The Romance of American Psychology "nsd0e1934"

4 Nervous in the Service

1. Edward A. Strecker and Kenneth E. Appel, "Morale," American Journal of Psychiatry 99 (September 1942):159.

2. Ibid., 160.

3. The best general secondary source on psychiatry in World War II is Greene, "The Role of the Psychiatrist in World War II." Another useful summary is Grob, From Asylum to Community, chap. 1. Key primary sources are Menninger, Psychiatry in a Troubled World, and U.S. Army, Medical Department, Neuropsychiatry in Worm War II, 2 vols., ed. Albert J. Glass (Washington, D.C.: Office of the Surgeon General, Department of the Army, 1966). In different ways, each of these sources offers evidence that World War II precipitated a radical shift in the concerns of clinicians: from mental illness to health, from prediction to prevention, from the individual to the environment.

4. Donald S. Napoli, Architects of Adjustment: The History of the Psychological Profession in the United States (Port Washington, N.Y.: National University Publications, 1981), 103.

5. Sol L. Garfield, "Psychotherapy: A 40-Year Appraisal," American Psychologist 36 (February 1981 ):174.

6. Steuart Henderson Britt and Jane D. Morgan, "Military Psychologists in World War II," American Psychologist 1 (October 1946):427 (tables 6 and 8), 428; Watson, "A Brief History of Clinical Psychology," 339-340.

7. Quoted in Menninger, Psychiatry in a Troubled World, xiv.

8. Ibid., xiv.

9. Comparative statistics on World War I and II psychiatry can be found in Menninger, Psychiatry in a Troubled World, chap. 23.

10. Castel, Castel, and Lovell, The Psychiatric Society, 45; Purcell, The Crisis of Democratic Theory, 98-99; Samelson, "Putting Psychology on the Map,"

123; Samelson, "World War I Intelligence Testing and the Development of Psychology," 277-278.

11. Menninger, Psychiatry in a Troubled World, 17, 254.

12. Ibid., 7.

13. Southern Psychiatric Association, "Report of Its Committee on Psychiatry and the National Defense," Psychiatry 3 (1940):619.

14. Ibid., 620.

15. William C. Menninger, "A Condensed Neuropsychiatric Examination for Use by Selective Service Boards," War Medicine 2 (November 1941):851.

16. Martin Cooley, "The Economic Aspect of Psychiatric Examination of Registrants," War Medicine 2 (May 1941 ):376-378.

17. Southern Psychiatric Association, "Report of Its Committee on Psychiatry and the National Defense," 619.

18. Menninger, "A Condensed Neuropsychiatric Examination for Use by Selective Service Boards," 843-853.

19. Selective Service System, Medical Circular No. 1, "Minimum Psychiatric Inspection," revised, May 1941, Journal of the American Medical Association 116 (3 May 1941):2060.

20. Ibid., 2061.

21. Medical Bulletin No. 58, issued in April 1941, quoted in Greene, "The Role of the Psychiatrist in World War II," 66.

22. Arthur Weider, Keeve Brodman, Bela Mittelmann, David Wechsler, and Harold G. Wolff with the technical assistance of Margaret Meixner, "Cornell Service Index: A Method for Quickly Assaying Personality and Psychosomatic Disturbances in Men in the Armed Forces," War Medicine 7 (April 1945):209-213.

23. For a chart contrasting the psychiatric screening program as it was designed with how it was actually conducted, see Greene, "The Role of the Psychiatrist in World War II," 171. See also Harry Stack Sullivan, "Psychiatry, the Army, and the War," Record Group 1.1, series 200A, box 117, folder 1444, RF Archives.

24. Albert Deutsh, "Military Psychiatry: World War II, 1941-1943," in One Hundred Tears of American Psychiatry (New York: Columbia University Press, 1944), 426.

25. Ibid.

26. All statistics in this paragraph are from Menninger, Psychiatry in a Troubled World, 341-343, app. D. Just as the four-volume work The American Soldier (1949) presented and analyzed the survey data gathered by the Research Branch of the army's Morale Division on soldiers' attitudes, another postwar multivolume work interpreted military personnel and medical records in order to discover why 2.5 million individuals had been rejected or discharged for psychological reasons. See Ginzberg, The Ineffective Soldier, 3 vols.

27. Statistics in this paragraph are from Menninger, Psychiatry in a Troubled World, 114, chap. 23, app. D, 587-588; Greene, "The Role of the Psychiatrist in World War II," 187-191,253, 277.

28. Greene, "The Role of the Psychiatrist in World War II," 210-211, 282-284; Menninger, Psychiatry in a Troubled World, 39-40. For an example

in which such statistics could not be cited, see Roy R. Grinker and John P. Spiegel, Men Under Stress (Philadelphia: Blakiston, 1945), viii.

29. Gordon Allport, for example, wrote the following about a former student of his who had just been drafted: "Although I am not a psychiatrist and should not like to be quoted as diagnosing a case, I should way [ sic ] that he is hysterical, sexually compulsive, lacks self control and breaks down in minor crises. He seems to me to be exactly the type of psycho-neurotic who will hinder rather than help national defense. The case is of interest because the same newspaper [that mentioned the student] featured the fact that 1/5 of the draftees were being rejected for physical reasons by army doctors. I suspect that only a small per cent of these physical defects were in fact as serious a liability as my former student's neurosis." Gordon Allport to Lawrence K. Frank, 30 November 1940, HUG 4118.10, folder: "1944-45 Frank, Lawrence K.," GA Papers.

30. Menninger, Psychiatry in a Troubled World, 293.

31. Ibid., 460.

32. Alan Gregg, "Lessons to Learn: Psychiatry in World War II," American Journal of Psychiatry 104 (October 1947):219. For data on the incomes of neuropsychiatrists, relative to other physicians during the 1930s and early 1940s, see Menninger, Psychiatry in a Troubled World, 433 n. 34.

33. Alan Gregg to Franklin Ebaugh, 28 September 1943, Record Group 1.1, series 200A, box 109, folder 1345, RF Archives.

34. For example, see William C. Porter, "The School of Military Neuropsychiatry," American Journal of Psychiatry 100 (July 1943):25-27.

35. The term "visiting fireman" is from Franklin Ebaugh to Alan Gregg, 28 February 1944, Record Group 1.1, series 200A, box 109, folder 1346, RF Archives. For other documents related to this program, see Walter Bauer to Alan Gregg, 4 January 1944, Record Group 1.1, series 200A, box 109, folder 1346; William Menninger to Robert Morison, 11 April 1946; RF grant action 46073, Record Group 1.1, series 200A, box 110, folder 1355, RF Archives.

36. Alan Gregg, "A Critique of Psychiatry," American Journal of Psychiatry 101 (November 1944):291.

37. Grob, From Asylum to Community, 17; and Gary R. Vandenbos, Nicholas A. Cummings, and Patrick H. Deleon, "A Century of Psychotherapy: Economic and Environmental Influences," in History of Psychotherapy: A Century of Change, ed. Donald K. Freedheim (Washington, D.C.: American Psychological Association, 1992), 76.

38. Menninger, Psychiatry in a Troubled World, 459.

39. Lawrence J. Friedman, Menninger: The Family and the Clinic (New York: Alfred A. Knopf, 1990), esp. chaps. 7 and 9.

40. Lewis Terman, quoted in Samelson, "Putting Psychology on the Map," 105.

41. Napoli, Architects of Adjustment, 90.

42. Bray, Psychology and Military Proficiency, 49.

43. Gilgen, American Psychology Since World War II, 173.

44. Capshew, "Psychology on the March," 73-75.

45. Walter V. Bingham with James Rorty, "How the Army Sorts Its Man Power," Infantry Journal 51 (October 1942):28-29.

46. For example, see Carleton W. Leverenz, "Minnesota Multiphasic Personality Inventory," War Medicine 4 (December 1943):618-629.

47. Menninger, Psychiatry in a Troubled World, app. D, 592, 597.

48. Capshew, "Psychology on the March," 102. For an enthusiastic description by a psychologist of "a patient-directed 'talking-out session' on the Carl Rogers model" near the German front lines, see Stephen T. Boggs to Gordon Allport, 24 March 1945, HUG 4118.10, folder: "Boggs, Stephen T. 1958-61," GA Papers.

49. James G. Miller, "Clinical Psychology in the Veterans Administration," American Psychologist 1 (June 1946):182.

50. Britt and Morgan, "Military Psychologists in World War II," 423-437, see esp. tables 6, 8, and 21.

51. Sullivan, "Psychiatry, the Army, and the War."

52. Roy R. Grinker and John P. Spiegel, War Neuroses (Philadelphia: Blakiston, 1945), 115, emphasis in original.

53. Menninger, "The Role of Psychiatry in the World Today," 570.

54. Menninger, Psychiatry in a Troubled World, 340. The term "everyman" is used in Grinker and Spiegel, Men Under Stress, vii.

55. Menninger, Psychiatry in a Troubled World, 55, emphasis in original.

56. Ibid., 352.

57. Grinker and Spiegel, Men Under Stress, 411.

58. Menninger, Psychiatry in a Troubled World, 38, 344.

59. Technical nosologies were radically altered by the war. For detailed comparison and definition of various types of war neuroses, see Grinker and Spiegel, Men Under Stress, and Menninger, Psychiatry in a Troubled World, app. B. See also Gerald N. Grob, "Origins of DSM-I: A Study in Appearance and Reality," American Journal of Psychiatry 148 (April 1991 ):427-430.

60. Menninger, Psychiatry in a Troubled World, app. B, 557. In appendix D, Menninger placed the following note under a chart documenting the percentages of neuropsychiatric admissions in various diagnostic categories: "Stress Often So Severe in Army That Psychiatric Reactions Develop in Normal Men."

61. Not enough time remained in the war to determine whether or not this policy prevented or reduced mental trouble. Years later, some evidence from the Vietnam War indicated that fixed one-year tours of duty may have contributed to dramatically lower rates of psychiatric disorder. See Robert E. Huffman, "Which Soldiers Break Down: A Survey of 610 Psychiatric Patients in Vietnam," Bulletin of the Menninger Clinic 34 (November 1970):346-347.

62. Menninger, Psychiatry in a Troubled World, 84.

63. Grinker and Spiegel, Men Under Stress, 181.

64. Ibid., 39.

65. Strecker and Appel, "Morale," 162.

66. Kenneth Appel, report to Eighth Service Command, June 1944, 4a-4b, Record Group 1.1, series 200A, box 110, folder 1348, RF Archives. For descriptions of one such effort that integrated lectures about adjustment with visual material, see R. Robert Cohen, "Factors in Adjustment to Army Life: A Plan for Preventive Psychiatry by Mass Psychotherapy," War Medicine 5 (February 1944):83-91, and "Visual Aids in Preventive Psychiatry," War Medicine 6 (July 1944):18-23.

67. Edwin Boring, "Psychology for the Common Man," 30, presidential address written in summer 1945 for the Eastern Psychological Association, HUG 4229.80, EB Papers.

68. Ibid., 36.

69. "Sell" was the word Edwin Boring used, in quotation marks. See Edwin Boring to T. D. Stamps, 27 February 1943, HUG 4229.5, box 48, folder 1065, EB Papers. For a summary of the book project, see the description of the Subcommittee on a Textbook in Military Psychology in Dallenbach, "The Emergency Committee in Psychology," 526-530. A general discussion of the effort can be found in Capshew, "Psychology on the March," chap. 5.

70. National Research Council, Psychology for the Fighting Man (Washington: The Infantry Journal, 1943), 300-301, 410-412.

71. Edwin Boring to Alice Bryan, 27 January 1943; and Mildred Atwood to Boring, 15 December 1942, HUG 4229.5, box 8, folder 168 and box 44, folder 949, EB Papers.

72. National Research Council, Psychology for the Fighting Man, 12.

73. Ibid., 339.

72. National Research Council, Psychology for the Fighting Man, 12.

74. Ibid., 336.

75. The best source on homosexuality during World War II, which gives a starting role to military psychiatrists, is Allan Bérubé, Coming Out Under Fire: The History of Gay Men and Women in World War Two (New York: The Free Press, 1990), esp. chaps. 1, and 5-6.

76. "Neuropsychiatry in the Army," Journal of the American Medical Association 121 (3 April 1943):1155.

77. National Research Council, Psychology for the Fighting Man, 340.

78. Ibid., 304.

79. Roy R. Grinker, St., Fifty Years in Psychiatry: A living History (Springfield, Ill.: Charles C. Thomas, 1979), 81.

80. John Dollard, Fear in Battle (Washington, D.C.: The Infantry Journal, 1944), and "Twelve Rules on Meeting Battle Fear," Infantry Journal 54 (May 1944):36-38. Fear in Battle , which incorporated results of research done with three hundred veterans of the Abraham Lincoln Brigade of the Spanish Civil War, was originally published in 1943 by the Yale Institute of Human Relations. It was funded by the Rockefeller Foundation but used by the army. See, for example, John Dollard to Samuel Stouffer, 28 April 1943, and John Dollard to Samuel Stouffer, 25 May 1943, HUG (FP) 31.8, box 2, folder: "Yale University," SS Papers.

81. Dollard, "Twelve Rules on Meeting Battle Fear," 38.

82. Ibid., 37.

81. Dollard, "Twelve Rules on Meeting Battle Fear," 38.

83. Ibid., 38.

84. Strecker, "Presidential Address," 2.

85. Ibid.

86. Roy D. Halloran and Malcolm J. Farrell, "The Function of Neuropsychiatry in the Army," American Journal of Psychiatry 100 (July 1943): 17.

87. This delayed delivery of on-site mental health services was avoided entirely in Vietnam, where clinicians relied heavily on the World War II learning curve in spite of the many important differences between the conflict in South-

east Asia and the earlier world war. Clinicians accompanied troops into the field from the very beginning of military escalation in 1965 and focused their efforts on environmental manipulation and preventive techniques. Lower psychiatric casualty rates, at least until late 1969, led leaders of the clinical effort to conclude that "the American soldier in Vietnam has generally been psychologically healthier than his counterpart in previous wars." Edward M. Colbach and Matthew D. Parrish, "Army Mental Health Activities in Vietnam, 1965-1970," Bulletin of the Menninger Clinic 34 (November 1970):339.

88. Grinker and Spiegel, War Neuroses, 70.

89. Grinker and Spiegel estimated that the drug was used on 50 percent of all their psychotherapeutic patients. See Grinker and Spiegel, Men Under Stress, chap. 17. For another general discussion of "narcosynthesis," see Grinker and Spiegel, War Neuroses, 78-86. Essentially, the idea behind narcosynthesis was that by inducing semiconsciousness, sedatives would prompt patients to reexperience the traumatic events in a therapeutic setting, bring repressed anxieties to consciousness, and allow the damaged ego to gather strength and heal.

90. Menninger, Psychiatry in a Troubled World, 305-307.

91. Grinker and Spiegel, Men Under Stress, 348, emphasis in original.

92. Ibid., 218.

91. Grinker and Spiegel, Men Under Stress, 348, emphasis in original.

93. Ibid., 158.

91. Grinker and Spiegel, Men Under Stress, 348, emphasis in original.

94. Ibid., 368.

95. Menninger, Psychiatry in a Troubled World, 451.

96. Grinker and Spiegel, Men Under Stress, 149.

97. Menninger, Psychiatry in a Troubled World, 451, emphasis in original.

98. Henry W. Brosin, "The Army Has Learned These Lessons," quoted in Grob, From Asylum to Community, 18, emphasis in original.

99. Menninger, Psychiatry in a Troubled World, 410.

100. The term "pensionitis" is taken from B. M. Baruch's report to Gen. Omar Bradley, director of the Veterans Administration, on 16 August 1945, quoted in Menninger, Psychiatry in a Troubled World, 391. The cost of pensions based on psychiatric discharges was a significant concern among policy-makers. In 1946, 60 percent of all cases in Veterans Administration hospitals were psychiatric and they cost $40,000 or more per case. As of June 1947, all the neuropsychiatrically disabled vets from World War I and World War II combined were receiving pensions costing the government $20 million each month. Jeanne L. Brand, "The National Mental Health Act of 1946: A Retrospective," Bulletin of the History of Medicine 39 (May-June 1965):236-237; and Menninger, Psychiatry in a Troubled World, 380.

101. Daniel Blain, "Programs of the Veterans Administration for the Physical and Mental Health of Veterans," Bulletin of the Menninger Clinic 10 (March 1946) 34.

102. Gregg, "A Critique of Psychiatry," 291.

103. Franz Alexander, "What Can Psychiatry Contribute to the Alleviation of National and International Difficulties? A Symposium," American Journal of Orthopsychiatry (October 1941 ):619.

104. Alexander, Our Age of Unreason, 235.

105. Strecker, Beyond the Clinical Frontiers, 199.

106. Lawrence K. Frank, "Freedom for the Personality," Psychiatry 3 (August 1940):349.