IV. Infantile Asthma – Containing the Anxiety

Increasingly frequent and severe attacks of coughing and wheezing in Billy G at nine months old brought about a rapid crescendo of anxiety in his mother. She had managed her first child's occasional attacks of bronchospasm reasonably well. This little girl, five years older than Billy, often came with her mother and brother to the surgery, a silent witness to the family crisis. The father did not participate until much later. In Billy's case the asthma was only part of a crisis that escalated around the problem of separation anxiety. His terror of being on his own was only gradually culled out from an enveloping confusion when an attempt was made to contain the panic.

At first the problem was tackled in a straightforward way, but the response to medicines was disappointing. He was referred to a paediatrician, but Mrs G meanwhile responded with interest to my request for details. The first few months of his life when he was bottle-fed were without incident. However, prior to the onset of his first attacks of asthma, plans were being made in the family for a holiday in Scotland with Mrs G's parents. Certain changes were being made in the domestic arrangements: first, Billy was weaned to a cup, and a change made from dried to cow's milk; second, he had hitherto slept in a cot in his parents' room, but was now put in the other room with his older sister. This produced an immediate reaction. He refused to go into the cot, screamed, wheezed and vomited. This continued for two weeks, and as the time for the visit drew near the difficulty was resolved by mother sleeping in the same room as Billy, while his sister slept in the parental bed with father.

While the family was in Scotland, Billy was frequently ill; and it was on their return that they first attended the surgery. He was seen at the hospital then, and not only his sister's but also his father's tendency to bronchospasm was noted, as was the factor of damp, overcrowded accommodation, due for demolition. X-ray and oth