Mad Laughter in a Six-Year-Old Boy1

Tommy was the most unfortunate child I have known, and the one who laughed the most. At a time in his life when he was acutely threatened with being abandoned by his mother he began to laugh incessantly. His laughter could be produced at will, like that of an accomplished actor. It had an exaggerated, crazy sound which filled the hearer with uneasiness; no one laughed with him. Tommy's laughter was an attempt to deny and ward off unbearable anxiety. It was also a means of attack, a provocation, and an expression of impulses which could not find other outlet. It was associated with a reduction of verbal articulateness, with the shouting of isolated incomprehensible words and phrases, and also with unco-ordinated motor activity as he threw himself on the floor and rolled about. In this it expressed a regressive tendency, the reverse of the normal development of a child entering the latency period, in which there is an increased capacity to use speech in isolation from emotionally expressive movement.

When Tommy was five, his mother brought him to the child guidance clinic because he was unable to stay in nursery school; he could not be separated from her. She reported that his behavior was unruly and uncontrollable; she was unable to take him anywhere. The two of them lived in almost complete isolation, incessantly together. Tommy's father had deserted his mother when Tommy was three months old. The mother's own parents had died shortly before this, and she became understandably deeply depressed. She was especially vulnerable to