1In studying the mental symptoms of a group of hospitalized patients with various diseases of the nervous system, it was found that the mental symptoms were related to the disability or suffering imposed on the patient by his illness and, moreover, that this relationship was a highly individual one since the same physical disability might produce very different reactions in different patients.

2It was concluded that one can best understand why such a disability is or is not psychologically traumatic (pathogenic) to any one patient in terms of the personality structure and, in particular, the unconscious conflicts of the patient. The illness is traumatic precisely because of the existence of such an unconscious conflict, even though at the time of the onset of the illness it was symptomless, or, as one might say, in a state of equilibrium. When this previously stable balance is disturbed by the impact of the symptomatic disability incident to the illness, mental symptoms ensue.