Effect of the Birth of a Sister on a Boy in his Fourth Year

A three-and-a-half-year-old boy developed acute anxiety directly following the birth of his sister. He was treated three times a week for nine months. This was not a completed analysis. Time did not permit exhaustive investigation into the genesis of his anxiety. Whether treatment should have been continued may be determined by a presentation of the case. Considering the acuteness of the boy's anxiety, prompt analytic treatment may have prevented the development of a neurosis or distortions of character that were incipient. It is often difficult to reconstruct or to assess the psychological effect that the birth of a sibling has in a child's life. This case, I believe, is further direct evidence that such an event may precipitate anxiety of psychopathological proportions.

The boy, Johnnie, was brought for treatment by a mother somewhat desperate because he would not stop holding his penis. In my initial conference with the mother she said she had always been his 'princess' and, because a new baby had now come into the family, she felt that she must have 'played a dirty trick on him'. Two weeks prior to this visit he had refused to close the fly of his pants and never stopped holding his penis while he was awake. He would play with his toys and eat with one hand while holding on to his penis with the other. He would go frequently to the bathroom throughout the day, sometimes to urinate, at other times just to stand a few seconds in front of the toilet. Whether at home or on the street he clung to his penis, resisting any attempt to dissuade him. He was an active child and liked to play out of doors most of the day: given the choice between fastening his fly or remaining indoors,