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Psychosomatic Medicine 6:82-87 (1944)
© 1944 American Psychosomatic Society

An Evaluation of Psychobiologic Factors in the Re-Education Phase of the Kenny Treatment for Infantile Paralysis

CHARLES BOHNENGEL M.D., M.C., A.U.S.1

1 Department of Psychiatry, Cornell University Medical College and the New York Hospital; and the Neuropsychiatric Section of Tilton General Hospital, Fort Dix, N. J.

In addition to being studied as a function of the neuromuscular system, muscular activity should be studied also as a function of the total organism as embodied in the concept of the personality and its functions. "Mental alienation" is composed of a sensory factor ("loss of mental awareness") and a motor factor ("mental alienation" in its narrower sense) and is therefore not one but two distinct though related symptoms. From the definitions and descriptions of "loss of mental awareness" and "mental alienation" given by Miss Kenny and her associates, it cannot be stated with certainty what roles structural, physiologic and psychobiologic changes play in their production. There are certain aspects of these symptoms which bear a resemblance to well recognized psychobiologic and psychopathologic reactions. "Loss of mental awareness" seems to correspond to psychosensory (proprioceptive) dissociation and "mental alienation" to psychomotor dissociation. Therefore it appears that these symptoms may be explained more satisfactorily on the basis of psychobiologic dissociation than on the basis of "physiologic block" as has been attempted by the group of physicians associated with Miss Kenny. "Muscular incoordination" also described by this group is a natural consequence of "loss of mental awareness" and "mental alienation" as well as of pain, spasm and actual paralysis and as such is one of several factors in the production of a series of personality adjustments which may stretch throughout the patient's active life. In the treatment of these symptoms Miss Kenny employs a number of well established psychotherapeutic principles. By means of the Kenny treatment it is to be expected that not only will the chronic physical crippling of infantile paralysis be curbed but that chronic changes in personality functioning also will be interrupted. Careful psychiatric study of case material will prove whether the above concept is essentially near the truth, and to what extent personality factors influence the elaboration and persistence of the symptoms "loss of mental awareness," "mental alienation" and "muscular incoordination." Once developed, these symptoms may in turn influence the personality functions of individuals to varying degrees. Finally, this syndrome comprising disturbances in the proprioceptive and motor functions of the personality is not peculiar to infantile paralysis. Rather, it appears to be the psychobiologic reaction to muscular immobilization due to any cause and has as its background not cellular pathology alone but the entire psychobiologic organization of the individual.

Note:
Aided by a grant from the National Foundation for Infantile Paralysis, Inc.






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Copyright © 1944 by the American Psychosomatic Society