Mind v. Body

When laymen say that someone died of a broken heart, they really mean a broken ego. Physicians agree that a deep blow to one's personality may lower physical resistance in some cases. Poorly handled losses have already been pointed to as triggers for many diseases, including cancer, tuberculosis, ulcerative colitis, heart failure. Question remains: does ego-damage really precipitate illness?

A University of Rochester psychiatrist-internist team studied 42 average semiprivate patients at Strong Memorial Hospital. They were selected only on the basis of age (18 to 45) and because they happened to be in the hospital at the time. Included were housewives, businessmen, teachers, laborers, with ailments ranging from bronchitis to brain tumors. Purpose: to see if their illnesses were preceded by any loss in vital personal relationships, any emotions of "separation" (real, threatened or symbolic).

The results, reported by Dr. Arthur H. Schmale Jr. in Psychosomatic Medicine, were startling. Every patient except one had suffered some such blow, and careful interviews with relatives confirmed it. In 35 cases the blow rubbed a childhood wound, such as death or divorce, which still remained unhealed. For all 41 patients affected, the upsetting experience brought feelings of "depression" that ranged from anxiety to real hopelessness. When illness struck, every conflict was still unresolved. The illness followed the blow within a week for 31 patients, a month for eight, and six to twelve months for two. Examples:

P: A 43-year-old father with chronic heart trouble expected his oldest son to support the family. When the son abruptly left home to join the Navy, the father felt hopeless and his condition worsened. After the son wrote that he would not come home on his first furlough, the father wound up in the hospital. A day later he died of ventricular fibrillation.

P: A 31-year-old salesman tried vainly to keep his wife from returning to work after her recovery from a perforated duodenal ulcer. He feared a fatal relapse; he also felt guilt that his own providing was insufficient. Eight hours after she went back to work, he came down with infectious mononucleosis.

P: A 45-year-old mother of ten found her third husband drinking at a wedding reception, after he had nearly died of hepatic failure. When she fearfully cautioned him to stop, he rebuffed her. Within minutes she lost all sensation throughout the right side of her body.

Such revelations about an "average" hospital population still do not prove that disease is a direct consequence of depression, notes Dr. Schmale. Disease and depression may be quite separate attempts by the bodymind to adapt to loss and despair. To really nail down a link between object loss and biological vulnerability, it is also necessary to see how some people survive personality blows without getting sick. But theoretically, health depends largely on keeping the ego intact. If it does, then a blueprint analysis of a patient's personality may become as useful in preventive medicine as the X ray. Says Schmale: "It may be possible to predict the specific circumstances under which the patient will become sick."

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