Rationalization of war memories.
Case 507. (Rivers, February, 1918.)
An English officer was buried by shell explosion and developed severe headache, vomiting and disorder of micturition, yet remained on duty for more than two months. Collapse came when he went out to seek a fellow officer and found the body blown to pieces, with head and limbs severed from the trunk. This vision haunted him in dreams. Sometimes the officer appeared as on the battlefield; again as leprous. The officer would come nearer and nearer in the dream, until the patient woke pouring with sweat and in utmost terror. Accordingly, he was afraid to go to sleep, and spent all day thinking painfully about the night to come. Advice to keep all thoughts of war out of mind merely brought the memories in sleep upon him with redoubled force and horror.
Rivers’ therapy was to draw attention to the fact that the terrible mangling proved conclusively that the officer had been killed outright and without pain. The officer said he would now no longer attempt to banish the thoughts and memories of his friend, but would concentrate on the pain and suffering his friend had been spared. No dreams at all came for several nights, but one night in his dream he went out into No-Man’s-Land and saw the mangled body, but without horror. He knelt down, as he had in the original experience, and woke as he was taking off the Sam Browne belt to send to the relatives. A few nights later came another dream in which he talked with his friend. There was but one more dream in which horror occurred.
Rationalization of war memories: Eventually unfitted for military service.
Case 508. (Rivers, February, 1918.)
A young English officer, after doing well for a period, was rendered unconscious by shell explosion. The first thing he remembered was being led by his servant towards his base, thoroughly broken down. He had headaches, sleeplessness, war dreams and spells of terrible depression appearing with absolute suddenness, unlike ordinary “blues.” For ten days in hospital no such attack appeared, but one evening he came to Rivers pale and anxious. A few minutes before, he had been writing a letter in his usual mood, when this causeless depression came on. In the afternoon he had walked about on some neighboring hills. The letter dealt with no depressing matter. In ten minutes the depression vanished. Nine days later another came as he was standing idly looking out of a window. The attack lasted for several hours, as no physician was present to meet the issue. If he had had a revolver he would have shot himself.
Rivers was inclined to interpret these gusts of depression as due to a forgotten but active experience. As there was no definite tendency to dissociation, Rivers hesitated to plunge in with the hypnotic method, nothing short of which, however, served to recall the incident. The man was gravely apprehensive about fitness for further service, and was repressing his fear, as he thought it either was cowardice or would be called cowardice. The patient, by his discussions with Rivers, had already become familiar with the idea that the gusts of depression might be due to a submerged experience. Perhaps, however, there had been no experience, and the patient was advised that possibly the thing repressed was the idea about fitness for service. Accordingly, the patient agreed to face the situation. One transient attack of morbid depression occurred, after an operation. Then the man fell into a state of anxiety neurosis such that he was passed by a medical board as unfit for military service.