Neuroses in war-time : memorandum for the information of the medical profession / Ministry of Pensions.

Date:
1940
Catalogue details

Licence: Public Domain Mark

Credit: Neuroses in war-time : memorandum for the information of the medical profession / Ministry of Pensions. Source: Wellcome Collection.

    3/8 (page 3)
    not easily be understood and was too often adopted by the medical profession itself as a diagnosis for any functional nervous disorder ap- pearing in soldiers during the war. Such was the appeal of the word “shell shock” that this class of case excited more general interest, attention and sympathy than almost any other, so much so that it is feared that it became a most ae complaint from which to suffer. Most of these ‘neuroses occurred either in the form of an anxiety state or as hysteria. Anxtety states reveal a common characteristic—the constant presence of fear or anxiety accompanied by vasomotor and visceral concomitants to a greater or lesser extent. Some are cases of mild type in which the anxiety is simply a prolongation and exaggeration of the natural anxiety experienced by everyone when exposed to war conditions. The feeling of fear is the normal reaction to threatened danger when the impulses activated by the instinct of self preservation are aroused, but these impulses have to be kept under control if an exhibition of cowardice is to be avoided. The source of this anxiety is very commonly the fear of being found afraid and the fear that control of these natural impulses, which are regarded as shameful, will not be forthcoming when the occasion arises. In some instances natural anxiety is aroused by the fears connected with loss of business and other financial and domestic worries caused by the dislocating effects of war. In cases of more severe type the condition is induced by morbid anxiety in which there is no apparent logical connection between war experiences and the symptoms of anxiety. In such cases the anxiety is out of all proportion to the apparent exciting cause or it may appear to have no obvious cause at all, though rationalisation on the sufferer’s part may seem to account for it. In most of such cases it is experienced as a diffuse state of emotional tension undirected to any specific object or situation and causes a state of fearful expectation, the patients being described as “‘ anxious ” and “ apprehensive.” Ina few predisposed cases the anxiety reaction is characterised by the development of phobias, or the anxiety may be transferred from its original object to some other situation which appears to the patient to afford reasonable grounds for apprehension, or to preoccupations of a hypochondriacal type. It may be accompanied at the outset _ by some degree of depression, or depression may be a secondary development after the anxiety has been concentrated. on the symptoms themselves and a vicious circle has been set up. Hysteria, more than any other form of mental reaction, provides the clearest example of the onset of neurosis due to failure of adaptation as the result of conflict between individual needs and social requirements. Suggestion is the most important factor as a cause for the symptoms. Physical manifestations of severe emotional disturbance such as mutism and tremors, or the effects of a minor physical injury producing some temporary loss of power in the maa are readily perpetuated as hysterical symptoms by means of HMO