Psychotherapy With Pentothal Narcosis requires psychiatric understanding and cannot be employed successfully as a means of reducing anxiety as though anxiety were a substance to be drained off. There must be an attempt to synthetize, using the assets of the personality after the stressful situation has been abreacted. The emphasis on the value of abreaction may lead to the assumption that it is the focal point of treatment, to the exclusion of matters which may be of greater significance. The patient may find it much easier to dwell on his combat experiences than on other current [or infantile, Ed.] situations. The psychiatrist may fall into this trap and be kept from discovering frustration which prevents recovery.
Psychiatric Nomenclature represents a conglomerate of terms with a wide latitude of classification of psychotic responses and a very limited and rigid classification of neurotic responses. Even among psychiatrists, there is a widespread lack of uniformity in the interpretation of various diagnostic categories. The Neuropsychiatry Consultants Division of The Surgeon General's Office, in attempting a revision of the diagnostic terminology, has held numerous conferences and solicited widely the opinions of leading psychiatrists in military and civilian life.
The term 'psychoneurosis' is to be dropped from the individual clinical records in army medical installations. In its stead, the physician will designate the specific type of psychoneurotic response, such as 'anxiety reaction', 'conversion reaction', 'compulsive obsessive reaction'. In addition to this term designating the syndrome, a brief statement on the personalitystructure and predisposition will be made, a brief statement on the external precipitating stress in the present illness, and finally an evaluation of the functional capacity of the individual to carry on in his last assignment. By this method it is believed the psychiatrist will of necessity be more specific and will be required to formulate a more complete picture of the patient in terms understandable even to a layman.
Psychoneuroses Among Officers is a matter of grave concern, not because of their frequency, but because of the effect they have on the other personnel of an organization. There are officers, temperamentally anxious, who in a comparatively short time develop exhaustion [transient anxiety states, Ed.] or a psychoneurosis during periods of battle. Such cases should be reclassified before harm is done, and all commanders must be vigilant to detect such cases by visiting regimental commanders, and as many battalion and company commanders as possible, daily during combat. Officers who are reclassified because
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of mental instability or inability to stand the pressure of combat are usually undesirable as officers in any capacity. Best results are obtained when there is a very close relationship between neuropsychiatrists, the inspector general, and the division commander. Good psychiatrists should be placed in officer candidate schools to examine candidates throughout the course with a view to eliminating those who are unsuitable before they are commissioned.
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G., R. (1945). Bulletin of the U. S. Army Medical Department. Psychoanal. Q., 14:577-578