Birth confusion and phobias

Abstract

In this paper, based in the clinical experience obtained from an agoraphobic patient we support the idea that the agoraphobic is a being that is not entirely born, that is to say, that in his phantasy he still remains bound to his accompanying object (mother). In this sense the agoraphobic could be a patient that has not yet cut the umbilical cord, a being half born. Based in these statements, we conclude that the birth trauma includes two traumatic moments. A first moment or “transit period” that correspond to the
expulsion of the foetus by the mother, and a second moment or “umbilical period” that includes the period that passes since his entrance to the external world till the umbilical cord is cut off. We suggest the hypothesis that the agoraphobic and extensively, all phobics are patients fixed at the “umbilical period” of the birth trauma. We discribe two forms of mental confusion bound to the birth trauma. In the first one the newborn continues to live his post-natal experience, as if he were not yet born, as if there were still two beings in one and not two separated beings already. This would be the “primary confusion” from which the new born
comes out by means of projections and introjections. These mechanisms should be, partially, caused by the purpose of getting rid of the confusion. The second form of mental confusion related with the birth trauma or “secondary confusion” could be caused as a consequence, of the cut, of the umbilical cord which increases death instinct. The projection of this instinct permits the formation of the dead-alive. Ah this, being immediately introjected, thus appears the confusion of death and life instincts, failing dissociation
pursued in projection giving place to the confusion (or confused fusion). The confusion of death and life instincts means also the confusion of idealized and persecutory objects; then the confusion comes back to the Ego. We sustain that in the case of secondary confusion death instinct is lived as if it were a confusion. This mechanism prevails in phobias. On the other hand, when the projection of the death instinct “takes the form of persecutory fear” (Melanie Klein) we have the conditions, that, when they
develop, will cause paranonia. Finally, we establish, that phobia is a defense against mental confusion, besides other meaning that have already been reported. It is considered, that the “catastrophic situation” (Hanna Segal) feared by the phobic is, originally, the
confusional desintegration, which is eluded, justly, by the phobic dissociation.