Overprotected Bleeders

Hemophiliacs are taught from earliest childhood to fear the slightest cut or bruising injury. And with good reason, despite new ways of improving the blood's clotting properties. But too much fear can be as bad as too little. After years of study of young hemophiliacs in Cleveland, Psychiatrists David P. Agle and Ake Mattsson have concluded that overemphasis on the dangers of the disease, working through psychosomatic mechanisms, may actually increase the frequency of bleeding.

Often, because of guilt feelings in the mother who cannot suffer from hemophilia but has transmitted it to her son,* a young bleeder is maternally overprotected. The father feels left out and takes little interest in the boy. Even legitimate parental concern for a hemophiliac son's safety can transmit unnecessarily restrictive fears to him. The reaction in either case, says Dr. Agle, can be self-destructive. In an effort to deny his fears, the hemophiliac boy may take what are, for him, absurd risks by jumping from trees, riding motorcycles and even picking fist fights.

Far more worrisome, doctors have found, is that emotional imbalance can lead to spontaneous bleeding without any apparent physical cause. The doctors are not sure just how the psychosomatic triggering operates, but Dr. Agle points out that even in normally healthy people, anger, anxiety and resentment can badly weaken capillary walls. The treatment for such emotional problems is no more clear-cut than it is in ordinary psychiatry. But the two doctors have now started weekly group meetings for parents of 30 Cleveland hemophiliacs under 21. The lesson they try to teach: your son certainly needs extra care, but he is a human being. Overprotection may have tragic results.

* Classical hemophilia, resulting from the absence of a clotting factor from the blood, is carried in an X chromosome. The mother-carrier, with one such abnormal chromosome, derives it from her father. West Germany's Dr. Widukind Lenz, of thalidomide fame, now reports that the risk of a woman's inheriting such a mutation increases sharply with the father's age at the time of her conception.

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