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The inclusion of “Return of the Repressed: Delayed Stress Reaction to War” by Lawrence Kolb in the 50th anniversary volume offers a discussion of the condition that had been named only three years earlier in the DSM III as post-traumatic stress disorder. Traumatic neurosis, shell shock, and war neurosis had begun to be discussed in the late 19th century. In 1921 Freud wrote the prologue to an edited book called Psychoanalysis and the War Neuroses, puzzling that war neuroses did not fit with his sexual theory of neuroses.
Kolb was a Navy veteran who had served in World War I. His distinguished career included 21 years as chair of the Department of Psychiatry at Columbia University. He then served as commissioner of the New York State Department of Mental Hygiene, where he made many reforms. He was a gifted and idealistic leader whose obituary in the New York Times underlined his accomplishments in public health. He did not begin his studies of how combat stress could lead to chronic illness until he was in his early 70s. At the Albany Veterans' Administration Hospital Kolb studied over 100 men with illness from wartime, most from the Vietnam War.
Although not a psychoanalyst, Kolb wrote in this article a highly sophisticated account of the ideas psychoanalysts had proposed about war neurosis.
Kolb was interested in using abreaction as an intervention for the chronically ill young men he encountered in the VA. The protocol was to induce with intravenous barbiturates a twilight state, then provide a brief sound of combat. This often caused the patient to go into a brief dissociative state where the forgotten memories could be recovered. Kolb offered a case vignette of a young Black Airman First Class,