5. The interhuman relationship

It is a commonly accepted notion that since the early months of life infants are able to make connections with their surrounding world. Therefore contrary to what

## Physiology of Human Birth and Mental Disease DOI: http://dx.doi.org/10.5772/intechopen.82216

condition. According to Fagioli's theorization, in the first moments of life the newborn realizes a memory-fantasy of the experience had in the intrauterine condition, from the sensation with the skin in contact with the amniotic fluid, (memoryfantasy of the sensation had before), and a first image of itself as 'libidinal and psychic self'; at the same time, the newborn by recreating in its mind the condition of wellbeing and calmness previously experienced, imagines the existence of another human being similar to itself. In those first moments of the newborn's life from the pulsional and vital rejection of the inanimate world, the certainty of an existing breast arises; that is, a human being similar to itself to whom to direct its feeling. In conclusion, the newborn makes the external world disappear, but not itself or its natural tendency toward another human being. This is the psychodynamic result of the first reaction to the external non-human world. For further references we suggest Chapter 2 in [1]. It is important to reaffirm that the annulment pulsion at birth is not isolated as it is merged with vitality. Together they become disappearance fantasy, which is creative and not destructive. According to Fagioli specification, these two specific human features the annulment pulsion and vitality, arising immediately in 'coming to light', make the newborn indifferent to the inanimate external world and at the same time enable the creation of the capability to imagine [21, 22]. This capability to imagine is a fundamental human dimension throughout all life. Indeed a loss or alteration of this dimension is founded in most psychiatric pathologies as I will further explain in the following paragraphs. The capability to imagine is an exclusive human characteristic, which begins at birth and develops throughout life. The first human thinking, which begins as image and non-conscious mental activity, represents the basis of any creative activity. The capability to imagine is realized at birth in the short span of time between the light stimulation and the subsequent pulsional reaction with the activation of the respiratory muscles by the central nervous system. Physiologically it occurs in those first instants of life when the newborn appears to be inert and it still not crying nor breathing. Only after this short span of time the newborn wails and moves. This is a common experience in the delivery room: a suspended moment, a bunch of seconds when the newborn is still and not wailing. However, as previously explained the light has already hit the retina therefore the brain has been activated and the mind is functioning. Although the newborn appears still and silent, it is already alive and human. This is how the biological formation of human psyche occurs. To sum up, light is the absolute new feature. Annulment pulsion toward non human reality and vitality determine disappearance fantasy as the capability to imagine, the creation of the first internal image and the certainty of an existing breast. The 'Human Birth theory' proves that the first act in the newborn's life is an autonomous psychic act. This is an individual creation arising from the biological reality through the reaction to light. Human life starts, when at birth mental activity begins. In our whole life, this activity will never cease, neither during the night. It will stop only at the death of the individual. Therefore, the lifetime of a human being is all comprised within an interval that starts when light activates the brain, while the end corresponds to the cessation of mental activity. During the night human thoughts will express themselves through images as non-conscious thought. The interpretation of oniric images and the presence or lack of affection concealed in these images is at the core of

Psychology of Health - Biopsychosocial Approach

psychotherapy according to the Theory of Birth.

It is a commonly accepted notion that since the early months of life infants are able to make connections with their surrounding world. Therefore contrary to what

5. The interhuman relationship

14

Freud affirmed [23], they cannot be considered as isolated, autoerotic and narcissistic beings [24]. Nowadays it is a proven fact that cognitive development is affected by early social relationship and by the newborn activity. Moreover, recent studies carried by Murray have confirmed the idea that infants begin to make connection to the world since the very beginning [25]. This study, based on observation and experimental approach, demonstrates the early communication ability shown by infants. As early as the first month of life, the newborn smiles without being able to distinguish to whom. At the same time the newborn is able to interact with other human beings approaching its visual area, through visual contact. During the second month, although the vision is not completely formed, the infant begins to make visual connection with the mother's face. (Visual acuity gradually develops over the first year of life and it will be completely formed at the age of two. In the earliest months of life the baby can differentiate only lights, shadows and sharp movements). According to Murray, during the second month of life the intersubjective primary phase begins. During this time the infant starts to smile and to socially interact with his/her parents that can now recognize their infant as human. Moreover at this stage, mirror neurons and the parent's tendency to imitate sounds and gestures of their infant play a fundamental role. These factors help to develop a sense of reciprocity and trust. Through their careful presence parents can provide love and affection to their infants, addressing their needs and guaranteeing a safe attachment [25]. It is well known that early experiences during the first year of life will have a major impact on the onset of mental illness during adolescence and early adulthood. B. Beebe has confirmed the existence of four type of attachment (secure, avoidant, ambivalent, disorganized) which had been previously identified by her mentor Stern. In her recent work is highlighted how a disorganized attachment during the first year of life can have dramatic consequence in adulthood, resulting in serious mental illness. Beebe also hypothesizes the importance of mirror neurons in early relational experiences [26]. Although these relevant experimental studies and observations should be considered the object of further research, we think that the core of this discussion does not lie in the behavioral and emotional mirroring. What is central is rather the infant's need to find confirmation of its feeling and identity in the interhuman relationship. Obviously it is necessary to consider that developmental processes, cognitive and emotional acquisition and the act of processing experiences are directly related to biological activities, neurofunctional mechanism and remodeling of the neural networking. The latter is still partly unknown and we do not intend to deny nor underestimate their role believing that they should be considered object of further investigation. We should remember that brain neural plasticity reaches a peak during the first year of life and continues developing until the age of 18–30 [10, 12]. However, we must point out the limits founded in the approaches previously mentioned. Although they highlight the importance of interhuman dynamics during the preverbal period and take into account the centrality of nonverbal communication (gesture, body posture, facial and vocal expression, physical or non-physical contact), they still mainly consider a relational context in which adult behavior and consciousness are the main agents. These act together with the primitive infant consciousness, which is considered as "internal operative models" shaped on the base of experience [26]. One of the major limits of these neuropsychological approaches lies in the complete absence of research on the origin of irrational and non conscious mind. According to the theory of birth, the infant non-conscious mind is the first to be formed in human beings and for a quite a long time will be the only function. The non-conscious mind is strictly connected to the infant body. In fact, body and mind are born together in "coming to light" with a drastic separation that marks the end of the conditions that guaranteed the fetus existence. We should recall how investigating the human birth dynamic can be fundamental in order to understand how mind's individuality and sociality are formed. Since birth, the infant is able to establish a relationship with other human beings with its all human reality. A few moments after birth, the cold inanimate reality does not exist and the search for human relationships begins. This is a crucial moment for every human being. As previously explained, because of the human birth dynamic, the newborn processes and develops a 'certainty of an existing breast'. This is not a rational certainty but rather an irrational, unconscious natural tendency toward another human being. While in the earliest moment of life, mental reality is shaped in the relation (refusal) with the inanimate world; firstly, light. Soon after, once the First Self is formed, in order to live, the search for the other starts. By 'living', we consider at the same time a material and psychic life. In fact, since this moment the infant development is strictly connected to both cognitive and affective growth. If the newborn is not physically nourished it dies. However a child that receives physical nourishment but is left alone, not warmly welcomed or taken care will manifest signs of severe depression until death [27]. I would like to further specify that according to the Massimo Fagioli Theory the newborn once born is neither undifferentiated nor shapeless. This means that it won't acquire an emotional and cognitive shape through the relationship with the mother. On the contrary, it is in the sharp caesura happening at birth that the newborn separate oneself from the mother and the intrauterine condition. In doing so an irrational mind is first created in the interaction with the inanimate world. Only in a second moment the newborn will establish a rapport with the mother (or with another significant human being). The newborn will naturally establish a relation of trust that characterizes the primitive and originary human sociality. This arises from the process occurring at birth in which the newborn without being aware is sure of the existence of a breast. The adult's duty is to be physically and psychologically ready to give warmth and nourishment, in order to confirm this infant intuition. The warm voice of the mother or another significant being, the harmony of the words heard, the lullabies sang, the care received and the affection given will physically transmit invisible forms of affection. The newborn feels and perceives the internal non-conscious reality of the caregiver. The caregiver's unconscious reality will be based on love and interest for the newborn if this is considered as a human being in all respects. On the contrary, the caregiver will be merely addressing the newborn's physical needs if this is uniquely seen as a body to nourish and to be look after. The caregiver's inner reality and their psychic wellbeing are fundamental for the healthy development of the newborn. It is also important for clinicians to consider what occurs in the adults' non-conscious mind during the interaction with the newborn immediately after birth and during the earliest years of life. During the infant development, cognitive acquisitions go hand in hand with emotional experiences. Consciousness comes only later when physical senses mature and the cerebral connection are completely formed, thanks to evident brain plasticity now widely demonstrated. Therefore mirroring and imitational processes are not key in the relationship. On the contrary, it is crucial for the newborn to find confirmation that the other is able to comprehend and recognize a personal demand for human relationship, and physical and affective presence. (Mirror neurons are triggered in some behaviors but probably they are not the cause of these behaviors or the related emotions). Obviously the infant cannot use verbal language but is able to feel. The infant is extremely sensible to any kind of affections such as love, hate, coldness and is at the same time able to react to them. If the adult gives love and affection, adequately responding to the newborn's needs, it will undergo healthy growth. In addition, the infant will develop a safe attachment or in other words, it won't be afraid of being abandoned because its affective expectations have not been disappointed. Therefore the infant will gradually

separate from the mother during weaning, developing little by little its own autonomy. This process occurs together with verbal language development which should be considered as an infant personal and creative realization. According to this vision, the newborn is not a wax table on which to impress mental, cognitive or social abilities. During the developmental phases, every step forward will be firstly

The capability of being well with oneself and others, being an active part of society is fundamentally influenced by the first year of life. If the infant's demand for love and acceptance is constantly disappointed due to relationship that aims only at addressing physical needs, the infant will suffer an unsatisfactory experience. The internal elaboration won't develop a sense of trust or well-being but rather a feeling of insecurity and struggle between a natural tendency toward others and the constant disappointing answer received. In these conditions, the original vitality will be compromised. After going through stages of rage and progressive loss of vitality, an alteration in the relationship characterized by pathological dynamic of introjection and projective identification will occur. On this point, we suggest reading Chapter 2 in [1] and Chapter 4 in [7]. Although altered, these dynamics will still allow a relation with human reality. If in the early stages no other valid human relationship occurs to change this condition, there will be a further evolution toward pathology. The child, in order to defend oneself from the external aggressive human reality, altered by dynamics of introjective and projective identification will annul the existent human world. In other words the infant will make mentally disappear the disappointing human reality. By doing so, personal humanity and capability to love will disappear too. The annulment

the outcome of a creative ability of the individual that happens along with neurofunctional maturation of the corresponding body system. If the newborn's needs and requirements have been satisfied during the first months of life together with an unconscious elaboration of the experience had during breastfeeding, this will increase vitality. This will lead the infant to an ever-increasing research of another human being during its growth. The infant will become more confident acquiring an awareness of its and others identity. All these stages will lead the infant to the crucial stage of weaning. This is a fundamental stage of human development after birth and the first year of life without verbal language. In the past, the definitive end of maternal breastfeeding coincided with the beginning of deambulation and verbal language. (Until not many years ago, in Italy and also other countries breastfeeding continued beyond the first year of life due to a lack of nourishment and an approximate birth control). Nowadays food weaning usually ends within the first 7–8 months of life. By saying this, we more widely intend the time in which the infant begins to become more independent from adults. In fact, during this stage the baby starts speaking and walking. If the newborn has had healthy relationships until this moment, he/she will have acquired a personal certainty and comprehension of the human world, along with the abilities that allow to be relatively independent. In this situation the infant will realize a complete separation of oneself from the other significant adult. In other words, the baby will not experience anguish. From a psychodynamic point of view, weaning will physiologically occur after having satisfied one's desire for the substance of the other. For further reading, see [8]. During the 8th–9th months infants have developed a certainty of their identity which will allow them to recognize their face in the mirror. This will happen even if they have never seen themselves before, causing a

reaction of joy at the vision of their face.

Physiology of Human Birth and Mental Disease DOI: http://dx.doi.org/10.5772/intechopen.82216

6. Pathology

17

### Physiology of Human Birth and Mental Disease DOI: http://dx.doi.org/10.5772/intechopen.82216

dynamic can be fundamental in order to understand how mind's individuality and sociality are formed. Since birth, the infant is able to establish a relationship with other human beings with its all human reality. A few moments after birth, the cold inanimate reality does not exist and the search for human relationships begins. This is a crucial moment for every human being. As previously explained, because of the human birth dynamic, the newborn processes and develops a 'certainty of an existing breast'. This is not a rational certainty but rather an irrational, unconscious natural tendency toward another human being. While in the earliest moment of life, mental reality is shaped in the relation (refusal) with the inanimate world; firstly, light. Soon after, once the First Self is formed, in order to live, the search for the other starts. By 'living', we consider at the same time a material and psychic life. In fact, since this moment the infant development is strictly connected to both cognitive and affective growth. If the newborn is not physically nourished it dies. However a child that receives physical nourishment but is left alone, not warmly welcomed or taken care will manifest signs of severe depression until death [27]. I would like to further specify that according to the Massimo Fagioli Theory the newborn once born is neither undifferentiated nor shapeless. This means that it won't acquire an emotional and cognitive shape through the relationship with the mother. On the contrary, it is in the sharp caesura happening at birth that the newborn separate oneself from the mother and the intrauterine condition. In doing so an irrational mind is first created in the interaction with the inanimate world. Only in a second moment the newborn will establish a rapport with the mother (or with another significant human being). The newborn will naturally establish a relation of trust that characterizes the primitive and originary human sociality. This arises from the process occurring at birth in which the newborn without being aware is sure of the existence of a breast. The adult's duty is to be physically and psychologically ready to give warmth and nourishment, in order to confirm this infant intuition. The warm voice of the mother or another significant being, the harmony of the words heard, the lullabies sang, the care received and the affection given will physically transmit invisible forms of affection. The newborn feels and perceives the internal non-conscious reality of the caregiver. The caregiver's unconscious reality will be based on love and interest for the newborn if this is considered as a human being in all respects. On the contrary, the caregiver will be merely addressing the newborn's physical needs if this is uniquely seen as a body to

Psychology of Health - Biopsychosocial Approach

nourish and to be look after. The caregiver's inner reality and their psychic wellbeing are fundamental for the healthy development of the newborn. It is also important for clinicians to consider what occurs in the adults' non-conscious mind during the interaction with the newborn immediately after birth and during the earliest years of life. During the infant development, cognitive acquisitions go hand in hand with emotional experiences. Consciousness comes only later when physical senses mature and the cerebral connection are completely formed, thanks to evident brain plasticity now widely demonstrated. Therefore mirroring and imitational processes are not key in the relationship. On the contrary, it is crucial for the newborn to find confirmation that the other is able to comprehend and recognize a personal demand for human relationship, and physical and affective presence. (Mirror neurons are triggered in some behaviors but probably they are not the cause of these behaviors or the related emotions). Obviously the infant cannot use verbal language but is able to feel. The infant is extremely sensible to any kind of affections such as love, hate, coldness and is at the same time able to react to them. If the adult gives love and affection, adequately responding to the newborn's needs, it will undergo healthy growth. In addition, the infant will develop a safe attachment or in

other words, it won't be afraid of being abandoned because its affective expectations have not been disappointed. Therefore the infant will gradually

16

separate from the mother during weaning, developing little by little its own autonomy. This process occurs together with verbal language development which should be considered as an infant personal and creative realization. According to this vision, the newborn is not a wax table on which to impress mental, cognitive or social abilities. During the developmental phases, every step forward will be firstly the outcome of a creative ability of the individual that happens along with neurofunctional maturation of the corresponding body system. If the newborn's needs and requirements have been satisfied during the first months of life together with an unconscious elaboration of the experience had during breastfeeding, this will increase vitality. This will lead the infant to an ever-increasing research of another human being during its growth. The infant will become more confident acquiring an awareness of its and others identity. All these stages will lead the infant to the crucial stage of weaning. This is a fundamental stage of human development after birth and the first year of life without verbal language. In the past, the definitive end of maternal breastfeeding coincided with the beginning of deambulation and verbal language. (Until not many years ago, in Italy and also other countries breastfeeding continued beyond the first year of life due to a lack of nourishment and an approximate birth control). Nowadays food weaning usually ends within the first 7–8 months of life. By saying this, we more widely intend the time in which the infant begins to become more independent from adults. In fact, during this stage the baby starts speaking and walking. If the newborn has had healthy relationships until this moment, he/she will have acquired a personal certainty and comprehension of the human world, along with the abilities that allow to be relatively independent. In this situation the infant will realize a complete separation of oneself from the other significant adult. In other words, the baby will not experience anguish. From a psychodynamic point of view, weaning will physiologically occur after having satisfied one's desire for the substance of the other. For further reading, see [8]. During the 8th–9th months infants have developed a certainty of their identity which will allow them to recognize their face in the mirror. This will happen even if they have never seen themselves before, causing a reaction of joy at the vision of their face.
