PREFACE

When I first became acquainted with the studies by the Greek psychiatrist and psychotherapist Athanassios Kafkalides in the late 1980s, I immediately realized that his use of LSD in psychotherapy signified a scientific breakthrough. From the 1950' onwards, scientific interest in the effects of psychoactive substances, in particular LSD, and the possibilities they offered for application in psychotherapy began to grow. Back in the 1960s, when Kafkalides began his research, considerable courage was required to establish the correlation between the states induced by LSD and our very earliest experiences from the time before, during and after birth, before we acquire speech. In addition, a strongly rational approach and scientific proficiency were needed to overcome the novelty and unfamiliarity of this field of research and to find an appropriate, coherent framework for investigation.

In this book Athanassios Kafkalides provides a summary of his work from 1960 to 1972 and gives an account of the re-enactment of very early experiences before and during birth in 16 patients, the majority of whom had severe neurotic and psychosomatic symptoms. LSD is able to bring our earliest experiences and our emotional states during such experiences into our consciousness; at the same time, with the appropriate expert support, an inner assessment and real understanding of these experiences becomes possible. On reading the case descriptions, it is astounding to see again and again how, in the course of an LSD session, the patient's problem turned out to stem from the dramatic early experience of a relationship - in the case of feelings of inferiority, for example, the experience of massive rejection and debasement in the prenatal stage of life. Kafkalides' findings thus enable us to achieve a new and direct understanding of the psychodynamics of neurotic and psychosomatic symptoms.

The statements made in psychotherapeutic research are often limited by the fact that such studies are restricted to individual cases. The framework used for research with LSD makes it possible to compare the re - enactment of experiences in several patients, allowing general statements to be made. The main point that Kafkalides was able to prove using this method was that a child's affective, positive or negative relationship with its mother before birth crucially determines its fundamental affectivity, its basic attitude towards life and the way in which it sees and experiences the world. Kafkalides' findings and the conclusions he draws from them seem to me to be so convincing that we cannot but accept this statement.

There is no doubt that this insight into the fundamental significance of prenatal affectivity presents a challenge for developmental psychology and psychotherapy as a whole, but in particular for psychoanalysis. Various psychoanalysts have suspected and begun to determine the significance of the prenatal mother-child relationship, but were unable to gain acceptance for their assumptions. Kafkalides' studies, which in a way furnish experimental proof of the importance of our earliest experiences of relationships, have provided a new basis for scientific discussion. Kafkalides also makes some initial remarks on this subject in the second part of the book, in which he introduces the basic categories of the "rejecting womb" and the "welcoming womb". He arrives at a new understanding of the roots and the psychodynamics involved in the development of neurotic, psychosomatic and psychotic symptoms of particular significance are his comments concerning sexual disorders and problems with relationships and their roots in prenatal disturbances. Of perhaps more general importance is the concept of "womb substitutes", which refers to the fact that reenactments of the relationships experienced before birth play a much greater part in our personal relationships, our relationships to groups and the way in which we see and experience the world as a whole than had been previously assumed. In recent years, psychoanalytic theory and practice have become increasingly ready to accept the significance of our early experience of the mother; Kafkalides' findings challenge those involved to enter into fundamental discussion and probably revision of central psychoanalytical assumptions. It is my impression that in the present day and age the results of Kaflkalides' research are more likely to find acceptance than they were at the time he carried out his studies.

There is now a whole host of findings in prenatal and perinatal psychology and medicine that support Kafkalides' results. Accordingly, and especially in the interests of the patients, I hope that this book will reach a wide audience, as Kafkalides' findings may encourage many therapists who have made similar observations in different settings to take them seriously, so that they may provide better support for their patients while reassessing their early experiences.

Heidelberg 1995    LUDWIG JANUS, M.D.