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CLINICAL
FORUM
327
or it was judged that no further progress was possible. They were then
generally discharged from the Army and sent home or transferred to a
veterans’ hospital.
In
a few cases, they returned to limited duty, which
was not combat-related.
Dissatisfied with the restrictions of suggestive hypnosis,
I
began
searchingforways to integratehypnosiswithmy beginning psychoana-
lytic experience, which emphasized the achieving of insight. At that
time, publications by Kubie (1943), Simmel(1944),
and
Wolberg (1945)
were about the only publications available on hypnoanalysis.
I
first
focused on the technique of abreaction.
Abreaction
In
case after casewhen the patient proved hypnotizable, a regression
to his battle experiences and the abreactive reexperiencing of them
resulted in a striking
loss
or mitigation of symptoms, such as anxiety,
nightmares, depressions,dissociations, and hysterical paralyses.
A
protocol of procedures for the initiating and carrying through of
abreactionswas gradually developed. It involvedmuch more than sim-
ply suggesting the patient back into combat and inducing him
to
reexperience his fear, rage, suffering, or guilt. Although these
abreactions were initiated in many dozens of patients, not once was a
psychotic reaction precipitated nor did there appear to be any case in
which the abreaction itself retraumatized the patient,
a
question I have
been repeatedly asked ever since. During this same period, a number of
more complex hypnoanalytic techniques were developed that are
reported in Watkins (1949,1992).
Abreaction has usually been defined as an emotionally corrective
experience involvinga reexperiencingof trauma and a release of bound
affect.It may alsobe regarded as the completionand closureof an unfin-
ished gestalt or, as Kubie (1943) put it, of the “repetitive core” of a
neurosis.
It may be of value to describe a few cases typical of those seen in the
SpecialTreatment Company at Welch Hospital.
Neurotic Depressive Reaction, Severe
Sometimesthe released rage stemmedprimarily fromearlier transfer-
ence situations, although precipitatedby combat.
“Hilton” was hospitalized after
60
days of combat, and the following
traumas werenoted inhis chart:(a)bayoneting a sleepingenemy soldier,
(b)
machine-gunning another, and
( c )
watching
his
buddy being shot
through the stomachand killed. After the last event,hemanifested con-
tinuous depression and feelings of guilt, including suicidal preoccupa-
tion and bizarre battle dreams. Under hypnoanalysis, he disclosed
severe hatred and murderous impulses toward his father. These
impulses had been reactivated by his combat experiences.
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