Evening star., 1934-05-09
BY THOMAS r. HENRY.


Depression shock"-almost exactly
the same thing and working in the
same way as shell shock-is the latest
problem of the psychiatrist.
DR.. Roscoe Hall, clinical director OF
st. Elizabeth's Hospital, told about its
symptoms at the conference Of the
Washington Institute Of Mental Hy-
giene at the Church Of the Epiphany
today.
1t is the unconscious naturalization
of some minor ailment into dis
abling sickness in order to save the
self respect of the individual.
DIR. Hall has dealt with scores of
war shell shocks" Here. as he eX-
plains it, is approximately what hap
pened:
The man in actual combat service
was torn between two powerful in
stincts, one of self preservation and
the other for self esteem and social
approval He was in a position of
great danger. There were apparently
two alternatives. He could, by
strength of character. repreSS the in
stinct for self preservation and stay in
action. This was the way of the ma
jority. Or he could repreSs the almost
equally powerful desire for self re-
spect and social approval and run
away Few actually did this.
But there were some in whom both
instincts seemed to exert about equal
pulls. They found still a third way
out Of their difficulties. Sickness
would take them out of danger. At
the same time it was not so much of
a disgrace for a sick man to be taken
out of action. He could not be ex-
pected to fight. His services would
not be worth while anyway. So he
simply got sick-developed all sorts
of symptoms which puzzled the Army
doctors. who could find no organic
reason for them, but yet could not
deny the actual condition of the
victims
The "shell-shock' victim did not
"fake"-that is consciously. He may
or may not, have gone through the
kind of reasoning outlined above. The
chances are he didn't. 1t was all done
for him below the level of conscious
ness. The mechanism" says DR.
Hall, was unconsciously determined. -
The soldier would find himself sud-
denly with really paralyzed arm. or
something of the sort. He couldn't
tell what was responsible for it.
Neither could the doctors But there
it was-and it was sufficient to send
the victim back to the security of a
hospital.
The symptoms of Shell-shock were
hysterical. with little or no organic
basis. But if a man has a paralyzed
arm the effect is the same. whether
something is actually wrong with the
nerve supply to the limb or whether
the paralysis is ordered from the
mans own mind.
Most persons have something the
matter with them most of the time
anyway. Ordinarily it wouldn't maks
much difference. But when it is a
means of preserving life and self
respect it can be magnifed into a
malady of the gravest nature.
Depression Produces
Situation Like War.
Now the depression offers a situa-
ton quite analogous to war.
Under the American scheme OF
things it always has been considered
a disgrace not to be able to earn
ones own living A man suddenly
loses a job and is penniless. He has
two alternatives, the same as the
soldier. He can grit his teeth ano
go hungry-and, what is harder still
let his family 60 hungry. And he
can keep up the almost hopeless strug-
gle OF trying to find employment
This is analogous to staying in the
battle 1t is, appearances to the con-
trary. probably what the great ma
Jorlty Of Americans have done.
Or he can throw away his pride
and apply for public relief. This. in
the reasoning of many, is worse than
death. 1t is analogous to the run
ming away of the soldier. Or, still a
third way out, he can become i'll. II
is not so much of disgrace, at least
for man who is physically unable to
work to accept charity. The man
knows the futility of tramping the
SS- ~ eiAio dNSCPCiIlS dll SOItS O1 CRUDE
rebuffs and insults in his hopeless
search for work. Pride demands that
ne keep it up, regardless of the futility
OF 1t all. He can save his self-respect
by being too sick to tramp the streets
so, just as in the case of the soldier
MS unconscious mind either magnifie.
some existing physical defect OF
creates one with no organic basis al
all The process may be hastened BY
the TACT that the man seeks liquol
TO drown his troubles. This leads tc
more and more acrimonious recrimina
tlons from his wife and children, forg.
ing link in the vicious circle. The
ilquor also, it is possible, disorganize.
MS nervous system to the point where
1t is easier for the subconscious ra.
tlonalization mechanism to assert it.
self.
These depression shock" cases ar.
coming to the clinics in greater anc
greater numbers the longer the eco
nomic stress continues.
Present Doctors Face Same
Problems as in War.
Dr. Hall has encountered many o.
the depression cases-both on tht
clearly pSychotic level at st. Eliza.
beth's and on the normal level at tn,
Life Adjustment Center of the Noun
Pleasant Congregational Church
where he is member of the psychi.
atric staff
The most clearly marked condition
he says, is anxiety which he described
as the most comprehensive of al
fears, causing a distress probably
equalled by no other form of human
suffering"
1t is characterized by horrible night.
mares, fear of living and fear of dying
suicidal drives and horrible visions o.
burning forever in He'll, contemplation
OF a helpless, unwanted old age, anc
scores of other terrors.
What can the doctor do about 1T
He is in as bad situation as ths
Army doctor, DR.. Hall pointed out
The one couldn't change the demand.
and dangers of war for the conven.
ience of his patients. The other cam
remove the fundamental cause.-the
depression. The best remedy would bt
to get the sufferer a iOb-and that.