Traumatic War Neurosis Research Articles

Événements à potentialité traumatique et changement de ou dans la personnalité

ObjectiveThe theme of personality change is often discussed as a consequence of psychic trauma. But the question arises whether there is a change in the structure or in the structure of the personality. MethodThe authors draw on elements of the psychoanalytic literature and psychopathology of traumatic war neurosis, on a plausible event of Blaise Pascal's life and on a case of a female air hostess hostage. Under discussion are evoked the Near Death Experiences (NDE) as a contemporary example of the changes in personality. ResultsAlthough many authors reported changes in personality trauma, clinical trails are not the same after conception of trauma and personality. Favoring a Lacanian conception of personality and by holding that the trauma resulting from the inlay in the structure of an event that becomes significant, the authors make a parallel with the creation of an invention as a new signifier in the structure and submit assuming that trauma leads to change in the structure rather than structural changes. The case confirms the statement, and a visit by the NDE and the critical discourse about the accompanying changes shows the possible idealization which they are subjected to. ConclusionIt is not a personality change in the sense of a change of such structure, which can occur in the aftermath of a confrontation at a traumatogenic situation, but rather a change in the structure by the effects of traumatic inlay. However, these changes can have a psychopathological dimensions which are characteristic of PTSD, but they also represent a constraint not devoid of evolutionary potential.

Psychotrauma and effective treatment of post-traumatic stress disorder in soldiers and peacekeepers

Psychotrauma occurs as a result to a traumatic event, which may involve witnessing someone's actual death or personally experiencing serious physical injury, assault, rape and sexual abuse, being held as a hostage, or a threat to physical or psychological integrity. Post-traumatic stress disorder (PTSD) is an anxiety disorder and was defined in the past as railway spine, traumatic war neurosis, stress syndrome, shell shock, battle fatigue, combat fatigue, or post-traumatic stress syndrome (PTSS). If untreated, post-traumatic stress disorder can impair relationships of those affected and strain their families and society. Deployed soldiers are especially at a high risk to be affected by PTSD but often receive inadequate treatment. Reviews to date have focused only on a single type of treatment or groups of soldiers from only one country. The aim of the current review was to evaluate characteristics of therapeutic methods used internationally to treat male soldiers' PTSD after peacekeeping operations in South Eastern Europe and the Gulf wars.This systematic literature review returned results pertaining to the symptoms, diagnosis, timing and effectiveness of treatment. Sample groups and controls were relatively small and, therefore, the results lack generalizability. Further research is needed to understand the influence and unique psychological requirements of each specific military operation on the internationally deployed soldiers.

Posttraumatic Stress Disorder is Overloaded

Valid disorders are subject to the disease of inflation. Any solid, established diagnosis that is popular and appealing risks overuse and becomes overloaded with excess features. Such is the fate of posttraumatic stress disorder (PTSD). Once a well-defined, well-characterized condition, it has currently expanded from the consequences of terrifying battles to the outcome of purported abuse in childhood. The alleged abuse is sometimes recovered and ranges from forgotten forbidden touching to the most serious and harmful invasion of the bodies and minds of children. It is time to call a halt to the unscientific expansion of PTSD. It harms patients to give them the wrong diagnosis with the wrong assumptions. Modern descriptions of PTSD date from the time of the Russo-Japanese War ( 1904-1905), in which early versions of high-explosive shells were used. These differed from cannonballs and other projectiles in that blasts occurred on impact, producing additional damage to bodies and structures and scattering shrapnel. Contemporary reports recognized a condition amounting to a traumatic war neurosis, marked by confusional states, brief excitement and irritability, fearfulness, and emotional instability. The typical and enduring pattern was further identified in France following explosions of the naval ships Iena and Liberte in Toulon dockyard in 1907 and 1911. After eliminating cases in which organic factors might have been relevant, Hesnard' recorded posttraumatic psychological responses including an initial state of semisomnambulism, automatic mental activity, absorption in some trivial occupation (for example, saving some garment), a strange lucidity or increased clarity, a feeling of exaltation, and a period of anterograde amnesia. The dockyard rescuers also showed symptoms of disturbance for several weeks, including recapitulation of the scene, terrifying dreams, diffuse anxiety, fatigue, and various minor phobias. This knowledge of emotional change after explosions, quickly abstracted in English, became part of the contemporary climate of ideas.1,2 In the First World War, soldiers who became panic-stricken and ran away, or who were too fearful to go into battle, were liable to be executed; more than 300 men in the British forces were shot for cowardice. Thus to complain of anxiety was unacceptable, although, as the war progressed, it was recognized that soldiers who had fought most bravely might lose their nerve after increased exposure to risk-even those decorated for exceptional gallantry might break down with anxiety. Many individuals who were not overtly wounded by explosive blasts but were nearby when they occurred developed paralysis, difficulty with limbs, or other symptoms, which came to be recognized as hysteria. The idea that symptoms were produced by the blast of high explosives caused the condition to be labelled shell shock. The term was applied to individuals who developed symptoms such as paralysis, amnesias, deafness, and visual difficulties. These symptoms, grafted onto the basic anxiety response, served a social and cultural purpose, enabling the individual to retreat from battle with dignity and-for a short while-sympathy. Soon the numbers of individuals given the diagnosis grew too large to be accommodated by armies that needed to keep their soldiers fighting. Diagnoses changed. After shell shock, the ultimate pattern of chronic anxiety related to particular events was recognized fairly well as combat neurosis and then, later, as posttraumatic stress disorder.2 Through the rest of the First World War and during the second World War, a stunned, semiautomatic victim with a pattern of characteristic anxiety symptoms relating to the event was treated with some degree of insight and support, and the pattern was recognized under various terms such as combat neurosis. Later, the same notion-rediscovered in Vietnam-was captured in both DSM-IV and ICD-10 descriptions. Not all individuals who experience stress or trauma, whether in battle or in civilian life, and who develop symptoms, necessarily show the typical anxiety pattern. …

Disappearing and Reviving: Sandor Ferenczi in the History of Psychoanalysis

ANDRE HAYNAL: Disappearing and Reviving: Sandor Ferenczi in the History of Psychoanalysis. Karnac (Books) Ltd., London UK/New York, 2002, 151 pp., $35.00, ISBN 1-85575-254-9. The author Andre Haynal has been one of the main translators and proponents of Ferenczi's work for the past 15 years, along with Michael Balint and John Gedo. He apparently was the supervisor for, and contributed to, the recently published correspondence between Freud and Ferenczi, Behind the Scenes. Freud in Correspondence. (Scandinavian University Press, 1997). This is a study of the history of psychoanalysis and its developments over the past century. His main thesis is that while Freud is the father of classical psychoanalysis, Ferenczi is the initiator of the development of theory and in contemporary psychoanalysis. Through the work of Michael Balint in the UK middle group and later Clara Thomson in the USA (interpersonal psychoanalysis) Ferenczi's ideas have blossomed following his death. Haynal's thesis is that while Stekel and Adler and Jung all left Freud and founded other schools of thought, Ferenczi was not a dissident in that sense and always considered himself part of mainstream psychoanalysis, even when Freud and he parted ways over his use of techniques and Ferenczi's concepts of co-transferences and the necessity for therapist disclosure, as well as the need for a listener, and the concept of what we now call an intersubjective third were all proposed as part of his developing concept for psychoanalysis in the 1920s. Because of his repeated boundary violations, tempestuous marriage, and love/hate personal and therapeutic relationship with Freud, his many contributions were overlooked for years by authors who portrayed him as unbalanced or ill during the later part of his life. The fact that self psychology and relational analysts now champion his infant maternal dyadic attachment and supportive empathie concepts as being more significant than the oedipal transferences and their interpretation, has done much to revive recent interest in Ferenczi's original diaries and publications. Ferenczi being part of the original Freud inner circle, shared an interest in spiritualism, especially thought transfer and word associations with Freud, traumatic war neuroses with Abraham, and active and pre-oedipal primal anxieties with Rank. He advocated the use of new aimed at experiencing and empathy rather than the old Freudian that had rational insight as its goal. Being dissatisfied with the results of classical analysis and the central issue of transference interpretation, Ferenczi began to experiment with sharing his own associations, countertransferences, and history with his patients in experiments called mutual analyses. …

"A Scene of Surpassing Terror and Awful Grandeur":The Paradoxes of Military Service in the American Civil War

In the years since the end of American involvement in the Vietnam War in 1973, American veterans of that conflict have commanded a great deal of public attention. Although a few dissenting opinions have been expressed on the matter, for the most part the American public has come to view the Vietnam veteran primarily as a victim, specifically a psychiatric victim, who suffers from symptoms of Post-Traumatic Stress Disorder (PTSD).2 PTSD is a psychological syndrome marked by intrusive recollections (nightmares or flashbacks), psychic numbing (the withdrawal from ordinary social relationships and intercourse), hyperreactivity (startle reactions to smells, sounds, or sights which remind the veteran of horrific scenes from battle in Vietnam), and related symptoms such as depression or cognitive dysfunction (e.g. the inability to concentrate). To a certain extent, PTSD is simply a restatement of diagnostic categories such as shellshock, combat fatigue, or the traumatic neuroses of war, employed to describe psychiatric victims of warfare earlier in the twentieth century. The view of both psychology and popular culture is that victims of PTSD were damaged by and continue to fixate on

Between Two Wars: Psychoanalysis in Europe, 1918-1938

In outline form, the major centers of European psychoanalysis have been described: from the first post-war meeting of the International Psychoanalytic Association in Budapest, 1918, when institutes for analytic training were proposed, to the Anschluss in March 1938, when Vienna was occupied by the Nazis and psychoanalysis on the Continent was extinguished for almost a decade. The emphasis has been on the organization and structure of institutes, chiefly Berlin, Vienna, and London, in that order. As an institutional history, both biographic details and theoretical issues have been kept to a minimum. The exceptions have been the controversies about lay analysis, Melanie Klein's developmental theories, and Ferenczi's innovations in technique. In these issues, some detail is necessary to understand how one institute differed from another within the analytic movement, although they were unified by the International Psychoanalytic Association (IPA). The history of the British analytic community, which survived World War II intact, is highly condensed, and Prague, Budapest, and Paris are briefly mentioned. A history of psychoanalysis in Russia has yet to be written, from its early flowering before and during the Bolshevik revolution (1918-1920) to its swift repression under Stalin in the later 1920s. Among the conclusions to be drawn from these data is the extent to which political events influenced the development of analysis, then in its most expansive phase. Even theory was affected by history, as in the evolution of Freud's repetition-compulsion from observations on the traumatic neuroses of war. Socioeconomic conditions influenced the propagation of analytic ideas, favorably in post-war Berlin, adversely in Vienna. Each country evolved the kind of analysis that suited it best, with a variety of institutions within the same international movement. The causes of these variations in psychoanalytic institutes are a matter for speculation. Some analytic historians have linked Freud's advocacy of lay analysis to his estrangement from the medical establishment of Vienna, or to his dread that analysis might become the "house-maid" of medicine and psychiatry, as in America. Others find the roots of Freud's attitudes toward medicine in his conflicts about becoming a doctor, his yearning for philosophic speculation, which he "sternly held in check." In contrast, psychoanalysis in the United States was always committed to medical education as a prerequisite for becoming an analyst, and, in 1926, there was a sharp break from Freud's defense of lay analysis. Hale, among others, has suggested that the American "medical fixation" was a reaction to the chaotic state of our nineteenth century medical education, with diploma mills and self-taught healers scattered over a vast continent.(ABSTRACT TRUNCATED AT 400 WORDS)

Post-traumatic accelerated cohesion: Its recognition and management in group treatment of Vietnam veterans

Post-traumatic accelerated cohesion (p-TAC) is the name given to a frequently observed group phenomenon in the treatment of Vietnam veterans who suffer traumatic war neuroses. It is critical that this group dynamic be discussed, especially since group is widely regarded as the modality of choice in treating these veterans. Post-traumatic accelerated cohesion is the rapid, premature development of cohesion in a group of virtual strangers, and is here presented in terms of its harmful impact on the group and the impasses it creates. Suggestions are given to resolve p-TAC and move the group toward fulfilling its goals. Placed within the self psychology and object relations theoretical frameworks, the discussion addresses issues pertaining to developmental arrests and post-traumatic self disorders and their relationship to p-TAC dynamics.

Post-traumatic stress disorder (traumatic war neurosis) and concurrent psychiatric illness among Australian Vietnam veterans. A controlled study.

Depression, anxiety, irritability with unpredictable explosions of aggressive behaviour, impulsivity, suicidal actions and substance abuse have been repeatedly observed among ex-servicemen from World War II in psychiatric treatment settings. In the most recent American Psychiatric Association classification of mental disorders the category of Post Traumatic Stress Disorder (PTSD) was introduced, replacing the earlier Traumatic War Neurosis and the above cluster of symptoms were included as associated features of this disorder. Two recent uncontrolled studies on U.S. Vietnam veterans receiving psychiatric care supported the linkage of PTSD with these abnormalities. However, the present controlled study found these associated features occurred with equal frequencies among one group of psychiatrically hospitalised Australian Vietnam veterans with PTSD and another group not so afflicted. Reservations, then, should be harboured about ascribing all the presented psychopathology and behavioural abnormalities of ex-servicemen to the stress of their war service.

The Use of Monoamine Oxidase Inhibitors in the Treatment of Traumatic War Neurosis: Case Report

The Use of Monoamine Oxidase Inhibitors in the Treatment of Traumatic War Neurosis: Case Report

Traumatic war neurosis: Egyptian experience.

Over the last 24 years the Egyptian Military Forces have been involved in 5 wars. Each war had its own characteristics. The Yemen War, an overseas battle, the theatre of which was completely different from our Egyptian desert, being mountainous and not leading to a modern or even classical combat. The 1956 war, the 1967 war, the war of attrition lasting from 1968 to 1970 and lastly the war of October 1973, all in a relatively short period have enriched our psychiatric experience in handling the problem of war neurosis. The Egyptian military psychiatric team believes that traumatic war is a well defined nosological entity, a belief which is not yet shared by a group of Egyptian civilian psychiatrists. Traumatic war neurosis has its own precipitating factors, its own clinical picture, its own psychopathology as well as its own management. This paper is about war neurosis as an Egyptian experience, and is limited to two main items, namely, the various clinical pictures which we, as a military psychiatric team, have seen among Egyptian psychiatric casualties and secondly their management.

War Atrocities in Vietnam

From the time of recorded history, wars have had their share of atrocities. Never before, however, have United States military engagements received such publicity about atrocities committed by our troops during the long campaign in Vietnam. Although the heavy bombings by US forces undoubtedly took their toll of innocents, such acts were impersonal when compared to an incident like the one at My Lai. In the current issue of<i>Archives of General Psychiatry</i>(30:191-196, 1974) Haley reports her experience, beginning in 1969, of evaluating 130 Vietnam-duty veterans for psychotherapy. Forty of the men reported responsibility for atrocious acts, ranging from those provoked during the intensity of combat to sadistic brutality unrelated to any immediate external threat. She makes a sharp distinction between the psychological effects on men guilty of atrocities and the depression that characterized the traumatic war neurosis observed in veterans of World War II and the Korean conflict.

Traumatic neuroses in Vietnam returnees. A forgotten diagnosis?

Traumatic neuroses of war in Vietnam returnees are frequently overlooked. Vietnam returnees, because they reject authority and mistrust institutions, come to the Veterans Administration only out of desperation. Often, they come years after discharge from service and after ineffective trials of psychotherapy in the community. Explosive aggressivity, "flashbacks" of combat scenes, and phobic elaborations about the world as an unbearably hostile place have led to such misdiagnoses as psychomotor epilepsy, LSD abuse, or schizophrenia. The misdiagnosis of schizophrenia may lead to long-term phenothiazine treatment, rather than appropriate psychotherapy.

Traumatic war neuroses five years later.

This paper presents a summary of our experiences with a large group of cases of traumatic war neurosis during the 5-year period since the end of the war. We have made certain observations that have been hitherto unreported and that we feel have both theoretical and practical therapeutic significance. 1. Traumatic war neuroses occur in non-combatant military personnel located in a combat area with a relatively high degree of frequency. This group is vulnerable because they are exposed to traumata without the possibility of effective motor discharge of the emotions thereby engendered. 2. Guilt about killing or assailing defenseless enemy personnel, either military or civilian, is an important factor in the precipitation of a traumatic war neurosis. In such instances the superimposed military code (superego) yields to the earlier and stronger civilian prohibition against violence toward others. 3. Traumatic war neurosis can and does occur in conjunction with physical injury. Separation from the unit because of physical injury removes the influence of group morale, which serves as a deterrent to neurotic breakdown. 4. Physical injury or medical or surgical disorder that leads to enforced immobilization seems to encourage the development of the traumatic war neurosis by depriving the individual of the possibility of discharge of tension through motor activity. 5. Speech disturbances such as stammering can occur in cases of traumatic war neurosis without any evidence of this disorder having existed previously. 6. An overidealization of the pretraumatic history occurs in cases of traumatic war neurosis. This is viewed as a defensive maneuver of the ego in its effort to find some stable point in a world that has become overwhelming and threatening to the patient. 7. The monotonous repetition of the traumatic war experiences and combat dreams in cases of traumatic war neurosis is caused by the transformation of the world into a threatening place. The patient reacts to civilian life as if he were still in combat. 8. Changes in the details of the repetitive traumatic experiences and the combat dreams are significant indicators of the points at which the traumatic experiences are linked with pretraumatic experiences. 9. In our experience, the use of intravenous narcosis or hypnosis has not been particularly helpful in cases of chronic traumatic war neurosis. This is due to the need for developing a firm relationship with the patient because of his feeling regarding the threatening nature of his environment and the people therein. 10. We have differentiated 2 character groups among our cases of traumatic war neurosis, according to their pretraumatic adjustment. We have characterized them as alloplastic and autoplastic, or outgoing and inhibited. In the alloplastic, therapy is usually relatively short and consists essentially of relating combat experiences to present feelings and attitudes. In the autoplastic, a further step can be taken beyond this in that the traumatic experiences are related not merely to their present feelings and attitudes but also to the pretraumatic experiences. We feel that this differentiation is important particularly from a practical therapeutic point of view.

War Stress and Neurotic illness. By Abram Kardiner, M.D. with the Collaboration of Herbert Spiegel, M.D. Second Edition of The Traumatic Neuroses of War. New York: Paul B. Hoeber, Inc., 1947. 428 pp.

(1948). War Stress and Neurotic illness. By Abram Kardiner, M.D. with the Collaboration of Herbert Spiegel, M.D. Second Edition of The Traumatic Neuroses of War. New York: Paul B. Hoeber, Inc., 1947. 428 pp. The Psychoanalytic Quarterly: Vol. 17, No. 1, pp. 102-124.

War Stress and Neurotic Illness.

This book is a restatement of Kardiner's earlier contribution to the study of traumatic neuroses originally entitled "The Traumatic Neuroses of War." The present edition contains an additional section concerning the acute phase of the war neuroses, written in collaboration with Herbert Spiegel. This section is an adequate, if incomplete, description of the emotional setting and of the psychologic and morale factors significant in the development of the war neuroses. There is no particularly new systematic approach in this part of the book; but, since it is based on the writer's own experiences in battle, it produces an authentic and vivid impact on the reader. The greater part of the book is devoted to the study of the chronic phase of the war neuroses. Kardiner makes much of the difference between the acute and the chronic phases. He adopts the rather unusual position that the acute phase of the illness

TRAUMATIC NEUROSES IN COURT

Excerpt I. INTRODUCTION We can think of no more vexed or vexatious law-medicine problem than the proper appraisal and just compensation of so-called "traumatic neurosis."1Our intent is not to hack ...

Review of The traumatic neuroses of war.

Review of The traumatic neuroses of war.

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

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

THE PHYSICAL AND PSYCHOLOGICAL ASPECTS OF ENVIRONMENT ESSENTIAL TO THE TREATMENT OF TRAUMATIC NEUROSES OF WAR

The treatment of traumatic neuroses of war should be conceived as a total therapy designed to affect, regulate or modulate all aspects of the psycho-biological organism and its environmental relationships and impacts. Any and every individual, physician, nurse, social worker and others should clearly understand that these patients are suffering from a most complex form of insecurity which has its medical, psychological and social symptomalologies. These patients are best treated in an environment which combines the atmosphere of a home, a personally supervised work-recreation program, prompt personal attention to everything that promotes good mental and physical health and a genuine sensible personal interest in each patient by every person in contact with them regularly during their stay in the convalescent center.

About Ourselves. A Survey or Human Nature From the Zoological Viewpoint. By James G. Needham. With illustrations by William D. Sargent, Speciation. Defense Mechanisms in Plants and Animals. Biological Basis of Social Problems. Regeneration. Biological Symposia, Volume II. Edited by Jaques Cattell, The Varieties of Human Physique. An Introduction to Constitutional Psychology. By W. H. Sheldon with the collaboration of

About Ourselves. A Survey or Human Nature From the Zoological Viewpoint. By James G. Needham. With illustrations by William D. Sargent, Speciation. Defense Mechanisms in Plants and Animals. Biological Basis of Social Problems. Regeneration. Biological Symposia, Volume II. Edited by Jaques Cattell, The Varieties of Human Physique. An Introduction to Constitutional Psychology. By W. H. Sheldon with the collaboration of