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Primal Therapy With Infants and Children

The Contribution of Dr William Emerson

Tim Hannan

After nearly forty years of research into the impact of peri-natal and childbirth trauma on the subsequent development of adults and children, there is an increasing appreciation of the value of birth work in re-patterning life scripts laid down at that time. (Grof 1., Lake 2., Janov 3.)

While the techniques used for accessing these early memories have been in existence for thousands of years, their recent development has assisted healing in areas as diverse as sexual abuse, separation trauma and spiritual crises. In most instances, primal work is undertaken by individuals in their adult years, often when other avenues have been exhausted. When given the opportunity in later life, their original suffering can emerge in its full legitimacy and be healed. It is often the case that difficulties encountered at birth go unrecognised by parents or significant others, and are painfully borne by a person through infancy, childhood, adolescence and young adulthood.

It is a matter of philosophical debate whether it is part of our life’s journey to suffer this prolonged agony and its attendant relational difficulties, but surely our humane response must be one of compassionate outrage and action to relieve this suffering, to challenge its necessity, to minimise the long-term emotional damage of these early traumas and to inter vene as soon as possible.

One such thinker is the American psychotherapist, William Emerson. His experience in working with adults in regressed states led him to believe (1974) that it was possible to undertake this work with infants and children.

“By adapting well-tried techniques, and including many innovative ideas, he has found that infants as young as one week old respond remarkably well to a process designed to help them relive their trauma and heal themselves. Some sceptics may doubt that this level of wisdom exists in neonates, but Emerson explains the process in new-borns thus:

They have two major psycho-historical inputs; intrauterine occurrences and birth experiences. There is likely to be little communication or expression of these since verbal language has not yet developed. However, providing them with structures that reflect their communication skills and simulating intrauterine/birth environments allows them to communicate the full range of their experiences. To do so, they must often utilise voice and crying tones, body action and reaction, breathing patterns and raw emotionality” (4)

Any mother of a newborn baby will bear witness to this “raw emotionality”. Yet it can be difficult to discern if their crying is excessive and thus possibly related to unfinished peri-natal business. Referrals for this type of intervention usually occur as a result of parents’ intuition that ‘something is wrong’. In the case of paediatric illnesses, temperament behaviours, learning disabilities, depression, anxiety or emotional handicaps, there may be good reason to suspect their aetiology in perinatal and birth traumas.

Diagnosis is carried out by simulating in a non-invasive manner the possible pressures experienced in utero. Each individual hypothesis is generated from birth records and anecdotal material supplied by parents, physicians or nurses. The child’s/infant’s reactions are accurately monitored both before and during simulation.

“Pre-simulation and simulation measures of heart rate, respiration rate, blood pressure and other physiological measures would then be compared, to see if physiological concomitants of anxiety or stress were present. A diagnosis of prenatal abuse would be accompanied by re-enacting some of the sounds that accompanied the abuse, while monitoring physiological responses. As infants get older, the range of diagnostic tools increases, and includes drawing, sand-play, sculpting, psychodrama and movement.”(5)

For Emerson, treatment is linked primarily to two factors, the first being the presence of accurate empathy between neonate and a significant other. The second relates to the cathartic release of feelings associated with the original trauma. The emphathic connection with the infant or child by a parent, sibling or therapist, in a deeply compassionate and understanding way helps heal the woundedness. In addition, it allows the therapist to ascertain if there is permission from the infant for the primal work to proceed towards catharsis and re-patterning.

As we sometimes observe in working with adults, healing often occurs without being conceptualised by the client. It does not always have to be made conscious for the patient. Similarly Emerson recalls:

I’ve had numerous cases where the unconscious feelings and perceptions of the infant or child were vaguely accessible to them, but clearly obvious to me. In many cases the truth would have been too painful for the parents to tolerate. In such cases I deeply and silently acknowledge the ‘truth’ of the experience to myself while having eye contact with the child (or infant). Quite often dramatic transformation followed” (6)

The success of treatment is not directly related to the number of sessions (ranging from three to twenty-seven, an average of fourteen), but to the degree to which the feelings of terror, sadness, choking, anger were contained and imploded. Insofar as the infant’s primal feelings are contactful both to himself and to others, the presence of mirroring and a high degree of contact are the greatest agents in healing primal pain.

Two types of techniques are generally employed in exploring trauma. Birth-simulating massage involves the application of ‘feather-tip’ pressures on the areas likely to have been affected or constricted during the pregnancy or delivery. This gentle recreation of the original environment may involve simply the use of energy work in the case of more severe trauma. In the second instance, evocative techniques are used which are varied depending on whether one is working with an infant or a child.

In his work with infants, Emerson uses the information gleaned in the diagnosis to initiate a discussion with parents, reconnecting them with their feelings around the time of the trauma, which in turn often evokes powerful feelings in the infant. This method relies on open, honest exploration of their feelings by the parents. Often the trauma experienced by the infant may not have been perceived as abusive by the parents, eg prenatal family crisis, separations, death, alcohol abuse, forced marital sex, prematurity, abortion attempts, all of which may have forced the foetus to prematurely armour itself against life’s vicissitudes whilst within the womb.

Techniques used with children tend to rely on games, which often include the participation of family, relatives or therapist. In fact, a feature of Emerson’s work is the team approach, where the therapist is joined by parents, siblings and other professionals at various stages. He has devised a remarkable array of games from which the child can choose to re-enact their process. Dream work, art work and sand play often give clues to the therapist which games may be most appropriate for the child’s needs.

In his paper, ‘Child Birth Re-Facilitation’, he categorises three types of games. Firstly there are the ‘done-to’ games, where the child is invited to re-enact their womb or birth process.

Examples given are:

Crushing Earth Mother: Child topples mother who crumples onto child and makes a crushing sound. Earthquake: Both parents surround child, making earthquake rumbles and movements to encourage child to escape. Cave-In: Children surround child and cave-in; child attempts to escape through the tunnels provided by the children’s arms and legs. Tunnel Crawl: All adults form tunnel by arching back while on hands and knees, children crawl through; adults contract tunnel by dropping abdomens, often accompanied by darkness and heartbeat music. (7)

In addition, Gestalt exercises such as dialoguing with the tunnel and guided fantasy journeys into underwater realms have been found to be helpful.

The second type of game relates to those in which the child has more control the ‘doing- to’ games. While the exercises remain basically the same as those previously described the child reverses roles and does to the parent, etc., what was done to them This may include ‘giving-back’ fantasies where the child is allowed to describe what they would like to do to even the score with the world or their parents.

The third type of game relates to those that are tailored to heal the specific trauma of each child. For children with abandonment issues, this may entail initially experiencing separation or having to leave pets behind, followed immediately by joyous reunion or celebration. Similar games are used in cases of agoraphobia, claustrophobia, as well as for social withdrawal and productivity difficulties.

Because of the importance of family support in this treatment, Emerson attaches considerable importance to optimizing the level of empathy each carer can offer the infant or child. As a result, he includes a training input for the development of empathetic skills for each family. This allows compassionate contact with the ongoing process of the child to be maintained and maximised.

“It is often necessary for significant others to work on their own unacknowledged traumas, so that their perceptions of infants and small children can be free of distortion and so they can be free of defensiveness around deep regressive feelings. Empathy training also focuses on the ability to communicate – many individuals are capable of accurate empathy but have difficulty communicating empathic understanding, especially to infants. They feel that infants will not understand, or feel silly in talking to infants. A skilled therapist can be extremely helpful in modelling various ways of communicating empathy”

There are four main areas in which therapy can work effectively. These relate to changes in somatic symptoms, resolution of psychological disorder, prevention of anticipated forms of psychopathology and self-transformation.

Symptoms such as asthma and bronchitis as well as psychologically based anxiety neurosis benefit greatly from primal therapy. In the case of this work being used as a prophylactic for future psychopathology, Grof (9) notes that there are often common patterns connecting difficulties experienced in adult life with those experienced in utero. Emerson looks closely at the various ways in which our most minute repetitive gestures correlate with peri-natal reactions to trauma. By studying video-tapes of both adults and children, and minutely analysing these sensorimotor patterns (what Piaget described as schemas), he found them to express as well as perpetuate unintegrated primal trauma.

“Movement forms an integral part of foetal and infant learning and associated schemas accrue into adulthood. It is common to find prenatal and birth schemas in the physical (though unconscious) repertoire in adults and to find that significant life patterns do not resolve themselves until the pre-natal or birth schemas are re-patterned”‘.

Other forms of bodywork, such as osteopathy and craniosacral therapy are used to support the primal work. By using a variety of approaches, bodily held tensions are released which otherwise may not resolve the remaining issues. If parents are made aware of the prevalence of primal feelings in the day-to-day expressions of their defensive infant, they also can assist the therapy by providing support and empathy for what might otherwise be seen as irrational, spoiled or explosive behaviour.

The self-transformation which Emerson notes in a large proportion of these infants and children, relates to their connection to their true nature. He admits had had not anticipated this by-product of the work, even though this reaction is well-documented by others in their work with adults in expanded states of consciousness. He has found that:

“Infants and children who completed therapeutic work were described by others as qualitatively different. They were described as lighter (and yet capable of seriousness) and more joyful, contactful, creative and independent (yet capable of dependence). They were also described as more emotionally aware, expressive and resolving (resolving upset quickly and easily). They were seen as highly unique human beings who had individuated beyond normal expectations and found themselves and their unique qualities, sometimes without parental support and encouragement.”

While most of this pioneering research was carried out in England between 1974 and 1989, it is now joined to a rapidly-increasing bank of knowledge on peri-natal psychology, presided over by the Association for Pre- and Peri-Natal Psychology and Health in California, of which William Emerson is currently a director. It is envisaged that he will hold a training workshop in Ireland in 1999.


1. Grof, S: Realms of the Human Unconscious. Viking Press NY 1975

2. Lake F: Tight Corners in Pastoral Counselling. Darton Longman Todd, London 1981

3. Janov A: New Primal Scream. Abacus Books, London, 1992

4. Emerson W: Infant & Child Birth Re-Facilitation. Institute of Holistic Education University of Surrey, 1984

5. Emerson W: Psychotherapy with Infants & Children. Journal of Pre- and Peri-Natal Psychology, Vol 3 No 3, California, Spring 1989

6. Emerson, 1989

7. Emerson W. Infant & Child Birth Re-facilitation. Institute of Holistic Eduction: University of Surrey 1984

8. Emerson, 1989, P. 198

9. Grof, S: Beyond the Brain. Suny NY, 1985

10. Emerson, 1989, P.200

11. Emerson W, 1989, P. 192

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