As the process of experiential self-exploration deepens, the element of emotional and physical pain can reach such extraordinary intensity that it is usually interpreted as dying. It can become so extreme that the individual involved feels that he or she has transcended the boundaries of individual suffering and is experiencing the pain of entire groups of individuals, all of humanity, or even all of life. Experiential identification with wounded or dying soldiers, prisoners in concentration camps and dungeons, persecuted Jews or early Christians, mothers and children in childbirth, or animals being attacked and slaughtered by an enemy are typical.
Experiences on this level are usually accompanied by dramatic physiological manifestations, such as various degrees of suffocation, accelerated pulse rate and palpitations, nausea and vomiting, changes in the color of the complexion, oscillations of body temperature, spontaneous skin eruptions or bruises, twitches, tremors, and contortions or other striking motor phenomena.
Whereas on the biographical level only those individuals who have actually had a serious brush with death must deal during their self-exploration with vital threats, on this level of the unconscious the issue of death is universal and entirely dominates the picture. Those persons whose life history has not involved a serious threat to survival or bodily integrity can enter this experiential realm directly. For others, the reliving of serious traumas, operations or injuries tends to deepen and change into the experience of dying described above.
Experiential confrontation with death at this depth of self-exploration tends to be intimately interwoven with a variety of phenomena related to the birth process. Not only do individuals involved in experiences of this kind have the feeling of struggling to be born and/or of delivering, but many of the accompanying physiological changes that take place make sense as typical concomitants of birth. Subjects often experience themselves as fetuses and can relive various aspects of their biological birth with very specific and verifiable details. The element of death can be represented by simultaneous or alternating identification with aging, ailing, and dying individuals. Although the entire spectrum of experiences occurring on this level cannot be reduced to a reliving of biological birth, the birth trauma seems to represent an important core of the process. For this reason, I refer to this domain of the unconscious as perinatal.2
The connection between biological birth and the experiences of dying and being born as described above is quite deep and specific. This makes it possible to use the stages of biological delivery in constructing a conceptual model that helps to understand the dynamics of the unconscious on the perinatal level. The experiences of the death-rebirth process occur in typical thematic clusters; their basic characteristics can be logically derived from certain anatomical, physiological, and biochemical aspects of the corresponding stages of childbirth with which they are associated. As will be discussed later, thinking in terms of the birth model provides unique new insights into the dynamic architecture of various forms of psychopathology and offers revolutionary therapeutic possibilities.
In spite of its close connections with birth, the perinatal process transcends biology and has important philosophical and spiritual dimensions. It should not, therefore, be interpreted in a concretistic and reductionistic fashion. To an individual who is totally immersed in the dynamics of this level of the unconscious—experientially or as a researcher—birth might appear as an all-explanatory principle. In my own understanding, thinking in terms of the birth process is a useful model with an applicability that is limited to phenomena of a specific level of the unconscious. It has to be transcended and replaced by a different approach when the process of self-exploration moves to transpersonal realms.
There are certain important characteristics of the death-rebirth process that clearly indicate that perinatal experiences cannot be reduced to a reliving of biological birth. Experiential sequences of a perinatal nature have distinct emotional and psychosomatic aspects. However, they also produce a profound personality transformation. A deep experiential encounter with birth and death is regularly associated with an existential crisis of extraordinary proportions, during which the individual seriously questions the meaning of existence, as well as his or her basic values and life strategies. This crisis can be resolved only by connecting with deep, intrinsic spiritual dimensions of the psyche and elements of the collective unconscious. The resulting personality transformation seems to be comparable to the changes that have been described as having come about from participation in ancient temple mysteries, initiation rites, or aboriginal rites of passage. The perinatal level of the unconscious thus represents an important intersection between the individual and the collective unconscious, or between traditional psychology and mysticism or transpersonal psychology.
The experiences of death and rebirth reflecting the perinatal level of the unconscious are very rich and complex. They appear in four typical experiential patterns or constellations. There is a deep correspondence between these thematic clusters and the clinical stages of the biological birth process. It proved very useful for the theory and practice of deep experiential work to postulate the existence of hypothetical dynamic matrices governing the processes related to the perinatal level of the unconscious and to refer to them as Basic Perinatal Matrices (BPM).
Fig. 9. The experience of deep existential despair in a psychedelic session dominated by BPM II. The painting shows human life as “a trip from nowhere to nowhere in a rainy day.”
In addition to having specific emotional and psychosomatic content of their own, these matrices also function as organizing principles for material from other levels of the unconscious. From the biographical level, elements of important COEX systems dealing with physical abuse and violation, threat, separation, pain, or suffocation are closely related to specific aspects of BPM. The perinatal unfolding is also frequently associated with various transpersonal elements, such as archetypal visions of the Great Mother or the Terrible Mother Goddess, Hell, Purgatory, Paradise or Heaven, mythological or historical scenes, identification with animals, and past incarnation experiences. As in the various layers of COEX systems, the connecting link is the same quality of emotions or physical sensations, and/or similarity of circumstances. The perinatal matrices also have specific relations to different aspects of the activities in the Freudian erogenous areas—the oral, anal, urethral, and phallic zones.
In the following text, I will briefly review the biological basis of the individual BPMs, their experiential characteristics, their function as organizing principles for other types of experience, and their connection with activities in various erogenous zones. A synopsis is presented in Table 1.
The significance of the perinatal level of the unconscious for a new understanding of psychopathology and specific relations between the individual BPMs and various emotional disorders is discussed in a later section.
First Perinatal Matrix (BPM I)
The biological basis of this matrix is the experience of the original symbiotic unity of the fetus with the maternal organism at the time of intrauterine existence. During episodes of undisturbed life in the womb, the conditions of the child can be close to ideal. However, a variety of factors of physical, chemical, biological, and psychological nature can seriously interfere with this state. Also, during late stages of pregnancy, the situation may become less favorable because of the size of the child, of increasing mechanical constraint, or of the relative insufficiency of the placenta.
Pleasant and unpleasant intrauterine memories can be experienced in their concrete biological form. In addition, subjects tuned in to the first matrix can experience an entire spectrum of images and themes associated with it, according to the laws of deep experiential logic. The undisturbed intrauterine state can be accompanied by other experiences that share with it a lack of boundaries and obstructions, such as consciousness of the ocean, an aquatic life form (whale, fish, jellyfish, anemone, or kelp), or interstellar space. Also images of nature at its best (Mother Nature), which is beautiful, safe and unconditionally nourishing, represent characteristic and quite logical concomitants of the blissful fetal state. Archetypal images from the collective unconscious that can be selectively reached in this state involve the heavens or paradises of different cultures of the world. The experience of the first matrix also involves elements of cosmic unity or mystical union.
The disturbances of intrauterine life are associated with images and experiences of underwater dangers, polluted streams, contaminated or inhospitable nature, and insidious demons. The mystical dissolution of boundaries is replaced by a psychotic distortion with paranoid undertones.
Table I BASIC PERINATAL MATRICES
Fig. 10. A painting reflecting a sense of oneness and fusion with the therapist experienced in a psychedelic session which involved reliving of the symbiotic union with the maternal organism during intrauterine existence and nursing.
Positive aspects of BPM I are closely related to memories of symbiotic union on the breast, to positive COEX systems, and to recollections of situations associated with peace of mind, satisfaction, relaxation, and beautiful natural scenery. Similar selective connections exist also to various forms of positive transpersonal experiences. Conversely, negative aspects of BPM I tend to be associated with certain negative COEX systems and corresponding negative transpersonal elements.
In regard to Freudian erogenous zones, the positive aspects of BPM I coincide with the biological and psychological condition in which there are no tensions in these areas and all the partial drives are satisfied. Negative aspects of BPM I seem to have specific links to nausea and intestinal dysfunction with dyspepsia.
Fig. 11. The Oceanic Womb. A state of melted ecstasy experienced in an LSD session dominated by BPM I. Experiential identification with the intrauterine existence of the fetus coincides with a sense of becoming the ocean and fusing with various aquatic life forms.
Fig. 12. The Amniotic Universe. Experiential identification with the blissful existence of the fetus with a sense of unity with the entire cosmos. This painting was inspired by an LSD session governed by the first perinatal matrix.
Fig. 13. Paranoia of Intrauterine Disturbance. A painting from a high-dose LSD session representing the toxic “bad womb”. The subject identifies with a distressed fetus who is exposed to torture and horror in a diabolical laboratory run by insidious demons. Experiences of this kind are among important sources of paranoia. As the picture indicates, this state is related to the condition of a chicken embryo intoxicated by its own waste products and of fish in polluted waters.
Fig. 14. The experience of the onset of biological delivery and of the beginning influence of BPM II. in a highdose LSD session. In a full identification with a fetus, the subject feels drawn into a monstrous annihilating whirlpool; the overall atmosphere is reminiscent of Edgar Alan Poe’s A Descent into the Maelstrom.
Second Perinatal Matrix (BPM II)
This experiential pattern is related to the very onset of biological delivery and its first clinical stage. Here the original equilibrium of the intrauterine existence is disturbed, first by alarming chemical signals and then by muscular contractions. When this stage fully develops, the fetus is periodically constricted by uterine spasms; the cervix is closed and the way out is not yet available.
As in the previous matrix, this biological situation can be relived in a rather concrete and realistic fashion. The symbolic concomitant of the onset of delivery is the experience of cosmic engulfment. It involves overwhelming feelings of increasing anxiety and awareness of an imminent vital threat. The source of this danger cannot be clearly identified, and the subject has a tendency to interpret the world in paranoid terms. Very characteristic for this stage is the experience of a three-dimensional spiral, funnel, or whirlpool, sucking the subject relentlessly toward its center. An equivalent of this annihilating maelstrom is the experience of being swallowed by a terrifying monster, such as a giant dragon, leviathan, python, crocodile, or whale. Equally frequent are experiences of attack by a monstrous octopus or tarantula. A less dramatic version of the same experience is the theme of descent into a dangerous underworld, a system of grottoes, or a mystifying labyrinth. The corresponding mythological theme seems to be the beginning of the hero’s journey; related religious themes are the fall of the angels and paradise lost.
Fig. 15. Painting representing a vision from a psychedelic session governed by the initial phase of BPM II. The incipient uterine contractions are experienced as an attack by a monstrous octopus.
Some of these images may appear strange to the analytical mind; however, they show deep experiential logic. Thus, the whirlpool symbolizes serious danger for an organism floating freely in a watery environment and imposes on it a unidirectional motion. Similarly, the situation of being swallowed changes freedom into a life-threatening confinement comparable to that of the fetus being wedged into the pelvic opening. An octopus entangles, confines, and threatens organisms floating freely in an oceanic milieu, and a spider traps, constrains, and endangers insects previously enjoying freedom of flight in an unobstructed world.
The symbolic counterpart of a fully developed first clinical stage of delivery is the experience of no exit or hell. It involves a sense of being stuck, caged, or trapped in a claustrophobic, nightmarish world and experiencing incredible psychological and physical tortures. The situation is usually absolutely unbearable and appears to be endless and hopeless. The individual loses the sense of linear time and can see no possible end to this torment or any form of escape from it. This can produce experiential identification with prisoners in dungeons or concentration camps, inmates in insane asylums, sinners in hell, or archetypal figures symbolizing eternal damnation, such as the Wandering Jew Ahasuerus, the Flying Dutchman, Sisyphus, Tantalus, or Prometheus.
While under the influence of this matrix, the subject is also selectively blinded to anything positive in the world and in his or her own existence. Agonizing feelings of metaphysical loneliness, helplessness, hopelessness, inferiority, existential despair, and guilt are standard constituents of this matrix.
Fig. 16. A demonic vision from a psychedelic session dominated by BPM II.
As far as the organizing function of BPM II is concerned, it attracts COEX systems with memories of situations in which the passive and helpless individual is subjected to, and victimized by, an overwhelming destructive force with no chance of escaping. It also shows affinity to transpersonal themes with similar qualities.
In regard to the Freudian erogenous zones, this matrix seems to be related to a condition of unpleasant tension or pain. On the oral level, it is hunger, thirst, nausea, and painful oral stimuli; on the anal level, rectal pain and retention of feces; and on the urethral level, bladder pain and retention of urine. The corresponding sensations on the genital level are sexual frustration and excessive tension, uterine and vaginal spasms, testicular pain and the painful contractions experienced by women in the first clinical stage of labor in childbirth.
Fig. 17. Paintings by the Swiss painter Hansruedi Giger, a genius with uncanny ability to portray the nightmarish world of the negative perinatal matrices. Picture a. combines the anatomical frailty of the fetuses with aggressive machinery and constricting steel headbands suggestive of birth. Picture b. is a rich tapestry of distressed and sickened fetuses.
Picture c. shows the mother and child locked into a torturing stillbirth machine. Picture d. reflects the intimate fusion of sex and death characteristic of BPM III. Picture e. brings together elements of aggression, sexuality and scatology. (From Necronomicon).
Third Perinatal Matrix (BPM III)
Many important aspects of this complex experiential matrix can be understood from its association with the second clinical stage of biological delivery. In this stage, the uterine contractions continue, but unlike in the previous stage, the cervix is now dilated and allows a gradual propulsion of the fetus through the birth canal. This involves an enormous struggle for survival, crushing mechanical pressures, and often a high degree of anoxia and suffocation. In the terminal phases of the delivery, the fetus can experience intimate contact with such biological material as blood, mucus, fetal liquid, urine, and even feces.
From the experiential point of view, this pattern is somewhat ramified and complicated. Besides the actual, realistic reliving of various aspects of the struggle in the birth canal, it involves a wide variety of phenomena that occur in typical thematic sequences. The most important of these are the elements of titanic fight, sadomasochistic experiences, intense sexual arousal, demonic episodes, scatological involvement, and encounter with fire. All these occur in the context of a determined death-rebirth struggle.
The titanic aspect is quite understandable in view of the enormity of the forces involved in this stage of birth. The frail head of the child is wedged into the narrow pelvic opening by the power of uterine contractions that oscillate between 50 and 100 pounds. Facing this aspect of BPM III, the subject experiences powerful streams of energy building up to explosive discharges. Characteristic symbolic themes are raging elements of nature (volcanoes, electrical storms, earthquakes, tidal waves, or tornadoes), violent scenes of war or revolutions, and high-power technology (thermonuclear reactions, atomic bombs, and rockets). A mitigated form of this experiential pattern includes participation in dangerous adventures—hunting or fights with wild animals, exciting explorations, and the conquest of new frontiers. Related archetypal themes are images of the Last Judgment, the extraordinary feats of superheroes, and mythological battles of cosmic proportions involving demons and angels or gods and Titans.
Sadomasochistic aspects of this matrix reflect the mixture of aggression inflicted on the fetus by the female reproductive system and the biological fury of the child’s response to suffocation, pain, and anxiety. Frequent themes are bloody sacrifice, self-sacrifice, torture, execution, murder, sadomasochistic practices, and rape.
The experiential logic of the sexual component of the death-rebirth process is somewhat less obvious. It can be explained by well-known observations indicating that suffocation and inhuman suffering in general generate a strange form of intense sexual arousal. The erotic themes on this level are characterized by an overwhelming intensity of the sexual drive, its mechanical and unselective quality, and pornographic or deviant nature. The experiences that belong to this category combine sex with death, danger, biological material, aggression, self-destructive impulses, physical pain, and spirituality (proximity of BPM IV).
The fact that, on the perinatal level, sexual excitement occurs in the context of vital threat, anxiety, aggression, and biological material is essential for the understanding of sexual deviations and other forms of sexual pathology. These connections are discussed later in greater detail.
The demonic element of this stage of the death-rebirth process can represent specific problems for both therapists and clients. The uncanny quality of the material involved can lead to reluctance to face it. The most common themes observed here are the elements of the Witches’ Sabbath (Walpurgis Night), satanic orgies or Black Mass rituals, and of temptation. The common denominator of the birth experience at this stage and the Witches’ Sabbath or Black Mass is the peculiar experiential amalgam of death, deviant sexuality, fear, aggression, scatology, and distorted spiritual impulse.
The scatological facet of the death-rebirth process has its natural biological basis in the fact that, in the final stages of birth, the child can come into close contact with excreta and other forms of biological material. However, these experiences typically exceed by far anything that the newborn might have actually experienced. They can involve the sense of wallowing in excrement, crawling in offal or sewage systems, eating feces, drinking blood or urine, or revolting images of putrefaction.
The element of fire is either experienced in its ordinary form— as identification with victims of immolation—or in an archetypal form of purifying fire (pyrocatharsis) that seems to destroy whatever is corrupted and rotten in the individual, preparing him or her for spiritual rebirth. This is the least comprehensible element of the birth symbolism. Its biological concomitant could be the culminating overstimulation of the newborn with indiscriminate “firing” of peripheral neurons. It is interesting that its experiential counterpart can be found in the delivering mother, who often feels in this stage that her vagina is on fire. It is also worth mentioning here that, in the process of burning, solid forms are converted into energy; the experience of fire accompanies the ego death, after which the individual identifies philosophically with patterns of energy, rather than solid matter.
Fig. 18. The Witches’ Sabbath according to De Lancre. The guests are shown arriving on brooms, Billy-goats, and various fantastic animals. In the upper right corner on thrones sit Master Leonard and two fallen angels. In the lower right corner are participants involved in the diabolic feast. At the bottom are three witches cooking the Sabbath brew. In the lower left corner are children playing with toads in a pool of holy water. In various other parts of the picture participants engage in music, dance, and orgies.
The religious and mythological symbolism of this matrix draws particularly on those systems that glorify sacrifice or self-sacrifice.
Fig. 19. The famous woodcut by Gustav Doré entitled La Danse du Sabbat. It shows the devil presiding at a wild ecstatic frenzy, characteristic activity at the Sabbath of the Witches.
Quite frequent are scenes from pre-Columbian sacrificial rituals, visions of crucifixion or identification with Christ, and worship of the Terrible Goddesses Kali, Coatlicue, or Rangda. The scenes of satanic worship and Walpurgis Night have already been mentioned. Another group of images is related to religious rituals and ceremonies combining sex and wild rhythmic dance, such as phallic worship, fertility rites, or various aboriginal tribal ceremonies. A classic symbol of the transition from BPM III to BPM IV is the legendary bird, the Phoenix, whose old form dies in fire and new form rises from the ashes and soars toward the sun.
Several important characteristics of this experiential pattern distinguish it from the previously described no-exit constellation. The situation here does not seem hopeless and the subject is not helpless. He or she is actively involved and has the feeling that the suffering has a definite direction and goal. In religious terms, this situation would be closer to the concept of purgatory than to that of hell. In addition, the subject does not play exclusively the role of a helpless victim. He is an observer and can at the same time identify with both sides to the point that it might be difficult to distinguish whether he is the aggressor or the victim. While the no-exit situation involves sheer suffering, the experience of the death-rebirth struggle represents the borderline between agony and ecstasy and the fusion of both. It seems appropriate to identify this type of experience as “volcanic ecstasy” in contrast to the “oceanic ecstasy” of the cosmic union.
Fig. 20. An old German woodcut showing the Sabbath of the Witches on Blocksberg. One of the most famous European sites associated with the Sabbath, Blocksberg was also the scenery of the Valpurgi’s Night in Goethe’s Faust. The picture portrays the famous scene of ritual kissing of Master Leonard’s anus and the beginning orgies.
Fig. 21. Two paintings by the Swiss painter Hansruedi Giger with blasphemic distortion of religious themes characteristic of BPM III. Picture a. combines elements of aggression, crucifixion, and death with a demonic atmosphere. Picture b. adds to these themes the motifs of sexuality and boa constrictor-type serpentine loops, further stressing the perinatal source of this imagery. (From Necronomicon).
Specific experiential characteristics link BPM III to COEX systems that are formed by memories of intense and precarious sensual and sexual experiences, fights and combats, exciting but hazardous adventures, rape and sexual orgies, or situations involving biological material. Similar connections exist also to transpersonal experiences of this kind.
In regard to the Freudian erogenous zones, this matrix is related to those physiological activities that bring sudden relief and relaxation after a prolonged period of tension. On the oral level, it is the act of chewing and swallowing food (or conversely of vomiting); on the anal and urethral level, the process of defecation and urination; on the genital level, the buildup to sexual orgasm and the feelings of the delivering woman in the second stage of labor.
Fig. 22. Experiential identification with the legendary bird Phoenix at the moment of transition from BPM III to BPM IV that occurred in a high-dose LSD session. It is a very appropriate symbol of death-rebirth, since it involves death in fire, birth of the new and movement toward the light source.
Fourth Perinatal Matrix (BPM IV)
This perinatal matrix is meaningfully related to the third clinical stage of the delivery, the actual birth of the child. In this final stage, the agonizing process of the birth struggle comes to an end; the propulsion through the birth canal culminates and the extreme build-up of pain, tension, and sexual arousal is followed by a sudden relief and relaxation. The child is born and, after a long period of darkness, faces for the first time the intense light of the day (or the operating room). After the umbilical cord is cut, the physical separation from the mother has been completed and the child begins its new existence as an anatomically independent individual.
As with the other matrices, some of the experiences belonging here seem to represent an accurate replay of the actual biological events involved in birth, as well as specific obstetric interventions. For obvious reasons, this aspect of BPM IV is much richer than the concrete elements experienced in the context of the other matrices. The specific details of the relived material are also easier to verify. They involve specifics of the birth mechanism, types of anesthesia used, nature of manual or instrumental intervention, and details of postnatal experience and care.
The symbolic counterpart of this final stage of delivery is the death-rebirth experience; it represents the termination and resolution of the death-rebirth struggle. Paradoxically, while only one step from a phenomenal liberation, the individual has a feeling of impending catastrophe of enormous proportions. This results frequently in a strong determination to stop the experience. If allowed to happen, the transition from BPM III to BPM IV involves a sense of annihilation on all imaginable levels—physical destruction, emotional debacle, intellectual defeat, ultimate moral failure, and absolute damnation of transcendental proportions. This experience of “ego death” seems to entail an instant merciless destruction of all previous reference points in the life of the individual. When experienced in its final and most complete form,3 it means an irreversible end of one’s philosophical identification with what Alan Watts used to call “skin-encapsulated ego.”
This experience of total annihilation and of “hitting the cosmic bottom” is immediately followed by visions of blinding white or golden light of supernatural radiance and beauty. It can be associated with astonishing displays of divine archetypal entities, rainbow spectra, or intricate peacock designs. Also, visions of nature reawakened in spring or refreshed after a tempest and cloudburst can appear in this context. The subject experiences a deep sense of spiritual liberation, redemption, and salvation. He or she typically feels freed from anxiety, depression, and guilt, purged and unburdened. This is associated with a flood of positive emotions toward oneself, other people, and existence in general. The world appears to be a beautiful and safe place and the zest for life is distinctly increased.4
Fig. 23. A sequence of experiences encountered during the transition from BPM III to BPM IV. The first picture shows a gigantic and threatening Golem-like figure blocking the access to the source of light. The second picture reflects a later stage of the process, during which the obstacle has been overcome and the subject faces and embraces the unobstructed rising sun. (From the collection of Dr. Milan Hausner, Prague, Czechoslovakia).
Fig. 24. The experience of a fundamental emotional and spiritual breakthrough represented in the first picture occurred in a perinatal LSD session at the time when the patient relived her biological birth. The lower part of the painting represents the “quagmire” of the patient’s unconscious with various dangerous monsters—essentially the image of the psyche that she brought into therapy. The upper part—free cosmic space with celestial bodies—is the entirely new area that opened up in therapy. At the interface the monsters turn into friendly creatures. The patient herself appears as a little princess with a crown, as a divine child (she herself made the connection to “crowning”).
The second picture shows how this newly achieved peace can be disturbed by negative influences from the external world. On a deeper level this reflects another wave of uterine contractions encroaching on the embryonal paradise of the fetus.
Fig. 25. In this picture of a transition from BPM III to BPM IV as it was experienced in an LSD session, the subject is shown climbing a steep mountain in her effort to reach the light. Ascent of a mountain is crossculturally a symbol of rebirth and spiritual search. The predatory birds attacking her represent the dark forces that are trying to prevent this development.
The symbolism of the death-rebirth experience can be drawn from many areas of the collective unconscious, since every major culture has the appropriate mythological forms for this phenomenon. Ego death can be experienced in connection with various destructive deities—Moloch, Shiva, Huitzilopochtli, Kali, or Coatlicue—or in full identification with Christ, Osiris, Adonis, Dionysus, or other sacrificed mythical beings. The divine epiphany can involve an entirely abstract image of God as a radiant source of light, or more or less personified representations from different religions. Equally common are experiences of encounter or union with great mother goddesses, such as the Virgin Mary, Isis, Lakshmi, Parvati, Hera, or Cybele.
The related biographical elements involve memories of personal successes and the termination of dangerous situations, the end of wars or revolutions, the survival of accidents, or recoveries from serious diseases.
In relation to the Freudian erogenous zones, BPM IV is associated on all levels of libidinal development with the state of satisfaction immediately following activities that release unpleasant tension—satiation of hunger by swallowing food, relieving vomiting, defecation, urination, sexual orgasm, and delivery of a child.