Hospitalism – ‌why‌ is ‌dangerous‌ ‌deficit‌ ‌communication‌ ‌and‌ ‌attention‌

Have you ever had to stay in a hospital or other government facility for a long time, away from your family and friends? How did you feel? You probably missed heartfelt conversations, hugs, and warmth. Because of this, you were overcome with melancholy and depressed. These are mild manifestations of hospitalism. In more severe cases, hospitalism syndrome is manifested by a number of somatic and mental disorders. Hospitalism is especially dangerous for children from boarding schools and disadvantaged families. I propose to understand everything in order: what is the origin of the phenomenon of hospitalism and what does it mean, how it manifests itself and how it is treated.

What is hospitalism

The name is derived from the Latin word hospitalis, which means “hospitable”, “hospital”. Hospitalism is a syndrome in which a person experiences psychosomatic disorders due to a long stay in the hospital, away from home and friends. At the same time, this means a lag in mental and physical development in children who grew up in a boarding school from infancy or were deprived of parental attention and love. Close, warm communication with the mother and other significant adults is the leading need of infancy. Deprivation (non-satisfaction of needs) leads to psychophysical and intellectual disorders, developmental delays.

Let us consider in more detail the definitions of hospitalism in psychology and psychiatry.

In psychology

Hospitalism is, in psychology, psychosomatic changes in personality as a result of a lack of communication with loved ones. Psychologists consider hospitalism from two sides: in children and in adults. In the first case, this means the child’s psychophysical retardation due to a lack of communication in the first years of life. In the second case, we are talking about psychosomatic disorders caused by a long stay in the hospital. However, it is worth noting that hospitalism that occurs in childhood can haunt the child throughout his life. At the same time, children, like adults, are susceptible to hospitalization.

In psychiatry

This is a deterioration in psychophysical condition due to a long stay in the hospital. An alternative name is homelessness syndrome. It manifests itself as social maladaptation, loss of work skills, loss of interests, exacerbation of chronic diseases, weakening of the need for communication and a number of other changes.

I will give a clinical example of the manifestation of hospitalism.

(The description of a clinical example in the article is published with the permission of the adoptive mother)

to see an epileptologist . Complaints: Seen by a psychiatrist with a diagnosis of childhood autism . The child is disabled since childhood. EEG revealed epiactivity. One of the knowledgeable specialists working with autistic people referred me to an epileptologist to clarify the diagnosis.

So, the child has autism spectrum disorder and epiactivity according to the EEG .

Actively identified complaints: Severe delay in speech development - speaks 5-7 words, makes contact selectively, withdrawn behavior. They deny seizures. Lives in a foster family for about 1 year. The girl lived in an orphanage from birth GJXNB until she was 6 years old. The anamnesis is not complete. Hyperexcitable. Hyperactive, restless. He visits specialized rehabilitation centers and notes the positive effect of the classes. Peaceful sleep. There was a delay in the rate of motor development: it is known that he walks independently from the age of 1.5 years. History of the disease: I got acquainted with the medical history from the words of the adoptive mother and partly from medical documents. Pregnancy 3, 36 weeks, OGA (complicated obstetric gynecological history), social factor. Childbirth 3, spontaneous, early. Birth weight 2450 grams, height 46 cm. Diagnosis at birth: Prematurity 36 weeks. Neonatal jaundice. Anemia. Hip dysplasia. We were treated in a psychiatric hospital with a diagnosis of childhood autism . Mental retardation is moderate. The last course of treatment was 1 year ago (chlorprotexen in a hospital setting). Next, psychotropic drugs (chlorprotexen) were gradually withdrawn, after which the girl became more active. The disability was registered with a psychiatrist. Lived in another region. They changed their place of residence in order to get a better opportunity for the rehabilitation of the child.

Mom has a second adopted daughter, and she also has her own biological son. Four of them live: a son, two adopted daughters and a mother. To my question: “What motivated you to take such a difficult child from the orphanage?” Mom replied that she hoped and would be able to pull her through and cope with these difficulties together. And this year they have made great progress.

The girl has an older brother in a similar mental and mental state, living in the same orphanage, who is currently taken to another foster family.

On examination: During the conversation and history taking, the girl selectively makes contact and partially follows commands. Hyperactive: moves chaotically around the office, takes toys, throws them, plays, changes the type of activity. He willingly fulfills his mother’s requests and answers her questions vaguely. Delayed speech development - pronounces words, even sings incomprehensibly, attempts at phrasal speech.

When the doctor approaches the child during the examination, she is negative, cries, and pushes away. Partially accessible for inspection.

The skull is of regular round shape, head circumference is 50 cm (normal), painless on percussion. CMN: pupils of normal size, D = S. Palpebral fissures D = S. Movement of the eyeballs in full, no strabismus, no nystagmus, reaction of the pupils to light is live. The face is symmetrical. The voice is loud, sonorous. Swallowing is not impaired. Tongue in the midline. Motor sphere: Muscle strength is sufficient, no paresis. Muscle tone: slightly reduced diffusely. Tendon reflexes are alive, D = S. There are no pathological reflexes. Gait is not impaired. There are no coordination violations.

Survey results:

EEG (11/10/2014) – diffuse changes in brain activity with signs of neurophysiological immaturity. At the moment of awakening, epileptiform activity is recorded in the frontotemporal areas on the right and left.

Autism is not Epilepsy

Diagnosis: Childhood autism, accompanied by epiactivity on the EEG. There are currently no data for active epilepsy.

Note that this is not cognitive disintegration. Recommendations: 1. EEG (background + sleep) control after 3-4 months 2. Observation by a psychiatrist. 3. Drug therapy: Pantocalcin 0.5, 1 tablet * 3 times a day orally 15-30 minutes after meals for 2 months. 4. Massage (gentle) at home, by mother. 5. Speech therapy classes. 6. Continue correctional pedagogical work in specialized rehabilitation centers.

1. Examination after 3-4 months with EEG.

So, from the article we learned about the phenomenon of hospitalism - this is a combination of mental and somatic disorders that arose in connection with a person’s long stay in the hospital, deprived of communication with loved ones and with home. We learned about the causes, stages of development, and manifestations of hospitalism in children. We found out that hospitalism in psychiatry is the result of the use of psychotropic drugs against the background of a current mental illness, in conditions of a long hospital stay, separated from loved ones.

They told about a clinical case in which a child from birth to 6 years old lived in an orphanage and a psychiatric hospital with manifestations of autism. In this clinical case, despite the presence of mental disorders (autism spectrum disorder), accompanied by epiactivity on the EEG, but in the absence of epileptic seizures, there is currently no evidence of active epilepsy. The child is indicated for follow-up examinations (EEG) and repeated consultations with an epileptologist, but the use of antiepileptic drugs is not indicated. We wish the mother and her girl a speedy recovery.

History of the discovery of the phenomenon

The phenomenon of hospitalism in psychology was discovered by psychoanalyst R. Spits (1945). He studied the phenomenon of hospitalism in children and infants forced to stay in the hospital for a long time, and in children living in a boarding school. The psychoanalyst found out that all the changes that are occurring are associated with the separation of the child from the mother. Spitz's teachings are based on Freud's psychoanalytic theory, in particular the position on the separation of the child from the mother.

Spits studied the condition of children who were in conditions favorable from a hygiene point of view (nutrition, care, cleanliness), but without proper maternal support. And this is what he noticed:

• in the third month of life, children experienced physical deterioration, weakened immunity, and increased mortality;
• a little later mental changes became noticeable, in particular depression, passivity, lethargy;
• in the second year of life, signs of deep psychophysical retardation in all areas (walking, speaking, ability to stand and sit) became noticeable.

As a result of his research, Spits (Spits, Spitz) concluded that children need the care and love of their mother. It is important for the life and development of the child.

The psychoanalyst identified two forms of the syndrome:

• hospitalism associated with complete deprivation of maternal care;
• anaclitic depression, which occurs if at first the child communicated normally with his mother, and then he was isolated.

Kreisler later revised Spitz's concept and came to the conclusion that any deprivation leads to hospitalism. Including inadequate child care in a family setting. Modern researchers adhere to the same point of view.

Prevention of the syndrome

Prevention of dangerous hospitalism syndrome in children is to fill the child’s day as much as possible with interesting activities, games, and possibly work.
If possible, you should provide sufficient attention and care from loved ones, talk to the baby, discuss everything that interests him. In adult patients, it is possible to prevent the development of this phenomenon by providing them with a social circle, allowing them to place photographs of loved ones or objects reminiscent of home in the ward.

It is necessary to maintain the patient’s social activity - if the condition allows, to involve him in simple assistance in caring for other patients, to ensure independence and independence in meeting his needs.

Causes of hospitalism

The phenomenon of hospitalism occurs when a person is in a hospital for a long time, a child is living in a boarding school, or a child is in a dysfunctional family, including a family with a cold, unemotional mother.

In psychology there is such a concept: “mother-child dyad.” This means that up to a year, mother and child are inseparable; they are considered as a single organism. Early separation before one year of age (indifference and coldness of the mother or absence of the mother in the child’s life) leads to hospitalism.

The syndrome occurs in conditions where the mother’s care for the child is completely or partially absent (lack of love, inattention). Unfortunately, this happens even in families, and seemingly prosperous families at that. For example, where parents are busy building a career.

Thus, hospitalism in children and adults occurs for the following reasons:

• long-term isolation in a medical facility;
• lack of communication with family, relatives, friends;
• passivity of relatives (close relatives are not interested in the individual’s life).

Risk factors include the following:

• the presence of chronic diseases due to which a person often ends up in the hospital;
• elderly age;
• living alone (no family, friends);
• life in a boarding school, orphanage, orphanage;
• infancy and childhood;
• stay in a boarding house, health center.

Psychologists note that most modern families are at risk. Parents are forced to work a lot, mothers leave maternity leave early. Because of this, the child lacks attention, care, affection, and communication. In addition, psychologists note that more and more often mothers are cold and unwilling to communicate with their children. They do not know the needs and interests of the baby, do not want to develop his abilities, and do not take into account his capabilities. Many modern children lack closeness with their mother. Hence, late development, behavioral problems, late development of speech or speech disorders, and many other problems.

Prognosis and prevention

The prognosis of the pathology is considered favorable if the patient does not have severe somatic diseases and adequate treatment was started in a timely manner.

The following factors influence the outcome of hospitalization:

1. Patient's age
2. Frequency of visits between the child and his mother or other close person,
3. The severity of intellectual, mental and behavioral disorders,
4. Presence of concomitant disorders
5. Treatment effectiveness.

Late diagnosis and inadequate treatment lead to disability and death of patients. Only the joint work of doctors, psychologists and the patient’s relatives will completely eliminate the disease.

Measures to prevent the development of hospitalism in children:

• Living in a prosperous family,
• Warm relationship with mother
• Admission of a child to a health care facility only with a person close to him/her,
• Organization of the daily routine,
• Regular communication with peers,
• Interesting activities and games in a group.

Hospitalism is a mental illness that leaves a negative imprint on all areas of personal development: intelligence, emotional state, psychophysical qualities.

Symptoms and signs

Manifestations of hospitalism in children and adults are not the same. Let's consider both cases in more detail.

Hospitalism syndrome in children

In children, hospitalization manifests itself as follows:

• underdevelopment of reflexes and instincts in infants;
• urinary and fecal incontinence;
• delayed speech development;
• delayed motor development;
• emotional coldness, alexithymia (inability to express emotions);
• compulsive behavior such as rocking back and forth;
• rickets;
• retardation in physical development;
• low level of adaptation;
• lag in mastering one’s body and language;
• soreness;
• lethargy;
• apathy;
• pallor;
• passivity;
• exhaustion;
• poor appetite;
• sleep problems;
• fever;
• drowsiness;
• muscle hypotonicity;
• lack of reactions to signals from others (does not respond to affection, does not respond to voices, does not concentrate gaze).

Children who feel deeply about the lack of interaction with their mother appear unhappy. Their condition is difficult not to notice; the problem is visible to the naked eye. However, if the child is returned to the mother or another person who will fully replace her as soon as possible, then after 2-3 weeks all symptoms and signs of hospitalization will disappear.

Children deprived of interaction with adults begin to walk, talk, read, etc. late. If no one deals with them at all and in any way, then they grow up as Mowgli children (wild children).

Hospitalism syndrome in adults and the elderly

The following manifestations are characteristic:

• social maladjustment;
• loss of interest in work and work as such;
• weakening of professional skills;
• impoverishment of the social circle, decrease in the quality of contacts;
• exacerbation of chronic diseases and transformation of acute pathologies into chronic ones;
• loss of appetite;
• decreased immunity;
• decreased adaptive capabilities;
• phlegm;
• impoverishment of facial expressions;
• slow motor skills;
• cognitive impairment (memory, thinking, perception);
• carelessness;
• inactivity;
• monotone.

In older people, hospitalism manifests itself as degradation. It develops due to being in nursing homes, hospitals, or when an elderly person is abandoned in an apartment and lives alone.

At the same time, hospitalism in adults manifests itself as a chronic illness syndrome. A person gets so used to lying in a hospital bed that he cannot live in other conditions. After leaving the hospital, he does everything possible to get there again. The fact is that during long-term inpatient treatment, a person’s worldview is distorted. He does not perceive himself in a different environment, he gets used to the disease. This happens especially often among pensioners. This manifests itself during hospital treatment for 10–15 months (on average).

With such a long stay in the hospital, a person develops mental deformations. Several options are possible (subtypes of hospitalism):

1. Deprivatization desocialization. This is a loss of ability to adapt, a loss of social skills. Develops slowly.
2. Paternalistic subordination. This is the obsession with being sick. Occurs due to excessive care.
3. Pharmacogenic psychological, emotional and social personality regression. It develops very quickly due to improper treatment.
4. Mixed option.

Spits' theory

Hospitalism is the concept in psychology with which R. Spits operated. In 1945, an Austro-American psychoanalyst introduced a special medical term for diagnosing childhood syndrome, which was observed in orphanages and infant homes.

Initially, it was assumed that the phenomenon of hospitalism was facilitated by the poverty and wretchedness of the environment in which orphans were kept:

• there are not enough vitamins in the diet;
• a small number of staff to fully serve young children and develop the necessary social skills in them.

Naturally, these factors have an adverse effect on the physical and mental health of the child. However, further research by Spits proved that the syndrome can occur even at a very high level of organization of a child care institution.

Following the psychoanalytic theory of Sigmund Freud, Spits' followers explained hospitalism as the result of psycho-emotional loneliness. That is, the syndrome is based on the fact that the baby is deprived of close communication with loved ones, especially with the mother.

A similar phenomenon is observed in children left for a long time in health centers. The hospital environment and the discomfort caused by medical procedures cause fear and a subconscious blockade of communication.

The syndrome is especially dangerous in early childhood, as it directly affects developmental inhibition: the child begins to speak, walk, and show interest in what is happening around him late. Some mental or physical disabilities may last a lifetime.

Vivid examples are cases where lost children grew up among animals. If they were found and tried to introduce them to a normal way of life, then it has never been possible to raise the development of little savages to a level corresponding to their human age.

Treatment of hospitalism

Treatment of the syndrome in children and adults differs. Let's take a closer look at each of the categories.

In children

Treatment involves not only eliminating the negative factor, that is, restoring warm communication with the mother, but also systematic work with various specialists:

• pedagogical correction;
• psychological correction;
• expanding your social circle;
• increasing the intensity of communication.

At the same time, symptomatic therapy is carried out, that is, psychological and medical treatment to eliminate signs of exhaustion and retardation. The program of events is selected individually.

In adults

First of all, you need to eliminate the negative factor: cure the chronic disease, switch to outpatient treatment. But the most important thing is to return to the person the support of loved ones and communication with them. Comprehensive treatment by a therapist or psychotherapist (psychiatrist) is indicated. It is advisable to avoid consultations within the walls of a medical institution; it is recommended to invite a specialist to your home.

The main rule for preventing hospitalism is communication.

Diagnosis and treatment

Diagnosis of hospitalism includes the following clinical methods:

1. Anamnesis collection - interviewing the patient’s parents and close relatives, staff and other persons who regularly contact him;
2. General examination of the patient by a pediatric neurologist, psychiatrist, clinical psychologist;
3. Neurological examination - determination of muscle strength and tone, response to external stimuli, complex targeted movements, identification of existing diseases of the nervous system;
4. A psychological examination makes it possible to assess the patient’s psychomotor development, ability to communicate and respond adequately, to care for oneself independently, as well as to detect lags in the mental and emotional sphere;
5. Dynamic observation of the patient is necessary to make a final diagnosis.

After receiving the results of diagnostic measures, specialists prescribe adequate and most effective treatment. Doctors pay special attention to young children, since the mortality rate in this category of patients is very high.

Treatment of hospital syndrome is a complex, multi-stage and lengthy process.

Treatment regimen for sick children with hospitalism:

• Increased communication between the child and relatives and peers.
• Return of a small patient to the family.
• Organization of a 24-hour hospital stay between the child and the mother.
• Equipping closed institutions with meeting rooms.
• Pedagogical correction is the development of a child’s communicative qualities by including him in a children’s team, as well as ensuring close interaction between mother and baby.
• The purpose of psychological support is the development of cognitive functions in the child. To do this, exercises are used in the form of games that have a training effect. Psychological assistance allows you to create a positive emotional background, eliminate fear, anxiety, and worry.
• Psychotherapists use art therapy, music and body therapy, relaxation sessions, and training to develop communication and socialization skills for patients. Group, individual and family psychotherapy allows you to restore and maintain a healthy psychological climate in the family and children's groups.
• Medication is used only in severe cases when all other treatment methods do not produce positive results. Patients are prescribed drugs that correct emotional instability, improve metabolic processes in the central nervous system and stimulate the development of cognitive functions.
• Treatment of existing somatic and infectious diseases, restorative therapy.

To cure the syndrome in adults, it is necessary to eliminate the underlying disease that caused their hospitalization in a health care facility. Chronic illnesses are best treated on an outpatient basis. Rehabilitation activities are carried out by a specialist psychotherapist or psychiatrist.

Why is hospitalism dangerous?

Each case requires individual consideration, but we can absolutely say that sometimes the effects of hospitalization are irreversible and even lead to death. Among people with hospitalism syndrome, there is a higher risk of developing mental disorders and antisocial tendencies.

Children's hospitalism is dangerous because the child will become wild and will never be able to return to a normal, human life. Victor Kaspar, Janie from California are vivid examples of Mowgli children from the past. But it’s scary that this is happening in our time. Not so long ago, all TV channels were full of shocking news: “A five-year-old Mowgli girl was found in a Moscow apartment.” There are a lot of such stories. Some people manage to become human, while others remain “wild animals”, living by instincts and reflexes. Unfortunately, even at the current level of development, pedagogy, psychology and other social sciences are not always able to help such children.

Reasons for the development of hospitalism syndrome

• Living conditions: confined spaces, changes in routine and diet, etc.
• Poor emotional reactions from hospital staff.
• Specific psychological climate.
• Long and frequent hospitalizations. Due to this, a person gets used to living in a hospital environment.
• Isolation from the usual way of life, family and friends.
• Long-term drug therapy leads to depression of some psychological and physiological indicators.
• Prolonged and intrusive care from medical staff.

Prevention of hospitalism

As a preventive measure, psychologists recommend that parents or other close adults communicate with the child as much as possible, and start communication as early as possible. It should be a very warm, emotional interaction. Play and engage with your child. Try not to leave your child alone in the hospital, do not leave him with an emotionally cold person. Study developmental psychology to properly care for your baby.

Prevention of hospitalism among adults implies maximum preservation of contacts with the outside world: communication by phone, Skype, chat, personal visits. Don’t abandon your grandparents, don’t isolate yourself if you yourself find yourself in the hospital.

If in hospitals, boarding schools and other institutions there was always a person next to the patient (pupil) who would pay attention only to him 24 hours a day, 7 days a week, then the hospitalism syndrome would probably not manifest itself. But we understand that this is impossible, at least in government institutions. In everyday life, you can hire a nanny or a nurse.

How does hospitalism manifest in children?

In the presence of hospitalization, the child lags behind in physical and mental development. Children's emotional reactions are also formed incorrectly. For example, when an adult smiles, a child stops smiling. He doesn't concentrate his eyes when people talk to him. Smiling and cooing generally disappear from his life. Such children begin to hold their heads up, crawl and walk much later. And they can develop full-fledged speech by the age of 4-5 years.

It is emotionally difficult to work with such a child. Medical personnel note that children with hospitalization do not make contact. They don't want to develop, have fun and learn.

Long-term hospitalization is dangerous due to the presence of complications. For example, there may be a delay in weight gain. And due to weakened immunity, the risk of infectious diseases increases. Complex forms of hospitalism cause disability and mental retardation, which ultimately cannot be cured.

Treatment of somatic diseases as an addition to hospitalism therapy

Somatic illnesses, as opposed to mental disorders, are associated with physical ailments.

These can be a variety of diseases of internal organs (cardiovascular diseases, respiratory pathologies, cancer, hereditary genetic disorders), as well as acquired injuries. If you have a history of such diagnoses, it is quite difficult to eliminate the manifestations of hospitalism without curing the underlying disease.

Therefore, when working with such patients, doctors use an integrated approach and the person (child or adult) is provided with comprehensive assistance. Positive dynamics in the treatment of somatic diseases improves the patient’s psychological state and increases his chances of recovering from the consequences of his stay in a hospital setting.

Case in California

The fact that hospitalism occurs in the absence of normal upbringing and isolation from society is clearly demonstrated by a relatively recent case that occurred in the American town of Arcadia.

Social services found a thirteen-year-old girl in the closet of a city house. The savage grew up in a cramped room, without seeing sunlight, without normal nutrition, conditions for caring for the body and any communication.

The girl's mother turned out to be a mentally ill person. She was unable to give a single adequate answer about her treatment of the child. If the social service worker had not discovered the terrible discovery, the girl was in danger of imminent death, since her body was already in a catastrophic state.

The girl was given the name Jenny and placed in a clinic at the University of California. She was given first aid and nursed under the close attention and care of a team headed by the famous psychologist D. Rigler. Doctors tried to return Jenny to her human form, but the results were disastrous: the girl never learned to express her thoughts and communicate. All her behavioral skills were reduced to only the most primitive reflexes.

By studying this case, which is directly related to the disease called “Hospitalism,” psychologists once again proved the vital need for a person to have harmonious communication and interaction with society.

Possible complications

The long-term experience of staying in institutional institutions affects both the health of children and the condition of adults.

Patients may experience the following symptoms:

• growth retardation in children;
• underweight, dystrophy;
• decreased immunity;
• infantile insanity;
• irreversible changes in the nervous system and brain, leading to disability;
• frequent colds;
• indigestion;
• urinary system infections (associated with ignoring hygiene procedures);
• difficulties with building social connections and interaction in society.

The development of these complications depends on how successful the rehabilitation was and whether timely medical and psychological care was provided to the patient with hospitalization at the proper level.

In conditions of stay in secure institutions, helping patients cope with hospitalization can be difficult. In these situations, returning to a normal family environment can help get away from hospital syndrome, which is not always possible.

To overcome the crisis, the overall fruitful work of patients with psychologists, doctors and other specialists who help them rehabilitate in society and get closer to normal life is important.

Pediatric hospitalism

Hospitalization is described by the following symptoms:

• very low anthropometric indicators (rickets);
• delayed development of movements and the ability to walk;
• emotional and facial poverty;
• obsessive, meaningless movements (for example, rocking from side to side);
• reduced immunity and frequent infectious diseases.

Hospitalism clearly manifests itself in infancy:

• the child suddenly loses weight and refuses to eat;
• the baby is sleepy and inactive all the time;
• muscles lack tone, limbs hang limply and limply when the child is lifted from the crib;
• there are no signs of a reverse reaction to contacts (does not turn his head towards the voice, does not follow the toy with his eyes).

Spits' theory is the basis for the study of hospitalism syndrome. Modern psychologists, as well as the Austro-American doctor, note the previously described pathologies that arise in boarding schools, nurseries and children's hospitals. However, another aspect is added to the causes of the disease - the influence (or rather, the lack thereof) of the mother on the development of the child.

Today, psychologists note a direct relationship between the full development of the baby and parental love. Children who are not loved by their mothers experience emotional and cognitive deficits:

• they don’t talk or play with them much, which leads to psychological and emotional poverty and violates the “I-concept” in later life;
• do not exercise, do not take good hygienic care, which provokes frequent infections and diseases that weaken the immune system;
• they do not learn to move correctly and respond to external impulses, which runs counter to the harmonious development of the vestibular apparatus and higher nervous system.

It is the lack of maternal attention that explains the increased percentage of cases of the syndrome in boarding schools and hospitals. That is, theoretically, if in such institutions each child was assigned a personal nanny who could replace the mother and take care of the baby all the time, all the prerequisites for the occurrence of hospitalism syndrome would disappear.

Deprivation theory

Hospitalism (in psychology this phenomenon is closely related to deprivation), developing in children and adults, negatively affects their future lives, leading to mental destruction and personal regression. The paradox of hospitalism is associated with the fact that a person staying in a hospital setting, even with good care, receives deep psychological trauma due to developing deprivation.

Psychologists and psychiatrists define deprivation as a condition in which a person develops an unmet need for emotional intimacy, resulting in gaps in the emotional, sensory and intellectual spheres. This problem is especially acute among the child population, deprived of maternal care and warmth.

Children deprived of the opportunity to have emotional contact with their mother have developmental problems, and subsequently the deprivation is transformed into more serious deviations of an already grown person.

A deprived person does not feel completely safe, does not have the opportunity to be socially active and receive new impressions, which forms in him a certain changed attitude towards the surrounding reality and himself.

In other words, the lack of a satisfied need for love and care (deprivation) creates ideal conditions for personality degradation in all directions - psycho-emotional, mental and physical.

Hospitalism – psychology

Hospitalism is a slowdown and distortion of children’s development due to their being in unfavorable conditions of boarding schools.

A syndrome of severe physical and mental retardation that occurs in the first years of a child’s life due to lack of communication with close adults.

It manifests itself in the delayed development of movements (especially walking), low anthropometric indicators, as well as slow and defective formation of higher mental functions.

Research by R. Spitz

A similar condition that occurred in children from orphanages has been noted by teachers for a long time. However, an explanation for this, as a rule, was sought in the meager conditions of existence of such institutions. A scientific description of the phenomenon of hospitalism (as well as the term itself) was first given in the 40s of the 20th century.

American psychologist Rene Spitz, who studied the condition and development of children in boarding schools, as well as young hospital patients.

Spitz found that even in the presence of good sanitary and hygienic conditions, satisfactory nutrition and care, children deprived of communication with their parents have an impoverished emotional sphere, and the development of thinking and speech slows down.

Spitz and his followers, relying on psychoanalytic theory, tended to view this phenomenon as the result of the separation of a child from his mother. They also believed that the consequences of hospitalization are irreversible and leave a negative imprint on the entire development of the child.

This point of view was supported by examples of extreme situations known to science, when children who were lost or abducted by wild animals at an early age, but managed to survive outside human society, were subsequently returned to the human way of life, but could not reach the level of development that corresponded to their age.

Conditions of occurrence

The facts identified by Spitz are not disputed by experts, but his interpretation of hospitalism has undergone significant changes.

It was found that such phenomena can arise not only in situations of separation from the mother, but also in family conditions when the child is not given enough attention.

It has also been established that although a lack of communication at an early age has an extremely negative impact on the development of a child, subsequently this phenomenon can be partially or completely compensated through vigorous pedagogical influence, enrichment of the developmental environment, and intensification of communication.

To avoid the occurrence of hospitalism, psychologists recommend that parents not neglect communication even with young children themselves (under the pretext that the child does not understand anything yet).

It is necessary to ensure that the child’s needs for mastering the world around him, for satiating cognitive interests, and for positive emotional contact are fully satisfied.

It is extremely undesirable to place an infant or young child in a hospital without a mother, especially if the treatment involves unpleasant manipulations and painful procedures.

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Hospitalism without boarding school ===

The hospitalism effect can also occur outside the walls of a boarding school if the child has been deprived of communication with people since childhood. Science knows several such examples. All of them date back to a very distant past.

In this regard, doubts arise: were some opportunities for pedagogical influence missed, which would have made it possible to achieve more encouraging results? It would seem that over the past decades, psychological and pedagogical science has stepped forward so much that if such a “savage” were in the hands of modern specialists, they would “make a man” out of him. Well, there is a relatively recent example. What does he demonstrate?

November 4, 1970 as a social service worker in the town of Arcadia, pc. California, a terrible discovery has been made. In a wretched house, in a closet, a girl of about thirteen was discovered, who, it seems, had spent her entire life in such confinement.

Her mother, who suffered from a mental disorder and was distinguished by extremely inappropriate behavior, did not want (or could not) explain her “pedagogical concept”, embodied in such a wild form. It seems inexplicable that she still fed the girl, not letting her die of hunger.

However, if not for the chance discovery of a social worker, the girl would not have long to live. The condition of her body was depressing. It is difficult to expect anything else in the absence of adequate nutrition, sunlight, fresh air and physical activity. But even more deplorable was her mental state.

The unfortunate girl not only did not know how to express her thoughts in words, but she also had no thoughts. All her behavior boiled down to a primitive set of instinctive reflexes.

Naturally, the poor girl was taken from her monster mother. A whole team of specialists from the University of California, led by psychologist David Rigler, took care of Janie - that’s the name she was given. Many years were devoted to titanic efforts to “humanize” Janie.

The results of this work were presented to the public in 1994 as part of a popular science program on national television.

Alas, the results, despite all the humanistic pathos of the work done, turned out to be disappointing: Janie never became a human being, repeating the sad experience of Kaspar and dozens of other “wild children.” (By the way, in this regard, reasonable questions arise for theologians.

What state is this human-looking body in? Is it even possible to ascertain at least some hint of the existence of a soul behind a set of primitive ones? If, according to the religious canon, the human at the moment of birth is spiritualized from above, then how does this manifest itself in such cases?)

However, this result was quite predictable. In fact, we have before us another example confirming the obvious truth: nothing truly human is initially inherent in a person, but must necessarily be introduced, formed, and starting from the earliest stages of development, the omission of which is irreparable.

Today, at every step one can hear pathetic declarations from “humanist” educators calling “not to interfere” with the natural development of the child. Among them, there are probably many wonderful people who sincerely hate drill and cramming. But it wouldn’t hurt for them to compare their idealistic attitudes with sad examples, one of which bears the name Janie.

Because a savage can be raised not only in a closet.

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Hospitalism, what is hospitalism syndrome in children and adults

Hospitalism is a whole series of psychological and somatic disorders that are provoked by a person’s prolonged stay in a medical institution far from loved ones and his own home.

This concept best defines hospitalism in adults, and in children the phenomenon of hospitalism manifests itself as psychopathic and physical underdevelopment, which begins in infancy and continues as the child grows up, under certain circumstances that arise - as a result of a lack of adequate communication between the child and the mother and a lack of elements education.

Hospitalism syndrome is manifested by a slowdown in development, difficulty in children mastering basic skills of self-care and control of their own body, underdevelopment of the speech apparatus, a reduced level of adaptation to the environment and society, loss of interest in work activity and work skills in general, low resistance to infectious agents and a tendency to chronicity pathological processes in the body. It is in childhood that the symptoms of hospitalism are long-lasting and often irreversible. In the most severe cases, with non-treatment and prolonged psychological oppression, hospitalism syndrome leads to the death of the individual.

Hospitalism is a phenomenon of lag in psychology; the term was first introduced by the Austro-American psychologist Rene Spits. It was he who conducted research over a long period of time - observing children in a hospital setting, without the mother being nearby.

Thanks to the origin of the research, the name itself arose - hospitalism.

Much later, the concept gained expansion and began to include not only separation in terms of health, but also the general lack of interest of the mother in her child, and this can happen even if they are constantly in direct proximity to each other.

What actions of adults provoke the development of the disorder in children? Risk factors, pathogenesis

Hospitalism in psychology is a set of long-term consequences that arise as a result of stress associated with separation from the usual environment and a long stay in systemic institutions. The development of such stress directly depends on the behavior of adults around children.

Risk factors for the development of hospitalism in children are:

The pathogenesis (development process) of hospitalism is associated with mental deprivation or, more simply, lack of attention to the child.