As with a lot of scientific issues, mental illness cases were examined and documented relating to individuals involved in warfare. The next case in this series pertains to war amnesia after WWI – which was 96 years ago. The article discusses dissociation and its causes.
“Amnesias in War Cases” by Douglas A. Thom, M.D., Captain, Medical Corp, U.S. Army, and Norman Fenton, A.M., Sergeant, Medical Corp, U.S. Army”
“There was no question of these soldiers being psychotic or neurotic prior to their loss of memory. The fact that in two of these cases the memory was completely restored by the use of psychotherapy again emphasizes the importance of psychic trauma in the causation of amnesia. The attempt will be made here to show the relation of the war amnesia to the process of dissociation.”
“The psychologist usually thinks of dissociation as some abnormal process manifesting itself only in unusual situations and not as an aspect of the normal mental life. The fact of dissociation runs a long gamut in mental life from just the dismissal of things from the mind to the abnormal condition of multiple personality.”
“In the cases of war neuroses, one of the great etiologic factors is the duality of consciousness – the presence of fear and pride opposed to each other and gradually wearing down the individual’s resistance. The exceptionally great strength of the dissociative function in these cases derives from the fact that the men were living upon an instinctive plane and consequently that the dissociative process functioning purely developed an exceptional potency.”
“In civilian life one can develop the capacity of having two ideas in the mind at once – or for lesser periods, one idea and some unrelated emotion – but two emotions cannot reside harmoniously for long without seriously affecting the individual’s well-being. Then, in this abnormal state of over-stimulation (or response), as these war cases illustrate, this dissociative process throws itself into the gap and rescues the mind from destruction. It serves a basic protective purpose – and its adequacy in preserving the individual is evidenced, positively, in cases where intolerable ideas or experiences were thrust from the mind.”
“This is shown by the man who was picked up in Paris completely amnesic. At Base Hospital 117, he cleared up under treatment and told of having belonged to an outfit in which the men abused him horribly. Malingering was eliminated in this case. Negatively, one recognizes certain cases in which the dissociative process did not function, or wherein the stimulus overwhelmed the individual – as in the war psychosis. A typical case illustrating this is that of a lad whose buddy was decapitated as he was running toward him to come along. Shortly thereafter, he was hospitalized as a psychosis. The case entered Base Hospital 117 confused with ideas of persecution and other psychotic symptoms, but with an ever-present vivid recollection of this experience, and was evacuated to a mental hospital some time later very little improved.”
“An interesting question arising here is whether the physiological accompaniments of fear-cessation of respiration and heartbeat, paralysis of bodily movement, glandular, hyperactivity and so forth – are sufficiently potent to produce unconsciousness. Of course, there are numerous incidents in civil life where persons viewing accidents faint and may remain unconscious for some time. This is probably what occurred (with the added fact of concussion). An later, upon return to semi-consciousness with the recurrence of emotional excitement, the dissociative process related to the self-preserving instinct asserted itself by eliminating with one effort the whole of the patient’s memories of his experiences.”
“In the great majority of war amnesia, especially those following concussion, there was a residual amnesic period which could not be recovered. This usually related to time following the concussion and before they came to themselves in a hospital, a period of varying length during which they were dull or confused.”
It is sad to note that society’s cultural notions in the early 20th century about the origins of mental illnesses, along with the admonition that men were not to show emotional distress, caused a lot of harm – as it continues to do in today’s society. After WWI in which 8 million men died, men began to break down in shocking numbers. Many men began to act like hysterical women; they screamed and wept uncontrollably. They froze and could not move. They lost their memory and capacity to feel.
Initially, the symptoms were attributed to a physical cause – the effects of exploding shells caused a nervous disorder called “shell shock.” Gradually, even though the name stuck, it was determined this was a psychological trauma response. Soldiers were shamed and threatened, though, with a court martial and were thought of as cowards.1 Not much has changed. Even today, 96 years later, with soldiers returning from war diagnosed with PTSD, they are still shamed to not reveal their psychiatric distress, just like we are as survivors. The lack of treatment for them is unconscionable. With more of us, as survivors, speaking out, hopefully one day we can turn this disrespectful behavior around for us.
1 Jewish World Review, June 25, 2002