CURRENT TRENDS IN MILITARY NEUROPSYCHIATRY

Abstract

In pursuing these policies of prevention and treatment, many difficulties remain. Perhaps the most outstanding is the widespread misconception regarding the whole subject of mental health in the mind not only of military personnel but of the civilian public, the family back home, and the public press. It is generally recognized that the concept of physical health covers a wide range of conditions ranging from a light head cold on down to terminal lobar pneumonia. Mental health, on the other hand, has been regarded as being black or white. Either a man was insane or he was completely normal. The possibility has not been considered that there might be anything in between. Actually, of course, mental health just as physical health ranges all the way from bad to good. A man may have minor temporary mental ill health just as he may have a head cold. Mental disorders may be acute or chronic, severe or mild; just as a man may have simultaneously a broken leg and the grippe he may have an acute anxiety neurosis superimposed on a psychopathic personality or an organic condition. A great deal of the confusion has arisen on the basis of terminology and semantics. Any word beginning with the letters "psy," to the average mind, suggests something mysterious and alarming: insanity, perversion, homicidal tendencies. Many laymen become frightened and resentful when a psychiatrist applies a medical term to conditions they were used to recognizing as a "case of the jitters" or "gone stale" or "nervousness." It is difficult for laymen to realize that when a case of the jitters is sufficiently serious to incapacitate a man or produce insomnia and indigestion, a psychiatrist may call it pstchoneurosis and yet not mean anything more serious than was meant by the layman who called it the jitters. Actually, of course, the problem extends further than this. The question arises whether present psychiatric terminology was designed to cover the entire range of mental health. Is it perhaps necessary to devise a new set of diagnostic terms to cover the range of acute transitory psychiatric disturbances which occur in "normal" individuals in reaction to abnormal stress? In conclusion, it may be said that the problems of mental health in this war have presented a major challenge to psychiatrists. To meet this challenge it was necessary to revise concepts and to approach problems with new viewpoints—it was necessary to shift attention from problems of the abnormal mind in normal times to problems of the normal mind in abnormal times.