The Nature and Treatment of Traumatic War Neuroses in Merchant Seamen: Daniel Blain and Robert G. Heath. Int. J. Psa., XXV, pp. 142–146.

Merchant seamen comprise a unique group in which the choice of work often represents a refuge from competitive life ashore. In treating such men, Blain and Heath warn against probing too deeply and stirring up the hornet's nest of unresolved prewar conflicts. War neuroses are divided into acute cases in which 'frustration of instinctual aggressive reactions to a real situation is outstanding', transitional phases, and chronic cases in which the war neurosis blends inseparably with the previously existing civilian neurosis. The acute war neuroses are so different from the ordinary peacetime conception of neurosis, so little tied in with conflicts interwoven with the personality, so similar in all afflicted individuals regardless of background, so strikingly without mental conflict, and so clearly a physiological disturbance, that the authors are tempted to remove them entirely from the category of neurosis.

The purpose of care at the rest center is to provide treatment before the chronic phase develops. Efforts are made to simulate a club rather than a hospital, and the attitude of old patients is that the mere coming to the rest center is sufficient to promote improvment so that newcomers feel duty bound to fall in line. Group therapy meetings encourage the men to speak openly of their illness and various subjects are discussed in an elementary manner with the aim of making the men realize that many of the physiological disturbances referred to as fear are normal reactions to danger about which no one need feel ashamed. Almost all the cases in the acute stage show an excellent response and so do many in the transitional phase. Cases showing conversion symptoms—of which the incidence is low—show gratifying results from hypno-suggestion, using sodium amytal intravenously combined with benzedrine by mouth, which produce a garrulous, euphoric hyper-sugggestible state.