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Gottschalk, L.A. (1956). The Relationship of Psychologic State and Epileptic Activity—Psychoanalytic Observations on an Epileptic Child. Psychoanal. St. Child, 11:352-380.

(1956). Psychoanalytic Study of the Child, 11:352-380

The Relationship of Psychologic State and Epileptic Activity—Psychoanalytic Observations on an Epileptic Child

Louis A. Gottschalk, M.D.

In the investigation of epileptic phenomena, there are few detailed clinical reports available that describe the epileptic activity and the sequence of interpersonal and intrapersonal events during which the seizures take place. In certain types of paroxysmal activity, variously called "psychic equivalent seizures," "affective epilepsy" (Wilson, 1940), and so forth, it may become impossible to differentiate between epileptic experiences (and behavior) and nonepileptic experiences (and behavior). This is especially likely to be so when the presumed seizure activity involves complicated and highly integrated patterns of behavior and psychologic processes. On the other hand, just as the clinical phenomenon of the "jacksonian march" gives a rough representation of neural structure and function, so the detailed description of more complex types of epileptic sequences may reveal relationships of brain structure and function to psychopathologic processes or relationship of psychologic stresses to brain function. Previous reports (Gottschalk, 1953), (1955) have provided evidence that psychologic factors, as well as other factors, can contribute to the form and frequency of seizures and associated clinical manifestations.

The present paper is about a ten-year-old boy, Ned, who was observed in psychoanalytic psychotherapy for a period of twenty-eight months and who was followed by correspondence and occasional interviews for another period of five years. This boy frequently had one of his three types of seizures during the therapeutic sessions in the playroom; and the type

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1 From the Department of Psychiatry, University of Cincinnati, College of Medicine. Part of this study was done while the author was a Research Associate at the Institute for Psychosomatic and Psychiatric Research and Training, Michael Reese Hospital, chicago, Illinois.

Presented in condensed form at the Chicago Psychoanalytic Society, March, 1956.

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