By Leah LaGoy

Imprints, by Arthur Janov, recounts the life-long impact of birth from the vantage point of an adult. The impact of birth -- what I call pre- and perinatal trauma -- is ready to be recalled by children if they are given the chance. The children suffering from this trauma tell us about it in the form of developmental delays, pediatric illnesses, feeding issues, sleeping problems, temperament issues, difficulty behavior and learning disability, to name a few.

In August of 1993, at the Pre- and Perinatal Psychology Congress in Washington D.C., my research was presented, showing the loss of an early twin in utero.

From conception on through pregnancy to labor and birth, the trauma an infant experiences, including the early loss of a twin in utero and birth, has a direct relationship and effect on bonding and attachment.

It is well-known that whenever a trauma occurs it awakens any earlier trauma. For example, if a woman finds herself pregnant and her husband has cancer, the woman will have memories and fears awakened of her own father who had cancer when she was in utero and who died when she was a child.

Likewise, if a child is put in a foster home or given up for adoption, any earlier experiences involving fears of losing a parent or sibling or of being gotten rid of will be aroused.

A very clear example of this is a 2 1/2 year old developmentally delayed boy I am treating who could not make any eye contact with me initially. His eyes did not track together, he was fixated on circles, his entire body posture turned inward, he did not feed himself, and he did not talk. His hands had been clenched into fists for his first three months of post natal life. This toddler came from an unplanned conception. The mother was thrilled to be pregnant, through it required her to make many personal adjustments in her life. The father was not happy with this pregnancy.

During the fifth session, I learned the mother had drank an entire bottle of wine celebrating the successful completion of a very difficult and important final exam when, unbeknownst to her she was two weeks pregnant at the time. At almost the sametime, she had to go on strong antibiotics because she was ill and had bleeding quite a bit vaginally.

As she reported these things to me her toddler began to grieve deeply and throw himself repeatedly out of her arms. The alcohol, drugs and bleeding occurred around the time of implantation. Her bleeding indicated a possible twin loss, which her toddler confirmed by his synchronistic grieving and enactment of repeatedly throwing himself out of her arms, behavior which he had never before displayed.

In addition, I acknowledged to the child the similarity in body sensation between the movement of energy in one's body which is like the movement of energy in Chinese acupuncture, and the sensation of alcohol intoxication. I understood this in terms of this toddler's entire turned-in body posture. Every time his energy began to really move in his body, I hypothesized that I reminded him of a sensation level of the alcoholic intoxication and possibly the medication his mother had taken around the same time.

Because these things were coupled with the loss of a twin, every time he felt his energy more, a chain reaction of memories overwhelmed him and his entire body turned inward with clinched fists as in a total effort to "hang on" in utero and not die. I told him that when his energy began to "run" it felt like when his mother drank all the alcohol but it was different. "It feels the same but it's different. This is your energy."

What I said to this toddler seemed to match his original experience for the very next week his eyes were focusing, though not perfectly, he no longer walked in circles anxiously, his body no longer turned in and he had begun to feed himself. The power of accurate interpretation and empathy and support on the part of his mother and I had enabled this toddler to begin to separate from his very early prenatal near death trauma and direct his energy into his own development.

Lack of an ability or willingness on the part of the infant to engage in eye contact is one of the early signs of the beginning of an attachment disorder. To understand bonding and attachment disorders, it is crucial to understand prenatal trauma--more specifically, the relationship between conception, implantation, the early loss of a twin and the umbilicus.

In addition, one must have a deep understanding of symbolism and a conviction in the depth of a child's psyche in order to communicate on a prenatal level, for it is through the emotion, behavioral and symbolic content of a child's art and play that the child will tell his or her story. Doing one's own regressive work is also very helpful.

Conception involves an attachment interaction when the sperm unites with the egg. Implantation involves an attachment of the fertilized egg to the lining in the mother's uterus. The umbilicus is the life support device which attaches the baby to the mother and through which the baby receives nourishment and toxins.

If the sexual act out of which a baby is conceived is hostile, fearful, ambivalent or just for a good time with no commitment on the part of the adults involved to one another, both the egg and the sperm carry that cellular imprint. If a fertilized egg has a difficult time implanting--attaching to the lining of the uterus--this is also cellular imprinted. Whatever the imprinting, the child will act out the experience symbolically in his or her play.

If a multiple conception has occurred, which occurs 60-80% of the time (Diamond 1991, LaGoy 1992), one of the twins usually dissolves within the first eight weeks of pregnancy. When a twin exits due to an abortion attempt, the attachment anxiety is greatly exacerbated and is coupled with annihilation and anxiety. Twin loss is played out through a variety of dramatic and highly anxious enactments by children. These enactments include fear of the loss of their own lives as well.

Birth trauma, when it simulates prenatal trauma, recapitulates and more deeply imprints the prenatal trauma which is basically attachment trauma for the fetus is literally attached to the mother during pregnancy. My clinical experience is that children who have been identified with attachment disorders have experienced prenatal attachment trauma as well as later trauma.

In considering conception, implantation, early twin loss and umbilical experiences in terms of attachment, one can begin to understand that a baby being put up for adoption has already experienced a tremendous amount of attachment trauma before he or she is ever born. Adopteees have most often been gestated in a womb of isolation, fear, general unconnectedness and often hostility.

Babies witness and feel all of what the mother goes through and have their own set of feelings which include fear, terror, despair, loneliness and rage.

My clinical experience has shown me that the more accurate I can be in my understanding and interpretation about the origin of a child's presenting symptoms which is shown to me through his or her behavior, play and art, and reflect these back to the child with the appropriate empathy, the easier it is for the child to cooperate in his or her healing. The psyche knows where it needs to go to unwind trauma, but it requires the empathic and accurate understanding of another person. The origin consistently seems to be in the pre- and perinatal period.