Lectures on War Neuroses
- Type:
Book Reviews
- Author:
Ross, M.D.,
F.R.C.P. Pp.116. Edward Arnold & Co. 6s.
Very little that is new about War Neuroses emerged during the first eighteen months of the present struggle. Wars change their pattern. Medicine progresses by fits and starts. And no one is yet entitled to say in what way, if at all, concepts of mental illness will be modified by the experiences of the present war years.
Dr Ross, whose sudden death occurred just after this small book went to press, was specially qualified to speak to those battalion medical officers and general practitioners for whom these lectures were designed. He had worked as a general practitioner himself. He had been a medical officer in the last war, and he had treated patients suffering from neuroses, mainly army officers, in the present war. In the period between the two wars he had established himself as one with a practical and direct approach to mental illness which featured the individual’s reaction to his situation rather than an emphasis on unconscious conflicts.
The plan of the book is simple and it contains much that is good sound common sense. A preliminary chapter gives the author’s views on the causes, symptoms, including somatic symptoms, and diagnosis of neurosis. The next chapter is entitled Acute War Neuroses, and here several pages are devoted to the subject of prevention, Colonel Rogers’s description of the duties of a battalion M.O. being quoted. There are special sections dealing with the treatment of specific phenomena such as paralysis, mutism and amnesia. The two final chapters on Chronic War Neuroses follow the same general scheme with sections on symptoms followed by others on treatment.
Some of the explanations put forward are not very convincing. To say for example that neurotic exhaustion is an indication that the patient is bored, or has a fear of consequences, or even that it is a sign of emotional distress, does not seem to do more than to classify it as a symptom. And Dr Ross was apt to be critical of the use of certain medical or psycho- logical terms without always suggesting what should take their place. Shell-shock, of course, D.A.H. understandingly, and Effort Syndrome less effectively are condemned. He would apparently tell patients with functional tachy- cardia that there was nothing whatever the matter with their hearts, but he does not attempt to suggest any reason why the heart should be singled out for disturbance, except to say that there are fashions in symptoms.
In conclusion a few special points may be referred to. Dr Ross is insistent on the importance of not allowing cases of acute neurosis to become chronic. As to in-born factors he says, ” We cannot alter heredity, but we can do much to correct errors of education.” He points out that there are neuroses of army life as distinct from warfare. An individual may, for example, break down when he finds himself called upon to undertake duties which his civilian experience, his ability or his lack of ability has not fitted him. And he suggests that the reason why there is more neurosis in the R.A.F. among the ground staff than the flying personnel is the responsibility felt by those who service the planes for the safety of those who fly them. H.C.S.
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