Letter From The President

Prenatal Therapy: A Preventive Olive Branch to Womb Babies & Infants

At the beginning of 2021 Ericha Hitchcock Scott and I agreed that November would be a wonderful month to collaborate and write about Prenatal Gratitude. This month we want to celebrate conception and the commencement of one’s life with all of you. While I will briefly discuss the significance and implications of prenatal psychotherapy and bonding effects, Ericha will share a young woman’s miscarriage love letter as a healing opportunity. Both of us feel truly grateful and honored to be of support to pregnant mothers, womb babies, infants, and their families.

I was born loving words,
Mother and I caught them
Tossed them to and from like sunbeams
Blew them to each other
Golden dandelion seeds
Before I knew them
And their first names were
Mama, Dadda, Babba, Drink, Love

Joining sentences like daisy chains
Like carriages to trainsets, like kites to sky
Mother reading to me at night
With the words lighting up her face
My oxygen and my sunlight
My joy and my toys.

From “Poem for my mother”, by Valerie Sinason


Thirty years ago, it would have been inconceivable to me 1) that womb babies had so much at stake, 2) that clinicians could so significantly support pregnant mothers and intervene someone’s trajectory in conception, womb, or post birthing, and 3) that prenatal trauma informed psychotherapy could repair intergenerational relational trauma complexities by offering parallel parenting education and ‘in utero guidance’ (Cortizo, 2019).

Prenatal hidden trauma, dissociation, and post birthing complications can remain invisible veils that interfere with one’s lives and that of a family, throughout lifetime (Cortizo, 2021). And while some pregnancies are unpredictably challenging, many can become hopeful beginnings. Prenatal psychotherapy offers a preventive olive branch to the womb baby, and an opportunity to assess, educate and support the maternal ecosystem. Culturally competent, comprehensive, prenatal evaluations with focus on pre-birthing bonding variables, and treatment outcome data, may ultimately contribute to further “tease apart the contributions of trauma, early attachment problems, and other developmental problems in the development of dissociative disorders” (Kluft, 2008).

More than a decade ago I started to advocate for universal, prenatal psychotherapy services compellingly and publicly, and it was at that time than a significant number of esteemed friends and colleagues began to privately share their own painful pre-post birthing stories with me also, it was during those momentous, intimate, interpersonal conjunctures that the importance of prenatal healing became most obvious. As a result, I have been able to ask more sensitive and relevant prenatal assessment questions which in turn evoked narratives of mothers who themselves were a product of unplanned and unwanted pregnancies, and who had to learn to bond with their own womb babies in ways they never felt attached to their own mothers or caregivers.

The world is full of brave pregnant women, most of them too busy and overwhelmed with prenatal medical newness and social-financial complexities to focus on their own wellness and trauma work. That is until a sudden event trigger them (i.e., death, romantic separation, abnormal lab, etc.), or the pregnancy itself becomes the unexpected trigger (i.e., tokophobia, unseen-dissociated pregnancy, miscarriages, abortion, sexual abuse flashbacks, etc.). Universal, optional prenatal psychotherapy services need to be offered early and as a part of the mother’s obstetrics care. 

When I think of gratitude most of mine goes to all the brave mothers who continue to bring children into our world, and who often deliberately decide to heal in conception.

Trauma therapy during conception aptly assesses, treats, and prevents traumatic transferences, emotional fusion, multigenerational transmission and projections (Bowen, 1976), and intergenerational traumatic bonding. Anecdotal evidence suggests that women who receive trauma informed care (TIC) in conception, during dating, throughout pregnancy and post birthing seem to have positive outcomes and minimal postpartum anxiety or depression. Numerous women who have spontaneously lost their babies have reported finding hope in the created relational warmth of the therapeutic alliance, and by remaining active in their own trauma and grief work. There are innumerable of such accounts.


At the beginning of a group for hospital administrators and staff, a young woman who was planning to write about her miscarriage – sat in the back of the room. She was a stranger to me, and she appeared to be extremely distraught. Since, I am well aware that this love letter writing process can be very intense and provocative, I approached her and gently asked if she was OK. She nodded her head yes. I explained that as the facilitator, I was responsible for her safety. I asked her if she would promise to tell me if she needed my help. She said “yes”, and I believed her. 

She was the last person in the room to read her letter out loud. Just before she read her letter, a man in the room read his letter to his wife about how much he admired her strength and tenacity throughout the challenging experience of artificial insemination. These types of coincidences cannot be planned.

Love Letter to an Unborn Baby

My Dearest Baby,

I knew from the very beginning of my journey that I wanted the very best for you. I took all the steps necessary to ensure that your life would be worth living. I took care of myself, I researched all the right foods, all the nourishing pieces that would make you perfect. I set up a life for you, that would give you the opportunity to be amazing. 

When I heard that you had transplanted yourself inside me, I knew I was going to do whatever it took to make sure you were given all the opportunities to live up to your potential. Your purity, your innocence, your fragile life inside me, precious beyond measure, I just knew you would be exceptional. 

During our last moments together, seeing your heartbeat for the first time, surrounded by chaos, surrounded by metal and noise and trauma. I never had the opportunity to tell you how truly special you are. That your little life, your short existence changed me forever. That I would have climbed a mountain and turned over the sands of time to give you all the love in the universe. You were the best moment that happened to me. I miss you every day. My love for you will never fade and we will meet again. I won’t disappoint you, I’ll begin living my life, the life I imagined for you and I know you deserve.  – love Mom

A few years later in a note to this author: “P.S. The LOVE LETTER WORKSHOP changed my life! I wrote this years ago in Malibu with you Ericha…. I was in the darkest place I have ever been. Mourning a loss. You gave me the courage to express my love. Thank you……! Let me reassure you that I have lived up to my promise. I love my life today even in the midst of all of this pandemic craziness. I am blessed to be healthy and surrounded by the love of family & friends.”

I share this letter in my love letter writing workshops today because it touches each of us on a very deep level. How different this world would be if we all received this much love, even before birth?

E. Hitchcock Scott, PhD, LPCC917, ATR-BC, is an ISSTD member and the author of the Love Letters Workshop and her shared text is an excerpt from a chapter she is writing for this Workshop. You can find more about Ericha’s work on her website 

It is this moment before the meteor falls,
Before the ice melts and the heat rises
Before the sea turns to sky and before the earth burns

Stay, live, learn and thrive a while with us
Here in this pause between ages
This heartbeat of the universe
Our loving  flicker of eternity.

Thanksgiving, by Valerie Sinason

Much gratitude to Valerie for generously sharing her precious poetry with all of us.


Bowen, M. (1976). Family therapy: Theory and practice therapy. New York, NY: Gardner Press.

Cortizo, R. (2019). The calming womb family therapy model: Bonding mother and baby from pregnancy forward. Journal of Prenatal and Perinatal Psychology and Health, 33(3), 207-220.

Cortizo, R. (2021). Prenatal broken bonds: Trauma, dissociation and the calming womb model. Journal of Trauma and Dissociation, 22(1), 1-10.

Kluft, R. (2008). International Society for the Study of Trauma and Dissociation: 25th Anniversary ISSTD 1983-2008. Springfield, VA: Ambertone Press, Inc.

Spanish-Bilingual Corner


“A pregnant woman is like a beautiful flowering tree, but take care when it comes time for the harvest that you do not shake or bruise the tree, for in doing so, you may harm both the tree and its fruit.” – By Peter Jackson, R.N., September 2002, Australia, in Mongan, 2015


“Una mujer embarazada es como un hermoso árbol floreciendo, pero tenga cuidado cuando llegue el momento de la cosecha de no sacudir o herir el árbol, ya que al hacerlo, puede dañar tanto al árbol como a su fruto”. – Por Peter Jackson, R.N., septiembre de 2002, Australia, en Mongan, 2015