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… Alone among men have I passed down through the gateway of Death and returned again. Mine eyes have looked upon the unseen things. Mine ears have heard the unspoken words. …
It was in the 'Three Contributions to the Theory of Sex' (1905) that Freud characterized the dual aspect of traumatic neuroses (TN), when, following the discussion of the influence of mechanical stimuli upon sexual processes, he added the remark:
This is where we have to mention the fact—not understood so far—that by the concurrence of fright with mechanical shaking the serious hysteriform of traumatic neurosis is produced. It may at least be assumed that these factors, which at a low intensity form a source of sexual excitement, cause a far-reaching disorganization of the sexual mechanism or strength.
It was not until the end of World War I, that it was recognized that this hysteriform neurosis, notwithstanding the hysterical appearance of its symptoms, is, in its essential parts, a narcissistic, ego-neurosis (11), (14), (16), (35).
In some of the earlier clinical text-books, the traumatic neurosis is, as a rule, described as 'traumatic hysteria', in other words a subspecies of hysteria. It has always been a difficult problem in these attempts at classification, to explain the far-reaching and persistent disorganization of the personality. In addition, frequent organic complications in the general picture of traumatic neuroses presented innumerable diagnostic riddles. Often the delimitation of psychogenic as against organic components is almost impossible. Some idea of the difficulties may be gained from the comprehensive review by Brun (4), who also takes into consideration the psycho-analytic concept of the problem.
The formerly common practice of indemnification experts of identifying psychogenic factors with a conscious wish to profit from the accident and consequently to reject them, has long been proved to be without scientific foundation (14). It would appear that in World War II t