by Edward J. Kempf, M.D. Wading River, N.Y.

Vicious Circle of Organic and Emotional Neuroses

The nausea and headaches from exacerbation of such continuous malfunctioning of the eyes are not uncommonly attended by a depressed, dark, gloomy outlook on life. Many ophthalmologists hold on physiopsychologic grounds that the mental state follows from the physical condition, constituting primarily an organic neurosis. Most psychiatrists hold that, although such organic causes of visual malfunction tend to increase headaches and depression upon mental fatigue and emotional discouragement or excitement, the tendency to visual decoordination is psychopathologically increased by internal mental conflict and emotional depression or excitement, with the formation of a progressive vicious circle. Abundant evidence from the biographical study of Lincoln shows that the organic and emotional neuroses formed a vicious circle and worked pathologically, daily throughout his life, and that he cultivated a common-sense attitude to protect himself from himself and his personal relationships that was largely successful but not infrequently broke down.

It is impossible to understand the effects on the development of Lincoln's personality of the injury to his brain in childhood without considering their connections with the conditioning influences of the different members of his family and his social and professional relationships. Conversely, we cannot estimate soundly his personal adjustments to the great crises of his life without correlating them with the organic factors in his neurosis. The thousands of biographical studies and estimations of Lincoln in books, papers, editorials, and speeches published since his death have largely been based on a fundamental misunderstanding of the determining factors in the development of the man's personality and his great motives, although many have estimated ably the part he played in history.

The studies of Lincoln's facial expression made by physicians have related it to his ocular symptoms only as an auxiliary effort to control vision. The permanently destructive effects on his brain by the accident in boyhood, as the cause of his visual, facial, and vocal impairment and melancholic detachment, have been entirely overlooked. Of course, the definite history of the accident and the dent in his forehead discredit the theory of cerebral injury at birth or of hereditary factors as the cause. A biography will be published soon giving special attention to the interactions of his organic and emotional neuroses with the origin and development of his great inspirations, leading up to and including his Presidency. It will show for the first time how the cerebral injury and family environment in boyhood influenced the development of his personality and mental convictions as a man.

Because of limited space, it must suffice here to add the well-known fact that Lincoln (born and raised in a wilderness log cabin) had an unusually attractive, intelligent, heroic, although semiliterate mother, to whom he was greatly attached in childhood. She died tragically of an epidemic fever when he was 9 years old, and his father married again when he was 10. His stepmother, an unusually intelligent pioneer woman, was very kind and devoted to her stepson and encouraged him to learn to read and write and to educate himself. He always retained a persistent, gloomy mother fixation, with interest in melancholy and tragic songs and poetry about the dead and the past.

His betrothed, Ann Rutledge, died in 1837 of an epidemic fever, and he reacted with suicidal melancholia, which lasted for several months. The following year he courted Mary Owens and proposed marriage but was unable to complete this obligation because of conflicting emotional revulsions against it.

In 1840 he courted Mary Todd, and suffered such intense schizoid depression that he was unable to appear for the wedding ceremony. He again became melancholic, incoherent, and suicidal but recovered sufficiently in a few weeks to return to his office. He married Mary Todd in 1842; but, although she had four sons by him, he was never able to love her. He continued to have repeated attacks of emotional nervousness, with headaches and indigestion, for the rest of his life, particularly when forced to endure some grave political or military frustration.

Abraham Lincoln, throughout his maturity, until his death, was never free for a day from the tendency to melancholy from the combined interactions of an organic visual neurosis and a specifically, conditioned, emotional neurosis that worked in a repetitive, vacillating, vicious circle, against the miserable effects of which he protected himself by cultivating a practical, common-sense philosophy of humanism and humor.

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