Marjorie Van de Water: Unfit for fighting (1944)

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The Pittsburgh Press (April 3, 1944)

Unfit for fighting –
4 of every 10 disabled soldiers are victims of emotional wounds

Toll of mental and nervous illnesses greater than battle injuries
By Marjorie Van de Water

Mental and nervous illnesses take a greater toll in the armed services than war wounds, Marjorie Van de Water points out in the first of five articles dealing with the return home of men discharged as “NPs” – neuropsychiatric cases. In this series, Miss Van de Water, author of Psychology for the Fighting Man, shows how the mentally wounded should be handled.

Four or five men in every 10 discharged from the Army for disability are mentally or emotionally unfit.

This means that mental and nervous illness is responsible for a far greater loss of manpower to the Armed Forces than are battle wounds, influenza, malaria or any other single illness.

It is a serious problem for the Army. And it is a serious problem for the home front, too. For the people at home are wondering just what it means when a man is charged for neuropsychiatric reasons. Are such men mentally ill, insane? Are they going to act “queer”? Can they make good on civilian jobs?

Each month approximately 25,000 of these men will be coming back to American homes and looking for civilian jobs if the present discharge rate continues.

Majority neurotic

Most of the worry of families, friends and employers is due to a lack of information about the sort of person the Army is sending home for this reason.

The great majority of the neuropsychiatric discharges are men who belong in the first, the “neuro,” part of the classification. They are neurotic. Few actually suffer from mental diseases. Few need hospitalization after discharge, although many might profit from good psychiatric advice.

Up to the present time, at least, the great majority are men who have not seen services overseas. They have had their crackup after a few months, perhaps only a few weeks, of training. They do not fit into military life and cannot successfully adjust to it.

It is debatable whether they can blame their troubles on their Army experience. Certainly, it is true these men might have adjusted perfectly well in civilian jobs if the war had not uprooted them. Most of them will go back to civilian jobs and fill them quite adequately. A few undoubtedly would never be very successful in either civilian or military occupations.

Many just don’t fit

But the Army has no corner on neurotics; there are plenty in civilian life. They just become more conspicuous in the Army. In the first place, men are so closely associated in the Army that they have no “private lives.” The oddities of any one individual become matters of public knowledge and public concern. Then, too, many individual oddities and quirks of behavior cannot be tolerated in a military situation – they just do not fit in.

Think how many persons in civilian life suffer from “nervous indigestion” – cannot eat this or that. They have their own private stock of favorite “tummy treats” or “banish burn” in the bathroom medicine closet. The Army cannot issue soda mint. Nor can time-out be taken in combat to stir up something for that after-meal discomfort.

Neither can the Army afford to have soldiers subject to headaches, stomach ulcers, high blood pressure, heart palpitation, dizziness, or faintness. These are ills to which the neurotic is liable. All are aggravated by emotion, by worry, by overconscientious “stewing” over present and future problems.

Few result from fear

Some men can’t stand the sight of blood. They pass out cold. But unless that person wants to be a dentist or a butcher or a surgeon, this is not likely to interfere much with his job in civilian life. It will in the Army.

Few of the nervous troubles of men discharged from the Army during military training are due to fear of combat. Many more can be traced to worries and troubles at home. Financial worries, homesickness, hunger for affection and companionship, concern over sickness at home – these are the things that make a soldier crack up in camp or “go over the hill.”

No one who leaves a comfortable happy home enjoys the tough grind of military life. Strict discipline, hard work, lack of sympathy and being plunged into a large group of strangers are hard to take for the individual who is naturally shy and unable to make new friends easily. Everything is new to him. The sergeant yells at him. Nothing he does seems right. He is bawled out right and left by the noncoms and he is teased by the other men.

They try their hardest

After a while, he may begin to feel completely discouraged and defeated. He is sure he can never make good in this strange new life. It is too hard. Most men get through this stage all right. Gradually they catch on to all the things expected of them and begin to feel at home. They make friends. But a few remain dispirited. It really is too hard for them. They are not fitted to be soldiers.

It is not their fault. Usually, this type of man tries his utmost. But his best is not quite good enough for the stern demands made on him. So, the Army decides he would be much more good to the war effort in a civilian job in a war plant where men are badly needed, too.

NEXT: The man who cracks up in combat.

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The Pittsburgh Press (April 4, 1944)

Unfit for fighting –
Battle crackups aren’t yellow; they’ve endured beyond limits

Relatively simple cure is rest, sleep and removal from combat strains
By Marjorie Van de Water

The man who cracks up in combat is not yellow. He is no more a weakling than a man who receives a bullet wound or who develops malaria.

Every man has his limit, mentally and physically. Modern combat puts a maximum strain on the fighters, so that if a man is in the fighting long enough, even the strongest may reach the limit of his endurance.

Fortunately, the cure for such cases is relatively simple. The principal needs are for rest, sleep and to be away from he strains of combat.

Shell shock incorrect

These cases were called “shell shock” in the last war. The term is no longer in use, because it was so loosely used and misused that it lost all real meaning. “Shell shock” was originally intended to describe the condition resulting from the nearby explosion of a shell. The force of the explosion sometimes will injure the body issue and may cause brain concussion. This true shell shock now is called “blast concussion.”

The nervous condition of men who have had more of war than their nervous systems can tolerate has gained new names in this war. The men now speak of combat fatigue, flying fatigue, gangplank jitters, destroyer stomach, war nerves and other such descriptive names. Medical officers prefer not to use any of these names. To do so would imply it is a new disease not known in peace; actually, it is not. It is the natural consequence of too much strain.

NPs don’t act wild

So, the medical officers lump all such conditions under the broad term neuropsychiatric disability, abbreviated as NP, which means simply the disability is a mental or nervous condition. As a label, it tells no more about the nature of the disability than would the term physical disability if that were applied to all wounds and physical illnesses.

You needn’t expect the NP to act wild. Too often, in fact, it is not noticeable that anything is wrong with him, so that he may be distressed needlessly by stupid strangers who ask “Why aren’t you in uniform?”

The first sign you have that he has been under terrible strain may be when he starts to light a cigarette. You may notice then how his fingers tremble. It is difficult, too, for him to control his emotions at times. If painful subjects are brought up, he may leave the room abruptly or possibly even burst into tears. It is well to be careful about questioning him on how he won his decorations. Too often they recall to him the horrors of friends killed and mangled – the awful sights and odors of the battlefields.

Battle nightmares

A chief difficulty that may persist for months is the torture of “battle dreams” in which the soldier relives the terrible experiences of combat over and over again. Sleepless nights and dream-filled slumber may deprive him of rest, so that when morning arrives, he is worn out to start the day.

He may drink in the hope that alcohol will put him to sleep or make him forget the things it is so painful to remember. He may take drug sedatives for the same reason.

Another conspicuous symptom is an oversensitiveness to noise. The dropping of a pan, the banging of a door, or even a sudden noisy movement may make the soldier leap from his chair and set him trembling.

Sympathy and understanding

When he first comes home, he feels like an utter stranger. He realizes no one around him has any conception of the meaning of what he has gone through. He feels it is useless to speak of what has happened to him, because none of these people could possibly understand. He may resent the fact that the folks at home are not suffering as he has suffered, that they are gay and apparently lighthearted. He feels cut off from friends and family.

He needs sympathy and understanding, but no oversentimental pity. Above all, he needs the feeling that he can still contribute in an important way toward winning the war. This he is well-fitted to do, for no one knows more than he the importance and urgency of war plant work.

NEXT: Home, not battlefield, may cause breakdown.

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The Pittsburgh Press (April 5, 1944)

Unfit for fighting –
Home ties cause more breakdowns of soldiers than battlefield

Too many are tied to apron strings; others see themselves as unwanted
By Marjorie Van de Water

Clinging-vine and hateful relatives in the home are bad for a soldier’s morale, and Marjorie Van de Water points out in her third article on the Army’s neuropsychiatric cases, cause more breakdowns than the battlefields.

The home, not the battlefield, is the cause of breakdown for most of the men discharged from the Army as neurotic.

Combat can and does cause men to crack up. But the great majority of the men so far discharged have had their difficulties right here in this country, in the training camps.

The trouble with most of these men is that, although their birth certificates indicate they are of “military age,” their behavior shows they are boys not yet grown up emotionally.

Many are tied to the apron strings of mother, sister, wife or perhaps father. They are affectionate boys dependent upon some loved one and literally cannot get along without her.

So homesick they’re ill

Nearly all normal boys need the love and care of someone. Most boys who go into the Army are homesick now and then and long with a wistful pain for Main Street and the old back porch, or a certain flight of stone steps in the city. Nearly all are delighted with a letter from home or a snapshot. But the pain of separation from home and family is so intense for a few that it is impossible for them to put heart into their military duties. They sit and brood. They are actually ill. Finally, they have to be sent home.

It may not be the boy himself who is the dependent one. It may be the mother or the wife who is utterly helpless when the draft takes away the man of the house. If there is serious illness, or the roof leaks, the only solution seems to be to send posthaste for the man who is now in uniform. If he is not able to drop Uncle Sam’s affairs immediately and go to the rescue of those at home, he feels guilty and worried and the home folks feel deserted and sunk.

Blind leading blind

And sometimes the man in uniform not only is held back by the stranglehold of a clinging vine at home, but he is also helplessly dependent on the same persons who must lean on him. It seems a little like the blind leading the blind, but it often happens that the mother-son or husband-wife ties are so intimate and tight that neither can get along without the companionship and help of the other.

But not all the soldiers discharged for mental or emotional unfitness have such indulgent mothers or wives and happy, comfortable homes. Contrasted with this type are the men who never get mail from home, nor do they want it. They have no home worthy of the name – no place or person to look back on with loving memory or to look forward to with longing. They see themselves as unwanted children, resented by unwilling parents or hated by jealous brothers and sisters.

4 in 10 from broken homes

Anticipation of return to such a hateful spot may be harder for a soldier to face than are the hand grenades and rifle fire of the enemy. When the going gets extremely tough, he has less need to cling to life than has the man with affection awaiting him after victory.

And so it is the home – with demanding and dependent love, or with rejecting and embittering hate – that may out too much burden on the soldier and cause his breakdown.

NEXT: Soldier with NP discharge makes excellent worker.

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The Pittsburgh Press (April 6, 1944)

Unfit for fighting –
Army’s NP dischargees make excellent workers in war jobs

Consideration of employers and care in placing of men are needed
By Marjorie Van de Water

Men discharged from the Army for neuropsychiatric disability are employable. In fact, most of them will make excellent workers in essential war jobs. But they needed consideration on the part of employers and care in placement.

As a rule, these men feel badly at being out of the Army. They don’t want to go back into combat – they have had a little more of that than their nervous systems could tolerate. But neither do they want to be left out of things. They are eager to do whatever they can to hasten victory.

Some will not want to take a job right away. They want a little time to get reacquainted with their families, to hunt up old friends, to take a look at the old familiar places. If they feel this way, they shouldn’t be rushed into a job. Let them take it easy a while.

It is well for the employer to remember that the type of person who cracks up in military life is nearly always an overconscientious sort of person. The “goldbricker” manages to escape strain; it is the man who won’t shirk and who faces the music who is the one to break. When such a man wants a day or an hour off, you can be sure he really needs it.

Advice from psychiatrists

Here is some advice for employers, gathered from psychiatrists who have been caring for these men:

Don’t heap lots of responsibility on them. Work it in gradually as they grow more used to civilian life and feel stronger. Remember that it may take a year or two before the discharged soldier has recovered completely from what he has gone through.

If the man has come away from the Army oversensitive to noise, be careful not to employ him where he will be exposed to sudden, crashing noise. The hum of machinery may not bother him much, but clanging steel, the noise of riveting, sudden loud bells or whistles may be unbearable.

*Lonely jobs taboo

Don’t give him a job as night watchman in the mistaken but well-meaning notion that it will be light work for him. Loneliness and time for thought are just the things these men do not need. Give him a job where he will be active and pleasantly occupied every minute.

Most of these men do poorly on sedentary work. After an active life in the Army, don’t expect them to sit still at a desk all day long. If you give a man a desk job, plan frequent breaks that will give him a little leg-stretching exercise. Hard work out-of-doors such as farm work is the best possible sort for most of them. It gives them little time to think during the day and makes it easier for them to sleep at night.

Consult his work record

The worst possible type of work for the soldier discharged for neuropsychiatric reasons is that which entails long dull periods of slack work punctuated by peaks of exciting bustle and rush. This, after all, is what he could not stand up under in the Army. Waiting gives time for thinking and brooding. Thinking and brooding lead to depression and the blues. Then the brief spurt of rush work puts the man under acute strain for which he is not fit.

In deciding how the discharged soldier would fit into a particular business or manufacturing organization, the employer should be guided more by the man’s work record before he went into the Army than by any account of his illness or experience in service. If he has a record of failures, tardiness, absenteeism, illness, and temperamental differences with employers and fellow employees, the chances are not good that he will make a model employee now. But if his work records shows he was a steady, reliable worker before the war, you can count on him to be an asset to your company now, once the training and adjustment period is past.

NEXT: Family can help soldier back to health.

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The Pittsburgh Press (April 7, 1944)

Unfit for training –
Family, friends can help soldier to regain his full mental health

Don’t be tearful, managing, indulgent or dependent; use consideration
By Marjorie Van de Water

This is the last of a series on the Army’s neuropsychiatric soldier cases ands what their relatives, friends and employers can do to help them regain normalcy as they return home with medical discharges.

The mothers, wives, families and friends of men discharged from the Army for neuropsychiatric disability can do a great deal to help them back to full mental health.

The greatest dread of these men when they are in hospitals waiting to go back home is that their families will not be sensible about their disability.

Emotional and fond mothers become frightened and tearful over the “NP disability” diagnosis. Little, it would seem, is known about such mental or emotional crackups. All sorts of superstitions and misinformation are spread about and terrify relatives.

Remember, he’s not yellow

The following facts will help to blast these false notions.

Because a man breaks in combat or in training does not mean he is yellow. He is not a coward. He did not run. He stayed at his post and suffered the consequences, until he could stand no more.

A mental break in the Army is not the fault of the individual; it is not a reflection on the character of the man or his family. It is not due to a “taint.”

A mental illness, even a severe psychosis, is not necessarily permanent. Mental illnesses developing in military service are of shorter duration and more frequently result in recovery than illnesses of civilian life.

Most of the men discharged for NP disability do not require hospital care, although for many, good psychiatric advice is desirable where it is available.

Soul-searching by kin

Many men trace their emotional and nervous difficulties back to the kind of home they had before they went into the Army. Perhaps the folks at home were too dependent upon the soldier, or perhaps stood in the way of his striking out for himself and making his own decisions. or perhaps the home was unhappy due to friction with an uncongenial brother or sister, father or mother. A little soul-searching on the part of the returning soldier’s next of kin might result in changes in the home to make it a more favorable place for getting well.

Here are some specific suggestions to relatives, friends and fellow workers that will help the soldier to get well:

  • Don’t gush. Let the soldier know in every way that you are glad to have him home, but try to control the tears and kisses.

  • Remember he is a man. Mothers are inclined always to think of their sons as little boys. He may have been a boy when he left home, but after service in the Army, he is a man and wants to be respected as a man. Don’t try to boss him all the time or make his decisions.

  • On the other hand, don’t meet him at the front door with a thousand family problems for him to handle. You have existed without him when he was away; get along a little longer until he has time to get his bearings.

  • Don’t fuss over him and indulge him. He should not be allowed to dominate the rest of the family or wreck the lives of those who are well. They have their rights, too, and these should be respected. It is not good for the returning soldier – it will not help to restore his health – to make him a pampered pet.

  • Don’t have all the neighbors in for parties to show off the returned soldier. He may want to relax for a while in the comfort of being home with just the family around him. Take his wants into consideration, not just what you think he should want.

  • Don’t push him into a job. If he wants to rest a while, he probably needs it. Some men want to try themselves out on a job that is considerably below their abilities until they regain confidence. This is wise. Don’t coax him to get something better.

  • A few men come back feeling “high” and think they are able to do anything. They are likely to overestimate their strength and abilities and will tackle anything. Such men need a little steadying. And you should stand ready to mop up when the bubble bursts.

  • If the returning soldier’s home has not been happy for him, it is best to try to face that fact and do what you can to alleviate the condition. It may be best for him to live away from home. In that case, be sure he does not feel neglected. Let him know you are interested in him and want to do what is best for him. Sometimes it is possible for individuals to get along with relatives with a minimum of friction provided they are not thrown into constant daily contact with them.

  • Avoid oversolicitousness. Don’t make an invalid of the returning soldier. Work is the most healing medicine for sick spirits. Let him take part in the work of the home and the community. He wants to do this. Particularly does he want a part in war work. He is out of the Army, but he is still in the fight. Make good use of his services.

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