ABSTRACT
A brief history of croup is presented. The forms of croup under examination are defined with emotional factors at one end of a continuum and viral and traumatic factors at the other. The complexity of the disorder and its peculiar clinical characteristics are explained. Some of these characteristics are: (1) the predominant 1-3-year age range, which corresponds to the anal stage of development; (2) the relief afforded by vomiting; (3) the occurrence of attacks at night and during sleep, (4) the relative dryness of the cough and its harsh metallic quality; (5) the frequent presence of a ticklish, irritating sensation in the throat; and (6) the presence of edema and/or laryngospasm. Three case vignettes are presented. These cases support a previously developed theory concerning the impulses and defenses underlying the croup attack. Croup is seen as a fixation at the oral level with a regression to that level in the face of conflicts of the anal or sometimes the oedipal stage. The psychosexual development of the larynx is discussed.
Subject(s)
Croup/psychology , Larynx/physiology , Psychoanalytic Interpretation , Psychosexual Development , Adolescent , Adult , Child , Child, Preschool , Croup/physiopathology , Female , Humans , Infant , Male , Psychoanalytic Theory , Psychotic Disorders/physiopathology , Psychotic Disorders/psychologyABSTRACT
Clinical and experimental investigations have demonstrated that music may serve subtle and complex psychological functions, the sounds per se serving more primitive roles than the themes and lyrics. The present study offers data obtained during the psychoanalysis of a musically talented man who had suffered life-threatening croup and asthma until the age of 5 or 6. Regression that was achieved as the result of interpretations based on the analyst's countertransferential responses revealed that the analysand was unable to achieve psychological separation from his mother and that music served predominantly the function of retaining a life-supporting connexion with her. Presumably as the result of a complex elaboration of respiratory and auditory introjection, music came to symbolize the noise of air-flowing through tubes into the steam tents and blood coursing through the umbilical cord, conceptualized as connecting him with his mother and making them permanently interdependent. The early ego defect was overcome through a transference-countertransference interaction that is delineated in detail. Then, the less primitive meanings and psychological uses of musical themes and lyrics were elucidated, again in response to interpretations based on countertransference reactions.
Subject(s)
Countertransference , Music/psychology , Psychoanalytic Therapy , Regression, Psychology , Transference, Psychology , Adult , Asthma/psychology , Croup/psychology , Ego , Humans , Male , Psychoanalytic InterpretationSubject(s)
Croup/therapy , Emergencies , Laryngitis/therapy , Child , Croup/psychology , Humans , Intubation, Intratracheal , MaleABSTRACT
Based on 14 paediatric case histories we present a hypothesis--to our knowledge for the first time--concerning the role of psychogenetic factors for the occurrence of pseudocroup attacks. Anxieties, insecurity and impaired ability to communicate with each other characterize the relationship of the patient and his mother. The developing independence of the child is hindered. The frightening pseudocroup attack tightens mother and child close together, allows a regression to an early childhood state of mother-child relationship, and demonstrates in a pathological way their interdependence and the dangers of autonomy.
