On the Psychology of Childhood Tonsillectomy

The purpose of this essay is the study of tonsillectomy from two separate standpoints. The first is the standpoint of clinical psychoanalysis. A review of relevant literature is cited to demonstrate that the operation can have important psychological repercussions, and then clinical material is cited to confirm and expand this fact. The second standpoint is that of applied psychoanalysis. In that approach the long history and present status of the operation is reviewed, and on the basis of extensive documentation the argument is advanced that this operation is scientifically invalid. Finally, a unitary hypothesis based on psychoanalytic principles is advanced to account for the persistence of the operation.

The demonstration of the scientific invalidity necessitates a protracted excursion into the pertinent medical literature. While the detailed documentation of this evidence is important to the thesis, it may not be of interest to each reader. For that reason it is relegated to an appendix so that it can be studied by those who wish to evaluate it critically and will not burden those readers who wish to devote their attention to the main psychological thesis.

While tonsillectomy is done in adults, the usual practice is to perform the operation in childhood, and the important psychological repercussions occur when it is done at this time. For this reason the psychological study is confined to tonsillectomy performed in childhood.

In the literature there are many valuable contributions to both surgery in general and tonsillectomy in particular in children. Anna