The Trauma of Birth and 5 Prenatal Psychology Pioneers

“In each separate case it is necessary to create, as it were, a theory and technique made for the occasion without trying to carry over this individual solution to the next case. …the essential factor remains always the capacity to understand the individual from himself… the common human element, certainly not to be denied, can constitute only the hypothesis, not the content of the understanding.” (WT, 3-4). Rank’s individualistic view challenges Freud’s presumption of scientific understanding based on the theory of a universal Oedipus complex. Learning from experience and theory will apply in general to other cases, but in the specific encounter “one must learn the speech of the other, and not force upon him the current idiom.” Rank compares Adler’s individual therapy favorably against Freud’s “uniform therapy.” (ibid) He refers to the personality of the therapist, the need for intuitive responses and his/​her self-awareness in the process as well as knowing theory and technique. “The therapist should learn not definite rules and prescriptions, tricks and catches, general theories and typical interpretations, no definite theory and technique…but to analyze [by] understanding and handling the therapeutic situation.” (p. 5)
This approach, anything but uniform, is as much art as science. In medicine today we have more science than ever, but psychological factors including relationship style are hard to define but no less important. Cognitive Behavioral Therapy (CBT) is a worthy effort to make more of what we do standard and measurable but neither diagnosis nor psychotherapy can be well codified, Diagnostic and Statistical Manual notwithstanding. Human intuition and life experience do not fit comfortably in boxes or lists. The capacity to communicate empathy, inquiry, suggestion and support are critical parts of patient care that cannot be coded.
Rank’s favorite book was “Huckleberry Finn,” Mark Twain his favorite author. In the 1930s Rank signed with “Huck” his letters to friends like Jessie Taft. In Twain’s novel, Huck argued for a quick, simple release of Jim, the slave, while Tom Sawyer wanted to plan the escape dramatically, elaborately, scolding Huck for his simple, obvious solution.

Rank requires us to recognize therapy as a unique encounter between two unique individuals. The therapeutic relationship cannot be measured scientifically any more than character itself. Psychotherapists are under pressure to be scientific but science has real limits in this context–the personal characteristics of an infinite variety of people and situation. There are common factors in the process but we exaggerate those at our peril, like the man searching for his lost keys under a street lamp because he can see better, although he lost them a block away.

Rank was critical of early analysts who kept patients on the couch until they confirmed the Oedipal paradigm: sexual desire toward mother and hostility toward father. He was acutely sensitive to the personal character of the analyst and was especially critical of Ernest Jones: “It’s really too bad,” he wrote Freud, “that analysts…lack insight into their personal, private affairs…analysts should surely be healthier or at least enlightened neurotics who’d rather suffer than inflict suffering on those around them (Letters, p. 41). Jones had the last word, as it were, labeling Rank and Ferenczi as seriously mentally ill in his influential 3-volume biography of Freud.

For strict Freudians, the analyst should be a blank screen upon which the patient projects a reality hidden in his or her unconscious. Freud himself was more active and human. Otto Rank, his assiduous pupil and closest aide, developed an approach that acknowledged the therapist as a unique person and utilized that fact. He was never analyzed, and Freud exonerated him from the requirement that applied to almost everyone else. Eventually Rank confronted the absence of will in Freud’s system, and challenged the surgical coolness that Freud advocated but did not practice.

In 1923 Rank and Sandor Ferenczi criticized analysts who extended therapy in relentless pursuit of the Oedipus complex. Then Rank published “The Trauma of Birth,” emphasizing the dynamics of separation and union. By 1926, when he left Vienna for Paris and then New York, he was writing critically about analytic theory and technique. He emphasized the present encounter rather than memories and history; conscious will vs. impulse (id); and therapist as real person vs. standardized image. Eventually he called himself a “philosopher of helping” and said, “I need a different theory for every patient.”

In his later writings Rank referred to the ethical in therapy, usually taken to mean what is good or right. But in view of his classical education and philosophic bent, he surely referred to Aristotle’s “Rhetoric,” where ethos refers to the character of the influential person. No two therapists are alike; character is an essential part of influence. This raises conceptual and methodological challenges while pointing the way to a greater understanding of therapeutic influence and effectiveness, as in “Persuasion and Healing” by Jerome Frank and the exemplary bedside manner of William Osler, the physician who initiated bedside rounds, to teach physicians how to engage with real people whose personal situation is not identical with, or explained by, their diagnosis.

On Will Therapy
Will Therapy (1936) is the English version of Rank’s writings on psychotherapy (1929-31, after his break with Freud in 1926). Rank’s English was very good–he spent 6 months in New York in 1924, at 40, and made several more visits before settling there in 1935. The word “ethical” in the book is misleading in the translation by Jessie Taft, despite her close collaboration with the author. (fn., p. 2). (This book introduced me to Rank in a monthly study group in Bethesda in 1977. The text is dense with theory and philosophy, mostly without clinical examples. For a mid-career psychiatrist the text was rich and engaging in the context of clinical discussion with group members, including several former students of Jessie Taft at the U. Penn. School of Social Work. Pauline Shereshevsky, M.S.W., one of these, was a family friend who had given me a copy of the first issue of the Journal of the Otto Rank Association in 1966. A decade passed before I read it.)

Sigmund Freud neglected will as a factor in human psychology. He did not address traditional ethics in therapy though he advised therapists to have the impassive stance of the surgeon, who does a job objectively without flinching at the sight of blood. Rank uses “ethical” several times in Will Therapy. Will is controversial in Western tradition beginning with Adam, Eve and the Serpent violating God’s order. Three centuries after the founding of Christianity, Saint Augustine taught that, unless wholly devoted to God, will is damned. Biblical scholar Elaine Pagels, in Adam, Eve and the Serpent (1988) summed up Augustine’s teaching: “…all humankind was fallen…human will was incorrigibly corrupt.” Hence, “original sin.”

A large segment of society (Catholic predominantly, Orthodox Jews and others, too) vigorously protect the fetus and the person in permanent vegetative state (PVS). Why? These states of helplessness have in common human form without will. Though not legally or socially a person, the fetus has passionate protectors and advocates–more vocal than does the newborn infant. The U.S. infant mortality rate is high 5/​1,000–34th among nations, after Cuba. yet there there is no rousing cry to stem the loss of helpless newborns. Similarly, at the end of life, we have some 15,000 PVS patients being kept alive by machines (they had no advance directives to the contrary). Rank’s focus on will is a key to this paradox: He pointed out that libraries are filled with books on the evils of will. Without will, the fetus and the PVS patient exemplify human godliness, cleansed of the infamous act of will that got our ancestors expelled from Eden and all of us condemned to death.

Rank’s ability to embrace character challenges the Freudian model of the impassive surgeon, which tries to fit every patient in the same theoretical box, as it were, as if psychology and anatomy were comparable. Will is not just a form of energy or purpose for Rank, it is a signal, indivisible part of personal character and identity that cannot be sliced, diced or simplified.

The main concepts (Otto Rank) slides

Thalassa: A Theory of Genitality by Sandor Ferenczi

The Confusion of Tongues by Sandor Ferenczi

The Unwelcome Child by Sandor Ferenczi

Francis John Mott

(1901 – 1980)

Francis John Mott was born on April 18th 1901 in Felstead, Essex, UK. He came from a middle class family. His father was a mill owner. As a child he didn’t enjoy that good health. He ws rather frail and that was partly the reason why he received little formal schooling. However, this did not stop him from learning extensively as he had always beed a keen reader. His early job also made it possible for him to learn French fluently. In 1933 he married Gwendolen Mayhew and their marriage was strong until death put them apart. During around that time, he also established a small publishing company which remained for a rather short time. Their main publishing work included religious and philosophical topics and a couple of his own

After the demise of the publishing firm, Francis Mott spent much time in the USA and Canada where he found the principal audience for his developing ideas on a universal pattern of creation in the natural world and in humankind including the mind. He lectured, conducted group psychology and individual dream analysis, and published several books. As a platform for supporting and developing his work he founded a group which came to be known as The Society of Life with members principally in North America and the UK who gave intellectual and material support.

After the 2nd World War, the whole family  returned to the UK with their 4 year old son and established their home in Kent where their daughter was born in 1947. He had made himself a soundproofed study in his garden and it was there that Francis Mott worked most of the day, teaching, doing therapy -mainly using dream analysis- and writing. He issued a monthly newsletter which he disseminated and was the tool for sharing his main ideas with his fellow people.

Despite the fact that he was mainly interested in philosophical aspects, he was also a practical man and he spent a lot of his time building walls in his garden, doing the plumbing or repairs in the house and also gerdening. He is described as a very friendly man, good at talking with all sorts of people and with lots of different interests. Unhappily he suffered in his last few years from trigeminal neuralgia which greatly affected his spirits and probably stood in the way of his plans to take his ideas to a wider public.

Mott’s Main Contributions to Prenatal Psychology

Η ΓΕΝΕΤΗΣΙΑ ΘΕΩΡΙΑ ΤΟΥ FERENSCZI

Είναι μια πράξη μερικής απελευθέρωσης του μη αφομοιωμένου σοκ που κληρονομήσαμε από το τραύμα της γέννας. Ταυτόχρονα, φαίνεται να είναι ένα παιγνίδι, μια επέτειος που γιορτάζει την ευτυχή απελευθέρωση από τα δεσμά. Τέλος, αντιπροσωπεύει την ψευδαισθησιακή άρνηση του τραύματος.

Το γεγονός ότι ο άνθρωπος καταφέρνει και επιβιώνει από τον μεγάλο κίνδυνο που αντιμετωπίζει στη γέννα, αλλά και η ικανοποίηση που παίρνει καθώς καταλαβαίνει ότι μπορεί να ζήσει έξω από την μήτρα της μητέρας  γράφονται ανεξίτηλα πάνω στο νου του και τον ωθούν κατά περιόδους στην επανάληψη παρόμοιου κινδύνου μόνο και μόνο για να νιώσει την ευχαρίστηση ότι και πάλι τα κατάφερε. Η προσωρινή επιστροφή στην μήτρα της μητέρας και η επανάληψη σαν παιγνίδι και η υπερπήδηση όλων των κινδύνων που υπάρχουν στην γέννα και στην προσπάθεια προσαρμογής αμέσως μετά για να ζήσεις  και που βιώνονται στην συνουσία, λειτουργούν αναζωογονητικά με τον ίδιο τρόπο όπως και ο βραδινός ύπνος.

Στα όνειρα, στις νευρώσεις, στους μύθους, στην λαϊκή σοφία κλπ. Η συνουσία και η γέννα έχουν τον ίδιο συμβολισμό της σωτηρίας από κίνδυνο, ειδικά από νερό αμνιακό υγρό). Η αίσθηση όταν κολυμπάς, επιπλέεις και πετάς εκφράζουν την αίσθηση κατά την συνουσία και την ύπαρξη στην μήτρα. Πολύ συχνά, τα γεννητικά όργανα συμβολικά εξισώνονται με το παιδί. Από τη στιγμή που η λιμπιντική ένταση που αρχικά περιορίζεται στα γεννητικά όργανα ξαφνικά εξαπλώνεται σ’ ολόκληρο τον οργανισμό ολόκληρος ο οργανισμός μοιράζεται αυτή την ευδαίμονα κατάσταση της ενδομήτριας ύπαρξης.

ΓΕΝΕΤΗΣΙΟΤΗΤΑ ΚΑΙ ΔΙΑΝΟΗΣΗ

separation … is one of the fundamental life principles. All organic evolution itself rests upon separation, but only the conscious knowledge of this life principle on the part of man who can preserve or call back the past in his memory, or can imagine the future in his memory, gives to the concept and the feeling of separation the fundamental psychic meaning.

The neurotic frequently introduces his story with the remark that he has felt himself different from others from childhood … Regardless of how far this feeling is correct historically in terms of actual content, at all events it is psychologically true insofar as the individual traces his difficulties, his sufferings, back to his difference. Whether this difference has belonged to the individual from childhood, whether it first appeared through painful experiences of later life, or whether it does not come to full consciousness at all, it exists, is given in the very fact of this individuality, which apparently he can neither accept nor affirm, but must deny … Accordingly, the individual suffers from his difference, from his individuality…

Such craving for likeness in the face of all the multiform differences -individual, social and racial – originates in man’s need to counteract the negative aspect of individualization, in the last analysis, death.

Separaton fear is also a fear of life… which …seems to me actually the fear of having to live as an isolated individual.