V. Chvála, L. Trapková
Centre of Complex Terapy, Jáchymovská 286, Liberec 10, 46010, Czech republik
1. The uterus as a protected area
With regard to phylogenesis the context of the uterus seems to be much broader than we usually supose. The development of this protected area during phylogenesis is undoubtedly connected with the ever increasing complexity of the line separating inner from outer space.
In contrast to the development of non‑living matter, the development of living matter is characterized by increased structuring, allowing interaction with ever more complex information. In its ontogenesis the individual organism may reach some developmental strata before it is able to cope with the tasks of the next phylogenetic stratum. The latter is created by a new context, a new order of relations between inner and outer space.
The new and phylogenetically younger order must indispensably create new layers of the receptor apparatus of the organism.1 Without this a new level of relations will not be perceived and progress will not be made in the development of the inner world.
Thus, simple division without any special external protection suffices for the development of a new structure at the level of unicellular and lower organisms . The more complex the internal structure of the organism, the more complex is the method of reproduction. At a certain level of development the primary structure will have to be protected prior to being released into the external space where it will react with its environment according to its possibilities.
The human child is not born from the woman directly to the whole world. In order to have a chance to survive it must be adjusted to its immediate environment in a specific manner. This adjustment closely reminds of the uterus, the womb, with its entire physiology and function. It is as though what we know well from the biology of reproduction were repeated at the social level. In the „social uterus“ we are able to observe the development and maturing of the indispensable „social organs and functions“ of man. The birth of the child may be viewed as the period of conception at a higher level of organization of live matter.
The analogy with the biological uterus is fruitful at many levels. What at the biological level can be seen materially is invisible, virtual at the higher level, visible linguistically, i.e., we can see the existence of the social uterus through language. The language is the adequate instrument, observation organ and means of impacting.
The metaphor of the uterus allows not to separate the physiological from the psychological but to understand their linkage in the continuity of development from the biological to the social. The coalescence of two embryonic cells will trigger off enormous creation which will generate the placenta and the foetus. Under the impact of the activity of the placenta the child and the uterus develop in harmony.
The man and the woman enter a relationship with a male and female disposition and they begin to create a space in which they prepare to live and to raise their children. The key role and probably the most important factor of development is human sexuality.
2.0.Physical and psychological sexual impotence and the development of symptoms.
If we want to understand the influence of sexuality on the development of symptoms we have to look at its continuous development from human conception to death. Freud revealed child sexuality along time ago and yet we still tend to look at it merely in its adult form. Throughout his whole life human is part of a developing social system for whose dynamics sexuality is the determining factor. It is possibly the main energy of the origin and development of life.
The physical form of sexuality attracts so much attention because we very often fail to observe its no less significant psychosocial aspect. In the same manner as there exists physical sexual potency, i.e., the capability of materializing sexual intercourse, there exists the psychological potency to establish and develop a close and intimate relationship between man and woman with the potency to grow. Only thus will it become a healthy environment for the child, conceived thanks to the physical potency of the pair. Psychological potency has a non‑material dimension, it is virtual reality and is extremely difficult to represent and to measure. We may merely observe its consequences, i.e., its absence. It is possible that it is this mental component of sexuality which has allowed humankind to develop culturally and spiritually.
Both streams of sexuality were known to Freud when he spoke of the sensual and tender stream of sexuality. The term „psychological potency“2 was used by Freud, who believed that it was the most frequent reason for which people came for help to the analyst. From what we see it is the most frequent concealed reason why people come to see the physician. The fact does, however, deserve a deeper understanding and explanation.
At first sight the examined sexuality of the pair seems to be in order. This is because physical sensuality may function a long time in people who are psychologically impotent, affected by a disorder of the ability to develop the shared emotional and spiritual space. Reich perceived this level of sexuality as energy flow.3 He imagined energy processes between man and woman at the physical level. No wonder. In our work with sick families we see that they are lacking something substantial, something similar to energy. Even though the decline in the family´s vitality belongs among the most frequent symptoms we do not seek physical energy. We do not seem to need to go beyond comprehensibility of psychosocial relations.
We have noticed that the woman is usually more sensitive to the psychological impotence of the pair. She seems to discern much sooner the shortcomings in the family´s emotional nutrition and suffers therefrom much earlier. We have repeatedly seen the woman pointing to these deficiencies for years without being able to discuss them or to come to any understanding in the language of the man´s vocabulary.
When malnutrition and the inability to come to an understanding continue for a sufficiently long time the members of the family begin to show physical symptoms. The woman need not be the first to show these symptoms. It appears that people are equipped with different ability to tolerate psychological impotence. The most sensitive member of the family is the first to come for treatment. The fact that the psychological impotence of the parents affects the entire family system is borne out by the experience that children are frequent bearers of symptoms.
3.0 Development in the social uterus
The sensual flow of sexuality according to Freud, instinctively attracts the man and the woman in order to trigger the process of the social uterus. Insofar as the pair are both physically and psychologically potent the purposeful growth of a social space will be provided, as will the indispensable growth of the physical uterus. Any attempt to permanently sustain only physical sexuality without any emotional culturing of the relationship is no more viable then an attempt to conceive a child without a placenta. There is evidence of this in case studies of sterile pairs. It is more rare to find a pair that is only psychologically potent. Without physical potency a pair is incapable of conceiving a child into a prepared and psychologically rich common space. Both parts of sexual potency must act simultaneously, they are mutually conditional and must be balanced. The question to be answered is how this balance developed historically. It appears that the material component is phylogenetically older.
The lack of the one or the other, or their dysbalance lead to developmental disorders. The number of married couples is increasing where the woman´s physical sexual activity declines irrespective of the fact that she is physically fit. The idea comes to mind that the woman is subconsciously balancing the lack of the psychological potency of the pair. The man´s exclusive enforcement of physical potency without any regard of the development of psychological potency destroyes the relationship. Sex becomes prostitution or onanism in two. This may become unbearable for the woman and subconsciously she tries to resolve it.
The decline of the physical sexual activity of the pair becomes the source of further polarization. The man begins to be dissatisfied. He begins to defend his physical potency convinced that it is being taken from him by the woman. The woman is pushed to the other pole when she insists that without „emotional nutrition“ from the man she is not interested in physical sex. This process is so profound and consciously often inaccessible that the healthy woman cannot force herself to have sex with the psychologically impotent man without damaging herself.
It is as though the relationship of the pair developed thanks to psychological impotence were representing the organ of nutrition of the fruit.As against the placenta which provides nutrition the relationship of the parents is the source of social interactions which lead to gradual triangulation during growth. The child relates to the mother and the father in order to enrich itself internally. This changing relationship generates the child´s individualization and separation. This is the genuine function of the social uterus. The fact that the relationship of the pair may be likened to the placenta as being the source of nutrition is borne out by cases of families with mental anorexia. Our cases have shown that the emotional starvation of the mother in a insufficiently potent pair will be projected in material form as an eating disorder in the daughter.4
The concept of the social uterus will allow us to describe a whole range of further disorders which we would otherwise be treating without understanding what they meant.
While the life of the child in the biological uterus takes nine months to birth, it lives around 18 years in the social uterus. From the biological uterus a child is born capable of biological survival in the world. The adolescent will leave the social uterus in a less complicated manner when he or she has gained the ability to live independently and socially and to establish his own family ‑ a new social uterus.
3.1 First three months
The first three months in the biological uterus are characterized by the rapid devlopment of the placentary system and the foetus. The development of the most important physical systems is completed. Likewise the first six years in the social uterus are decisive for the forming of the fundamental sexual and social abilities of the child for school entry. We have no doubt that the greatest demands are put on the psychological potency of the pair in the first years of the existence of the family, even though the consequences of malnutrition may be manifested at a much earlier stage.
The exposure of the foetus to toxic substances damages or aborts it. However, obstetricians fail to detect cases when an extremely poor psychological environment in the parents´ relationship will have the same impact on sensitive individuals.
Similarly sensitive to psychological conditions are the first years of life in the family. We would not be surprised if the so‑called cot‑death syndrome were found to be analogical to miscarriage in an unfavourable environment although we are well aware that it is very difficult to determine what is poison for child is under such circumstances.
We have to note that some time ago in a study on sterility we expressed the view that what is known as psychogenic sterility may be connected with the immature parental structure of the pair.5 In such cases the child is miscarried at a very early stage from the biological uterus or is not conceived at all. Today we would also point to the inadequate psychological potency of the pair which is eviudently dependent on the level of maturity of the partners, i.e., on what chance they were given in their respective families to complete the process of separation.
3.2 Second trimester and preparation for child‑birth
When the pitfalls of the beginning of life in the uterus have been overcome there comes the relatively calm period. The uterus rapidly increases its volume for the development of the foetus. Is this different from the period of latency as described by Freud? The social space for the child which starts going to school will also develop in leaps and bounds.
Another dangerous period in the biological uterus is the period following the 28th week when the child is capable of survival following possible pre‑mature birth. This is, however, highly risky and the child could not survive without special care. At this point the child´s development is fully dependent on the ability of the uterus to grow and on the function of the placenta until that time when the lung tissue is sufficiently mature for independent breathing. Intrauterine stress accelerates the maturing of the child´s lungs.
After the age of ten the child is capable of surviving a family breakup but the consequences may affect him for the rest of his life.Difficult conditions in the family may also lead to the accelerated maturing of the child´s social functions. Providet that the child´s development has not been marked by any major problems and the social uterus has provided sufficient nutrition adequate to the developmental stage to all members of the family then the probability of the occurrence of serious psychlogical and somatic disorders is small. Puberty around the age of 12 starts the last stage of residence in the social uterus, just as prematur contractions may announce child birth.
Childbirth is the riskiest stage of pregnancy. It represents a great conflict between mother and child. The „discussion“ between the mother and the child through mediators is full of paradoxes and seeming misunderstandings. There is no unified view about what triggers them off. Most probably it is a range of factors from increased sensitivity of the mother to reports from the child, and external factors.
The density of hormonal receptors in the uterine muscle which are responsible for uterine contractions is very low during pregnancy.6 Infection and external factors which affect the uterus also seem to have a significant influence on the process.7 The combination of many factors finally causes a situation whereby the more the child announces that it is being threatened and needs more space the more the mother´s uterus contracts and paradoxically decreases.8 Only thus is the road out of the uterus found and opened: the birth paths are relaxed and opened thanks to conflict.
The release of the child from the original family is analogical to biological birth. Even here conflict is indispensable to find a way out. The child is only seemingly free to move. In actual fact it is hardly capable of imagining life outside the family. Also in the case of the social uterus the immediate environs of the adolescent become more sensitive to his or her behaviour. The initial protection of the child is lost and stress and irritation in the family increases. Many new things accompany the adolescent into the family at this stage of his life, these external factors initiate defence elements , remind of the onset of infection in the biological uterus.
Here we can also observe a whole range of disorders. Premature birth when the child is extruded without having initiated any such process reminds us of the situation of a child which is being put on its own feet prematurely and without support. Prolonged pregnancy corresponds well to a situation in a family with an adolescent child who is hindered by his too anxious parents from separating from the family. Both situations are a dangerous source of symptoms in the family. The carrier may be any member of the family and the attention of the physician is focused on this particular member. Without a good understanding of the situation medical care may worsen rather than improve the symptoms.
4.0 Symptoms accompanying development in the social uterus
We believe that what we are looking at is more than just a symptom.Freud and others after him pointed to the somatization of anxiety and its connection with child birth. We believe that the individual stages of intrauterine life are loosely followed by life in the „social uterus“. This creates sequences of layers of life experiences in which from time to time one layer will remind of a previous one. Surprisingly, long forgotten manifestations of the organism may be updated in a novel situation when the psychosocial system finds itself in a similar context. This process may span generations.
We see, for instance, that in its social uterus the child has experienced traumatic situations from which it has been left with open wounds which could have been forgotten for the time being ( separation from the mother, divorce, sexual abuse, etc..) The child may with relative success separate from its original family and establish a family of its own and traumatic memories can remain dormant throughout his whole life. When, however, in his new family the child finds himself in a situation which will remind him of the critical period in the past the trauma will revive. It is as though under the impact of a similar constellation this person is plunged into a trance in which his perception changes. Present reality is totally overwhelmed by emotions drawing on past experience. He is able to really experience past pain and it will affect his present behaviour. For the members of his family who naturally have no knowledge of the original context this behaviour will be incomprensible, illogical. The trigger moment may be a simple and seemingly uneventful moment , such as the 15th birthday of the daughter, an age which for unclear reasons was the critical age in the life of the mother.
Parents who have experienced lack of emotional saturation in their childhood are taken charge of by their children to the latter´s detriment (see Miller 10 ). This shall be brought to our attention by symptoms in the family.
We have worked with a family where the daughter began to suffer from asthma at a time when from our point of view a premature social child birth was initiated. She found herself a boyfriend when the situation at home had become intolerable owing to a long standing conflict between the parents. The parents lived in the same household yet had nothing in common any more. The man had lost interest in the intellectual life of the woman and she responded by a total loss of sensuality. The attempts of the daughter to separate caused attacks of asthma. The situation as discussed with the family reminded us of a situation when after premature birth a child is placed in an incubator because its lung tissue is not mature. The picture was so powerful that we asked the family whether anyone had experienced such a situation. The mother then recalled labour. The daughter had actually been born prematurely and together with the mother she had experienced forceful separation. The doctors at that time did not give the mother any hope. The lungs were not fit for independent life. The memory was so vivid and overwhelming that it forced tears into her eyes.
5. Illness or developmental disorders in the synchronization of the members of the family?
The establishment of the family, building social space for the child´s development, puts great demands on the family. It assumes the synchronized development of all members of the system. The constellation of relations in the triangle father ‑ mother ‑ child is characterized by immense mutual dependence. What happens to one happens to all. The other two members of the triangle respond to the developmental changes. The child is that member of the family who naturally experiences the most dynamic development and it is therefore usually the factor which initiates changes in the entire system.
We have often treated serious somatic symptoms in children by alleviating anxiety in the mother. We believe that the best solution is to open the sources of psychic potency of the spouses in order to allow the father to reduce the anxiety of the mother. The family symptoms then disappear. It is often very difficult to persuade the man to be involved in such a task.
There is a wide range of causes and we shall indicate one of them. Since the time of Freud hindrances have dramatically disappeared in the entire population yet shame to reveal onself physically, shame to reveal weak points in one´s spiritual life is so powerful, mainly in men, that it hampers the development of an intimate and confidential psychological closeness of the pair. Sometimes we have the impression that the more men brag of their physical potency to the outside world the less they are ready to open up to the wife psychologically thereby blocking the development of the pair´s psychological potency .
Hence originates the lethal starvation of the woman for spiritual closeness without which physical closeness is impossible. This situation deteriorates even further with the woman´s maturity. The continuing contradiction between the tender and sensual flow of sexuality as the cause of the poverty of relations between man and woman was pointed out by Freud. He expressed the fear that disorders of the development of the Oedipal triangle will worsen in the population. Sadly we are only able to confirm his fears.
We derive a concetupal framework from the metaphor of the family as social uterus. We use this framework to deskcribe and understand phenomena which we see in ow clinical practice. We consider that bonds between individual members of the family can always be described as the so- coalled Oedipal triangle in diffrerent developmental stages. The Oedipal triengle is a proces of matiring relations. Normally, we do not consider symptoms linked with its development to be patological. Usually such symptoms are nothing more than unconscious disorders of timing, of rhytm, and co-ordination of the family entity. The symptoms may be behavioral, such as anorexia, bulimia or incest; Or the may be chronic and somatic , such as allergies or various seizures.
The dynamics of the development of such triangles in the family are closely linked with the development of sexuality of all its members which to us appears as the integral driving force deciding health and disease. Obstacles standing in the way of this force are the source of anxiety with its rich symptomatology. In living systems sexuality is desire for growth it follows that opposite trends accompany anxiety.
The concept of the social uterus represents a practical tool in work with the family. It is a prism which allows us to represend complicated events taking place in the family using the family´s natural language. The picture of the family as a social uterus does not contradict the general knowledge of various psychotherapeutic schools. It is an evolutionary view of the development of the human psyche. The family provides a space in which can proceed the press of the replication af lanquaque with in which human psychosocial experience is located.
Prague, May 25 1996
1. Chvála,V. Trapková,L.: The metaphor of therapy as the encounter of receptor fields, Kontext 4/94
2. Freud, S.:Selected works, I ‑ III, p 272, 2nd Czech edition, Prague 1993
3. Reich, W.: The functions of orgasm, 1942 Prague 1992, Czech translation by A. Pech
4. Chvála,V. Trapková,L : About hungry women and sleeping men, or about anorexia, Prague 1995, Editor O. Šorm
6. Zahradnik, H.P. Schaefer, W., Wetzka,B. et alia: Prostaglandine und Gerburtsbegin, Z. Geburtsh. Perinat., 198, 1994 . no 5/6, pp. 181 ‑ 185
7.Husslein,P. Egarten, Ch.:Über die Ursachen des Wegensbegin beim Menschen, T. Geburts.Perinat., 198, 1994, no 5/6, pp163 ‑169
8. Jung,H.: Utersontraktion und Geburstbeginn. Z. Geburtsh.
Perinat., 198, 1994, no 5/6, pp. 160 ‑ 162
9. Grof, Stanislav : Beyond the limits of the brain, Gemma 1994
10. Miller,A.: Das Drama des begabten Kindes und die suche nach dem wohrem Selbst, Suhrkamp Verlag, Frankfurt am Main, 1994