung für die Pathogenese der Obesitas." 107-123, quoted by Dorner, "Significance of Hormone-dependent Brain Development and Pre-and Early Postnatal Psychophysiology for Preventative Medicine," 429).

327Fedor-Freybergh and Vogel, "Encounter with the Unborn: Philosophical Impetus behind Prenatal and Perinatal Psychology and Medicine," xix-xx.



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there is "no possible separation between the physical and psychological development of the unborn."328 Indeed, contrary to standard thinking, which assumes function following from structure in the embryo and fetus, research329 is finding just the opposite. Fedor-Freybergh and Vogel describe these results:

It is the morphological structure which develops as a result of the inborn primal functional urge. An organ would not develop if there were no functional urge compelling it to do so. In the same way, the psychological capacity of the human is not posterior to the completed morphological structure of the human body, not to its subsequent introduction into and experiencing of a particular sociocultural environment after birth. the unborn has its psychological processes functioning long before birth.330

As described earlier, the neglect of or denial of the significance of the prenatal period follows a certain pattern. Previous to this, the perinatal, neonatal and post-natal stages were also considered, for the most part, as psychologically devoid of meaning. This attitude illustrates the propensity that exists to divide up human experience into "life periods" over against the continuous unity of development. Life-span developmental psychology seeks to study the continuity of development and as such, must include the prenatal period. Wucherer-Huldenfeld writes:

In indisputable favour of prenatal psychology . . . [is] its ability to follow the specific human far back. The unity of the prenatal development as well as the total development that comes after birth, becomes more distinct in this way. And so appears a personage that exists and must not be separated in the stages that succeed each other, since they form a unity.331

Certainly any prenatal or fetal "psychology" must at this time be somewhat limited due to the nature of it's subjects. Much research remains to be done. Relatively sophisticated psychological concepts such as self-awareness; self-concept, self-consciousness, and personality remain beyond the pale of any present prenatal psychological constructions. Yet,
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328ibid., xviii.

329P.G. Fedor-Freybergh, "Psychophysische Gegenheiten der Perinatalzeit als Umwelt des Kindes," in Okologie der Perinatalzeit, ed. S. Schindler and H. Zimprich (Stuttgart: Hippokrates Verlag, 1983).

330Fedor-Freybergh & Vogel, "Encounter with the Unborn: Philosophical Impetus behind prenatal and perinatal psychology and medicine," xx.

331A.K. Wucherer-Huldenfeld, "Ursprung und Anfang des menschlichen Lebens," in Vorgeburtliches seelenleben, eds. G.H. Graber and F. Kruse (München: Goldmann, 1973) quoted and translated by S. Schindler "A New View of the Unborn: Toward a Developmental Psychology of the Prenatal period."


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researchers in other sub-fields within psychology, especially developmental, abnormal and clinical, would do well to investigate the prenatal factor.

Related to the M-FDS, this is especially true for abnormal psychology. If, as Lake and others332 have contended, there is a fetal and even embryological origin for even some of the psychopathologies that exist, then their verification would be quite a profound addition to the knowledge of psychopathology. Certainly, given the relative lack of definitive answers regarding the etiology of pathologies utilizing the present post-natal paradigms is a reason to continue the search for pre-natal causes.

If, based on Lake's formulations or anyone else's, a prenatal psychology does exist that is continuous with a post-natal one, this gives rise to numerous ethical considerations given present practices. Primary among them is abortion. For instance, in a letter written in response to comments made by Rev. Canon Beeson regarding abortion on the radio, Lake wrote:

I must question your assumption that what you call "a world of difference" between early and late intra-uterine life is of such an order as to make abortion permissible in the first half of the pregnancy without fear of doing mortal damage to a sentient human being, such as you would admit would be done by the aborting of a baby in the last months of intrauterine life.333

Lake goes on to affirm that he has been compelled to recognize that "consciousness of individuality, . . . extends back into the first trimester of intrauterine life."334 He states unequivocally that "to destroy the small one by aborting it, is as much a murder as it is to destroy the mother by killing her."335

Writing in With Respect, Lake draws the parallels between the acceptance of a prenatal psychology or lack of it with attitudes towards abortion:

Those who advocate abortion for reasons of personal or social inconvenience are usually insistent that the foetus has no human sensibility, no self- awareness or knowledge that it has a life which, by the abortifacient agent, is being brought to a violent end. They state that in no sense could the foetus be regarded as a person or a human being.338

Other related ethical issues also inevitably arise. what of fetal tissue research? What of extra-uterine fertilization and implantation? What of maternal abuse of various drugs while pregnant? What of societal views of maternal stress and its causes? While all of these questions are beyond the scope of this dissertation, all arise as implications of Lake's M-FDS.

Lake, while believing that the M-FDS was an objective theory, certainly saw nothing wrong with his subjective identification and enthusiasm for it. In a paper written relatively near the end of his life, he appealed to the scientific process for vindication:

It is . . . an objective theory. It does not derive from my beliefs, biases, prior assumptions or emotional needs. . . . I have not become subjectively identified with the importance of this advance in etiological theorizing, with its implications for preventing so many psychological, psychosomatic and social disorders. This looks like, and indeed is, a 'passionate commitment' but only after years of cool appraisal. Even 'passionate commitment' is commended337. . . as an appropriate attitude even a necessary one, to research in the behavioral sciences. If this is true it matters immensely. If it is false, my evidence will not stand up to examination and my finding will not be replicated -- and that fizzle will be the end of the story."338

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332Moss writes: "So long as we do not exaggerate our claims, it seems reasonable to claim that the evidence so far gathered points in the direction of a useful link between the circumstances of the pre- and pen-natal period, and the later emergence of neurosis." (Moss, "In the Beginning," 16:2).

333Frank Lake to Rev. Canon Trevor Beeson, 1 October 1979, Nottingham: Clinical Theology Association, Ungdale, 3-4. 334ibid., 1.

335Lake, With Respect, 72.

336ibid., 50.

337KerIinger, Foundations of Behavorial Research, preface.

338Lake, "The Internal Consistency of the Theory of a Maternal-Foetal Distress Syndrome," 5.


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