Bulletin of the Menninger Clinic. LI, 1987: Unmasking the Illusions of Safety: Psychic Trauma in War. Col. John A. Shaw. P. 49-63.

The author examines psychic trauma that occurs as the consequence of the over-whelming external stress of combat. Applying psychoanalytic theory to the study of 150 cases of combat stress, he finds that three intrapsychic processes are involved in the response to such trauma: narcissistic defenses, denial, and the illusion of safety. The myth of personal invulnerability, the illusion of safety in which narcissistic omnipotent defenses figure prominently, is a striking feature of the mental life of soldiers. The mechanism of denial is combined with a sense of group cohesiveness to support this illusion. The experience of actual warfare attacks this illusion, and at a certain traumatic moment the defense fails. This challenges the whole intrapsychic system that had helped the subject believe in his eventual survival. This is a developmental crisis from which the individual may remobilize his defenses and integrate a realistic, combat-effective outlook in which mature superego functions figure prominently. If, however, the defenses continue to fail, a full traumatic stress disorder ensues. The author explores the implications of these findings for both military and civilian psychiatry.