Book Review - Frank Lake's Mutual Caring

Book Review - Frank Lake, M.D., Mutual Caring: A Manual of Depth Pastoral Care, Edited by Stephen Maret, Ph.D., Emeth Press, Lexington, KY, pps. 134, 2008

Reviewed by John A. Speyrer

"A state of infinite, unending, distress exists and is maintained in the primal consciousness of all those who are victims of the Maternal-Foetal Distress Syndrome. They can by no means account for it or understand its origins. Yet it is present in them as the first and total experience of their cosmos, kept up in every moment of each day, month, year, for a life-time....There is no disputing the fact, God
would have them so. This is God's most stern decree."

-- Frank Lake, M.D. - Mutual Caring (2008), p. 63.

"The schizoid personality disorder has at least some of its roots in innocent infantile affliction of great severity. The more clearly this emerges into conscious or its mood dominates the mind, the less possible it is to believe in the goodness, or even in the existence of God.
-- Frank Lake, M.D. - Clinical Theology, (1966), p. 554.

The third edition of Lake's, Mutual Caring, edited by clinical psychologist, Stephen Maret, Ph.D., is much smaller than its second edition, from which all theological material was removed and more of the author's theory was added. The work was originally written in 1982 while the author was dying from cancer. It was the last of a trio of books in which psychiatrist Frank Lake stressed his theory of the overwhelming importance of the first three months of pregnancy, for better or for worse as a molder of the personage of an individual for the rest of his life, even taking precedence over his earlier beliefs of the significance to the individual of the traumas of one's birth itself. This was Dr. Lake's Maternal-Foetal Distress Syndrome, a position he proposed during the last part of his life and which subject was to comprise the doctoral dissertation of Stephen Maret.

In the introduction to his book, the author writes that in therapy, the deeper and earlier one goes into fetal experiences more skill is required of the therapist to facilitate the opening-up experience needed to access these earliest traumas. Rather than disparaging other forms of non-regressive psychotherapy, such as psychoanalysis, behaviorism, etc., Dr. Lake believed that these and other theories may well be true at their own levels. He makes this clear as the sub-title of his book is, A Manual of Depth Pastoral Care. The problem is that non-depth therapy theoreticians disparage the possibility of fetal insight and understanding. Dr. Lake's theory of the Fetal-Maternal Distress Syndrome remains interesting to hypothesize about, but ultimately, impossible to prove. In some fields of inquiry, experience can provide its own truth which for many of us is all that is needed.

The older theories of fetal life in the womb, recounted in earlier times, described it as one of tranquility and peacefulness. This however, was shown to be a lie when one examines the prose and poetry of Simone Weil and Søren Kierkegaard and many others, including Pope John Paul II. Dr. Lake believed their writings to be an accurate reflection of severe intrauterine stress. That one could rationally hypothesize this seeming truth is acceptable. At times, though, it does seem to be a leap of faith by Lake to be convinced that the mentioned authors, as well as the bleak depressive personalities and theories of some existentialist philosophers, have their origins in, and were shaped by, their negative intrauterine experiences. And yet, the expressed dark depressive feelings in their writings must have had their origins in reality.

The expressions of some of Lake's clients during these regressive intrauterine sessions are attributed to the tortured intrauterine environment and which may very well have pointed to their descriptions of experiencing toxic fetal events as "daggers" to the umbilical area. As confirmatory evidence, I heard a regressed fellow participant in a primal-oriented workshop describe his uterine environment as primarily toxic. Perhaps it was no coincidence that he was later to become a professor of environmental science!

In the beginning of the regressions which Lake led, there were difficulties in both verifying the interpretation of the regressed client and in understanding how such a primitive undeveloped brain could experience and record such extraordinarily traumatic events. Oftentimes the leaders of the workshops did not believe what they were being told by the attendees, but if they were open, the confirmations continued until the evidence became overwhelming and difficult to dismiss.

Dr. Lake emphasized the difficulty in scientifically studying the re-livings which occurred at his workshops. He believed that they could be studied scientifically with all appropriate controls in place, but emphasized that none of the elements which existed at his workshops could be foregone, as they were all essential. For example, a scientific laboratory is not comparable to a leisurely week-end workshop, he insisted, where, in the later, much camaraderie in a supportive and open home-type environment was always present.

The methodology of Dr. Lake's guided intrauterine fantasy "trips" changed over time, as elements which had been shown to be productive of uncovering intrauterine memories were retained and improved upon. The relaxation countdown was always used and the clients were always lying down rather than being seated. Deep breathing was also an essential element of the sessions. One change which soon occurred was that instead of beginning at a later period of gestation, the fantasy "talk down" began at conception. (pps. 33-34)

Even speculation about parental feelings at the time of the subject's conception were fair game for examination, as the workshop leader would ask them to explore the state of mind of their mother and father to-be, even before they had intercourse! Was the sexuality comprised of joyful anticipation or instead merely conjugal duty consummated without love?

The psychological pain uncovered in and by the fetal self during the fantasy trip was felt as fully and as often as possible to reduce its negative effects on one's life. To that end, each subject on the six-day workshop had two three-hour sessions. Leisure time for feedback of shared sessions of participants was also provided.

Even the mother-to-be's consideration of aborting her fetus could be accessed, when such past event had been felt by the fetus itself! According to the founder of primal therapy, psychologist, Arthur Janov, Ph.D., intrauterine and birth material should not be pushed or rushed to be felt before their time, as this can result in psychotic breaks or overwhelming anxiety and depression.

After many years of self-primal therapy, I attended, in Michigan, such a workshop led by Australian primal-oriented psychiatrist, Dr. Graham Farrant, One participant, a Canadian primal-oriented therapist, was so impressed with his workshop experiences that he soon thereafter voyaged to Australia to continue his intrauterine regressive work with Farrant. I had been unsuccessful in accessing my intrauterine beginnings at the workshop, although years later, at home, I was to experience two late stage fetal intrauterine regressions. One was blissful; one not.

Dr. Lake writes that over 1200 have participated in his workshops. (I am assuming that this number does not include the LSD workshops which he held beginning in 1953 until the late sixties when use of LSD became illegal). While many regressed to the earliest biographical events possible, others only returned to their five or six-week embryonic stage of development, which had their own particular, individual characteristics.

Lake writes, "With one in ten, some patient individual facilitation may be necessary. One person in twenty does not make it at all." (p. 47) This is due to "...clear clinical indications why, at this time and place, with their particular dynamics in the state they are, and inner and outer life supports and integrating factors being what they are, their organism has decided in its wisdom not to add the contents of the embryonic cellar to which is already a too-precarious balance." (p. 47) Dr. Lake did have a wonderful way with words. Here he seemingly explains that, in some cases, he would rather not push for access and instead avoid doing therapy with an individual who might possibly experience a psychotic break or disintegrate as a result of the experience.

Lake delineated four levels of intrauterine stress from which effects the person may suffer from in the future. The first being "ideal" in that the mother fully accepts and welcomes the fetal presence. The second level is present when the fetus "copes" with the situation in which it finds itself. It makes do. When there is a greater deficiency of the mother and of the environment the level is described as the third or "total opposition" level, where coping with the situation falls far short, but which despite being so undesirable still the fetus wishes to "leave room, when the attack is over, for a return to openness." (p. 50) The fourth level is described as total maternal rejection or the level of transmarginal stress.

"Stressed beyond bearing, the fetus longs not for life, but for death." (p. 51) It is at this level, this fourth level, where the schizoid, anti-social self, comes into being. Schizoid sufferers who have achieved insight know that their observation, from a point or stance beneath their defenses that others are still using, is absolutely accurate and factual." (p. 52) I'll say amen to that, although my experiences and insights are from the transmarginal stress levels of the birth experience itself, rather than from the earlier, yet to be felt, periods, which Lake is discussing.

In regard to the sheer power of extreme or transmarginal foetal stress to drive anguish, Dr. Lake writes:

In my tome of 1966, Clinical Theology, I found it necessary to devote almost four hundred pages to this "Schizoid Personality Disorder." That other psychiatric textbooks often mention it in one or two paragraphs is attributable, I would say, though few psychiatrists would agree, to the fact that to a socially acceptable degree, the basic schizoid perceptions and behavior patterns that express them, are in fact typical of psychiatrists themselves. This is true in their relationships not only with their patients, but also with their spouses and families and with themselves. It is to this ill-recognized, but pervasively operative fourth level of distress, radically hostile to life itself, that I would attribute the significantly higher rate of suicide among psychiatrists and their spouses, higher than the rate among doctors in general, which is so much higher than that of the general community....

Those who have penetrating insight into their own schizoid dynamics are acutely observant of those who are, like so many doctors and professionally trained role-players of all kinds, suffering from the same abysmal despair of life, but have not had the breakdown that would strip away their defenses. The primal affliction, so awful as to make death infinitely preferable, is still well repressed. Schizoid sufferers who have achieved insight know that their observation, from a point or stance underneath the defenses that others are still using, is absolutely accurate and factual.... There are, of course, millions of young people, afflicted by this same need to reject life-as-it-comes-to-them who are too gripped by the many-leveled distress of it to achieve the pained detachment of an observer. They take to drugs, of all kinds, and some to alcohol, or both, in order for a while, to blot out the anguish. They become careless of precautions, desperate in piling "remedies" together for if death comes, that will be no disaster, rather a blessed end to all. What follows could not be worse. If oblivion to the body's anguish, to constant mental self-torture, and to the social self-scorn that has made commitment to the bonded exchanges of love unbearably painful were all part of the package of actually dying, that would be bliss indeed. (pps. 51-52)

Although the first trimester of pregnancy may be extremely traumatic, one's later actual birth struggle can provide an extraordinary degree of life and death catastrophes for it to resonate with the first trimester crises. The baby being born may reach such levels of suffering as to unrepress its earlier first trimester feelings of wanting to die. At this stage, according to Lake, the violence of birth itself may become transmarginal.

Mutual Caring was Dr. Lake's final work. It's title is derived from the therapy technique, which is less dependent on training than on mutual caring whereby the client and therapist may switch roles as the client "sits" for the therapist and vice versa. The attentive presence of a caring person often suffices for those who are experienced in using the process.

Lake titled the fourth chapter, "Theodicy and the Foetal Experience." In attempting to describe the indescribable psychological and physiological suffering which some fetuses endure and which reverberate throughout their lives, Lake, assumes the role of apologist for God for permitting such depraved torture. Is it Dr. Lake's position that we become needful of God and pray to Him in order to alleviate the sufferings which He has permitted us to experience? That seems to be accurate summation.

The problem of evil has been a persistent philosophical puzzle and one recognized most intimately by those who have suffered from the transmarginal stress of aspects of our pre- and peri-natal beginnings. In chapter 4, Dr. Lake begins his attempts at reconciling a benign creator with one who is seemingly indifferent to the sufferings of His creatures, at a time when we are most exquisitely susceptible to profound anguish and its lifelong aftermaths. I use the word "attempts", because I believe Lake has failed in his endeavor.

"God punishes us for what we can't imagine."
--Character in novelist Stephen King's, Duma Key

The Deity has established conditions under which many, many fetuses experience a living hell during the most impressionable and sensitive times of their lives and because of those conditions continue to suffer a hell on earth with the chance of perhaps continuing in Hell itself thereafter if we fail to follow His commands. As God is omniscient, he well knows where we will spend eternity. What does this possible scenario have to do with love - or with justice, which involve two contradictory images of God, taught to us from our very beginnings? Little, but with sadism,...much.

Is the Fetal Distress Syndrome fetal gestation gone awry as a result of a genetic deficiency or of mal-development of some required neuro-transmittors? No, but even if ultimately, yes, the origins of fetal suffering, according to Lake, is "the mother's own emotions." (p. 62)

These may encompass unhappiness from troubled family relationships and economic hardships, among causes of maternal malcontentedness during early pregnancy. Mother's feelings can then be displaced and symbolized onto organ systems of the developing fetus' body and mind. The "invading badness" is perceived by the fetus as entering through the umbilicus. Sometimes the affliction becomes too severe to be repressed, while "(i)n others, it can break out from repression during some childhood, adolescent or adult crisis of miserable failure or rejection, and refuse to be repressed again." (p. 76)

The passion and death of Christ is seen by Dr. Lake as the embodiment of the supreme act of love. However, does this retroactive love from the Savior take the place of the nonexistent love from Him whilst the little ones suffer torment as fetuses?

Spirituality and particularly mystical/spiritual aspects of religion have a long history of use as a method of assuaging sufferings derived from such occasions of personal misfortunes and catastrophes. It is sometimes successful since its use raises in some susceptible ones' defense levels to new and more effective heights.

When our defenses against our early traumas are strengthened, as occurs during such mystical/spiritual experiences, a state of contentment and well-being is psychologically provided whereby our repressed traumas become more encased. At such times we may experience less suffering and in some cases, sublime rapture and oneness with God and with all creation, even though the trauma imprints themselves remain untouched and remain in their original pristine state. (See on this website, The Psychology of Mysticism Index .)

"Nothing . . . of the horrors of the foetal-placental cosmos will have come as a surprise to God. Nor did he wait till we found out about it before he did something to remedy it,
indeed all that needed to be done. He accepted responsibility for setting up this sort
of human creation, with all its possibilities of foetal contentment, satisfaction
and joy, . . . and the possibility of the total absence of . . . care,
plunging the foetus into . . . hell.

-- Frank Lake's Mutual Caring, p. 79, 1982. Quoted in Frank Lake's Maternal-Fetal Distress Syndrome: An Analysis Chapter 5 - Conclusions, p. 278, doctoral dissertation of Stephen M. Maret, Ph.D.

Dr. Lake ponders the question of whether any evidence exists which shows foresight or planning on God's part for the alleviation of overwhelming affliction during the most critical period of humankind's gestation? The author poignantly asks the right questions. He wants to know if God's creation "sadistically crushes" its suffering little ones this way, should He not "be totally ashamed of himself?" (p. 61)

I say not only ashamed, but also totally guilty for His serious offense of commission. Or is God a sociopath who bears no guilt and acts with complete indifference to human sufferings? Is He to be given carte blanche acceptance for any of his unfeeling decisions regarding His creation without a thought to their results? I vote, nay!

In His own family, does His son not reveal, for all to recognize, His own masochistic psychopathy in dutifully following His Father's wishes by conceding to His own passion and death? Do we not have here exhibit #1 of a dysfunctional family?

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