Neuropsychiatric problems of the flyer

Abstract

The foregoing constitutes a general description of the psychiatric ills to which the flyer is heir. It is easy to recognize the fact that leaving the earth for the alien environment of the atmosphere produces no new syndromes. The individual personality continues to react with its environment in much the same ways regardless of what the environment may be. Some environments may contain more situations of stress and hence be productive of a relatively higher incidence of neurotic reactions than are others. The individual's response to stress tends to be the same regardless of where he may be. Since this is true it goes without saying that the neuropsychiatric problems of the peace-time aviator are qualitatively the same as those of the combat flyer. Quantitatively there may be some difference. The most important point to bear in mind is that the best treatment of these reactions is prophylaxis. In war this is vastly more difficult than in peace. All flyers should be assured of adequate rest and relief from flying duties so that they do not become “stale.” Adequate recreational outlets for the increased tension borne in the air must be provided and encouraged. Early symptoms of impending neurotic disorders and psychosomatic disturbances must be promptly recognized, their basic origin determined and appropriate psychotherapy begun before irreversible behavior patterns are established. The physician must be aware of the potentialities present and not be content to give the patient ever changing symptomatic treatment. In short, the intelligent management of the neurotic flyer is the same as the intelligent management of all other neurotics. It follows that the procedures of mental hygiene are also the same. A final word of warning is in order concerning an old fallacy that all neurotic disorders might be prevented in flyers and others by proper selection of personnel. The experience of the war has shown this not to be true. This is because even the most stable and well adjusted personalities do not represent perfection. Consequently there is always a weak spot in the personality armor which may succumb only to a specific stress to which it is sensitive. It is impossible to predict whether or not the individual will be exposed to the specific stress he cannot tolerate. In some of course the weak spot is large. In others it is small. So-called predisposition is important, therefore, in a quantitative sense but to a considerable degree all individuals are predisposed. Another fallacy exploded by the war is that the known neurotic cannot fly successfully. Hastings, Wright and Glueck's 5 report of 150 successful combat pilots, 50 per cent of whom had histories of pre-existing instabilities sufficient to be considered evidence of neuroticism by most standards, serves to emphasize this point. In many cases flying itself may afford the individual relief from his basic conflicts and an outlet for his basic anxieties. This is not meant to imply that neuroticism is a favorable characteristic. All things being equal the efficiency of the non-neurotic is likely to be greater than is that of the man who starts any activity with a neurosis already established.