Psychodynamics in a Chronic Debilitating Hereditary Disease

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Abstract
AFFECTED AS WELL as nonaffected members of families with hereditary diseases may manifest deep-seated emotions of guilt, hostility, anxiety, denial, and paranoia.1-4 These reactions seem to be tempered, in part, by misconceptions which arise pertinent to the contributory role of "genetic factors."5 Additional factors seem to be related to the form of the handicap, albeit physical, as in facially disfiguring anomalies such as mandibulofacial-dysostosis,6 or mental as in Huntington's chorea and Hurler's syndrome. Finally, social pressures, ie, the negative way in which society views illness and grotesque phenotypes, contributes to the psychological aberrations in such families. The purpose of this paper is to present information on the attitudes and feelings in members of two kindreds afflicted with myotonia dystrophica. Emphasis will be placed upon the genesis of psychologic distress in these families. The role of dynamic genetic counseling in such