What is the Psychology of Organic Epilepsy?*

In approaching the consideration of organic epilepsy, recent investigations have started from a new point of view. It is recognized, of course, that the organic lesion is enduring and is actually both mentally and physically crippling. But one may wonder to what extent an individual should be handicapped by any given physical injury. Seemingly there would be various degrees of handicap, corresponding not only to the extent and location of the lesion but also to certain characteristic traits in the personality. The individual's attitude towards his injury, the extent to which he allows it to interfere with other fields of progress, and the influence it has upon his emotional development in general would be decisive questions. It may be that these psychological reactions are directly attributable ta the lesion; or it could be that the tendencies were present first, and the organic injury served as a gigantic disturbance to bring them into play. In either case it is important for us to formulate more definitely just how the physical lesion can produce, directly or indirectly, a crippling in mental and emotional life.

To state the situation psychologically, we must remember that the ego is the element in the personality which perceives, organizes, and directs. The brain and the body are essential in the ego's task of meeting reality; and where these are injured in any way there is a severe handicap to the personality as a whole. An organic lesion may not only cripple the brain itself, but it usually puts out of action certain parts of the body which are also useful to the ego in carrying out its ordinary functions. Under the circumstances, such losses are apparently permanent and unavoidable. In addition, the injury is a wound to the ego's sense of well-being and completeness; some form of emotional compensation is absolutely necessary. The ego, therefore, draws to itself certain quantities of libido in the form of self-love, self-protectiveness, and self-engrossment whi