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In the late 1980s, an eminent Hungarian psychotherapist, the late Dr. Jenö Raffai, developed a revolutionary new method he later called Bonding Analysis with which he accompanied pregnant women throughout their pregnancy, enabling the mothers-to-be to get into mental and emotional contact with their unborn babies. The primary objectives were on the one hand to satisfy the baby’s primal needs for bonding—that is to say, for feeling accepted, secure, protected, and most of all loved—and on the other hand to enhance the future mother’s bonding capacity.

The Origins of Bonding Analysis
The origins of this new approach were rooted in Dr. Raffai’s psychoanalytical treatment of a particular psychotic youth. Dr. Raffai discovered that the youth’s psychic disturbances could be traced back to the time he had spent in his mother’s womb. What he predominantly lacked was the conscious feeling of his physical boundaries, which made it impossible for him to perceive himself as an autonomous being, making him feel devoid of having a body of his own. Searching for the causes of these phenomena, Raffai found out that the youth’s mother had suffered the loss of her husband during the pregnancy. Instead of mourning that loss in an adequate way she had transferred this trauma to her unborn baby, considering it thenceforward to be an integral part of her own body and not wanting to let it go, so she would not lose it as she had lost her husband. At that moment the development of the baby’s self-perception of its physical boundaries came to a standstill.

Raffai explained that by transferring that image to her baby it stopped perceiving itself as an autonomous being. The baby could no longer differentiate between its own body sensations, feelings, and cognitive processes and those of its mother. The development of an autonomous self can only take place if the baby perceives its own self on the basis of the image that has developed in the mother’s consciousness; this is imperative for allowing the unfolding of fetal self-awareness (Raffai & Hidas, 2010).

Prenatal Bonding
To be mirrored necessitates the existence of another person, which form the basis of a relationship. With regard to the prenatal and postnatal relationship between mother and child, the two appropriate terms are bonding (on the mother’s side) and attachment (on the baby’s side). Raffai concentrated his work on developing a method of analyzing the bonding capacity of pregnant women and then worked towards strengthening it; in cases of poor bonding, he would endeavor to find the reasons for this and then make the women aware of the problem, thus empowering them to establish a healthy, stable, protective, and supportive bonding relationship with their babies long before their birth. In this way the securely attached babies were themselves being empowered to develop a healthy self, and later, outside their mothers’ wombs, socially and emotionally stable relationships. The primary focus of Raffai’s work was the utmost importance of the emotional and mental states of pregnant women during the gestation period and their impact on the babies.

Bonding is the baby’s most essential primal need because when fulfilled it secures its survival. The infant behaves in ways that elicit contact or proximity to the caregiver—in most cases the mother. The newborn baby possesses the necessary innate instinct to use a certain behavioral repertoire, transmitted via genetic programming and the transfer of intergenerational experiences, to ensure that its primary caregiver provides food and conveys feelings of protection and affectionate support when catering to its needs (Hüther, 2006).

Prenatal Bonding: Its Importance, Functioning, and Neurobiological Processes
The essential questions are now, first, why is prenatal bonding more important than the bonding that starts after birth, as is still a common assumption among the public at large? Second, how does prenatal bonding work? And, last but not least, what are the neurobiological underpinnings of prenatal bonding and its impact on the developing brain?

The answer to the first question is given by Professor Gerald Hüther, a renowned German neurobiologist and brain researcher: the first bonding, which actually starts at conception, is the very first and earliest bonding experience of every human being and serves as an internal working model for all future relationships (Hüther, 2006). Hüther’s model is based on the expectation/assumption that others are trustworthy, that one sees oneself as valuable, and that this self is effective when interacting with others.
Furthermore, and as essential as the first reason, prenatal bonding definitively has the greatest positive effect on the development of the fetal brain, especially the limbic system and the brain stem. The system that controls the bonding behavior is situated in the orbitofrontal cortex of the right-brain hemisphere. This region harbors the circuitry between the lower emotional areas and the higher cognitive regions—the place where cognitive and emotional processes are integrated and coordinated. It has been shown, for example, that emotional negligence and child abuse lead to a reduction in the growth of synapses within the orbitofrontal cortex. (The synapses are the linking elements within the neuronal networks; information is transported from cell to cell by neurotransmitters.) The orbitofrontal cortex represents the highest level of behavioral control and regulation of limbic excitation, including the newborn’s capacity for self-regulation (Hüther, 2012).

The prenate’s brain development starts as early as the 18th day after conception with the formation of the neural tube that will grow during the next six weeks into the main brain structures of cerebellum, thalamus, basal ganglia, and cerebral cortex. Every day, around 700 new synaptic connections are formed in the prenate’s brain, creating altogether around 60 million new neuronal networks per day. The baby is born with approximately 100 billion neurons while the adult brain consists of hundreds of billions of neurons connected via thousands of billions of neural synapses that determine our cognitive, emotional, and behavioral processes. The more synapses a human brain has the more complex and differentiated its neuronal networks will be.

The setting up of the highly complex interconnected neuronal networks—comprising all cognitive and psychological processes linked by neuro-electrical and neuro-chemical activity—begins in the womb. Genetic information constitutes the basis for the development of the nervous system, but the neuronal connections may be influenced by negative factors such as maternal stress and alcohol or drug abuse. Neural networks can also be altered with the help of effective early bonding experiences that subsequently have a positive impact on the development of a child’s adult personality. Neuronal circuits are extremely plastic, which means they can easily adapt to new circumstances.

Professor Hüther (2008) explains the function of the synaptic connections in the following way. They turn into inner representations (mental pictures) that ingrain themselves into the baby’s brain. With every new image the baby expands its knowledge about the world outside its mother’s womb so that the moment it is born it already possesses a vast amount of these mental images and associative connections. This experience also helps the baby to form a positive interior maternal image that is not only linked to the visual cortex but is also associated with her special voice and scent and is especially marked by their common experiences. The more positive internal images the mother conveys to her baby the more anchored and consolidated that kind of experience becomes in the prenate’s brain (Hüther, 2008).

How does Raffai’s bonding analysis work? Communication between mother and baby takes place via mental pictures, visualizations, and verbal messages. Everything that is being sent and said is registered by the baby’s mind and body. This communication is made possible through mirror neurons, which form the neuronal basis of the human capacity for emotions such as empathy. After the first series of baby sessions the flow of information and communication becomes more and more intense and the mother develops intuition for her baby’s needs. That way the baby’s learning ability is enhanced and its brain intensely stimulated (Balkenhol-Wright & Karrasch, 2017).

Another channel through which mother and baby communicate is via the different brainwaves—alpha, delta, and theta waves. At the root of all our thoughts, emotions, and behaviors is the communication between neurons in our brains. Brainwaves are produced by synchronized electrical pulses resulting from masses of neurons communicating with each other. Alpha brainwaves open the door to meditative states and facilitate the visualization of mental images: they aid overall mental coordination, calmness, and mind/body integration. Delta brainwaves are generated in deepest meditation and dreamless sleep: they suspend external awareness and are the source of empathy. Theta brainwaves are dominant in sleep and deep meditation: they open the gates to learning and memory. When these waves are active our senses are withdrawn from the external world and focused on signals originating from within. Vivid imagery is enhanced, and intuition and information beyond our normal conscious awareness are being activated. This is exactly what happens when a pregnant woman is gently led into a meditative state during bonding analysis sessions…

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This has been an excerpt from Neurobiological Underpinnings of Bonding Analysis by Christa Balkenhol-Wright. For more excellent material for the psychotherapist, please subscribe to our monthly magazine.