Otto Rank, Injury of Birth - Psychoanalysis. T. 1...

Otto Rank

Integrated goal:


• the main provisions of O. Rank's theory;

be able to

• use the discoveries of O. Rank in the analysis of myths;


• The skills of psychological counseling based on Rank's findings.

Birth injury

Otto Rank (German Otto Rank; current name Rosenfeld (1884-1939) is an Austrian psychoanalyst, one of the closest students and Freud's followers, Rank criticized the Freudian stance according to which the father's cassation threats are key in the formation of the Super-I, he held to the view that in the normal development of the Super-I takes participation, first of all, the image of a strict mother (not real, but the one, as in the sadistic aspect, the child understands it.) Then Rank called into question the paramount importance of the Oedipus to the complex as such in the psychic life of the individual, so he began to create his own concept.

Sigmund Freud was the first to come to the conclusion that the deadly fear associated with birth trauma can serve as a hidden source and prototype of all the fears that a person will experience in his life. However, this topic did not receive further development from him. Moreover, when his student Otto Rank was carried away by this problem and suggested studying the time of the fetal stay in the mother's womb in studying the mental development of the person, Freud took it as an attempt to revise his concept and condemned the book "The Birth Injury" that Rank released.

According to Rank, an important role in the formation of the human mental world is played by the act of his birth, coupled with an incredible trauma. Freud carefully studied the material, which in the form of free associations he received from patients when it came to post-uterine life. However, all sorts of information about how the child's psyche was affected by his stay in the mother's body or about what accompanied the act of birth, Freud believed "fantasies". Meanwhile, not only Otto Rank, but also other researchers, first of all Nandor Fodor and Litart Pirbolt, paid the most serious attention to perinatal and prenatal psychic dynamics.

Of course, Freud also took into account the possible consequences of birth trauma. But he meant extreme physiological difficulties in the process of birth, which could contribute to increasing fear and anxiety in the lives of those whose births were accompanied by certain difficulties. But Rank wrote about something else. He was referring to the process of separation of the infant from the mother's womb. Rank also idealized the time of the fetal stay in the mother's body, believing that it can be characterized as serene, happy and in all respects calm.

Rank considered that the experience of a biological trauma can be considered the key moment in the complex dynamics of the process, which can be characterized as death-rebirth (the embryo dies and is reborn as an infant). Its importance for psychology and psychotherapy was first established and described in detail by O. Rank in the work "Birth trauma". It provides, in particular, the interpretation of hysterical conversive symptoms. Freud saw in the conversion of the reflection of the psychological conflict, expressed in the language of corporeality. Rank was also convinced that their true basis is in physiology, which reflects the initial situation at birth.

It was important for Freud to explain how the primary psychological problem turns into a bodily symptom. Rank also sought to show how a purely somatic phenomenon can receive a serious transformation, acquire through a secondary biographical study of psychological content and even a symbolic meaning. These discoveries of Rank have been further developed in transpersonal psychology.

Generally speaking, writes S. Grof, a non-fixed anxiety can be traced back to the past more or less accurately before the deadly alarm at birth. In various phobias that conceal the anxiety, crystallized into specific fears of people, animals or situations, the initial anxiety of birth is present in an altered and mitigated by later biographical events. If the intensity of the affect reveals a deep perinatal source, the generalized type of phobia reflects a specific stage of birth, and the specific choice of people, objects and situations is determined by later biographical events. "

Rank in Birth Injury In detail, he analyzed how the birth trauma is associated with the fear of certain animals (zoophilia). If the object of phobia is a large animal, then the topics related to the threat of absorption or incorporation (wolf) or the danger of pregnancy (cow) are important. Transpersonal psychology shows that the archetypal experience of the onset of the process of death-rebirth is just a sensation of swallowing and incorporation. Fear of small animals is probably associated with their ability to penetrate small holes in the ground and again get out of them (mice, snakes).

Transpersonal psychology also shows that some animals have a special symbolic significance for the process of birth. Thus, the images of giant tarantulas often appear at the time when labor begins, as symbols of the devouring female element. This seems to reflect the fact that spiders catch free-flying victims in their webs, immobilize them, entangle and bind them, suck life out of them. It is easy to grasp the relationship between this sequence of events and the child's experience in the course of biological birth. That's why many are generally afraid of spiders.

In general, anxiety, which is considered the most important of psychiatric symptoms, logically and naturally accompanies the process of birth. Childbirth is a critical situation for survival, including extreme physical and emotional stress. However, it should not be assumed that Rank was in this case a brilliant seer or the most detailed phenomenologist of birth trauma. In fact, birth traumatizes not because the child from paradisiacal bliss in the mother's womb passes to the extreme conditions of the outside world. The very passage through the birth canal is associated with extremely high emotional, physical stress and incredible pain. This circumstance Freud emphasized in his original arguments about birth. But Rank does not have this moment at all. It turns out that the Rank concept of birth trauma is more suitable for those who were born with the help of cesarean section, rather than by physiological births.

Thus, one can agree with S. Grof that O. Rank's system lacks a deep understanding of the transpersonal sphere, which is inherent in the works of Z. Freud, A. Adler or V. Reich. The score relied more on the significance of birth trauma than on sexual dynamics. He challenged the decisive role of the Oedipus complex and saw in the Ego an autonomous representation of the will, and not a slave of the unconscious. Rank suggested a change in the technique of psychoanalysis. They were just as radical and decisive as his theoretical conclusions. He argued that the method of verbal work with patients can only have an auxiliary character. The main attention should be given, according to Rank, to direct therapy. In other words, he offered to help patients re-experience the condition of birth trauma. If this did not work, then the therapy was considered incomplete, incomplete and simply incorrect.

Rank theory singles out separation from the mother and loss of the uterus as the main traumatic aspects of birth. The essence of the trauma for him is that after the birth of a child, trials are awaited.

In the main essay Birth injury (1924) Rank put forward his own psychological concept, in which the decisive factor of development is the fear caused by the trauma of birth. As to the significance of birth trauma in psychology, Freud himself first drew attention to the fact that it can be a prototype and source of all future anxieties and anxieties. He considered this issue in a number of his works, but refused to accept Rank's sharp judgments on this matter. And one more serious difference with respect to birth trauma in Freud and Rank: Freud singled out extreme physiological difficulties in the process of birth as a source of alarm, and Rank connected anxiety with separation from the mother's womb, i.e. from a heavenly state in which all needs were met immediately and without any effort.

Rank considered birth trauma as the root cause of the fact that separation is perceived as the most painful and frightening human experience. In his opinion, in all later frustrations of partial impulses one can know the derivatives of this first trauma. Most of the events that an individual experiences as traumatic, due to their pathogenicity, are similar to biological births. The entire period of childhood can be considered as a series of attempts to respond to this trauma and coping psychologically with it. Childish sexuality can be interpreted as a child's desire to return to the uterus, anxiety about it, curiosity about where he came from.

But Rank did not stop at this, he considered that the entire mental life of a man arises in primary anxiety and in primary displacement, accelerated by birth trauma. The central human conflict comes from the desire to return to the uterus and the fear that accompanies this desire. As a result, any change in the pleasant situation will be unpleasant and will cause anxiety. Rank also proposed an explanation of dreams that differs from Freud's interpretation. The state of sleep is similar to that of the intrauterine life, and dreams can be seen as attempts to relive a birth trauma and return to a prenatal situation. And they even more than the very state of sleep, represent a psychological return to the uterus. The analysis of dreams in the most reliable way confirms the psychological significance of birth trauma. Similarly, the Oedipus complex - the cornerstone of Freud's theory - is reinterpreted with an emphasis on the birth trauma and the desire to return to the uterus. At the core of the myth of Oedipus lies the mystery of the origin of man, which Oedipus tried to unravel, returning to the mother's womb. This happens not only literally, by marrying the mother and having sexual intercourse with her, but also symbolically, when the blind hero disappears in the crevice leading to the underworld.

According to Rank's psychological theory, birth trauma in sexuality plays a key role based on the deep, controlling the whole psyche of the individual's desire to return to the intrauterine existence. Differences between the sexes can mostly be explained by the fact that a woman is able to repeat the reproductive process in her own body and find her immortality in procreation, while for a man, sex symbolizes mortality, and therefore his strength lies in non-sexual creativity.

Analyzing the general human culture, Rank concluded that the trauma of birth is a powerful psychological force underlying religion, art and history. Any form of religion in the extreme tends to recreate the original supporting and protective primitive situation of the symbiotic union in the mother's womb. The deepest roots of art go to the autoplastic imitation growth and release from the mother's womb. Presenting reality and at the same time denying it, art is a particularly powerful means of psychological adaptation to this primary trauma. The history of human dwellings, from searching primitive shelter to complex architectural structures, reflects the instinctive memory of the uterus - a warm, sheltered shelter from dangers. The use of military equipment and weapons is based on the most careful consideration on the indomitable aspiration to pave the way for the mother's womb.

LSD psychotherapy and other forms of deep empirical work have largely confirmed the main thesis of Rank about the primary importance of birth trauma. However, in order to better match current clinical observations, the Ranks approach has to be substantially amended. Rank's theory distinguishes separation from the mother and loss of the uterus as the main traumatic aspects of birth. The essence of the trauma for him is that the postnatal situation is much less favorable than the perinatal situation.

Beyond the uterus, the child is forced to face irregular feeding, frequent absence of the mother, temperature fluctuations, noise. He must breathe, swallow food and take out waste substances on his own.

When working with LSD, the situation is more complicated. Yet most of the psychopathological diseases are rooted in the dynamics of BPM-11 and BPM-111, which reflected the experience of those hours that separate the serene state inside the uterus from postnatal existence in the external world. In the process of re-residence and the integration of birth trauma, the individual may seek to return to the uterus or, conversely, to complete the birth and exit from the birth canal - this depends on the stage of the perinatal process. The tendency to exteriorize and relieve the emotions and energies trapped during the battle of birth becomes a deep motivational force that determines a wide range of human behavior. This mainly refers to aggressiveness and sadomasochism - to those two states for which Rank's interpretation looks especially unconvincing.

But despite all these shortcomings, Rankom's psychological relevance of the birth trauma and its numerous consequences was indeed an outstanding achievement for several years anticipating the results of studies using LSD.

It is interesting to note that some other psychoanalytic researchers also recognized the importance of various aspects of birth trauma. Nandor Fodor in his pioneering work "Lover's Quest" described in detail the relationship between different aspects of birth and many psychopathological symptoms (1949), and in this description there is a profound resemblance to the results obtained with the use of LSD. Litart Pirbolt published an extensive work "Prenatal Dynamics" (1975), in which he set forth in detail the unique conjectures about the psychological relevance of prenatal existence and the experience of birth. This topic was also given much attention (although more speculative than based on clinical results), in a number of original and fascinating books by F. Mott.

Rank's theory was also supported by Ferenczi. He supported Rank and thereby showed that not everything follows Freud. In his theoretical system, he seriously considered not only perinatal and prenatal events, but also elements of phylogenetic development. Being one of the few disciples of Freud who immediately adopted his concept of Thanatos, Ferenczi also introduced into his conceptual system an analysis of death.

In the essay Talassa (1938) Ferenczi described the entire sexual evolution as an attempt to return to the mother's womb. In his opinion, during sexual intercourse, interacting organisms participate in the satisfaction of germ cells. Men have the privilege of really and directly penetrating the mother's body, while women take on fantasy or are identified with their children during their pregnancy. This essence of the "regressive trend of Talassa", the desire to return to the original water existence, from which man refused in primitive times. The amniotic waters represent in the ultimate sense the waters of the ocean, introjected into the mother's womb. According to this point of view, every cell of mammals inhabits land has a deeply motivated desire to change the once taken decision to abandon ocean life and choose a new form of existence. Another, for example, was the decision, truly accepted millions of years ago by the ancestors of modern whales and dolphins.

However, the ultimate goal of all life can be the attainment of a state for which there is a lack of sensitivity to irritations and, in the final analysis, inertness of inorganic matter. Perhaps death and dying are not absolute, and the seeds of life and regressive tendencies are deeply hidden, even in inorganic matter. And then you can imagine the entire organic and inorganic world as a system that constantly fluctuates between the will to life and the will to death, and neither life nor death can receive absolute superiority. Thus, Ferenczi came close to the concepts of "eternal philosophy and mysticism", although his reasoning was expressed in the language of the natural sciences.

From the moment of his birth, a man "constantly has a regressive attraction to reproducing the situation of the mother's womb," which is partially realized after the formation of an "erotic sense of reality" in the co-operation of heterosexual partners. This "material regressive attraction" is again overdetermined: it is followed by a "thalassal regressive attraction," the legacy of the great catastrophe of the desiccation of the sea, which forced sea animals to live on the earth, led to the transition to respiration by the lungs and the emergence of amnions that enable the embryo to exist fish, i.e. provide him with a lost marine existence in the mother's body, as well as the appearance of copulation organs, allowing the introduction of spermine into the moist body of the female body. " Anxiety, considered generally the most important of psychiatric symptoms, logically and naturally accompanies the process of birth, because labor is a critical situation for survival, including extreme physical and emotional stress. The possibility that all anxiety comes from the trauma the child receives in the birth canal was first noted by Freud. However, Freud did not develop this idea, and the theory of birth trauma as a source of future fears later engaged his teaching O. Rank. Three decades later, the theoretical reasoning of the pioneers of psychoanalysis was confirmed in psychedelic studies.

Representatives of transpersonal psychology support the concept of Rank. The key moment in the complex dynamics of the process of death-rebirth is the experience of biological birth trauma. Although Rank's presentation of the nature of this trauma, according to S. Grof, is not exactly the same as that obtained in studies with psychedelics, many of his conclusions can be of great value when it comes to experiencing perinatal levels. For this reason, Grof calls this stage of psychedelic therapy "Rankian"; which, however, does not accurately reflect the clinical picture, since the process of death-rebirth involves much more than just experiencing biological birth. Jungian psychology is a good idea of ​​the meaning of psychological death and re-birth and carefully examines it in different cultures. The Jungians approach is extremely convenient when processing the specific content of many perinatal experiences, especially the characteristic mythological themes and images that are often encountered in this context. However, according to Grof, the Jungians missed the relationship of this sample with the biological birth of the individual and the significant physiological range of this phenomenon. Involving archetypal elements in the process of death-rebirth reflects the fact that, at the level of deep experience, the encounter with the phenomenon of death and new birth usually causes a spiritual, mystical revelation and frees the way to the transpersonal spheres. This connection has its analogy in the spiritual life and ritual practice of various cultures that have existed from time immemorial. Examples include shamanic initiations, rituals of passage, vigilant ecstatic sects, or ancient mysteries of death-rebirth. Sometimes the symbolic context used in one of these systems is more appropriate for interpreting and understanding a particular perinatal experience than an eclectic mixture of Rank, Reich's concepts and existentialism.

Rank's theory reflects important clinical aspects. Take, for example, the interpretation of hysterical conversion symptoms, which was first proposed by O. Rank. While Freud saw conversion as a reflection of the psychological conflict expressed in the language of somatization, Rank believed that their true basis was in physiology reflecting the initial situation at birth. The question for Freud was how the primary psychological problem turns into a bodily symptom, whereas Rank had to explain how a purely somatic phenomenon can in time acquire (through a secondary biographical study) a psychological content and a symbolic meaning.

Some serious manifestations of hysteria bordering on psychoses (psychogenic stupor, uncontrollable waking dreams and fantasies about reality), apparently, are dynamically linked, according to Grof, to BPM-1. They reflect a deep need to restore the blissful emotional state, characteristic of a serene intrauterine existence and symbiotic unity with the mother. And if emotional contact and the state of bodily contentment associated with it are easy to recognize as related to the experience of a desired good womb and a good breast, then in a specific content of dreams and fantasies themes and elements concerning the childhood and adult life of the individual come through.

Freud's psychoanalysis, or in some cases the individual psychology of Adler, are the most convenient systems for discussing experiences centered around biographical topics. But both systems are completely useless when the process goes to the perinatal level. For some experiences that directly affect the context of the birth process, the therapist and the patient can apply O. Rank's conceptual framework. Simultaneously, the powerful energy of the perinatal level can be described in the Rayhian terms. However, both the Rank system and the Reich system require significant modifications in order to correctly and in detail reflect the entire process. Rank understands a birth trauma in terms of the difference between the intrauterine state and existence in the external world, not taking into account the specific traumatic effects of the second and third perinatal matrix. Reich correctly describes the energy aspects of the perinatal process, but speaks in this case of compressed sexual energy, and not about the energy of birth.

So, O. Rank has questioned the Freudian theory of the sexual origin of neuroses and shifted the etiological focus to the trauma of birth. He believed that in any neurotic symptom there is an attempt to exteriorize and integrate this emotional and biological shock fundamental to human life. Therefore, one can not expect a real cure for the neurosis until the patient experiences this event in a therapeutic situation. Given the nature of the trauma of birth, we can conclude that verbal therapy is ineffective and must give way to immediate experience.

In the works of the 1930s. O. Rank has departed from a purely biologic interpretation of the psyche and turned to the problem of the formation of individuality. This process, according to O. Rank, begins with the severance of biological ties and continues at a psychological level. However, every step on the path to the formation of individuality generates a feeling of abandonment, loneliness, activating the trauma of birth. The experience of freedom is traumatic if it does not lead to a new connection with the world at a higher level. Otherwise, the payment for freedom becomes neurosis (a situation literally borrowed and developed by E. Fromm). In this connection, Rank tried to comprehend the problem of will, which he interpreted as an autonomous creative force in the service of individuation, and also solve the task of "will therapy". On the whole, O. Rank's teaching was a connecting link between Freud's psychoanalysis with its positivist attitudes and modern trends in depth psychology, in particular neo-Freudianism.

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