Another Case of Improvement after Cessation of Repression.The next case is that of an officer, whose burial as the result of a shell explosion had been followed by symptoms pointing to some degree of cerebral concussion. In spite of severe headache, vomiting, and disorder of micturition, he remained on duty for more than two months. He then collapsed altogether after a very trying experience, in which he had gone out to seek a fellow officer and had found his body blown into pieces, with head and limbs lying separated from the trunk.
From that time he had been haunted at night by the vision of his dead and mutilated friend. When he slept he had nightmares in which his friend appeared, sometimes as he had seen him mangled on the field, sometimes in the still more terrifying aspect of one whose limbs and features had been eaten away by leprosy. The mutilated or leprous officer of the dream would come nearer and nearer until the patient suddenly awoke pouring with sweat and in a state of the utmost terror. He dreaded to go to sleep, and spent each day looking forward in painful anticipation of the night. He had been advised to keep all thoughts of war from his mind, but the experience which recurred so often at night was so insistent that he could not keep it wholly from his thoughts, much as he tried to do so. Nevertheless, there is no question but that he was striving by day to dispel memories only to bring them upon him with redoubled force and horror when he slept.
The problem before me in this case was to find some aspect of the painful experience which would allow the patient to dwell upon it in such a way as to relieve it horrible and terrifying character. The aspect to which I drew his attention was that the mangled state of the body of his friend was conclusive evidence that he had been killed outright and had been spared the long and lingering illness and suffering which is too often the fate of those who sustain mortal wounds. He brightened at once and said that this aspect of the case had never occurred to him, nor had it been suggested by any of those to whom he had previously related his story. He saw at once that this was an aspect of his experience upon which he could allow his thoughts to dwell. He said he would no longer attempt to banish thoughts and memories of his friend from his mind, but would think of the pain and suffering he had been spared.
For several nights he had no dreams at all, and then came a night in which he dreamt that he went out into No Man’s Land to seek his friend and saw his mangled body just as in other dreams, but without the horror which had always previously been present. He knelt beside his friend to save for the relatives any objects of value which were upon the body, a pious task he had fulfilled in the actual scene, and as he was taking off the Sam Browne belt he woke with none of the horror and terror of the past, but weeping gently, feeling only grief for the loss of a friend.
Some nights later he had another dream in which he met his friend, still mangled, but no longer terrifying. They talked together and the patient told the history of his illness and how he was now able to speak to him in comfort and without horror or undue distress. Once only during his stay in hospital did he again experience horror in connexion with any dream of his friend. During the few days following his discharge from hospital the dream recurred once or twice with some degree of its former terrifying quality, but in his last report to me he had only one unpleasant dream with a different content, and was regaining his normal health and strength.”

 

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