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This paper is based on some 1,000 hours of psychotherapy with cases of combat reactions to the October 1973 war. It attempts to place combat reactions in a certain psychoanalytic light and to further our psychoanalytic understanding through a minute analysis of the processes that underlie them. As I want more to share my clinical impressions and conclusions than to argue formally about certain psychoanalytic concepts and theories, I shall merely describe the processes involved, without a formal reference to the widely known literature on combat reactions or to the relevant psychoanalytic terminology and theory.
Most discussions in the literature on combat reactions (henceforth CR) generally follow two lines of thought. They are (1) attempts to find suitable treatments for symptoms through objective, concrete, and precise descriptions, comparisons, and analyses; or (2) attempts to understand the patient's subjective experience—during and after the trauma—in order to find connections with previous experiences and personality characteristics.
The treatment of a large number of CR cases has demonstrated, first of all, two widely known points: with all its precision, bordering sometimes on measurement, the critical disadvantage of the objective approach comes from its very nature—that the patient is seen only from the outside and the therapist is essentially no more than a (systematic) observer; on the other hand, despite the outstanding advantages of the subjective approach its vagueness and overgeneral analysis of the material is more than disappointing. The therapist receives only secondary help from attributing to the war such effects as: “a change in the patient's view of life”; “a sudden change in the patient's reference