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.