Rationalization of war memories: Returned to duty.
Case 506. (Rivers, February, 1918.)
A young English officer was wounded just as he was extricating himself from burial in a mass of earth. He became nervous and sleepless and lost his appetite. After the wound had healed, he was sent home on leave, which had to be extended as he got worse. An out-patient in London for a time, he was finally sent to a convalescent home, still troubled with insomnia, battle dreams and concern about his recovery. He made light of his condition and was on the point of being returned to duty by the medical board, when his sleeplessness led to his being sent to Craighlochart War Hospital.
He could not sleep without a light in the room, else every sound attracted his attention. He tried hard all day long to banish all unpleasant and disturbing thoughts, but at night it took him a long time to get to sleep and then came vivid dreams of warfare. He did not, himself, feel that he could ever forget the war scenes.
Rivers, in general believing that the attempt to banish such experiences absolutely from the mind is poor psychotherapy, narrated his views to the patient. Rivers advised him no longer to try to banish the memories, but to try to transform them into tolerable, if not pleasant, companions. The war experiences and anxieties were talked over. That night the man had the best night he had had for five months, and during the following week the sleeplessness was no longer so painful and distressing. If unpleasant thoughts came, they had to do rather with home life than with the war. General health improved; insomnia diminished. He was at last able to return to duty.