Emotional Impact of Nearness and Separation for the Asthmatic Child and his Mother1

The point of departure for this study is an observation, striking both in our own cases and in the literature; namely, that often when an asthmatic child goes to the hospital or away to camp, the asthma dramatically improves, and equally dramatically recurs when he comes home (Abramson, 1952); (Hallowitz, 1954); (Rogerson, Hardcastle, and Dugid, 1935); (Unger and Unger, 1952). Although some authors interpret this as a result of isolation from allergens (Unger and Unger, 1952), others believe it to be a result of the child's separation from the emotional climate at home (Abramson, 1952); (Hallowitz, 1954); (Rogerson, Hardcastle, and Dugid, 1935), and, as such, evidence of the importance of emotional factors in some cases of asthma. In their studies on psychogenic factors in asthma, French and Alexander (1941) have stressed the central role of fear of estrangement from the mother in producing the asthma attack. These authors and subsequent writers (Gerard, 1946); (Saul and Lyons, 1955) have discussed the strong dependent and orally regressive needs in asthmatic patients. Similarly the asthmatic children we observed were intensely dependent on their mothers.

What appears to be a paradox—namely that the child threatened with alienation from mother may react with an asthma attack, yet be free from asthma when separated from her—points to the need for scrutiny of the meaning of separation.