One of the greatest difficulties which are met by the professionals who practise psychoanalysis is that session verifications are hardly communicable and verifiable out of setting: that has contributed to lead many people's minds, even scientists' who should use the verification of the observable datum as a praxis, to structure the wrong conviction that psychoanalysis is not scientific (see the article by Nicola Peluffo "Psicoanalsi e Scienza" appeared on the pages of this Magazine). 1

Nevertheless every day in thousands of different laboratories all over the world (the professionals' studies), people of different nationalities and cultures touch the same associative themes and describe the same universal conflictual nuclei: Oedipus-castration, death anxiety, conflictual management of sexual and aggressive desires. The repeated observation of the same dynamics has brought to the individualization of repetitive mechanisms of psychic dynamism organization that have assumed, for the researchers of such phenomena, not only the significance of mere hypotheses, but the value of scientific laws.

No psychoanalyst in the world, I believe, would dare doubt the existence of Oedipus or the phases of libido fixation.

Difficulties arise when some scientists use instruments of observation that others do not (yet) possess: Galileo learnt it against his will, as well as the consorts Curie and a lot of other precursors.

In the fifties a Freudian psychoanalyst, Silvio Fanti, had the intuition to extend psychoanalysis session time, leading it from the classical 50-60 minutes to 3-4 consecutive hours, with the intention of adjusting the observation time of phenomena to the dissolution rate of resistances: he founded a new technique, the micropsychoanalysis, which is currently practised by a few hundred professionals in the world.

Micropsychoanalysts very soon had to deal with the production, from their analysed people, of an unusual associative material: a large number of analysis hours were being devoted to the description of deep sexual-aggressive dynamics temporally placed, by the patients, in a completely archaic period: the intrauterine age.

Many analysed people in micropsychoanalysis have been describing with anxiety the existence of threat-annihilation experiences coming from the maternal pole and specular desires of destruction-assimilation coming from the fetal pole.

The repeated observation of this phenomenon induced Fanti to theorize the existence of an early phase of libidinal organization (sexuality and aggressiveness) that he defined "Initiatory Stage" and the existence of a mother-fetus psychosomatic aggressive exchange that defined "Intrauterine War": such hypotheses were published in his book "L' Homme en micropsychanalyse" published in 1981. 2

Yet formerly in Italy Nicola Peluffo, at that time teacher in Social Psychology at the University of Turin, even still before meeting Silvio Fanti, had begun to practise long sessions and, on the spur of the unusual observed material, had concentrated his researches on those themes. He formalized them, back in 1976, in his book "Micropsicoanalisi dei processi di trasformazione" (Micropsychoanalysis of transforming processes). 3

There would be no need to say that a frantic reaction against the two authors' theses broke out from some sectors of the academic world, especially the ones permeated by Catholic culture which could not accept that the fable of uterine Nirvana and loving gift of life could be brought up for discussion. In 1989 I was personally a witness to a painful episode which made me understand as ignorance and prejudice reign in some, wrongly renowned, Italian universities. I had followed the degree thesis of a final year student of the faculty of psychology of the university "La Sapienza" ("The Wisdom"[sic!]) of Rome and She, fascinated by the new micropsychoanalytic theses, had dedicated a whole chapter to the existence of the "intrauterine war": the coarse scornful laughter that the so-called "professors" (the most magniloquent names of Italian Psychology) addressed to her, is still ringing in my ears.

Luckily the truth will out as we shall see in the next chapters

In "Micropsicoanalisi dei processi di trasformazione" 4 , sent to press in 1976, Peluffo exposed therefore the fruit of his researches, started in 1972, and quoted the biological literature of that time, among which the work by Alan E. Beer and R. E. Billingham who tried to show, in their article titled "The embryo as a transplant" how the fetus may be considered as an (aggressive) allograft in every stage of its existence:

"...The conception - the two authors write - normally starts with the inoculation of the female guest from sperms coming from a male donor, not genetically similar. These specialized cells have been shown to bring transplant antigens and therefore they have the power to set off a reaction... ". 5

Peluffo underlined that, after all, the maternal somatopsychic unity behaves towards the reaction provoked in itself by the antigen-embryo as towards any illness for which the mother's immune system provides the child with defenses. That is "... reacts against the possible effects of her own immune reaction towards the graft-child, stimulated by the child who in his/her turn would feel the mother as an invader." 6

Beer and Billingham concluded that the uterus cannot be considered a privileged place for an embryo model transplant and hypothesized that the mother's immune reaction is stopped or deleted by some mechanisms associated with the fetus. More than thirty years of researches and experimentations have confirmed their hypotheses: as Zoltan Fehervari and Shimon Sakaguchi remember in their recent work devoted to the regulatory T lymphocytes (T reg) 7 : "Research hints, too, at a role for T-regs in protecting pregnancies. Every pregnancy unavoidably poses quite a challenge to the mother's immune defenses. Because the fetus inherits half its genes from the father, it is genetically half-distinct from its mother and thus is in essence an organ transplant. Within the trophoblast, the placental tissue that attaches the fetus to the uterine wall, a number of mechanisms give the fetus some safety from what would amount to transplant rejection. The trophoblast not only presents a physical barrier to would-be attackers in the mother's blood but also produces immunosuppressive molecules.

The mother's immune system seems to undergo changes as well…Some recent experiments offer more direct support. At the University of Cambridge, Alexander Betz and his colleagues have shown that during pregnancy in mice, maternal T-regs expand in number. Conversely, an experimentally engineered absence of T-regs leads to fetal rejection marked by a massive infiltration of immune cells across the maternal-fetal boundary. It is tempting to speculate that in some women, insufficient T-reg activity may underlie recurrences of spontaneous abortion."

Nicola Peluffo affirmed in that pioneering work that, at the level of psychic elaboration, the state of somatopsychic imbalance constituted by pregnancy would induce the appearance in the mother of oneiric and fantasy experience of bacterial invasion, that isn't anything else but the psychic representation of a somatic process: the immune reaction. Moreover in the involucre constituted by the maternal-fetal unity, there would be a meeting, a dialogue, an interaction, among mother's unconscious, preconscious and conscious psychic experiences, that work as stimulus-fantasies which evoke, in the future baby, the arising of answer-fantasies, existing in the hereditary potentiality. Such psychic dynamics, often characterized by the structuration of invasion or mutual phagocytation fantasies, would take the place of the somatic rejection reaction, the conflict would move on the psychic elaboration level, leaving the somatic field.

Afterwards Silvio Fanti maintained this subject and, in his book "La Micropsicoanalisi" (1981), with regard to the intrauterine war wrote: "The mother just escapes the cellular explosion of her uterine derivative, which outlives only by dodging or taking the psychobiological blows that she inflicts on it". 8

This thesis doesn't give any space to mediations. According to Fanti the uterine age, far from being that period of softened quietness which once was supposed to be, is the theatre of a psycho-biological conflict that will leave important sequences for the whole individual life.

We must schematically remember that:

-- From the immunological point of view the embryo is an allograft since the first attempts of nesting.

-- The biochemical stimuli, coming from paternal and then parental material, unceasingly excite the maternal immune system, that replies blow for blow synthesizing antibodies that bind to the trophoblast first facilitating its lysis, then its phagocytosis.

-- Even if some psychobiological tolerance develops between the two poles of the uterine life (especially through the action of T reg), it still remains very precarious, as proved, for instance, by the violent psycho-somatic reactions of gravidic hyperemesis, which are an attempt of elimination-rejection of the conception product. 9

-- This mutual exchange of somato-psychic blows constitutes the first sexual-aggressive apprenticeship of the future individual and settles the lines on which future life will develop. 10

Confirmations from evolutionary Biology

Also the evolutionary biologist from Harvard, David Haig, considers pregnancy a process which does not develop in perfect harmony. Haig asserts, thus confirming the observations from the psychic side made by micropsychoanalysts, that mother and fetus engage in an unconscious fight for nourishment and for mutual survival. And also Haig thinks that the conflict can even continue after birth and influence the future life, explaining psychological disorders as depression and autism.

In a work of 1995 11 Haig seems to use the same terminology that for decades micropsychoanalysts have used raising waves of criticism and causing lack of understanding.

Haig remembers as the most intimate human relationship is that between a mother and her fetus.

The latter receives nourishment from the maternal blood, shares every breath that its mother takes, anything she eats and draws on fat maternal reserves when food is scarce. But Haig wonders if the idea of harmonious cohabitation is nothing but an illusion and formulates the question: "... is the fetus an alien intruder, a parasite that takes what it can without concern for its maternal host? ".

Haig, as Peluffo and then Fanti had already emphasized in their works, reminds us that, contrary to what happens in other mammals, the human placenta is invasiv: the embryo, since its first implantation, sends out cells that invade the blood vessels supplying the uterine lining. These invasive cells destroy the maternal endometrium and open some real pumping mouths in the maternal vessels: "The result is that the fetus has direct access to its mother's blood, and the mother, unable to constrict the vessels". Furthermore the fetus, having direct access to the maternal vascular system, can introduce in the maternal organism a number of strategically important substances for its survival. 12

Sometimes, Haig remembers, the placenta may have an inadequate supply of maternal blood: one way for the placenta to get an increase of the hematic supply and therefore of the vital substances, is to determine an increase of maternal blood pressure, which is event that occurs in preeclampsia. According to Haig's hypotheses, this would not be a casual eventuality, but the result of a fetal strategy finalized to get an increased blood afflux in the intervillous spaces where the fetus draws nourishment. Ananth Karumanchi and his colleagues 13 have confirmed such hypothesis: in women suffering from pre-eclampsia there is an unusually high level of a protein, the sFlt1, produced by the fetus itself.

Haig still reminds us that some hormones secreted by the fetal placental pole, among which the chorionic gonadotropin (hCG) and the placental lactogen hormone (hPL), can effectively interfere with the maternal physiology, for the egoistic aims of fetal growth. 14 The hPL, for example, is held to act directly on the maternal prolactin receptors increasing the resistance to the hypoglycemizing action of insuline. If the mother is not able to oppose such fetal hormonal signals (especially the diabetic subjects) hematic high-levels of glucose will be maintained for extended periods after meals.

The scientific reasoning introduced by Haig is a heritage that anyone who is interested to the fetal psychism should hold in due consideration. I recommend to the reader who further wants to study this matter in depth a careful reading of Author's imposing bibliography. At the foot of this article I have selected some of his works. 15

The intrauterine war and its consequences in the human psychism

For anyone who carried out an intensive and deep psychoanalytic treatment it was indisputably evident that the uterine epos was not the nirvana that has been talked about for a long time. In each micropsychoanalysis a long period of sessions is occupied by the psychic experiences of material related to the initiatory stage. Just here more precise information is necessary: we micropsychoanalysts do not think that the human being can store the "memories" of the intrauterine traumatic experiences as such, in the way they are lived by the fetus. The fact is that very probably the human psychism stores protomental feelings of uneasiness, pain, anxiety and the relative reflexes of motor, hormonal, behavioral answer of the fetus. 16

These elementary mnestic traces are stored in the psychism and, just like tracks, they will aim to be run through again and strengthen until the moment that, even coming back to be represented in an anxiety dream, they will acquire an intelligible form and will be able to be reconstructed in the psychic imaginary of adult people, with adult's typical mental representations.

Therefore, when we listen to any adult person describing in detail the feelings he/she affirms to have experimented in uterus, we know that these are reconstructions: what is fundamental is that such representations can bind not neutralizable anxiety accumulation previously repressed.

An emblematic clinical case

She's a woman, carrier of a border-line syndrome with a psychic ground permeated by primary narcissism. The lady has a marked tendency to somatization and is diabetic.

The analysed woman has married a patient of mine who, through his analysis had succeeded in overcoming a position of serious paranoid defense with a well-structured erotomaniac delusion. Once liquidated his delusion defense the man had met his partner and, at a distance of seven years from their meeting the relationship culminated in a pregnancy. The woman had lived her pregnancy in a defensive position of total split: her body bringing up a new being but her mind refusing to get aware of it.

In the first day of life the newborn fell into serious respiratory insufficiency and was intubated, remaining for 40 days in neonatal intensive care. The medical staff has never been able to verify the causes that had determined the bad course of events. At a distance of 4 years I causally met the young family in a department store and I immediately realized that their child had autistic marks; therefore, passing over the couple defenses I passionately advised the parents to have their child seen from childhood specialists. Unfortunately my diagnostic suspect was substantially confirmed and anyhow the child started to be adequately treated. The young woman started a micropsychoanalysis, doing a good job which allowed to free herself from her psychic demons. A hard analysis, marked by endless silences, in which the patient lay completely immovable, prostrated by a dreadful feeling of annihilation.

Here is an example of the gathered material in the rare moments she succeeded in breaking her narcissistic shell and verbalizing her emotions:

[She, upset, cries] "I felt something go out from here, as if I were breaking in half, as a trunk that splits. Oh, my Gooood! [she screams]

I'm a soft thing inside and I can't speak. I've something in my mouth! It doesn't go out, it doesn't go in, I have my mouth full and I keep still, still. I think I felt myself a fetus again! That's horrible! You know when I'm here without speaking? I feel nothing and I'm silent? Last night I had my heart in my mouth: a deep bestial fear. I was on the bed, I felt myself moving and I was terribly scared! A feeling of imminent end.

It was as though my war had begun since that moment! I must make everybody pay for what I felt. A war has begun against everything that was outside! I feel only hate! Where is the good? I don't remember it. I feel only hate! I feel shattered, as if a hundred years had passed in a hour. Oh God, what a bad sensation, now! I don't feel me! I can't feel time anymore! [new emotional discharge, then, after ten minutes of silence:] Now I can feel my voice less bad. I would like to hug you. Only here I've been able to feel positive feelings. I have felt different since a few days, I have felt I receive things. For the first time in my life they're coming inside me and I feel soft. What a sensation of heat, of dissolution! How fine I feel! I would like to feel always this way! I would embrace everybody now!

In another session:

"I'm really attached to me. I only keep on thinking about me, It exists only me.

... my head is turning... I'm like devoured by a huge thing... I must be careful because there's something that can suddenly extinguish me... I'm afraid and I must keep careful, still, immovable, I must disappear
[extreme death anxiety]. I live this way, with this fear, and nothing can help me. A felt myself a circle, a very little ball with something pulsing, pulsing, pulsing. It's void all around, I feel myself falling down, and I'm afraid... I haven't got my body anymore... I'm in a stormy sea, in troubled, foamy waters... I slip in a sore or a fold and I stay inside there, like a muscle of a beast... I'm inside a fissure, a fold... I've had a fight not to die... a war, a battle. Once on a pedalo out at sea I started feeling scared: I thought the water would rise and eat me. I've got my diabetes from that moment! I stored all of my fear in it! I put it all there! [after a violent emotional discharge:] I feel better, much better. I am tired but happy. Doctor, let's go to celebrate: I feel reborn. I feel upset now, as if had struggled hard.

This case, which contains material that can be easily superimposed on the one coming out from any analysed person who achieves a micropsychoanalysis in depth, allows to make some further reflections. The young woman who expresses her anxieties so clearly is a diabetic. She's in treatment since her infancy but anyhow she decides to take the risks of a pregnancy.

Her analysis is characterized by a marked conflict with an idealized and suffocating mother, an inextricable symbiosis that short-circuits oedipal aggressiveness.

The last pregnancy months are difficult. In the last days the pregnancy worsens to gravidic gestosis: during the labour, that announces dystocial birth, the patient results in pre-eclampsia, pressure values become threatening, and she undergoes anesthesia and caesarian birth. Therefore the physical separation between mother and newborn happens in state of incounsciousness. Her child is born apparently healthy but the next day his conditions inexplicably get worse and he is intubated. She ignores him mentally, being a prey to a powerful unconscious hate that only psychoanalysis will be able to extinguish. Only during the analytical work she will have a dream by which she will give birth (mentally) to her child and definitely realize his existence:

"Last night I had a dream that changed my life: I dreamed I had given birth to my child.

I finally know that I gave birth to him and that he exists. Now I'm aware of having had a child and he seems to be grown during these days! It's wonderful! Last evening we communicated! It seems to me the turning point in everything I was looking for! That's what happened and it is as if some empty spaces were missing: it's something that fills me, fills me. Nice! Now things take shape again and I have realized that some things don't belong to me anymore! That is touching. My husband has been sick and I was amazed at myself! I was affectionate with him. And then, I have never talked so much to my sister as in the last period. It's fine to have a child: I feel him inside me, I feel him outside me. I've recognized that another person exists! I feel as if something had melted, as if I had had an ice puppet inside that now has melted, and such a heat is left now, such a fullness! And I feel like crying, because I feel so lively! Here it is, happiness, I believe, is something like that! "

What could be happened during the intra-uterine epos of these two human beings indissolubly bound in the maternal-fetal symbiosis?

Probably the mother wasn't able to oppose the egoistic fetal hormonal stimuli (a diabetic subject is already in a critical state) and her organism must have recorded that potentially mortal threat: while carrying out chemical-humoral countermeasures to protect herself from the aggressor 17 she will have recorded the Other's presence as a persecutory mortal enemy, structuring, unavoidably and without any moral responsibility, defensive hate and desires of aggression-expulsion-liquefaction of the alien.

Therefore that fetus has developed in an involucre of defensive hate, its protomental defense mechanism will consist in the reinforcement of narcissistic closure: from here the structuraction of the autistic nuclei. Obviously, in order that such circumstances may occur, we must be in the presence of a phylogenetic ground, both of motherly and fatherly branch, predisposed to narcissism.

Of course we don't exclude genetic or epigenetic toxic hypotheses, for the structuraction of the autistic syndromes but, since we assume a holistic vision and it is inconceivable for us to separate soma from psyche, we are also interested in psychogenic determinants of mental disorders.

People of different cultural levels speak of their own annihilation anxieties in uterus, perhaps in different ways, but they all express with intense anxiety the feeling to be threatened by the organism which contains them and the cannibalistic parallel aggressiveness which was activated in those archaic phases of development. I want to specify that even though the definition "intrauterine war" effectively strikes the collective imaginary and therefore is destined to impose itself, it has the fault of attributing a moral connotation to the event: it rather involves neutral strategies of survival of genome that fights for its self-affirmation.

In any case, to free people from these traumatic emotions has a wide therapeutic echo. As Kandel hoped, at least in this case, psychoanalysis and biological sciences have met, giving the evidence of the fact to the clinical confirmation of the intrauterine war. Fascinating horizons of study have been opened, that may be shared only giving up the prejudice.

Written by: Quirino Zangrilli © Copyright
(Translated by Flavio D'Ambrogio)

This article appears in Scienza e Psicoanalisi

References:


1 Nicola Peluffo, Psicoanalisi e scienza, in Scienza e Psicoanalisi, 2000.
2 Silvio Fanti, L'Homme en micropsychanalyse, Denoel, Parigi, 1981.
3 Nicola Peluffo, Micropsicoanalisi dei processi di trasformazione, Books' Store, Torino, 1976.
4 Nicola Peluffo, Micropsicoanalisi dei processi di trasformazione, Books' Store, Torino, 1976.
5 Beer A. E. and Billingham R.E., L'embrione come trapianto, in Le Scienze, n. 7, Milano (original publication: The embryo as a transplant, Scientific American, 1974 Apr; 230(4):36-46).
6 Nicola Peluffo, Micropsicoanalisi dei processi di trasformazione, Books' Store, Torino, 1976.
7 Zoltan Fehervari e Shimon Sakaguchi, I peacekeeper del sistema immunitario, Le Scienze, dicembre 2006.
8 Silvio Fanti, La micropsicoanalisi, Borla, Roma,1984 (prima pubblicazione Denoel, Parigi, 1981).
9 Here it is interesting to notice the correspondence between oral impregnation fantasies (absolutely constant!) and the oral elimination attempt: for the child and for that "Child" (Peluffo calls it "Bimbo"; see N. Peluffo, Le manifestazioni del Bimbo nella dinamica transfert-controtransfert [Child's demonstrations in the transference-countertransference dynamics], Scienza e Psicoanalisi, 2006) that will remain in his/her psychism, the fetus is in the belly (sewer). If it is wanted to be eliminated, it can only be vomited or defecated, or expelled with urine
10 I have exposed a glaring example of the consequences of uterine psychosomatic conflict in my work "La strutturazione dell'idea delirante" [The structuraction of the delirious idea] appeared on "Bollettino dell'Istituto Italiano di Micropsicoanalisi", First Semester 1986. I refer its reading to those people who believe that psychoanalysis doesn't have therapeutic value.
11 Haig, D. (1995) Prenatal power plays. Natural History 104(12): 39.
12 We know that the drive towards the literary productions must necessarily have a contact with real contents: fantastic for the conscious, but absolutely real for the unconscious. From here the attraction for these works arises: for instance the "Alien" science fiction saga draws its strength from the intrauterine reminiscences of the audience.
13 Excess placental soluble fms-like tyrosine kinase 1 (sFlt1) may contribute to endothelial dysfunction, hypertension, and proteinuria in preeclampsia, Sharon E.e coll, Maynard American Society for Clinical Investigation, 111:649-658, 2003.
14 David Haig, Genetic conflicts in human pregnancy, the quarterly review of biology, volume 68, no. 4, december 1993.
15 - Wilkins, J. F. & Haig, D. (2003) What good is genomic imprinting: the function of parent-specific gene expression. Nature Reviews Genetics 4: 359-368.
- Wilkins, J. F. & Haig, D. (2003) Inbreeding, maternal care, and genomic imprinting. Journal of Theoretical Biology 221: 559-564.
- Haig, D. (2000) Genomic imprinting, sex-biased dispersal, and social behavior. In Evolutionary Perspectives on Human Reproductive Behavior, D. LeCroy and P. Moller (eds.) Annals of the New York Academy of Sciences 907: 149-163.
- Haig, D. (1996) Placental hormones, genomic imprinting, and maternal - fetal communication. Journal of Evolutionary Biology 9: 357-380.
- Haig, D. (1996) Altercation of generations: genetic conflicts of pregnancy. American Journal of Reproductive Immunology 35: 226-232.
- Haig, D. (1993) Genetic conflicts in human pregnancy. Quarterly Review of Biology 68: 495-532.
- Haig, D. (1992) Intragenomic conflict and the evolution of eusociality. Journal of Theoretical Biology 156: 401-403.
- Haig, D. (1992) Genomic imprinting and the theory of parent-offspring conflict. Seminars in Developmental Biology 3: 153-160.
- Haig, D. & Grafen, A. (1991) Genetic scrambling as a defence against meiotic drive. Journal of Theoretical Biology 153: 531-558.
- Haig, D. & Graham, C. (1991) Genomic imprinting and the strange case of the insulin-like growth factor-II receptor. Cell 64: 1045-1046.
- Moore, T. & Haig, D. (1991) Genomic imprinting in mammalian development: a parental tug-of-war. Trends in Genetics 7: 45-49.
16 I think that lymphocytes store forever the memory of what happened and that some forms of autoimmune disease which break out in adult age may already be fixed in the intrauterine stage: it is obvious that mine is just a hypothesis, but if I were a biologist I would hold it in due consideration.
17 Concerning this, Haig's hypotheses on genomic imprinting are of very great interest. The limited space prevents us from exposing them but I refer the reader to the following links:
-- Genomic imprinting : a talk with David Haig
-- Academic articles for David Haig Genomic imprinting