What is the Psychology of Little's Disease?*

Since the advent of Freud's depth psychology, we have increased our understanding of the rôle which libidinal factors play in all types of mental and bodily disease. Naturally we might expect it to be used to interpret the pathology of brain disorders, to assign its rôle of causation in the genesis of psychoses. Investigators have not stopped here but have applied depth psychology to organic bodily disorders both as an accompaniment and a sequela of such disease. Recently attempts have been made to use dynamic psychology to explain the inception of various types of organic disease itself.

If one wished to prophesy, it would seem evident that psychoanalysis will make headway in its general medical acceptance in this broad new field in the order named, first in and about nervous and mental disease. At present we are content to present clinical material and formulations regarding the first terms of the use of psychoanalysis as applied to the accompaniments and sequelae of well-known organic brain lesions. Last year we outlined the possible psychology of epileptiform attacks following infantile cerebral hemiplegia. In the present article we submit some remarks upon mental arrest sequent to cerebral diplegia in Little's disease.

When we refer to the psychology of Little's disease we are of course dealing with only one part of the total problem. No approach can overlook the fact that there has been a traumatic brain injury at birth entailing hemorrhage and direct or secondary destruction of the brain cortex. The lesion, of course, accounts for the bilateral spastic paralysis and for the epilepsy which is occasionally present. Organic factors also can explain the mental and emotional difficulties which often follow. Psychological conceptions 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. They further ha