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Following the recent trend of psycho-analysts toward applying dynamic psychology to organic bodily disorders, Clark here presents a study of a nine-year-old boy suffering from Little's disease. Clark concedes that he is dealing with only one part of the total problem. The lesion accounts for the bilateral spastic paralysis, for the epilepsy sometimes present, and also for the mental and emotional difficulties which often follow. Psychological conceptions, believes Clark, serve to supplement these formulations of a structural nature; they attempt to consider the dynamic processes by which the effects of a brain injury are translated into various forms of emotional tendencies and reactions, and by which these emotional conflicts influence the intellectual as well as the emotional development of the individual. If emotional energies are fixated upon special needs and special tendencies they may not be available as impelling forces in mental growth. This situation is not fundamental in causing amentia but is an important contributing factor.
There is a tendency to impound an excessive amount of libido within the personality as a compensating and protective agent for the crippled or weakened ego. This may take the form of primary narcissism, which involves a trend of self-love and aloofness from outer objects except where they contribute to the sense of magic omnipotence; or it may be manifest in an exaggerated secondary narcissism, which consists of projections into external affairs but with a constant need for self-aggrandizement and rewards of praise or approval. The degree of both these tendencies would influence the amount or quality of emotional energy free for participation in the outer world. It would also affect the individual's ability to pass through the various stages of libido-development.
In particular the narcissism might block the urge to ingest knowledge, or the impulse to 'take in' might remain too highly charged with purely erotic pleasures to al