Nerves of War

Basically, it isn't so much the heat of battle that makes a soldier break down and become psychoneurotic; it's a combination of past woes and the sympathy he knows he'll get behind the lines. Later, pensions seem to help make the neuroses last longer. So says Dr. Lothar B. Kalinowsky, research psychiatrist at Columbia University's College of Physicians & Surgeons, after a careful study of the war neuroses in various armies.

The German army was a good laboratory example, Dr. Kalinowsky told the annual convention of the American Psychiatric Association in Detroit last week. After World War I, which produced many "shell-shock" cases, German psychiatrists concluded that the neuroses were caused less by battle experiences than by secondary mental processes, e.g., the wish to escape from danger, and resentment of comfortable civilians. By 1926, pensions were a factor in these neuroses. Thereafter, Germany denied pensions to many shell-shock victims.

As one proof that this policy worked, Dr. Kalinowsky points to the retreat of the shattered Nazi armies from Stalingrad in the bitter winter of 1942-43: "Many soldiers were unable to continue due to physical exhaustion, but hysterical symptoms were extremely rare. They did not promise any gain, and failure to stay with the group could lead only to death from exposure or, at the best, to imprisonment by the Russians." Delayed reactions after the soldier was safe were more common but usually did not last long--again, because there was nothing to gain.

The German army experience was matched in other countries where the civilian population was under fire. Even the heaviest bombings in the Battle of Britain had negligible effects on the mental health of civilians: there was nowhere for them to escape to, and no hope of compensation. Significantly, children evacuated to "safe" areas posed greater mental problems than those who stayed under the full force of the blitz.

Dr. Kalinowsky finds some sad contrasts in the U.S. Army's experience. Mental misfits might be expected to have been weeded out in the induction stage (when 38% of medical rejections were for neuropsychiatric reasons). Yet 49% of all disability separations from the Army were neuropsychiatric or for "personality difficulties." The Kalinowsky conclusion: there should be more study of the likelihood that pensions perpetuate the very disabilities for which they are granted; if they were ended, many war neuroses would end with them.

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