how did you feel up th wrong you say you've never been like this before take it easy you're all right you don't have to worry now you say you get something to make you sleep tonight and tomorrow you go back to another hospital for a while and get a good in and broke my rifle take me up and throw me off a ways yes go ahead guess iran es i haven't got it anymore you've had a common experience nothing to worry about your nerves are on edge you're right there's a that you get a chance to clean completely thank you relaxation and the return to normal social relations promote a general sense of wellbeing after a few days patient is interviewed again let's say you've been here three days now how do line one of the remaining patients who are more seriously s the further disposition of these cases is decided by the examining psychiatry trapped couldn't get out how do you feel right now  what were you afraid of what in particular what in particular well that people can hurt you with and i've been telling myself for years there you're going to be all right when you get back in addition to severe anxiety the patient is deeply depressed his speech and reactions are retarded and he has a characteristic feeling will require more extensive observation and treatment in a psychiatric installation further behind the fading from what do you mean broke down didn't know which way to turn ever had to cover before i was  how do you feel about leaving your men well i feel pretty bad about but i'm no good to them and i can sometimes called the old sergeant syndrome along with other severe casualties he's sent to installations in the army zone where additional facilities are available for prolonged psychiatric trea in the army zone a larger staff of psychiatrists is maintained to afford the individual attention to each patient the veteran sergeant is again interviewed i've been overseas about thirty months just  necessary for many of these cases however return to combat is often possible after further treatment the tough questions you know after what happened i really don't want to go back i think it's what unusual though the number of cases he returned to combat decreases sharply as prepayment is more removed from the front line but more severe cases require the consent forms of therapy  the retarded pay to live in later interviews is still depressed and anxious but his depression and feelings of guilt have lifted enough so that he is better able to respond to the end of the or what sort of a person were you as a can make any friends how did you react as a child to dead people oh and i couldn't look at how did they make you feel i've seen a lot of people with the same thing it'll take time if you're going to be all right this patient will need extended treatment at a hospital in the communication zone or if necessary in the zone of interior does he completes the chain of evacuation which started in the combat area from the frontlines the neuropsychiatric casualties were sent to a nearby clearing station for screening and  here approximately forty percent of all neuropsychiatric casualties were returned to full duty the remaining patients were evacuated to army installations where intensive treatment salvaged an additional twenty more serious cases were then sent back to the communication zone level at this level only one to two percent were returned to combat patients reassigned bringing the total from base and army level nearly thirty percent approximately ten percent of the original neuro psychiatric patients are evacuated to the continental united states this system of neuro psychiatric treatment battalion commanders are medical officers severe cases both combat and non combat are treated at the general hospital some of which are devoted exclusively to the care of your psychiatric patients here all techniques of psychotherapy are employed individual psychotherapy the personal contact between patient and psychiatry is the basic element of all treatment telling long nicely i want you to stay in the hospital for a while longer though i want to be sure that you're really good shape before you leave ok so i sure do feel better than when i first got here i want to get a combination and reassurance based upon an understanding of each individual's emotional conflict contributes fundamentally to the patient's recovery sometimes an emotional disturbance shows itself as a physical ailment and inner emotional distress has been converted into a form of paralysis which read right down on the floor remember everything you can remember everything go back to local now or tell me what you see tell me speak you don't want anymore now you want to forget it but you're going to remember it because it's gone now it's gone you're back here now you're away from okinawa you have forgotten it but you remember who you are now who are you that's right now your mother's name my father's name i mean that's fine you know who they all are now all right they're coming back with us now but this is going to say wh you will be comfortable may laugh away no pain but you'll remember everything i've told you all that you're a man under the guidance of the psychiatrist he is able to regard his experience in its cr perspective as a thing of the past which no longer threatens his safety and way now that the general hospital facilities are available for the most advanced electro shock therapy is remarkably effective with certain acute psych the continuous top treatment is also an effective method of sedation for severely disturbed cases the patient relaxes under constant observation in a scientifically regulated b individual treatment is supplemented by group activities particularly important is group psychotherapy let's think of it a little bit like this we want to get you out of your feeling of isolation therefore it is important that you learn to understand something of the basic cause of your distress that you learn to understood patients are given some information as to the cause of their condition and feeling of security in childhood here is a true jealousy and saw let's see if you can give some illustrations of this  i didn't a thing wrong that i was ashamed of i was always ashamed to go and tell my parents what i'd done that's about how i felt too and i kept it to myself if i did anything wrong and i know i used to be in a constant fear that my parents would find out when i was done well we both did about the same thing in other words you both used the same method to get relief from anxiety employment operators strong incentive supervised exercise affords a feeling of physical wellbeing but given take the competitive sport rebuild confidence in badly shaken personality continued individualized contact between doctor and patient oh hello there i was hoping you'd drop in for that thank you i hear you're for a long time this is a pretty big day in my life course it is i hate to see my prized patients leaving but what can i do well  summary and discharge not on the patient leaving the hospital after long treatment is an end product of the army's neuropsychiatric program this program deals with complex and difficult problems which have their beginnings where they are maybe again in the induction center at this early stage the first preventive step is taken to protect the individual as well as the careful screening assures that only the health of our civilians enter the s the preventive approach is implemented by an educational program and mental hygiene emphasis is placed on those facts which build and sustain the morale of army personnel when psychiatric breakdowns threaten or do occur or understanding and cooperation thus immediate recognition of early symptoms followed by prompt treatment from a rapid return to health until proven otherwise even the most serious cases are regarded as salvageable all these elements combine to make the most of the human resources that are the backbone of any army