Birth and motherhood, images and resonances

Birth and motherhood, images and resonances
Dr.ssa Mara Breno and Dr. Diego Frigoli*

Everyone has a fairy tale inside,
which he cannot read on his own.
He needs someone who,
with the wonder of his eyes,
reads it and tells it to him.
(Pablo Neruda)

Everything in the world, every event in our life, like our own body, is “impregnated” with soul, and all things present a visible and concrete facade, as well as a more recondite one in contact with the archetype: birth is one of them!
In it lies the mystery of fertilization, the mystery of how from two cells that meet, first the embryo and then the fetus develops, with the formation of organs and apparatuses, until the miracle of a new existence. It is not, however, just a biological process that takes place under the impetus of a genetic drive, but each stage, starting from the decision to procreate, is sustained by emotions, feelings and images that operationally are intertwined with the biological development that occurs during the intrauterine life.
From this perspective, emotional and intellectual life – defined by Tradition as the “subtle body” – should be considered today as an interweaving of forces guided by the morphogenetic field of the Self. On this interweaving is deposited the experience of fears, desires and thoughts that accompany the birth of our psychological identity. Our Self – the authentic centre of our being – is like the sun that illuminates our life on earth with its rays, giving beauty and harmony of form and colour. On the psychosomatic level, the Self radiates those qualities of the soul that include the feelings of love, truth, joy, courage, understanding, intelligence, wonder, etc.. In short, all those original qualities that are part of our individual nature and will define our personality as adults. How to know this dimension of being human that is so central and complete to be hidden in the meanders of our psyche? Scientific studies have succeeded in identifying the gene, seeing its implications in the constant dialogue with the environment (epigenetics) and elucidating the central mechanisms of heredity. But as for the psyche, how to know the experience of the centrality of the Self, we have defined from the beginning as the soul, if it belongs to the world of mystery, of what is not immediately perceivable and which we modernly call unconscious?
The conscious will cannot reach this level of depth because the language of consciousness is not that of the soul. Therefore, the mediation given by the analogy and the symbol is necessary – the language of the unconscious by gradually reaching the depth of our being can enable it to express itself, releasing the darkest bodily forces sedimented as implicit emotions in the limbic system.
In the past, the unconscious was represented as the “repressed”, that emotional and instinctual world unable to access consciousness understood as the expression of conflict with culturally inherited norms and judgements. The Jungian revolution, through the identification of the collective unconscious, characterized by the contents that are not specific to our personality, opened the way to the possibility of knowing those motions of the soul that the psyche has inherited as representations of the human behaviour. These modes of operation can be found in mythological plots, ritual customs, anthropological and religious experiences that in every time and space, beyond any ethnic migration, represent the common heritage of humanity. The contents of the collective unconscious, thus, consist of a series of images, behaviours and emotions that are organized by the archetypes and understood as true a priori conditions capable of ordering into symbolic images, the emotions experienced by humanity in its history. Just as the instinct regulates and determines the succession of our behavioural actions, so the archetype correlates, on the plane of the psyche, our images into an organized whole. For example, wanting to study the instinct of hunger, we find that it is not possible to investigate it directly, but only by analysing the appetitive actions and behaviours that this instinct puts in place to satisfy itself, such as searching for food, prey, hunting, etc.. The instinct may also awaken in our fantasies or dreams in the form of violent and aesthetically delicate images: in the former, the echo of the lust for devouring may appear, as happened in the myths of Dionysus, where the priestesses, under the impetus of God’s possession, literally mauled a ram; in the latter, it may take the form of delicate desires in which food becomes the expression of a soul sensibility, as happened in the refinements recounted in the firm Babette Lunch. The archetype, then, possesses the ability to translate the physical into the psychic, the domain of instincts into corresponding images, and manifests to consciousness as the organizer of these images.
The Ecobiopsychology, delving into the meanders of matter and body, has studied the “physical” aspect of the archetype, discovering how these psychic images appear not only confined to the territory of the mind, but also as reflections of specific bodily events.
From this perspective, how to deal with the prenatal life, that state of grace during which we are welcomed and protected and learn that human repertoire that we will later manifest and expand throughout our experience? It is during these weeks of gestation that our relationship life, characterized by acceptance, tolerance and the search for mutual good, in short by the shared love, begins. In the past, it was believed that the fetus was a passive host, needing to get everything it needed for its growth from its mother; in reality, it is also the one who reciprocates hospitality and welcome with precise information and actions for the benefit of maternal health.  Therefore, the stay in the utero is a real biological-psychological dialogue that can be defined as maternal-fetal symbiosis. This symbiosis, which science today is addressing to through the attachment theory, implies that those biological-psychological functions of mutual benefit to both, will become the basis for the adult’s future relational behaviours. The human being, in his or her “first home”, receives the innate gift of generosity, helpfulness, altruistic reciprocity and gratitude that is expressed precisely and specifically in corresponding and symmetrical actions toward the maternal host organism. We know, for example, the reparative process of fetal stem cells on maternal tissues that is present in pregnancy and lasts for many years after the child’s birth. But this symbiosis manifests itself at every moment of their living together in the “first home” from the pre-implantation stage of the embryo to the onset of labor and beyond, establishing a true synergy between the two organisms, which very early enter into harmonious synchrony.
This synchrony has been studied and confirmed by the attachment theorists who pointed out how the psyche also goes slowly forming parallel neuronal processes in the fetus and cell maturation, and most likely in the embryo as well.
Thanks to the brain investigation technologies (fMRI), it has been observed that the maternal-fetal and later the primary mother-child relationship is responsible for the development of neuronal circuits that promote the maturation of the mind. The DNA is responsible for the mapping and distribution of neurons, but it is the mother-child relationship that creates the synaptic networks within the neuronal distribution.
To use a metaphor, the brain map distribution can be compared to the difference between writing a book and reading it. Once a book (the DNA) is written, it will be the same in all its copies. However, every single reader may interpret the story slightly differently, with different emotions and projections as the chapters unfold.
The mentalization, the capacity of the human mind to create internal representations of its own identity in relation to that of the other and to reciprocal emotional patterns, is the result of the two-way correspondence whose beginning is situated in the maternal-fetal symbiosis. When an adult patient gets in touch with his or her own emotions and empathic capacity, he or she can access these patterns that enable him or her to build appropriate relationships. However, in the moment of altered maternal-fetal synchrony, and later in the mother-child one, “abnormal” neuronal networks will be created, blockages of synaptic connections responsible for behaviours, whether mild or severe, from simple character frailties to generalized or unmotivated anxieties, phobias, neurotic behaviours up to dissociated behaviours. The traumatic disruption of these connections results in a dissociative experience between the psychic registers necessary to understand, formulate and modulate attachment experiences and relationships, resulting in the adult inability to interpret real-life nuances and facets of emotions.
What are these patterns given by neuronal connections which first structures the child's mind and then that of the adult? As mentioned earlier, they are systems of mental representation built on neuronal connections that will become cognitive structures capable of configuring the space, time and causality of relationships with the external world, based on their assimilation of primary experiences. These functional patterns, learned from very early childhood and before that from fetal life, show a tendency toward stability, and consequently also carry within them the possibility of building more authentic, and valid relationships in obedience to one’s expectations, desires and planning. It can be guessed from what has been written, that if the lack of maternal-fetal or mother-child synchrony, results in emotional dysregulation, due to trauma occurring in the early stages of attachment, often brought about by caregiver’s lack of responsiveness and availability to the child, instead of adequate neuronal connections and mature internal Working Models, Dissociated Internal Working Models (D-IWMs) will be observed. This dissociation can occur between implicit and explicit level of mental functioning (vertical dissociation) or between different models (horizontal dissociation) responsible for the psychic registers necessary to understand, formulate and modulate attachment experiences and relationships such as anger, sexuality, seduction, pleasure, etc., emotions that are always implicated in the nuances of real-life signification.
What is meant by vertical and horizontal dissociation? In vertical dissociation, the traumatized subject does not remember or makes a traumatic experience as if “not happened” because of the loss of connections between implicit (unconscious) and explicit (conscious) memory, while in horizontal dissociation, the subject is unable to realize those recognitions of other’s emotions that permit healthy and constructive social relations, thus remaining frozen in the interactive exchanges that reflect their own motivations.
Since current studies on memory inform us that these IWMs are precocious and develop in our “first home”, i.e. in our fetal life from the fourth month of gestation, the earlier the traumas are, the more they will create neuronal disconnections, precisely at the time when the apparatuses responsible for mentalization are being constructed. If then the traumas also involve the period of birth up to the first two years of life, a time when the cerebral cortex of the right hemisphere dominates the recording of experiences – in fact, the left hemisphere takes over after the age of two -, one can understand how it becomes impossible for the cortex of the left hemisphere to translate disconnected, not integrated emotions into adequate words.
Undeniably, trauma takes on often unspeakable aspects responsible for deep wounds in the human soul leaving unhealed scars and constantly active pain. The question arises spontaneously: what these traumas consist of? Patients tell of abandonment, of poor emotional responses, of inappropriate behaviours on the part of the caregiver, as if the child’s sensitive eye reflects an absolute truth. In reality, every pregnancy is an adventure, an act of trust towards the future that the mother lives in function of her child, in which, however, personal memories, emotions, experiences, possible implicit D-IWMs that have never been elaborated , are activated or present circumstances that refer to social, affective, economic problems that could not be foreseen at the moment of wanting to bring a new life into the world.
To summarize, every pregnancy understood as a transformative moment, constantly implies an inner confrontation, albeit unimagined, between the implicit memory of when a woman was herself contained, imagined, experienced by the “first home” of origin and the time of her own planning, of her ability to care for her child and feel secure in this parental role. Giving birth to another human being is an act of profound responsibility, which inevitably confronts the adult’s maturation with any trauma buried in the unconscious memory. For this reason, all mothers, to a greater or lesser extent, having overcome the surprise and joy of the announcement of the expected pregnancy, always wonder whether they will be able to be mothers, to bring up a child, to follow it in its development until it reaches maturity. This general concern is not a sign of uncertainty, fear or anxiety, but the representation of an archetypal event that occurs every time the psyche of a human being passes from a level of relative maturity to a higher level, dictated by the confrontation with consciously caring for another.
Every psychotherapist who has been confronted with the affective universe of a woman’s desire to have a child, or with the emotions and fantasies of a pregnant woman, remains involved in the process of gestation and experiences the therapeutic moment as a sort of “shared brood” destined to be able to process the fantasies and emotions that arise during the gestation process. It often happens that during pregnancy, sudden fears, fantasies of inadequacy, depressive moments arise and with their urgency, induce the therapist to direct interventions, to reassure and contain the fragility of an inner condition potentially threatening to the person’s equilibrium. In other situations, one encounters women, probably more secure and aware of their own transformative moment, in which the therapist detects a more explicit confrontation with the archetypal images that pregnancy inevitably brings with it.

The article continues with a narration by Mara Breno.

I would like to report the emotions of childbirth and birth, almost a ritual prepared with extreme care by both the fetus and the mother, with the exchange of precis signals, through Elisa’s words. Elisa is a patient in her first pregnancy, who experienced this unfamiliar, mysterious and almost magical event with that readiness and emotion necessary to welcome this transformative passage and a new life. One week after giving birth, Elisa decided to describe her experience, starting from her first contractions, in order to fix it and explore it in depth distinguishing herself in this, from the internal experiences of the relationship with her own mother. Elisa had been in therapy with me for four years, and the central topic that had led her to the analysis concerned trying to understand the emotions that had constellated her life and work. Elisa carried memories that were at times painful and at times serene, her maternal legacy needed to be elaborated in order to find deep security in her feminine and in her intimate relationships, she needed a secure basis for her future projects.
Elisa, despite her intellectual qualities and sensitivity, still felt the incompleteness of her dimension and authenticity, and was determined to undertake therapeutic work in order to achieve her goals and desires – having a child represented the fulfilment of one of them. The pregnancy was accompanied by deep and vital analytic dialogue until the process of delivery. Shortly after the baby came into the world, Elisa contacted me again, wishing to share with me her writing that had emerged from the intense emotions she had experienced during childbirth.
Before leaving the reader with the narration, which I have titled “The Dance of Life” , I would like in my turn, to share the emotion I felt in receiving it, not only because of the testimony of the fruitful therapeutic work, but also because of the surprise of being able to read firsthand about topics and affections that are not usually recounted, but linger in the depths of every woman’s memory. I will accompany the patient’s writing (in quotation marks) with brief comments that will permit the reader to delve into this emotional world rooted in times in the archetypal aware that the unconscious by means of words, concepts and phrases constantly seeks a dialogue with consciousness.

The Dance of Life

«For me, as I imagine, for every woman, the childbirth was definitely a very strong and intense experience. The thing that struck me the most was the experience of a sort of splitting: at times I was inside myself, at times it was as if I could see myself from the outside. Everything seemed to take place at the same time. I was simultaneously inside and outside myself. Inside me, in experiencing this growing pain and these waves that were the contractions; outside me, because I could see myself from the outside. I could hear the midwives’ voices, I was super aware and lucid of what was going on around me, what they were saying to each other: the comments, the strategies to be adopted, etc... And I could see myself, but more importantly feel myself, from the outside».
Interesting is this dual description of seeing oneself from inside and outside. It seems that Elisa observes the ongoing life process from the outside in order to integrate it. On the one hand, there is labor – an event deeply rooted in nature -, and on the other hand, there is a psyche trying to integrate and make conscious what is happening.
«I had an accompanied birth thanks to a midwife present to support me during the labor at home».
In emphasizing the presence of the midwife, Elisa shows how she had indulged herself the presence of a good mother to care for and guide her through the transition.
«So, I was able to stay at home until I was 5 cm dilatated. The contractions started at 9:00 a.m. and we did not go to the hospital until 7:30 p.m.. The contractions, even in the prodromal phase were intense, not so much for their power (although also the first contractions, there and then, had seemed strong to me, I realized their true intensity later when they increased), as for their frequency (from the start they were quite close, every 3-4 minutes). The frequency never changed, and this gave me the impression that I could not fully recover. They were so close that I thought I would not be able to catch breath and recover energy …».
The fantasies related to the impossibility of having psychological control over what is happening are evident - the mind is exposed, unprepared for such an experience. At the same time, when the mind lets go, relying on the physicality of the body and instinct, can endure the pain favouring the process itself.
«The first contractions started at home after the morning shower».
Another symbolically significant passage, the underlining of the shower water in contact with Elisa’s body and the amplification of the sensoriality as an anticipation of contractions underlines the analogical overlap between the flow of water and the imminent breaking of waters. An ongoing identification guided by the constellation of an archetypal passage – that of birth.
«And I soon felt the need to listen to music. Not music in general, but Nada with her “Desperate Love”. I’ll never forget those first vocals to calm down the pain, the “ah, ahaha, ahhha” of the refrain as my childbirth mantra … And along with Nada, a whole playlist of 70s music proposed by Spotify (by the way I am not a fan of Nada so I still cannot explain how I felt this absolute need to put on this song in the background».
In this passage, the psychotherapist can imagine that tuning into the 70s echoes the unconscious voices of the parental world as an ancient memory sedimented in the cells; at the same time, focusing on the maternal-fetal symbiosis, can assert that in that moment her experience is literally “a desperate love”.
«For the rest …. Like waves … And “living me” and seeing me from the outside I could hear my voice change. I had been told that you can hear from the voice the power and the intensity of the contractions. And so it was for me. I could hear myself from the outside, first vocalizing, before that even singing and smiling. Then the vocalizations became more intense».
The voice and the vocalizations are the first modes of expression rooted in the depths of the emotional world, to represent and contain the emotions related to childbirth. At the same time, in archetypical terms, they are also the voice of instinctual forces that take shape, find an opening and empower themselves through the voice itself.
«Sometimes they fell silent and became deep breaths and exhales. And then they became screams. Especially during the expulsive phase, the screams seemed to come from another voice. That was no longer me. They were screams that were necessary for me to give all the force to the pushing. They were screams coming from the animal world, not the human world. And it was necessary to keep my mouth open, and wide open to take in air and throw out energy».
Elisa, in her experience explores an archetypal aspect. She immerses herself in the creative act of giving life, revealing how much the descent into childbirth leads the woman into deep contact with the most instinctive parts of herself.
«I felt so much of the energy of the water in the part interested by the contractions. I tried to get into the flow, and let it pass … I tried to ride the wave by letting it pass through me. But it was not always so easy».
By letting water as an archetype of the maternal, invade her and accompany her in the fulfilment of childbirth, Elisa tries to enact an acted meditation related to an archetypal aspect. This awareness related to the ongoing process, reveals how familiar she has become with her body and the emotional world it contains.
«I did most of the birth with my eyes closed. I tried to get inside myself and look for my centre. I concentrated in letting this pain go by, letting myself go through it. I appealed to the strength and presence of my father … but it was not so easy. The eyes closed enabled me to stay within myself, but more importantly, they were the only possible weapon against the pain. I had no other alternatives. The midwife and my partner were very supportive, with physical aids (with their hands placed on my pelvis and lower back) as well as with their soothing voices (I remember my partner saying: “It will pass now, it is ending. It is passing” and trying to silence me, not to silence my voice, but to silence my pain».
Psychoanalytic literature has written extensively on the mother’s need for containment while carrying the baby, when she gives birth to her child and in the first months of life. Bion has dealt with the importance of this function performed by the caregiver for the formation of the child’s mind, which is well emphasized in the writing by the partner’s accompaniment through security and emotional support through his words.
«Instead, in the expulsive phase, I felt like a sumo wrestler. This is the strongest and most adherent image of what I experienced. I followed the midwives’ instructions (both my own midwife and those of the hospital) in testing different positions. I was confused. I did not know which position to choose, it did not come naturally to me. But I wanted to try the ones I had been suggested to and see whether they were functional for me. At a certain point, it looked like I would give birth in water …, but the water seemed to calm down my contractions. It was very helpful to quiet the pain, but for the pushing phase I felt the water was not my element. I had no control over what I was going to do and what I had to do. I lacked the aid of the earth and its support».
In a different form the archetype of the mother earth returns, and inevitably in a more physical phase, requiring strength and energy, it shows up in its supporting function.
«I did the expulsive phase with a lot of ground anchoring, positions that leveraged my legs, and it was the position of the sumo wrestler the one that kicked off an intense expulsive part. My legs, the quadriceps, started shaking and they did not stop even in the intervals between one contraction and another. And that during the expulsive phase, the contraction phase and even afterwards when I was getting stitches. In the end, I gave birth on a stool. Semi-sitting. but unbalanced.  With the support of my partner from behind. I was literally clinging to him. I could see the mirror below me. Again, I could hear the midwives talking.
Definitely, the most intense part was the head coming out. And those moments when the midwives were telling me not to push and I felt instead an uncontrollable force inside that just wanted to come out, and a deflagrating weight and power that did not want to be contained. In the expulsive phase, I could not count on a strong support and aid from my baby, but I knew when to start pushing, even if it was not so easy to focus on when to stop, I just felt when the contraction was about to end».
Here it is clear the bewilderment of an Ego in front of a natural process to which the Ego itself can only surrender.
«Then the head … For a few pushes, I could feel it on the threshold, between two worlds. I could feel my vagina taking on this circular shape given by the baby’s head. I had told the midwife that I had dreamt of my son with lots of dark hair. And at that moment she said: “He is a baldy, he is not as you have dreamt of”. It was a strong feeling to know that the head was there already visible to the hospital staff around me».
Otto Rank defined this moment as the trauma of birth, a joyful but potentially traumatic moment as highlighted by Elisa. Her words have opened a window on a deeply charged and rich experience that every woman experiences, and that this writing gives to the reader. A profound truth is revealed: this passage cannot but be experienced as a totalizing reality.
«Once the head was out, I thought I had to do some more pushing but the baby was practically already out, it was already born. Little did I know that the hardest part was waiting for me … I saw my son at my feet. Lying down lengthwise. Immediately they said he was full of mecomium. He was crying and it was a greyish colour … They started to suck up the mecomium, but they said that had to suck it up by another method and then it was time to take him out. From that moment on, I couldn't see my son until the following morning…».
Among the most common fantasies of a pregnant woman, especially having come to term, is the need to see her child, not just to see if as imagined, but also to check with her own eyes that the newborn is healthy and that “everything is at the right place” as a natural narcissistic guarantee of verification of what one has been accomplished in the darkness and secrecy of her womb. This passage underlines a potentially traumatic moment for Elisa and potentially for her own child in need of finding that symbiosis experienced in utero.
«After they took him out, a doctor arrived and told us that they were going to transfer him to the neonatal pathology for some checks. Fortunately, they did not use the term “intensive care” (a term I did not hear until the next morning) so I did not get alarmed.
I was very sorry that I could not do the skin-to-skin contact, not to have my baby close to me, but I could not be concerned about his health status. I think it was the postpartum hormones … because I remembered I felt like drunk. I was talking and saying things without a filter. Real things, but just without any inhibition. I was like tipsy. I talked to the midwives and the doctor as they stitched me up from the laceration. My legs meanwhile even lying down, would not stop shaking. I must have asked the gynecologist something about Emanuel’s health status, but I cannot remember the answer exactly. I remember talking to the gynecologist (Sabrina) whom I had met at the Full Term Pregnancy Clinic at the Buzzi Hospital».
This description is also interesting as it makes us part of how a mother, despite her desire and love for her child, instinctively takes distance from childbirth in order to regain her own identity. Indeed, behind the experience of motherhood, of the possibility and desire to care for her child, there is also the need to maintain a proper distance from the labor of childbirth, which the woman must experience in order to regain her centering in view of future caregiving.
«But really the hormones took me to another dimension. The same hormones sustained me in the following days. Even the next morning, after seeing my son in a thermal cradle with labored breathing, after realizing that yes, we were in the ICU (Intensive Care Unit) (complete with green gowns and careful hand-washing procedure), I was still confident. I had a great strength that sustained me, a power that probably came from the feat accomplished, from the life I had generated. I was worried, yes, but compared to my partner who was very emotional, easy-tearing, very shaken, I was supported by other feelings. I was always confident that Emanuel’s clinical picture would soon settle down. After 24 hours they took him off the oxygen they were giving him in the crib; after a little more than 48 hours they took him off cord feeding to give him milk by bottle. And by Thursday evening (less than 72 hours later) they took him out of the thermal cradle and tried to attach him to my breast».
For all of us, on the day when we realize that the knowledge of our experiences is dictated by our soul, we step out of the most juvenile dimension, catch a glimpse of ourselves and open up to our Self. In all of us, there is always a treasure we do not know, a wealth of emotions of which we suddenly discover an unexpected new face, charged with all the fascination and the arcane of the imaginary. Through the astonishment of reading the vicissitudes of life, of their pressing into our good or bad moments and those evoked by imagination, we can sense the presence of that faculty of perception or sensation called by the Greeks aesthesis. This word, whose root refers to an inhaling, a welcoming of the world within, a holding our breath in wonder, enables us to grasp the world, our world. Our eyes that are always open, have learned by closing to immediate reality, to open to the indistinct to thus discover a new faculty of seeing, which is formed in the wake of the transfiguration of reality. This is what Elisa felt and made me feel. Today everyone wants to look, but those who do not stop to think, while looking, do not think, and if they do not think they cannot understand. Thought and imagination are the systole and diastole of life. The more one exaggerates on one side, the more the other claims its privileges, for the heart without the continuous passage remains immature, and without contemplation it dies and rots. Elisa was able, even in the moment of magical anticipation of labor, to bind herself not so much to the contingent experience of what was taking place, but to the ecstatic moment when life suddenly came to her, to the point where she “touched” the deepest aspects of transformation.

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Mara Breno – Psiychologist, psychotherapist. Expert in psychosomatics and relaxation theories with particular regard to psychosomatic and symbolic aspects. Teaching manager and supervisor at the School of Psychotherapy of the Istituto ANEB. EMDR therapist, with scientific and divulgative contributions to her credit.  

Diego Frigoli - Founder and promoter of the ecobiopsychological thought. Psychiatrist, Psychotherapist and Director of the ANEB Institute – School of Specialization in Psychotherapy. Innovator in the study of the imaginary focusing on the symbol in relation to its dynamics between the individual and the collective knowledge.

Translated by Raffaella Restelli – Psychologist, member of the British Psychological Society (UK), Ecobiopsychological Counselor and expert in ANEB Psychosomatic Medicine. Linguist in ANEB Editorial area.