In Episode 49 of The Craniosacral Podcast, Matthew Appleton of Conscious Embodiment Trainings discussed some key factors to consider when trying to understand the emotional needs of babies. The following article summarizes some of the matters Matthew brought to our attention in that interview.
The Influence of Birth Trauma on the Physical and Emotional Well-being of the Baby
Matthew Appleton MA RCST UKCP
This article is based on a talk given at Annual Congress of the International Society
for Pre and Perinatal Psychology and Medicine, Maastricht, the Netherlands,
The premise of this article is that although the process of being born exerts stress and
trauma on babies, it is not necessarily the birth process itself that leads to
traumatisation. Rather, it is a lack of empathy and understanding on the part of
caregivers, of the impact of birth, which inhibits babies from fully discharging the
emotional charge associated with the experience that leads to traumatisation. This
observation is based on almost two decades of working with babies, children and
adults in clinical practice, as well as attending and later facilitating many workshops
and courses aimed at uncovering birth memories through embodied, regressive
exercises. The consistency of specific body movements, emotional responses and, by
older children and adults, reported experience, indicate a huge territory of human
experience, that we may call the pre and perinatal realm which has yet to be
integrated into mainstream psychology, science or public awareness. Because of this
lack of awareness babies have to hold their experience on their own. As such we can
say that babies have to bear the burden of our cultural shadow, which, as I hope to
show, is a deep insult to their integrity as sensitive, feeling, relational beings.
During birth babies are under a lot of stress, due to the pressure being exerted on them
by uterine contractions and by the bones of the maternal pelvis on the foetal cranium.
At various times babies experience a great deal of disorientation and pain. The longer
babies are under stress, the more likely they are to experience this as traumatic. Stress,
if it is short lived and leads to positive outcome, does not impact us in a negative way.
Stress mobilises us to act. Babies are very active in their own births and stress is a
natural motivator in this. Under stress the sympathetic nervous system is activated and
stress hormones, such as adrenalin and noradrenalin are released. We only experience
stressful situations as traumatic if our coping threshold is overwhelmed. Trauma
leaves us ‘altered and disconnected from our bodies… we feel utterly helpless and
hopeless.’(1) When a situation turns from stress to trauma we are flooded with stress
hormones and in this hyper-aroused state our physiological imperative is the
overwhelming drive to survive. If the trauma is intense or long enough we may go
into a hypo-aroused state, sometimes known as parasympathetic shock. In this state
our bodies produce painkilling endorphins and we dissociate from our physical
experience. We become frozen and immobilised.
If we are unable to move out of states of hyper-or hypo-arousal or long term stress,
our neuro-endocrine levels will constantly be activated, as if we were still in the
original stressful or traumatic situation. As such we become traumatised. If the levels
of activation are able to drop so that our coping threshold is neither overridden nor
stressed then we are not traumatised, even if the situation we encountered was
traumatic. Birth is both stressful and traumatic. At various times babies may feel as if
they are going to die, for example, if their oxygen supply is cut off as contractions
compress the cord or the cord is wrapped around the neck. If they are flooded with
analgesics given to the mother or crushed by the unnaturally prolonged and intense
contractions produced by augmentation or induction drugs, this can also feel life
threatening. Babies can also feel empowered if they are able to encounter the stresses
and traumas of birth and successfully navigate their way through. However this
success does not depend on having simply survived the event of birth, but on having
integrated the experience of birth in such a way that the baby is no longer cycling in
states of hyper- or hypo-arousal. The baby who has fully integrated the experience of
birth in this way, develops a sense of relaxation and resilience. It is the foundation of
an underlying sense that ‘I can encounter difficulty and overcome it.’ But babies are
not able to integrate the experience of birth on their own. They need the empathic
support of people, ideally their parents, who know what they have been through.
Babies Tell Their Stories.
According to the child psychoanalyst Alice Miller ‘It is not the traumas we suffer that
make us emotionally ill, but the inability to express the trauma.’ In the case of babies
and infants it is not their ‘inability to express the trauma’ that is the problem, but our
inability as parents, caregivers and professionals to see, hear and empathically
respond to what is being expressed. Because babies are not able to express themselves with words, we tend to disregard their experience. Present day medical science reinforces this by telling us that babies do not remember the pain of birth. Clinical experience of working with babies (and adults who access birth memories either spontaneously or through birth simulation exercises) tells us that this theory is not only incorrect, but is in itself traumatising, in a similar way to the denial of memories of sexual abuse was in the past.
Babies carry the memories of the pain of birth in their bodies as lived experience,
which may become reactivated after birth and throughout life. They tell us about it,
not in words, but through ‘memory crying’ and ‘baby body language.’(2) Most parents
and professionals are aware of ‘needs crying’ by which a baby is expressing a present
moment need, such as hunger, cold, boredom, tiredness or the discomfort of a wet
diaper. There is almost no awareness that babies also cry because they are
‘remembering’ their birth. This is not remembering in the sense that we may
remember what we had for lunch yesterday, but is a felt embodied experience of what
it was like during the birth. Babies remember exactly where in their birth their coping
threshold was overwhelmed. Until such time that this traumatic experience is
integrated into the baby’s ongoing experience of self(3), the trauma has a life of its own, which operates within both psyche and soma. At the somatic level it manifests as hyper- and hypo-arousal of the neuro-endocrine system. At the psychic level it expresses itself though strong emotions, along with existential themes associated with the will to exist and fear of annihilation. Memory crying tends to express three essential emotions: anger/rage, anxiety and sadness. We can hear these themes in the emotional tone of the crying and see them in the accompanying emotional expressions.
There are two types of baby body language. These are ‘fixed’ and ‘active’. Fixed baby
body language includes conjunct sites and conjunct pathways. Conjunct sites are areas
of compression that are left over from where the baby (mostly the baby’s cranium)
was up against (‘in conjunction with’) the mother’s cervix or a pelvic bone for a long
time. Conjunct pathways are pathways of compression and stress that were created by
being painfully pushed (by maternal contractions) or dragged (i.e. with forceps/
ventouse/c-section) over a maternal bone. One of the most obvious examples of fixed
baby body language is what is called the ‘birth lie side.’ This consists of the side of
the baby that was closest to the maternal spine. In the last few weeks of the pregnancy
and during labour this side of the baby, which may be left for some babies and right
for others, tends to be more compressed, especially in relation to the maternal lumbosacral promontory (LSP), a thick mass of bone, located where the lumber spine meets the pelvis. The birth lie side is usually obvious as that side of the cranium is more compressed. The eye, on that side, is closer to the nose and slightly lower than the eye on the other side (in cephalic presentations) as the eye has been compressed medially and dragged inferiorly as the baby’s head passed over the LSP. There also tends to be more tension and nerve activation, due to compression of the peripheral nerves, on the lie side.
Active baby body language consists of repetitive, spontaneous, but meaningful
movements, such as the touching of conjunct sites and tracing of conjunct pathways.
These are very specific and reveal exactly where in the birth process the baby felt
stuck and overwhelmed. In baby therapy sessions, babies will often take the therapists
hand and pull it into contact with the conjunct site or pathway. They will indicate the
exact pressure they need to meet the compression that they are feeling in the body.
Babies, like any one else, contract against pain and this contraction holds the
compressive forces in the tissues of the body. The right level of pressure, along with
the right empathic response to the baby’s ‘story’ allows the body to relax the
contraction and release the compressive forces that have been held there. Babies know
what they need to do and they need us to know as well, so that we can support them.
Baby body language and memory crying usually co-arise as a unitary process. The
body language shows us where in the body the memory is held and at what stage in
the birth (or prenatal life) the memory is located (4). The emotional tone of the memory
crying, along with facial expressions and the emotion conveyed through the eyes, tell
us how the baby experienced this event. As such babies tell us their stories. The role
of the baby therapist is to hear the story and empathically mirror it back to the baby.
This includes mirroring the body language and emotional expressions, accompanied
by verbalising what is being expressed. This may be something like ‘I can see how
hard it was you as you were trying to rotate in the mid-pelvis. That really hurt, didn’t
it.’ Or ‘you were doing so well, you were nearly there, when those forceps grabbed
you and yanked you out.’ The more accurate we can be in reading the body language
and attuning emotionally to the baby’s story, the less likely we are to project stories
onto the baby. For the most part of a session when we are working with babies and
their families we do not know what needs to happen. It is only when the bit of the
birth that the baby wants to work with clarifies, through the baby body and memory
crying that we engage with mirroring and other supportive processes.
When babies feel that their story is being listened to and appropriately responded to
they feel it as an opportunity to fully release the emotional charge associated with the
birth memory. This means that the intensity of the emotional expressiveness increases,
before it decreases. Usually when a baby memory cries, it is mistaken for a needs cry
and the baby has a breast or bottle shoved into the mouth or is told to ‘shush’. Whilst
this is done with the best of intentions, there is a mismatch between what the baby is
experiencing and how the world responds. At first babies may protest and struggle
against such interventions, but after awhile they give up on themselves and surrender
to the inevitably of not being understood. The assumption is that a quiet baby is a
content baby and quiet babies are often referred to as ‘good babies.’ This can lead to
what I call ‘Good Baby Syndrome’, whereby a baby has learnt to diminish his or her
need for authentic emotional expression and has become resigned to not being
Yet it is only through empathic listening and emotionally attuned mirroring that
babies are able to release the emotional charge associated with birth trauma and
down-regulate their neuro-endocrine activation. Imagine this scenario. You have had a
very stressful day at work, maybe your boss or a client was very aggressive towards
you. You feel agitated and upset and when you arrive home you try to tell your
partner. Instead of listening your partner tells you ‘shush, it’s fine, you’re ok’ or
thrusts a sandwich into your hand telling you ‘you must be hungry, that’s what’s
wrong with you.’ Instead of calming your agitation, you would initially feel angry, but
after time would give up on being heard. You would become resigned to not being
understood. Imagine another scenario: your partner really listens to you and is deeply
empathic to what you are feeling. As you tell your story you feel the emotions deeply,
you might cry or feel your anger more fully, as you recount what has happened.
Afterwards you feel calm and relaxed, with a deep sense of satisfaction that you have
been listened to and understood.
It is the same experience for babies. When they feel we are deeply listening they tell
their story more fully. The memory crying often becomes louder. But it is the
releasing of the traumatic experience, rather than a railing against not being heard.
There is a very different quality to the crying. But it is not always easy for parents (or
indeed many therapists) to tolerate the intensity of memory crying or to fully trust in
its therapeutic value. For most parents memory crying and baby body language are
new concepts and they may be understandably sceptical. Their own unresolved birth
trauma, and history of not being listened to, will also be stimulated, so that their
tolerance to hear their baby’s pain may be quite low. Educating parents to understand
the value of memory crying helps them to trust the process and deepen their empathy
for both their baby and themselves. Working within, rather than over-riding the
capacity of parents to tolerate the emotional intensity of memory crying creates a safe
context in which babies’ birth stories are able to unfold and trauma can resolve. Once
the story has been empathically listened to, the baby body language and memory
crying greatly diminishes and mostly disappears, as the process that the baby felt
stuck in has now been completed. This enables the baby to move from a state of
traumatisation, to a newly found quality of resilience.
Emotional Attunement; Mirror Neurons and the Electromagnetic Fields of the Heart
Babies feel when we are emotionally attuned to their experience and when we are not.
The more we bring our own prenatal and birth experiences into consciousness and
resolve our own trauma, the more present and empathic we can be to babies. We
cannot support babies from a theoretical basis alone. The work of supporting babies
asks of us that we face and work with our own split off and disowned emotional pain,
before we can authentically empathise with their stories. Babies are usually far more
emotionally attuned to us than we are them. This is largely due to how we have been
educated to override our instinctual and intuitive selves, being governed, instead, by
theoretically shaped cognition. In doing so we have closed down our senses, whilst
babies’ senses are very open and their lived embodied experience is informed from
moment to moment as to how emotionally attuned we are to them.
We have still a lot to learn about the specific ‘mechanisms’ by which babies attune to
the nuances of relationship. Recent discoveries in neuroscience and
electrocardiography may give us some clues. The presence of ‘mirror neurons’ was
discovered in the 1990’s by researchers studying rhesus monkeys. These are thought
to be neurons in the brain that fire in relation to observed actions and expressions by
another person. As such the ‘mirror neuron system’ is active in our ability to
empathise with others, as it enables us to feel what another person feels though
observing their body language (5). It is via the mirror neuron system that baby’s are able to imitate the facial expressions of others. An example of this would be when a baby copies an adult when they stick out their tongue. It could well be that these mirror neurons are ‘two-way mirrors’, whereby when the babies body language and expressiveness is mirrored back, they feel that we are emotionally attuned and empathic with their felt experience. Clinical experience shows that babies know when we are and when we are not emotionally attuned to them. Mirror neurons may be just one of the means by which they are able to detect this.
Another possible means by which babies seem to read our minds may be through the
electromagnetic field of the heart. Electrocardiogram (ECG) readings reveal that the
electromagnetic field of the heart is much larger and much more powerful than the
electromagnetic field of the brain (6). There are three separate fields of the heart,
corresponding to the 3 phases of the heart, have been detected by ECG: The first
extends only a short distance from the heart. The second and strongest of these fields
extends out about 3 feet. The third reaches out to between 12 and 15 feet. Other larger
fields are also believed to exist. These fields interact with each other and also with other
heart fields around us. The heart field of a baby’s family forms a dynamic interactive
gestalt in which babies are emotionally embedded and actively engaged with. The
interaction of the heart field of a mother and her baby are especially important and most
strongly active at the frequency of the field that extends to 3 feet.
The relational interaction of the heart fields does not begin at birth, but even before the
actual prenatal heart has begun to form:
The electromagnetic (EM) field of the heart is a primal force in our individual development. In our embryonic and foetal development the initial cells of what becomes our heart are some of the first cells to form. Well before the embryonic heart starts to function as a pump it generates a pulsating EM field that surrounds the whole developing embryo. Through embryonic and foetal development the hearts energy field is stabilised by the mother’s heart field and the two heart fields imprint each other.7
The heart field of the mother reflects her emotional state. Coherent waves occur when
we feel love, joy, nurtured in relationship and other positive emotions. These expansive
coherent frequencies resonate and entrain with other coherent frequencies in the
environment. This reinforces coherence and the interactive heart fields of a coherent
relational field create a stable energetic holding within which babies feel safe and known. If parents, and especially mothers, are experiencing negative emotions such as fear, frustration or pain the frequency of the electromagnetic field becomes incoherent. Incoherent waves do not radiate out to the environment in the same way that coherent waves do. They cannot synchronise with other waves, which is what makes them incoherent. Because these frequencies inhibit the capacity to interact with other heart fields in a coherent way, babies and their parents feel isolated and out of synch with each other. If the baby is experiencing incoherence the mother’s heart can help the baby’s heart re-establish coherence. The mother’s heart entrains with the baby’s heart and her coherent frequencies lift the baby out of incoherence. Entrainment occurs when the frequencies of the hearts of mother and baby match. Entrainment equals empathic emotional attunement and is a measurable phenomenon. Coherency and entrainment maintain a sense of relationship and safety for babies.
Dissonance and Attachment
When a baby memory cries and cannot be consoled it creates a great deal of distress and frustration for parents who are trying to do their best. Because they are responding to it as if it were a needs cry the baby’s distress escalates. This in turn generates parental distress and frustration. Instead of the coherence of the parents’ heart-fields pulling the baby out of incoherence, the baby’s incoherent heart-field draws the parental heart-field into incoherence. A cycle of frustration and distress becomes the norm for both baby and parents. Relationships become tense. It is hard to find pleasure, comfort or meaning in relationship. The whole family is operating at the level of survival, rather than thriving. Feelings of failure and guilt compound parental distress. Tempers fray. The relational field is permeated by shock and despair. It becomes dissonant, rather than entrained. Dissonance, in this context, is the absence of emotional resonance and empathic attunement is not possible.
Dissonance disrupts bonding and attachment, disrupting what is known as the First Year Attachment Cycle. This cycle begins when a baby feels a need. As babies are unable to satisfy their needs on their own, they become sympathetically aroused. If the need is gratified, the baby feels relief and relaxes. The repetition of this experience creates a foundation of trust in relationship and the world as being places where needs get met. An example of this would be the baby is hungry, cries and is fed. Satiety brings relaxation. If the need is not met, the baby becomes increasingly distressed and overwhelmed. If it goes on long or often enough the baby collapses into resignation and trust in relationship/the world is lost. Neither relationship nor the world is experienced as safe. As we saw earlier empathic mirroring of babies stories is also a need and, insofar as this is met the attachment cycle is positively reinforced. Insofar as it is not met the cycle is negatively reinforced. In the latter case the baby’s emotional expressions seem incoherent to the parents (‘I have tried feeding, rocking, distracting, nothing seems to work’) and the parents’ responses are incoherent to the baby. This throws the baby into an incomprehensible world in which nothing feels safe or trustworthy.
When parents are able to understand that their babies’ emotional expressions and body
language are not random, but are intelligent and meaningful they can appreciate their
babies at a much deeper level. Babies feel this and become more embodied, as they trust that their inner sensations and the response from the environment are coherent and meaningful. The baby who is embedded in a coherent relational field is able to relax more fully into the experience of being here. There is more of a sense of presence, as the baby is not caught up in a past trauma or so flooded by stress hormones that the only viable option is dissociation. A coherent heart field supports the growth of the prefrontal lobes.(8) These neural structures enable us to regulate emotional reactions and to control impulses and survival responses. Well-developed pre-frontal lobes are essential to our capacity to regulate stress. The sense of stability and security that babies feel and which becomes laid down in their neurology, informs and supports all subsequent stages of bonding throughout the rest of life.
The Effects of Unresolved Birth Trauma
As we have seen unresolved birth trauma has a number of effects, which compound the
original trauma and increase the likelihood of traumatisation. In the short term spiralling
cycles of distress lead to inconsolable crying (insofar as the real cause of the crying is not recognised and appropriately responded to), feeding problems, fractiousness and disturbed sleep. These in turn disturb bonding and attachment, leading to existential anxiety and even terror, insofar as babies do not feel held in a secure, coherent relational field. When babies memory cry and their inner experience is not met in a meaningful way by their caregivers, there is increased frustration and bewilderment. Rather than expand out into an incoherent and dissonant environment, babies contract into themselves. They may also be experiencing physical discomfort and pain, due to the compressive forces still held in the tissues of the body. This is accompanied by the emotional pain that lingers from the birth itself, as well as that of not having the birth story recognised and empathically engaged with.
Later in life this will lead to the formation of what I call Super Conductive Survival Systems. A Super Conductive Survival System is a cluster of responses to a present moment stress stimulus that is similar to an earlier prenatal or birth trauma. It is a system, in that it has a life of its own and hijacks our awareness and our usual capacity to respond. It is survival based, as it evokes behaviours that helped us to survive when we encountered the original trauma. It is super conductive, as it conducts trauma-based energies (i.e. bioelectric and biochemical) in the same way that water or metal are super conductive to electricity. A super conductive survival system consists of,
• The activation of dense neural pathways.(9)
• Flooding of the body with stress hormones, leading to hyper- or hypo-arousal.
• Diminished consciousness and possibilities, as we are being run by primitive
survival strategies, rather than inspired by creative choices.
• Inappropriate behaviours, such as rage, fear (the ‘fight/flight’ response of hyperarousal)
or terror/dissociation (the ‘freeze’ response of hypo-arousal).
• Distorted perception – we experience threat where there is none.
• Self-limiting beliefs, such as ‘I can’t do this’ or ‘I never handle these kind of
The following scenario is an example of a Super Conductive Survival System, which
might be associated with someone who was born by forceps. They are struggling to
finish a project and someone offers to help. This is the present moment stress stimulus
that echoes an early trauma. The offer of help is experienced, as the forceps were, as
painful, invasive and manipulative (distorted perception). The activated person becomes
angry and shouts at person who has offered help (inappropriate behaviour). The limbic
system becomes over-excited and adrenaline production increases (activation of dense
neural pathways and flooding of stress hormones). The over-stimulated limbic system
and adrenal surges hijack awareness (diminished consciousness/possibilities). The
present moment physiological response is that of the baby encountering the forceps
again. This may lead to shame and the sense that ‘I’m not a good person to be
around’ (self-limiting belief #1) and, more-unconsciously, ‘It’s not okay to get help’ (selflimiting belief #2). This is a very generalised example. Not all babies born by forceps are going to have the same responses as this.
The denial of babies’ experience of stress and pain in the birth process means that is
does not get adequately addressed early in life. Memory crying and baby-body language are ways in which babies convey in a very specific manner what their experience of birth was like. Because babies do not get the empathic support they need to resolve their birth trauma they have to hold their painful experiences on their own. This keeps them cycling in distress, disrupting bonding and attachment and leads to the formation of super conductive survival systems, which undermine self-esteem and well-being later in life. There is much more that could be said about the psychological and physiological consequences of unresolved birth trauma, which are beyond the scope of this article. I have focussed here on the relational aspects of missing how babies convey their birth stories, and how this reinforces trauma, leading to traumatisation, rather than resolution and resilience. As I write this I am aware that although the ways of working therapeutically with memory crying and baby-body language are being taught, there are still only a very small number of practitioners working with babies in this way. However, it is my belief that we have to take the long view and that only by acknowledging this lack can we begin to address it, through therapeutic and educational means.
1) Levine, Peter & Kline, Maggie. Trauma Through A Child’ North Atlantic Books. 2007. p. 4.
2) I am deeply indebted to Karlton Terry, founder of the Institute of Pre and Perinatal Education (IPPE), for introducing me to this terminology and teaching me to see and hear babies with more clarity.
3) I use the term ‘self’ here to indicate an a continuum of embodied experience, rather than the more formed ego that emerges out of this embodied experience. From a more exact ontological perspective we might use the term ‘being’, rather than ‘self.’ But as the dynamic ground of our being-nature is the living foundation from which the sense of ego forms, I use the term ‘self’ as an emergent, rather than fully formed psychological structure.
4) A knowledge of the different stages of birth from the babies perspective enables us to match conjunct sites and pathways to the different pressures exerted as the baby passes through the pelvic inlet, midpelvis and pelvic outlet. Some baby-body language may also refer to prenatal experiences and postnatal procedures. As such, baby-body language is very specific and is universal, albeit reflecting the different cultural contexts within which gestation and birth occur.
5) Murray, Lynne. The Psychology of Babies. How relationships support development from birth to two.’ Robinson. 2014. p. 8-9.
6) Childre, Doc, Martin, Howard & Beech, Donna. The HeartMath Solution. HarperOne. 1999.
7) Russell, Linda G. and G. E. Schwartz. ‘Energy Cardiology: A Dynamical Energy Systems Approach for Integrating Conventional and Alternative Medicine’. Journal of Mind-Body Health. 12:4. 1996
8) Pearce, Joseph Chilton. The Biology of Transcendence . A Blueprint of the Human Spirit. Parker Street Press, Rochester, Vermont. 2002.
9) Early childhood trauma has been shown to overexcite the limbic system, the primitive midbrain region associated with emotion and memory. This is done by the formation of dense neural pathways, which are geared more towards survival based behaviour, than the higher brain structures, such as the pre-frontal lobes, which are associated with emotional regulation and relationship.
Copyright – Matthew Appleton 2014