Chapter 2
E. THE EFFECTS OF THE PARADIGM
The existence of a "positive umbilical affect" flow wherein "powerfully impressive experiences from the mother and her inner and outer world . . . reach the foetus"163 and its response in turn is "ideal" because of a prenatal sojourn in the "the womb of a gloriously happy and fulfilled wife and mother-to-be"164 is somewhat rare.
That during fetal life this person was well-supplied in every way, that the birth process went smoothly, that the maternal bonding was immediate and strong, and that the environment of infancy and early childhood was affirming, in all likelihood results in an adult whose psychological and emotional adaptation is, while not perfect, near ideal. They have the psychic tools to cope well with the exigencies that dynamic existence gives rise to. They, as Lake describes them, are those with "more robust natures, nurtured in kinder wombs, [and therefore] can shrug off . . . disappointments, or bear them, finding no antecedent pattern of neglect to latch on to."165 They, in turn, visit the benefits of their "history" on their progeny to the "third and fourth generation.
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163Lake, "Research into the Pre-natal Aetiology of Mental Illness, Personality, and Psychosomatic Disorders," 5.
164Lake, "Theology and Personality," 65.
165Lake, "Supplement to Newsletter No.39," 2.
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That the great majority of persons do not share this ideal "history" gives rise to two other major categories of adults, the "normal" and the "abnormal" (ie. neurotic and psychotic), and very often these categories overlap, sometimes simultaneously and sometimes serially. The first includes those who cope with life by "murdering the truth" successfully, those who "go along with it"166 and by the dynamics of repression succeed in keeping the truth of the early trauma and tragedies of fetal life safely at bay. Lake described this dynamic:
As soon as the tragedy of human life impinges upon the infant, indeed upon the fetus still within the womb, the truth of what has happened is immediately murdered by repression and turned into a lie which denies that it ever happened.167
Lake continues to describe this "average man:"
His is a life lived over the top of the tissue of closely woven lies, a fabric of falsehood. . . . Therefore, the line between the 'normal' person and the 'neurotic' is not that the normal personality can function without the intrinsic falsehood whereas the neurotic person cannot. Quite the contrary. We call a person 'normal' if the self-deception that he uses to repress, deny, displace, and rationalize those basic wounds that are ubiquitous in human beings from babyhood works quite well. He is 'normal' in so far as his defenses against too much painful reality are as successful as (all unbeknown to the person himself) they are meant to be.168
When the "success" of these defenses against these "basic wounds" begins to flag and the "murdered truth" begins to emerge into present reality, often in an altered form, then the second group of persons emerges: those who are considered psychologically deficient, neurotic or even psychotic.
The "normal" person often hides a cryptic "wounded" person who emerges only due to some present life stressor. The manifestation of this emergence takes the form of presenting complaints, which are recapitulations of and reverberations from the earliest fetal experiences, perhaps, as Lake described, in "the uterus of a desperate, dissipated or dishonored woman whose hatred of life may take her own in suicide or that of the foetus in an attempted abortion which didn't quite come off."169
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166D.W. Winnicott as quoted by Lake, "Studies in Constricted Confusion," C68.
167Lake, "Theological Issues in Mental Health in India," 65.
168ibid., 118.
169Lake, "Theology and Personality," 65.
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The various maternal-embryo/fetal dynamics of the blastocystic and implantation stages, of the rest of the first trimester, of prenatal, peri-natal and postnatal life, gives rise to "wounds" and the consequent reaction to these wounds which manifest themselves in particular patterns. The original formation of these particular coping pattern depends upon several components. The intensities and duration of stress, the "input" point in the "dynamic cycle" at which the stress comes, the active or passive reaction of the fetus to this stress, and the constitutional "diatheses"170 are all important predictive factors.
As was noted in the previous chapter (see Fig. 2), diminution in resources at the "being" phase of input in the dynamic cycle gives rise to the most severe "personality disorders, the most disruptive of healthy self-hood and relationships":171 the schizoid, hysterical, and anxiety-depressive reactions.
These "reactions" are all mediated by the severity and duration of the diminution and the response of the fetus. A reduction of maternal supplies at the "well-being" input phases results, depending again upon the severity and duration of the stress and the response of the fetus, in the maladaptive patterns of paranoia and anxiety-less depression.
Whatever the stress and whenever it strikes, the "womb-distressed" person, Lake writes, "complains as if it remembered the bad times it had been through. It reacts to the world around it as if it were still in the bad place, still having to 'feel its keenest woe.' It reacts defensively as if the attack were till going on."172
These reactive coping patterns, once used, are then utilized again and again, setting up particular paradigms of "wound management" that are recapitulated endlessly into adulthood. Lake writes:
Similar 'neglect-shaped' experiences in infancy and childhood plunge these unfortunately damaged creatures into an excessive and seemingly unreasonable degree of distress, adding to their new injury all the
catastrophic feelings and sensations that belonged to the first one.173
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170Lake, "Treating Psychosomatic Disorders Relating to Birth Trauma."
171Frank Lake, "The Dynamic Cycle," 8.
172Lake, "Supplement to Newsletter No.39," 4.
173ibid.
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Thus Lake states:
All the common diagnostic entities of psychiatric practice, hysterical, depressive, phobic, obsessional, schizoid, paranoid, have their clearly discernable roots in this first trimester. Each of them constitutes a particular view of the foetal-placental world and what goes on in it. . . .it is important to recognize these 'world views,' since they are the same fixated patterns of perception which impose themselves, more mistakenly than accurately, on roughly similar events throughout life.174
When there is type of "block" from mother to fetus of "being itself", it is, as Lake described it, "an almost irremedial disaster. It is of all things the most destructive of the life of the organism."175 Three main psychopathologies or "wound management reaction patterns" result: anxiety depression (also called involutional melancholia and/or accidie,)176 the hysterical personality reaction, and the schizoid personality disorder (in its most serious manifestation called schizophrenia).
1. The Anxiety-Depression Reaction
An active response, due perhaps to constitutional strength, to a diminution of "being-itself" results in anxiety depression. Lake wrote:
Depression and anxiety emerge from our deepest experiences of loneliness, of being unrecognized, over-looked, ignored, neglected, forgotten, disregarded, dropped, slighted, unnoticed, scorned, given the go-by.177
Even though the fetus, in the threat of "objectivelessness", would like to "block, squeeze, push, cut or pluck off the [umbilical] cord,"178 to do this would be to destroy himself. He quickly learns that his active response of anger and rage threaten to
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174Lake, Tight Corners in Pastoral Counselling, 24
175Lake, "The Dynamic Cycle,"
176Frank Lake, "Anxiety Depression,"
177Lake, "Supplement to Newsletter No.39,"
178Lake, "Studies in Constricted Confusion," C-42.
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destroy it's own environment by risking a rupture with the all-powerful mother and therefore must be dissociated from consciousness and immediately repressed. The anger and rage are controlled by "turning its force against the self" and splitting off the memory to the unconscious. When, to this repression, is added a reactive move, "the compulsive development of a rigidly compliant and mild personality to offset the hidden rage, we are in the presence of the dynamics of anxiety depression."179 All of this "surging conflict is recorded in the history of early uterine life"180 and there is "overwhelming evidence that this sense of our presence being painfully overlooked by the person whose loving recognition [ie. "being-in-relatedness"] is more necessary than mere physical existence, occurs within the early weeks and months of life in the womb."181
That this same basic process is replayed again and again through the pre-, peri-, and post-natal stages results in a dam of repressed anger and rage. Immense emotional energy is expended by the ongoing attempt to not remember these painful memories. In addition, the erection of a defense of idealized external behavior (ie. a reaction pattern) exactly opposite of the rage within serves to ward off from consciousness what is truly within. Rage, distrust, despair and apathy within are converted respectively into compulsive compliance, idealization, optimism and doggedness without.182 This process is propelled by fear of the consequences of the expression of the rage within. Lake states that "the murderous rage is so strong that to save others, a man may kill himself."183
These are the dynamics of depression. That this is common is suggested by Lake when he relates that 75% of persons suffer from depression at some time.
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179Lake, "The Dynamic Cycle," 10.
180Lake, Tight Corners in PastoraI Counselling, 101.
181Lake, "Supplement to Newsletter No.39," 2.
182Lake wrote "The panic and dread, emptiness and fear, rage and envy, are all dealt with within the repressive layer, and 'appear' in consciousness only as their opposites, confidence and pride, capability and calm, compliance and generosity. The person is entirely unaware of the contents of his unconscious mind, and is aided and abetted by a variety of mental mechanisms in remaining so." (Lake, "The Dynamic Cycle," 17).
183Frank Lake, "The Bearing of Our Knowledge of the Unconscious on the Theology of Evangelism and Pastoral Care," 68.
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Lake writes:
There are many depressed people whose inner conflict consists in the tiring tussle between ancient rages within, fanned into smoldering anger by present-day frustrations, and the forces of fear that keep such feelings under control. They never burst into flame in consciousness because of the forceful repressive and suppressive mechanisms that control them so totally that such people will deny that they are angry.184
The only cure is to help them become aware of the cauldron within and to attempt to get in touch with its primary and early causes. This is where Lake's use primal therapy comes in.
2. The Hysterical Reaction
The hysterical and schizoid reactions are really one reaction pattern on opposite sides of the "the abyss" of trans-marginal stress.185 Unlike the active response of the anxiety depression reaction, the hystero-schizoid response, perhaps due to constitutional weakness, is passive in the face of the diminution and loss of "being-itself." Referring to the hystero-schizoid reaction to distress, Lake writes:
A primal injury to the personality has split its roots into two quite separate systems. One grows up to seek . . . the world outside itself. [whereas] the other root grows up into the world of the mind, the inner world of reflection reason, intellectual and mystical resources.186
The fetal reaction to distress that grows from the root of externalization is the hysterical pattern, which results from the loss or diminution of "being-itself", with a concomitant rise in apprehension leading finally to panic. This panic, stemming from non-attention, from non-recognition of "being" is defended against by a reaction pattern of compulsive attention-seeking behavior, often extremely extraverted, and compulsive attachment. This insures that continued "being" (and "well-being"), not given in the intra-uterine period and thus not stemming from within, continues to come to the hysteric from outside himself. His behavior is designed to manipulate and induce
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184Lake, Tight Corners in Pastoral Counselling, 98.
185Lake "Studies in Constricted Confusion," C69.
186Lake. "The Bearing of Our Knowledge of the Unconscious on the Theology of Evangelism and Pastoral Care," 33.
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a steady flow of "being", of attention, of recognition. Thus any behavior that results in this "goal" is utilized, including histrionic self-dramatization, seductivity, exhibitionism, oversuggestibility, exaggeration, irrational outbursts and impulsivity. That this behavior compels others to give reluctant attention and acknowledgement is simply a recapitulation of the original dynamic, when the resources of "being" were not freely given, but withheld and constricted. The dependent "being" relationships are superficial because there is never satisfaction of the primal hunger for "being", instead there remains the constant anxiety that the source of "being", ever reluctant, will act capriciously and constrict the supply. This leads to further behavior designed to prevent this from occurring.
Since the primal hunger for "being" remains, the hysteric is always "hungry". He is "hungry" for touch and talk, an emotional sponge.187 Since "being" has never been internalized, and even though much "input" in the form of "being" and "well-being" seems to take place, the "status" of the hysteric is so spirit-impoverished and egocentric as to prevent any "output"; all "output" energy is directed toward gaining, holding, and maintaining the superficial "input" from others. "Achievement" is limited to self-glorifying, self-assuring, short-term goals.
3. The Schizoid Reaction
When the loss, constriction and diminution of "being" occurs to a point of absolute intolerability then the hysterical becomes the schizoid. The hysteric seeks "being" outside himself whereas the schizoid detaches himself from the external world and lives reflective self-creation. Lake wrote:
Being essentially self-creating, it [the schizoid] continues to be self-subsistent. It feeds upon itself, turned in upon its own mental processes.188
What separates the hysterical from the schizoid and makes them seem the very antithesis of each other is the intervention of a trans-marginal break, wherein there is a paradoxical switch that translates the hysterical wish for life and "being" into the wish
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187Frank Lake, "The Hysterical Personality Disorder," chart H.a., in CIinical Theology.
188Lake, "The Bearing of Our Knowledge of the Unconscious on the Theology of Evangelism and Pastoral Care," 33.
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for death and "non-being." Similar to the genesis of the hysterical reaction type, the schizoid reaction is passive and commences in response to mounting anxiety in the light of the constriction of recognition, in the light of the diminution of the resources of "being." First, there is conscious and then unconscious panic. There is a margin of tolerance that ends "at a point determined by constitution, heredity and recent experience,"189 which when passed, results in ultra-maximal stressing and dread. "The heart breaks and there is a falling headlong into the abyss of dread and non-being.
The self is annihilated. God is dead. . . .There is an identification, not with human beings, but with non-being."189 Despair, intolerable dereliction, an overwhelming sense of forsakeness, feelings of futility, hollowness, nothingness, inferiority, depersonalization, uselessness are characteristic of this "death of the spirit." Paradoxical reactions result.
Previous to the trans-marginal stress, the fetus desired to be affirmed, recognized, and loved; after he desires to be left alone and isolated. Pain is now embraced where previously pleasure was pursued. A desire for death replaces a desire for life. Perceptions are disorganized and include hallucinations and delusions. The sense of time is inverted. There is self-scorn, self hatred, and self-destruction. A sense of ontological guilt that "I ought not to exist" is characteristic.
That all this had its root in the first trimester was strongly affirmed by Lake. The origins of affliction, he wrote, that are responsible for "many of the characteristic and severely self-damaging features of schizoid affliction. . . . must be firmly placed in the first trimester, within three or so months of conception."191 A horribly bad umbilical flood has invaded the fetus "overrunning all defensive barriers, penetrating the whole body."192 Thus, all of the body becomes loathsome to the person, and the ego splits itself off from what is now considered revolting. The "good" takes refuge in the head, or in extreme cases, in a disembodied "spirit". There is a basic awareness of "to be me is to be bad."
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189ibid., 34.
190ibid.
191Lake, Tight Corners in Pastoral Counselling, 23.
192Lake "Studies in Constricted Confusion," C42.
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This experience of dread and the "abyss" is split-off from consciousness and deeply repressed. "A great fear and hatred of this weak, hurt, wretched, humiliated, annihilated, disintegrated self and spirit, keeps it most rigorously repressed and defended against as 'not-me."'193 Instead of the compulsive attachment of the hysteric, there is compulsive detachment, distrust and introversion. There is a strenuous avoidance of commitment and intimacy coupled with a clinging to autonomy. There is emotional flatness, spiritual poverty, and overintellectualization. Contempt for others hides envy and jealousy. Sexual expression is often fetishistic and impersonal.
Since there has been no sense of inculcated "being" and consequently no sense of "well-being" at the input phases, the schizoid sufferer has nothing to expend in the "output" phases. Unlike the hysteric who looks for "being" and "well-being" from others outside himself, the schizoid had no "being" and gains sustenance ("wellbeing") from ideas. There is no essence of integrated self-hood and no self-identity. Consequently, the "status" and "achievement "of the schizoid are not characterized by giving, but by negativity.
While the hystero-schizoid and anxiety depressive reactions result from a loss of "being", the depressive and paranoid reactions are the outcomes of a blockage, constriction or diminution of "well-being". Thus, basic "being" is not the issue and is indeed assumed. What is at risk are the ongoing resources that allow for continued growth and conveyance of an inflow of affirmation, love, kindness resulting in "good spirits, courage and personal vitality."194
4. The Paranoid Reaction
When the fetal reaction to deprivation of sustenance is passive, the paranoid personality reaction results as a defense against the primal loss of "well-being." "Being-itself" is secure and thus the integration of ego is not threatened. Rather, the root experience of the paranoid is the gradual loss of a sustaining supply in relation to his own increasing needs for physical and emotional sustenance.
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193Frank Lake. "The Schizoid Personality Disorder," chart S.a., in CIinicaI Theology.
194Lake, CIinicaI Theology, 133.
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When this occurs in the first trimester, and Lake was insistent that it did,195 the umbilicus and placenta gradually shut down their flow of supplies. The fetus has the sense of having its rights violated and of being denied, with the attendant feelings of worthlessness, humiliation, helpless, inferiority. He feels undervalued and has an extremely low sense of self- esteem.
These feelings are eventually split-off, denied and repressed and reaction patterns to maintain the repression take hold. The main line of defense is usually projection, in which the paranoid unwittingly attributes to others his own denied desires and faults. Even though he projects an air of sufficiency and confidence, sometimes by belittling others, defensiveness, suspiciousness, argumentivity and hypersensitivity to criticism remain.
Because his "rights" were previously violated, he is determined to exercise his
rights. Since self-esteem ("status") is constantly being established, he is constantly and vigilantly on the lookout for possible detractors. Thus, he never enjoys "status" because it is constantly in flux, always awaiting the next indication that it exists. His achievements are trumpeted and failures are explained away as someone else's fault. He is constantly trying to prove his point and prove himself to the world. Thus, the "output" of his "achievement" is always in the service, not of others, but of proving his "status."
5. The Depressive Reaction
Just as an active response of a constitutionally stronger fetus lead to depression when the sources of "being" are restricted, so an active response to the constriction of "well-being" also results in depression. Whereas the first also includes anxiety because the very "being" of the organism is threatened, the depression or "accidie" resulting from the blockage of "well-being" does not have the dimension of anxiety to it. The fetus reacts to this cutoff of supplies with rage, bitterness, sullenness and resentment. There is "ample experience of unmet need, of rage at the injustice of it."196
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195"The baby felt identified with weak-being, with emptiness and meaninglessness, with a tearful sense of inferiority and low self-esteem. Well, with absolutely no alteration, you can take that into the first trimester. . . .
I assure you that this is intra-uterine, every single bit of it. We've had it in hundreds and hundreds of people." (Lake, "Post Green Speech," 167-168).
196Lake, Tight Corners in Pastoral Counselling, 101.
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Behind the secondary process of rage is the primary cause, "the situation of basic needs which the mother could not or did not meet." This rage is restrained, sometimes out of fear and sometimes out of sympathy for the mother who seems not to have any supplies to give.
That in the normal mother-fetus relationship the umbilical exchange between mother and fetus is mutual (ie. nutrients from mother exchanged for waste from fetus) is undeniable. However, the exchange of supplies between mother and fetus is most often perceived to be unidirectional. It is the fetus, because of its relative lack of strength, that is usually supplied and/or "invaded" by the mother's "affect flow" and not vice versa.
However, the existence of the umbilicus provides for the mechanism allowing a reversed flow to occur, and indeed, this does occur. Lake states that a reaction at times arises where the "foetus feels a need to give to this poor, weak mother. Well aware that it has little to give because little has been received, none the less there can be a fateful sense that 'it is my role to keep her alive."'197 Thus, when a constitutionally strong fetus receives an ambivalent or clearly negative affect flow from a weak, inadequate mother, the "fetal therapist" form of depression results. The fetus accepts the burden of doing everything possible to prevent and palliate the mother's stress and resultant distress. This necessitates a denial of and refusal to meet one's own needs.
This often results in a life-long pattern of a reversed flow of love and caring, from child to parent. At the root of this behavior, even involving adult children with their parents, is the "valiant attempt to get a small modicum of maternal tenderness."198 Also recapitulated into adult life is a denial of and refusal to meet one's own needs. In "dynamic cycle" parlance, there is no input, and thus there tends to be no output. Since the "input" sense of "being" is tenuous and the input sense of "well-being" is almost nonexistent, the "output" phases of status and achievement are meager.
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197Lake, "Theological Issues in Mental Health in India," 20.
198ibid.
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6. The Psychosomatic Reaction
Whereas the "fetal therapist" response pattern results from a dysfunctional reversed flow of fetal-maternal exchange, another common "wound management" coping pattern results from a mixed affect flow from mother to fetus. The "good" of the needed nutrients of "being" and "well-being" are mixed in with the "bad" of the "foetus being 'marinated' in his mother's miseries."199 In order to get the "good", the "bad" must also be accepted "with the corollary that the 'badness' must not be fired back at the placenta/mother via the excretory umbilical arteries, but 'loaded up' in the foetus' own body structures."200
Thus the invasive "badness" of both the experiences themselves and the repressed memories that follow is dealt with in one of two ways. The first and most common involves the displacement and containment within the fetal organism.201 This is done either by displacement into an emotional state such as depression or paranoia, or by displacement in or on a body part. The second mode of dealing with the "badness" involves a symbolic displacement onto some representative image.
When a displacement occurs onto or into a part of the body, then psychosomatic symptomology results. In Lake's 1969 survey of clients who had experienced an LSD-assisted abreaction of pre- or peri-natal events, 34 out of 57 reported some type of psychosomatic affliction.202 Lake saw the fact that none of these reported a worse condition as a result of the experience and 16 reported an improvement as an indication of the connection between their present complaints and the early genesis of them.
According to Lake, somatic displacement of early emotional wounds accounts for much of the presenting complaints of "sickness." Depending upon which constituent segment of the body is the "diatheses," and thus which is displaced upon, different somatic 'diseases'203 or outcomes result.
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199Lake, Tight Corners in PastoraI Counseling, 141.
200Lake, "Mutual Caring," 21.
201Lake, "Supplement to Newsletter No.39," wi 1.
202Fifteen reported migraines, five asthma, seven allergic rhinitis, three arthritis, four dermatitis. (Lake,"Treating Psychosomatic Disorders Relating to Birth Trauma," 232).
203This is taken from four Lake sources:
1. "Studies in Constricted Confusion," C-41, C-42, C-59 and C-60;
2. "Supplement to Newsletter No.39," wi 1;
3. Tight Corners in Pastoral Counselling, 30-7;
4. Frank Lake, "The Maternal-Fetal Distress Syndrome. Negative Umbilical Affect: Defenses against invasive pain by symbolic displacement and containment." One page chart (Nottingham: Clinical Theological Association, Lingdale).
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Displacement onto the head, face, or scalp, which is usually the last refuge of the "good" as it is being invaded by the "bad', results in flitting or persistent headaches, migraines, facial tics, and perhaps Sydenham's chorea and Giles de Ia Tourette syndrome. Specific naso-pharyngeal displacement results in a chronic running nose and a susceptibility to catching colds. Displacement into the mouth effects oral tension, a clenched jaw, and a compulsive biting the skin of the mouth whereas tightness in the throat follows from displacement into the throat. Transfer of the "badness" to the eyes results in conjunctivitis, or either 'shame-faced' aversion of eye contact or visual (ie. 'if looks could kill') daggers.
When the 'badness' is shifted onto respiratory tract and lungs, the bronchial musculature, usually used to 'expel" the bad, now can also paradoxically 'contain' it. Coughing, hawking, spitting, along with a general noisy and angry demeanor result. Cystic Fibrosis, wherein there is an attempt to expel the mucus without the fluid to do it, is representative. Likewise, bronchitis, asthma, hay-fever and myriad other allergies result due to an hyper-sensitivity to various 'foreign' environmental substances which can 'enter and cause harm" and are thus symbolic of the invasive entering and harming of the 'foreign" flood of maternal affect.
Transference of the 'badness" to the musculo-skeletal components of the body results in chronic back pain, aching muscles and joints, cramps and stiffness, local swelling of hands, feet, legs, ankles, and arms. Nail-biting, lumbago and arthritis, as well as the more specific possibilities of sero-positive Rheumatoid Arthritis, Sjogren's disease, and carcinoembryonic antigen (CEA) follow displacement into the feet, knees, ankles, wrists, hands, and fingers.
Hypertension and stroke, atopic eczema, anal and genital paroxysmal itching,
urticaria204 and localized dermatitis, are the outcome of displacement onto the heart and skin respectively. Nausea, vomiting, dyspepsia, flatulence, bloating, anorexia nervosa, diarrhea, mucous and ulcerative colitis, colic, peptic ulcers, diverticulitis, hypochondriasis and constipation all derive from alimentary tract displacement.
The feeling of having a bladder or accumulations of badness somewhere underneath the sternum . . . [such that] it feels to be . . . filthy, black, bad, heavy, lumpy, gooey, brown, green, bitter, shitty"205 is what Lake terms "sub-sternal displacement". Slightly farther down in the body are. the bladder, genitals and genito-urinary tract. Displacement here produces the irritable bladder syndrome, frequent and urgent micturition, enuresis, pre-menstrual tension, dysmenorrhea, amenorrhea, vaginitis, sexual frigidity and impotence.
According to Lake, all of these result from displacement of experiences and memories resulting from an invasive negative or strongly negative affect flow from mother to fetus. Lake affirmed that this type of displacement results because of a specific "diatheses," and thus in a specifically psychosomatic outcome. When the "diathesis" is, mental or emotional, then the more classic psychiatric categories result.
This is the M-FDS in its basic paradigmatic format. Lake makes the application of its consequences first to the physiological and psychological dimensions and then to the theological.
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204Raised weals of red or white skin.
205"Supplement to Newsletter No. 39," w11.
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