TRAUMATIC neuroses have long been a troublesome medical and forensic problem. When the matter of financial compensation (gain) is involved, the question immediately arises: Are we dealing with a compensation neurosis? Is there a difference between a traumatic neurosis and a compensation neurosis? If so, what is that difference? In other words, when a person exhibits a set of functional nervous symptoms after an accidental injury and the person responsible for the injury has a financial obligation to the victim of the accident, how can one assess the respective roles played by emotional trauma per se, on the one hand, and by the unconscious desire for financial remuneration, on the other? In order not to confuse the issues involved in this question, I shall eliminate from this discussion any consideration of malingering, i. e., conscious simulation of symptoms for the sole purpose of gaining financial or other forms of profit. However, even with this limitation, one is still left with a group of cases which neither fall into the group of traumatic neuroses nor have the characteristics of a compensation neurosis. I shall call these conditions the "attitudinal pathoses." 1 Since World War II the world has been neurosis minded. The literature on traumatic neurosis and its allied conditions is encyclopedic, and much of the ter¬ minology is confusing, unsatisfactory and inadequate. For this reason, I shall attempt to clarify our ideas of traumatic neurosis and compensation neurosis and then add what I believe to be a new operational concept that is both necessary and useful.
TRAUMATIC NEUROSISKardiner 2 states that the importance of traumatic neurosis is due not only to the severe incapacities which result from it, but also to the many and complicated forensic problems which it brings in its wake. The chief of these problems is that of compensation. The essence of the traumatic neurosis is not an organic lesion but a failure in the victim's total possibilities for adaptation. In other words, the traumatic neurosis is "psychogenic," i. e., the resultant of conflicting forces or drives within the personality structure of the individual. Dynamically, the traumatic neu¬ rosis is a reaction not specifically related to the type of injury which caused it. Therefore, it is misleading to designate a neurosis according to the provoking situ-
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