PERSONAL AND MORALE FACTORS IN THE ETIOLOGY AND PREVENTION OF TRAUMATIC WAR NEUROSIS IN MERCHANT SEAMEN

Abstract

The emphasis in the literature on heredity and constitutional makeup, physical illness and fatigue, concussion and alcoholism, as predisposing to traumatic war neurosis is well known. The articles by William H. Dunn( i), Zabriskie and Brush(2), Aubrey Lewis(3), Kardiner(4), Rado(5), and the symposium on “Convoy Fatigue― (6), of our own Medical Division, afford a complete discussion. More recently the importance of fatigue has been stressed, especially the emotional variety. The questions Where, When, and How a traumatic event occurs are of supreme im portance. The causes of mental exhaustion, parallel to physical exhaustion, lie in factors such as: unsatisfactory placement in the group; anxiety over proper safety measures; resentment against imagined mistreatment. Without release, the hostile attitude to ward parties presumed to be responsible for these conditions is (according to my findings) intensified and becomes an important factor in disturbing the balance. The purpose of this paper is to show that such a premise is correct. The importance of the personal morale factor was brought to my attention by my first case of traumatic war neurosis. A young man who had made a good adjustment previous to the war had gone through two years of severe war experi ences with continued fatigue, exposure to danger and emotional strain. He released in my presence a torrent of aggressive hate which I now conclude to have been most important in precipitating the neurosis. In this case, extreme hatred against the superior officerof the ship overshadowed other events. In addition to the subsequent train