The Thoughts of Frank Lake, M.D.

Dr. Frank Lake

(Late English Theologian and Psychiatrist)

By John A. Speyrer

"Preventive war is like committing suicide for fear of death."
-- Otto von Bismarck

Bismarck's analogy seems logical and reasonable but it may not be an apt one as forty years ago a friend confided to me that his father had just killed himself because he was scared of dying. His father's physician had diagnosed his condition as very advanced generalized atherosclerosis and told him that he had not long to live.

Naturally, I had been surprised and puzzled. My friend's account of his father's suicide at the time seemed to be quite contradictory, being paradoxical. Why would a person seek as a solution to his mental misery to complete the very action which was the source of his misery and depression?

I did not get an answer to this puzzle until three decades later. When the answer arrived it was the result of personal insight during my primal therapy -- the answer received in a way I would have preferred not to have felt. [See my article, The Fear of Death: On Dying In The Birth Canal.]
-- John A. Speyrer, Webmeister

"Freud's sharp awareness of the 'death-wish' in many of his patients did not, as far as I am
aware, lead him to give a clear account of its origin. Nor could he do so without achieving conceptual clarity about the effects of dread, that is, of existence 'beyond the frontier',
when longing for life has been so thwarted as to become intolerable, changing it catastrophically into a longing for death."

-- Frank Lake, M.D. Clinical Theology: A Theological and Psychiatric Basis to Clinical Pastoral Care (1966), page 698 - chap. 9, "Schizoid Personalities"


Frank Lake was born in England in 1914. He graduated from medical school in 1937. Always interested in theology and its relationship to psychiatry, he served as a medical missionary in India. Upon returning to England from India in 1950 he retrained in psychiatry.

It was in 1953 that the Swiss discovery, LSD, began to be used in psychotherapy in Europe and in the U.S. Dr. Lake soon noticed that the psychedelic was a powerful force in lowering patient's physical and psychological defenses as frequent painful infantile memories began to be uncovered in his patients. But what really surprised him was the frequency with which his patients began reliving the trauma of their births.

Though at first Lake believed that re-living birth trauma was impossible, checking a number of his patient's medical records confirmed that their re-livings mirrored the traumas listed in their birth records. Lake thus became convinced that his patients were indeed reliving an actual biographical event.

His early LSD powered seminars were held with the Anglican clergy throughout Great Britain. Later the groups were expanded to include social workers, nurses, physicians and other health-care workers (Also, on this website, see Lake's Birth Trauma, LSD and Claustrophobia).

The writings and experiments of the Russian neurologist, Ivan Pavlov regarding stress, was a great influence in the thinking of Lake as regards to birth trauma. The discovery of the concept by Pavlov was a serendipitous event.

When caged dogs in a flooded laboratory basement were rescued right before they drowned, Pavlov noticed that the animals retained overstimulated (nervous) reactions over time as well as having lost their prior conditioned behaviors.

Pavlov's concept of transmarginal stress was soon embraced by Lake as he noticed that Pavlov's theory was also applicable to some of his patients -- those patients with the most severe birth traumas (The concept explained in the fourth category below).

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"When death is the greatest danger, one hopes for life; but when one becomes acquainted with an even more dreadful danger, one hopes for death.
So when the danger is so great that death has becomes
one's hope, despair is the disconsolateness
of not being able to die."

-- Dr. Frank Lake


Frank Lake found that, from a trauma viewpoint, births could be placed within four categories:

  • The first type of birth is non-violent as the fetus looks expectantly toward beginning a new phase of existence and such anticipation is achieved. This is the typical "good" birth in which the fetus concludes that life will be a challenge which they will successfully meet and any difficulties they encounter will be temporary and will be overcome. The experiences in this type of birth serve as a lifescript and optimism is a lifelong common feeling among those who have experienced a non-violent birth. The other stages listed below do not occur.

  • "The second stage occurs when the birth passages prove difficult to dilate, or the bony pelvis is too narrow to allow the head to pass, at least not until severe moulding has occurred."

    The physical and mental suffering which the fetus endures is on a larger scale and/or the time consumed in the birth process is longer than that in first category. The baby being born wants to return to the comfortable womb it has just left.

  • In the third category, the fetus' head ". . . is jammed in the pelvis and can move neither forwards nor backwards. The will to return to the womb is as useless as the will to move forward. Only one struggle is possible, the struggle to live in spite of growing distress, crushing of the head, and lack of oxygen. The identity of someone suffering from an anxiety state not uncommonly has this biological emergency as its primary determinant."

Later in life such a

". . . person may wake in the middle of the night with a sense of intense panic, fast-beating heart, breathlessness, sweating, extreme heat or cold, and though the struggle is certainly to maintain life, death seems to be just round the corner. When this emergency passes there is a great sense of relief that life is restored, together with room to turn round, room to move and room to breathe."

  • It is in the fourth category of birth that the elements of desire for death as well as the fear of death are developed. Here is this, the most traumatic type of birth, where the feelings associated with Pavlov's concept of transmarginal stress is begun. Dr. Lake writes that the fetus' desire for immediate annihilation becomes automatic as

    "(t)here is a limit to the pain and panic any living organism can bear. When that limit has been reached there is a sudden, dramatic and drastic reorientation of the whole will. Instead of struggling to live, the organism is struggling to die. Life under such conditions is intolerable. Death is preferable."

    It is the feeling of one in whom

    "the loathing of the pain of being born may be so great that the wish to die almost entirely replaces the former longing to live. In fact, the intensity of the earlier longing is transformed, mechanically and without any act of the will to the latter, at the point where sheer intolerance of pain takes over. As with Job, the infinite desire is to be carried from the womb to the tomb. Indeed, the passage from the womb has become the tomb of the baby's natural hope of a secure and friendly universe. In so far as a sense of personal identity takes its roots in this experience, it is the identity of one whose spirt lives within the schizoid position, whatever defences have been used against it. In one or another it is the identity of someone who is always feeling that death is preferable to life." See footnote [This paragraph and the paragraph above are from Dr. Lake's booklet, Personal Identity - Its Origins, p. 7]
    Dr. Stephen M. Maret, in his doctoral dissertation, Frank Lake's Maternal-Fetal Distress Syndrome: An Analysis, wrote that Dr. Lake believed that philosopher Søren Kierkegaard psychobiohistorically was "incomparably the most perceptive diagnostician of the tortuous paradoxes of the schizoid person." Maret again quotes Lake as associating Kierkegaard's "incurable melancholy" "closely with dread and the abnormal, paradoxical wish to die and be annihilated, in order to escape the mental pain of it." [Stephen M. Maret, Ph.D., op. cit., p. 175-179]

    Lake investigated the writings of, among others, Simone Weil, St. Augustine, Martin Luther, St. John of the Cross, St. Teresa of Avila, John Bunyan, Jean-Pierre de Caussade, as well as P. T. Forsyth and found them to be innately knowledgable of birth trauma with transmarginal stress. He arrived at this conclusion based on the description of their individual psychopathologies. Interestingly, all eight of these individuals were intimately involved in religious mysticism. This almost begs for a reply to the question, "What is the relationship between severe birth trauma and mystical experience?" [See my index of articles on The Psychology of Mysticism on this website] Maret writes that Lake found that the early poetry and later writings of the late Pope John Paul II also show empathy into the schzoid position molded by the transmarginal stress of birth.

    One's peri-natal influences last for a lifetime or until healed. Lake believed that

    "Those who have been intensely active in their will to live become intensely active in their desire to die, and in the steps they take to achieve it. Similarly, those who are passive and lukewarm in their will to live, remain so when it has become the will to die."

    The author believed if the early stages of labor went well and there was a happy womb-life during gestation, then the person tries to preserve this earlier positive attitude as the basic characteristic of his personal identity - his personality. "But if this, and the memory of it, has been almost entirely destroyed by the devastating effects of transmarginal stress, then there seems to be no living identity worth preserving."

    In the same way that Pavlov's dogs lost their previous conditioning as a result of near drowning, the fetus in the throes of transmarginal stress in the birthing process, loses his earlier womb-based decision that life is exciting and worthwhile. All of the earlier positive intrauterine environmental conditioning will have been erased and the infant born with a fear of the world and its dangers.

    Lake ponders the question of the reasonableness of asserting that the solitary experience of a devastating birth experience can change the course of life "even to the point of determining whether the self can accept social involvement or not?"

    He decides that

    "(t)he evidence shows that suffering in the birth passages which exceeds the margin of the tolerable, does cause profound deviations in the sense of personal identity which last for life. In conjunction with constitutional and hereditary factors which determine the amount of pain that can be borne, and for how long, and in what manner, either actively or passively, it does seem to be a fact that when birth injury inflicts the fourth stage of intolerable pain, this is bound to express itself in the social matrix as an avoidance of commitment, involvement, or social embodiment."

    Dr. Lake discontinued the use of LSD in 1970. He had found that using deep breathing techniques with Janov's primal therapy was as effective as, or superior to, LSD therapy.

    [Unless otherwise attributed, the quoted sections above are from Lake's Personal Identity -- It's Origin, pages 7 - 9.]

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    "Once the great pain of the prototype -- the near-death experience around birth -- has been relived many, many times, the preoccupation with death as solution is . . . gone."
    -- Dr Arthur Janov, Why You Get Sick, How You Get Well


    Arthur Janov, Ph.D. (The originator of primal therapy) writes in Imprints: The Lifelong Effects of the Birth Experience, (1983) that sometimes suicidal ". . . (d)eath is a solution now because (at) near death . . . (dying) . . . was the only "solution" to birth trauma" then. "Death becomes stamped in as the answer, and given the right circumstances it becomes the only solution to life's problems. . . . Suicidal despair . . . is most often a memory of near death." Those who relive the death experience in and around birth seem to finally resolve that fixation on death and suicide (p. 214).

    Dr Janov concludes the chapter on Suicide As a Solution to Birth with these two paragraphs:

    It may seem odd that those few minutes around birth can determine whether or not one will consider suicide as a serious alternative at a later age, but the Primal evidence is convincing that this is the case. Attempts at suicide are attempts of the system to go back and get close to that death feeling. It's a way of recovering that original physiological experience in which the baby first came close to death in order to get into life.

    What this means is that suicide is really an attempt at healing, It is really an attempt to conquer death. It is, ultimately, a testimony to the power of Primal Pain: one would rather be dead than feel it. And not so accidentally, feeling the early death allows us to leave those suicidal feelings behind, forever (ibid.. p. 222).

    Feeling the physical and mental pains of a severely traumatic birth has always been a tormenting phase in primal therapy. In the early years of primal therapy psychiatric drugs were not used to attenuate the sometimes disintegrating effects of reliving such traumas. It was felt that such drugs were "not needed and either retard the patient by blocking feeling or cause him to skip over one level of consciousness or another. They nearly always prevent full connections." (Arthur Janov, Ph.D. Primal Man: The New Consciousness, (1975) p. 438-439). This position has changed as Janov presently believes that one may be in a state of numbness - without feeling, while an anti-depressant may enable access to one's early specific feelings and thereby allow for their resolution. (Arthur Janov, Ph.D., Why You Get Sick and How You Get Well (1996), p. 136.

    In his most recent book, The Biology of Love (2000), Janov writes about suicidal feelings:

    It is not often that the person wants to die. It is rather that the imprint is that death can end agony. It is that equation from birth that drives the person both toward and away from death. When hopelessness is added to the mix there is a feeling of impending death together with the feeling that there is no use in trying to change anything.

    It is so unfortunate that a person in a suicidal urge is unable to know and heal the origins of his wish to die. The knowledge is present in the unconscious biographical memory of the sufferer like all of the rest of the story of his life. The account, written in pain, italicized, underlined and highlighted continues to exist as inaccessible, banished information as it shapes his personality, causes his anguish, and all the while, like an unknown parasite, consumes his being.

    According to Stanislav Grof, M.D., having a tendency towards hypochrondria (an inordinate, unreasonable fear of disease) also points to the possibility of having nearly died during the birth process.

    Grof, a Czech-American psychiatrist, who has done extensive work with LSD beginning the same year, (1953) as had Frank Lake, believes that a traumatic birth may not be the only source of suicidal ("death as solution") depression, but that it is one of the most powerful. He writes in Beyond the Brain (1985) that hypochrondrial symptoms may be the result ". . . of serious physiological difficulties from the past, such as diseases, operations, or injuries - and particularly the trauma of birth."

    Dr. Grof writes that most birth traumas are readily treatable, and that after successful regressions to birth, we "typically experience a strong surge of positive emotions toward ourselves, other people, nature, God, and existence in general. We are filled with optimism and have a sense of emotional and physical well-being." He continues,

    It is important to emphasize that this kind of healing and life-changing experiences occurs when the final stages of biological birth had a more or less natural course. If the delivery was very debilitating or confounded by heavy anesthesia, the experience of rebirth does not have the quality of triumphant emergence into light. It is more like awakening and recoving from a hangover with dizziness, nausea, and clouded consciousness. Much additional psychological work might be needed to work through these additional issues and the positive results are much less striking.
    -- Stanislav Grof, M.D., The Cosmic Game: Explorations of the Frontiers of Human Consciousness (1998), p. 146-7


    "The torment of despair is precisely this - not to be able to die . . . not as though there was hope for life; no, the hopelessness in this case is that even the last hope, death, is not available. When death is the greatest danger, one hopes for life; but when one becomes acquainted with an even more dreadful danger, one hopes for death. So when the danger is so great that death has becomes one's hope, despair is the disconsolateness of not being able to die." -- Frank Lake, Clinical Theology (1966) p. 595-6, from Kierkegaard, Sickness Unto Death 150-1.

    Lake cites Kierkegaard's following story as an ironic yet humorous account of "the ultimate ultra-paradoxical reaction" of the death wish: "A man walked along contemplating suicide; at that very moment a slate (roof) tile fell and killed him, and he died with the words" 'God be praised."' (Søren Kierkegaard, The Journals, trans. and ed. Alexander Dru [London Oxford Univ. Press, 1938]: Extract #52, 785.) (All quoted material in this footnote is from Dr. Stephen Maret, op. cit.).

    Return to footnote referenced paragraph
  • On this website, also see:

    On the Origins of the Fear of Dying in the Writings of Michael A. Persinger and Others

    The Fear of Death: On Dying In the Birth Canal