How does womb life affect a fetus? Does it shape his infancy? What about the rest of his life? Can a mother affect her pregnancy adversely by her mood, behavior or actions?

Arthur Janov, in his new book, Life Before Birth: The Hidden Script That Rules Our Lives, would go as far as to say that pregnancy and the first few months of life can determine whether someone will develop depression, diabetes, heart disease, asthma, or cancer. Janov, who is a leading psychologist and bestselling author, integrates neuroscience, psychotherapy, clinical observation and research in his narrative.

I was seven months pregnant when assigned to review this book, eager to begin, and hanging on every word.

Aside from his innovative gestational trauma therapy (he suggests a psychotherapy that accesses womb-life to relive early traumatic experiences), Janov tells us a lot about how a mother’s behavior during pregnancy shapes her unborn child. If a mother experiences significant anxiety during pregnancy, her child may be at risk for a higher output of the stress hormone cortisol. Maternal stress can have disastrous effects on a fetus, affecting oxygen levels, which can lead to placental failure. Janov also focuses on epigenetics, how genes are affected by intrauterine life. Apparently, genes can be changed through experiences the fetus undergoes while in the womb. The fetus may decide whether to express or repress certain genes.

I agree with Janov that stress is an anathema to pregnancy, but I have issues with some of his assertions. For instance, he cites one researcher who claims that the fetus is so incredibly vulnerable and fragile that even subtle perturbations in the mother’s mood can have measurable affects on the fetus that last for years. He also suggests that the low level of serotonin found in SIDS babies may be the result of previous traumas in the womb and at birth. What is the mother to do? Live in a bubble? How can a mother control subtle perturbations in her mood?

Continually, Janov stresses that a mother’s actions while carrying her infant have a lifelong effect. I found this to be his mission far more than spreading the message of his new therapy. Babies in the womb feel their mother’s anxiety as early as four months gestation, he states, so pregnant women should watch their stress levels, avoiding tasks or projects that could exacerbate it.

It’s hard to believe that the root of all of our problems come from what happened in the womb. I am not entirely convinced of his argument. But I do have to say that our society makes pregnancy seem like it’s not a special condition. Doctors tell pregnant women that they can do anything, run, work fulltime, travel. So I do champion Janov for elucidating that stress does affect the fetus and that a mother has a responsibility to her unborn child to avoid it.

Life Before Birth is a thought-provoking read. Janov is obviously well informed and knowledgeable, but the book itself suffers from too many generalizations, poor structural editing and organization. Chapters don’t progress from one to another. I think many writers of these types of books forget that both fiction and nonfiction books need a strong narrative to pull the reader thorough.

My upshot: It’s worth a read, but you may abandon along the way. One with a serious interest may hang on. ( )

I found the concept absolutely fascinating and I myself would like to experience my birth. Unfortunately I found it more like reading a textbook and highly repetitive. It easily could have been 100 pages shorter. It was more like a professor trying to do a series of lectures in book form. In spite of the plodding that one must do to get through the book, it is worthwhile as it does make you stop and think if just maybe the solutions doctors are using to treat problems may not be correct. In the end it seems to uphold the old psychiatrist joke of "its all your mothers fault" Actually indeed it may be. Less technical would have given this an additional star. ( )

Arthur Janov has published several books in the 40+ years since his seminal work, The Primal Scream. The central argument in all of them, however, remains the same: our prenatal and birth experiences exert a profound, albeit unconscious, impact on our lives. Because these experiences (both positive and negative) occur when our higher brain functions are not yet developed, they are imprinted in our psyche as inchoate sensations and feelings that form our initial impression of the world. And these, in turn, shape our relationship to the world around us.

Janov contends that talk therapy cannot access---much less resolve---primal wounds to the psyche. What is experienced at a primitive, preverbal stage of development cannot be effectively processed at a higher developmental level. Janov’s premise is that people need to regress and actually relive (not just recall or reimagine) fetal and birth events in order to fully process them and be rid of their pernicious effects. This rebirthing process, so the argument goes, will give us greater agency as adults, since our behaviour will no longer be patterned on unconscious reactions to past events.

While this sounds commonsensical, his patented psychotherapeutic technique is a much harder sell. He never describes how exactly the regression process actually works, nor how therapists can be sure that patients are indeed accessing and working through prenatal memories if they are back in a preverbal state and cannot communicate what they are experiencing except by means of various muscle twitches and guttural noises. Janov throws a lot of data at readers about demonstrative proof of patient improvement, but I fear it’s just a case of smoke and mirrors. Note the operative word he uses: “improvement” as opposed to recovery. Some patients are less psychotic, Janov boasts, after only one year of intensive treatment. That’s not exactly a resoundingly positive testimonial.

Do the moods or behaviours of a pregnant woman affect her fetus? No doubt, there is ample evidence in support of this claim. But do these fetal experiences actually determine our fundamental psychological orientation to the world as well as a predilection towards specific addictions and physical illnesses? Janov clearly thinks they do. I just wish his arguments were more convincing. The book is chock full of references to scientific and medical research, but what data he presents to substantiate his theory is largely indirect. Is some of it suggestive? Yes. Conclusive? Hardly. As any statistician (or defence lawyer) knows, correlations are not proof of causality. Janov is obviously aware of this, which explains his irritating habit throughout the book of prefacing statements with “well, this is pure conjecture on my part” “others may disagree with me,” etc.

Granted, psychotherapeutic theories and practices are notoriously difficult to prove scientifically. You can’t point to a person’s id or put someone’s neurosis under a microscope to examine its workings. There’s simply no way of knowing if people can actually recall---never mind relive---events that happened while they were swimming around in amniotic fluid in their mama’s belly. There is also no way of knowing if Janov’s therapy is a valid means of treating troubled people or whether he’s simply milking the one idea that first brought him a modicum of fame. A frustrating read. ( )

I found this book to be a little bit heavier reading than I was expecting. That is not to say that I didn't get anything out of it--I did understand it to some extent. It wasn't a book that I could sit and easily read for hours. I'd put it down and not pick it back up for a few weeks to read some more. For me, it was very slow reading. This would be a good book for those who really like indepth clinical books. I generally do not like passing on books unless I like them, but this is still a book that I could see passing along to the right person who would enjoy it's content and clinical talk. ( )

Janov’s Primal Therapy, the darling of the New Age Movement in the 1970s, was embraced by meaning-of-life chasers (including such as John Lennon, James Earl Jones and other celebrities) and scoffed at by his professional colleagues (with not just a little name-calling on both sides). Now, 44 years after his first client screamed and writhed his way to mental health -- and several books later -- Janov again writes about the fruits of his several thousand case studies.

The first half of Life Before Birth reads like a third draft with three more drafts to go. It suffers from repetition -- Janov’s need to restate every few pages that our prenatal experience is the most important predictor of our future behavior. And every third or fourth time that he mentions that, he feels compelled to repeat that primal therapy is the answer to mental-health problems -- not a band aid, but a cure, the therapy that will replace all other therapies.

The second half of the book is more organized and an easier read. It is also populated with the true-to-life examples that bring these sorts of books alive to the reader with a limited knowledge of biology, biochemistry, and scientific lingo.

Format criticism aside, the stats are impressive. For each of the thousands of therapy sessions over the past 44 years, Janov and his colleagues have recorded vital signs (temperature, pulse, respiration, and blood pressure) before and after each therapy session. They report that, somewhere around the end of the first year of therapy, the vitals begin to show improvement, and with a few more years of therapy the improvement becomes remarkable.

Improvement after a year and more is hardly the “quick fix” that Janov’s early critics claimed he was promising. He did, though, promise 100% success. No such brash claims appear in this recent work, though he continues to defend his therapeutic method as the only one with potential to cure mental illness. Others, he claims (and he particularly picks on behavioral therapies), simply teach people successful ways to tolerate their discomfort and bury their negative feelings.

His criticism of all talk therapies is that they “address the wrong brain.” Focus on the “left frontal, thinking brain” is self limiting, he says. Without addressing wordless regions in the right brain, where feelings are stored, no true progress can be made.

Our lives are imprinted with our experiences from the moment of conception, he explains. Our mothers’ moods and thoughts generate biochemical reactions within her body that are transmitted to us in the womb. If mother is anxious, distressed, unhappy, we are too. It all makes perfectly good sense. The tough part is learning to identify the chemicals, the brain patterns, and the resulting behaviors from prenatal life through life in the outside world and all the way to our death beds.

Janov has developed a sense of it through 44 years of practice and a lot of observation. What he knows intuitively from his experience is harder to prove with hard science -- but he has made some headway in that regard. After all this hard work, though, he must still say, “All of this is still very much theoretical work.”

Life Before Birth is intended for nonprofessionals, but necessarily dips its toes into some heavy scientific and medical jargon. It is relatively easy to mumble your way through the big words here and there, and a lot of meaning can be extracted without understanding all the biology and biochemistry that he carefully explains. But without these explanatory facts, his claims would be casual conjecture.

Janov relates many of the studies that support his own research, some of which have been made possible by new technologies in brain scanning. For me, these are some of the more interesting aspects of the book. I do believe that Janov’s primal therapy is a good addition to the mental-health professional’s tool kit, but I am less convinced that it will or should replace all other therapies, mainly, perhaps, because people will continue to seek out processes that they find appealing and comforting. Many, many people would rather live a life covered with bandages than undergo major surgery.

Two important points were not addressed. Even if Janov's therapy proves to be the only one that cures mental illness (and some chronic physical ones as well), it would not be available to most people: hundreds of hours of therapy at a cost of many thousands of dollars is hardly a global solution.

Janov closes with a list of cautions for prospective mothers, the things they can do to provide their child, in utero, with the best possible opportunity for a long and healthy life. This leads to the second point, the notion that providing the best possible prenatal environment for future generations goes beyond the actions of individual mothers. There are prenatal-care programs for women who cannot afford private medical care. How can these community initiatives be augmented? What can the community as a whole do to support the health of future generations?

Though so terribly plodding in spots (particularly at the beginning), Life Before Birth is a worthwhile read filled with good information and food for thought. ( )