Panel Reports—Psychological Consequences of Physical Illness in Childhood1

Edith Buxbaum opened the panel by exploring a wide range of material designed to reflect some of the cultural attitudes toward illness. One of her purposes was to add to the list of reasons mentioned by Anna Freud as the cause for the absence of exact observations on the psychological effects of illness. A reflection of the cultural attitudes is offered by an experiment. Dr. H. Winkler used photographs of children—some handicapped, some of them healthy and well-built—as a stimulus. Lay observers tended to ascribe undesirable and unpleasant characteristics (such as, vicious, suspicious, and hostile) to the pictures of the handicapped children, although the people who knew the children could easily contradict these impressions. In general, people do not like handicapped children or adults. It seems that there is a deep-seated horror and resentment against illness in humans which may be expressed by parents in their attitudes toward the sick child, and which may have been responsible for the reluctance of psychoanalysts to observe the effects of bodily illness. Measures used for the cure of illness are also restrictive measures and parents have always known and exploited these measures for punishment, i.e., to send a child to bed, confine him to his room, deprive him of favorite dishes, etc. In some societies even the forcible administration of laxatives is used for the same purpose. In Erewhon, a strange country which lies on the other side of the earth, illness is considered a crime and is punished as such, while crime is considered an illness to be treated by people trained in this particular skill. In nineteenth-century England, the medical man described an abscess as having "peccant" matter, and people said of a person with an abscess that he had a "bad" arm, or that he was bad all over, when they only meant diseased. The Mohammedans sent their female prisoners to hospitals; the New Zealand Maoris visit any misfortune with forcible entry into the house