Anxiety Neurosis in Combatants

Symonds on fear and Post Traumatic Stress Disorder (PTSD)

“…In 1941, Symonds' objections to the term LMF encouraged its replacement by 'lack of confidence', a slightly less stigmatizing term (Jones, 2006). With the assistance of his junior colleague, Denis Williams, and a station medical officer in Bomber Command, Donald Reid (who would be co-authors of the Air Ministry reports), Symonds resorted to clinical research to challenge the prevailing practice, believing that evidence was required to support the view that if fear dominated the mind to the exclusion of other emotions it became a morbid and pathological state (Symonds, 1943c).…”

“…But he was concerned about the inability and inaccuracies of clinicians, particularly non-specialists, to make this differentiation. Elaborating on these issues in his third lecture, Symonds (1943c) broadly conceptualized a fear form of anxiety neurosis. The frightened flyer, who had developed fear after a succession of appalling catastrophes, also developed anticipatory fear about operational flying, became preoccupied by situational cues enhancing these emotions, though endured until exhausted and either reported sick or attracted the concerns of superiors or comrades.…”

“…Symonds criticized Southborough's conclusions, highlighted the rarity of cases of lack of confidence, and firmly concluded that these men were not waverers deserving managerial ridicule. Symonds (1943c) acknowledged that what was generally called 'anxiety neurosis in combatants' had its origin in a state of morbid fear, and was an ingrained response to fear. As to how a normal state, that of fear, gave rise to a morbid state, a neurosis, was in that period popularly hypothesized in psychodynamic concepts, the conflict being between the instinctual forces of duty, self-respect and loyalty on the one hand and self-preservation on the other.…”

“…During the previous war, Rivers (1917) had modified the Freudian model of war neurosis, suggesting that it was self-preservation, not sex, that was the frustrated instinct, which was contained by repression and/or sublimation. Symonds (1943c), using the analogy of pain, maintained that an anxiety state may develop as a direct result of overstimulation of the fear mechanism, and commented that this was common in war though rare in civilian life. Furthermore, as observed in acute physiological trauma, an asymptomatic or latency period could occur because of complete or partial inhibition, and reflection and anticipation of danger may also be potent stimuli evoking fear.…”

“…Sir Charles Putnam Symonds (1890Symonds ( -1978, the distinguished London neurologist who worked at Queen Square Hospital, made significant, though under-appreciated, contributions to the psychiatric literature on the consequences of experiencing danger and psychological trauma. During World War II, Symonds published a trilogy of articles based upon his presentations of the Dunham Lectures at Harvard University in March 1943 and two Croonian Lectures before the Royal College of Physicians in May 1943 (Symonds, 1943a(Symonds, , 1943b(Symonds, , 1943c. This body of work was consequent to his wartime medical service which involved psychological investigations of operational aircrews.…”

Symonds on fear and Post Traumatic Stress Disorder (PTSD)

“…In 1941, Symonds' objections to the term LMF encouraged its replacement by 'lack of confidence', a slightly less stigmatizing term (Jones, 2006). With the assistance of his junior colleague, Denis Williams, and a station medical officer in Bomber Command, Donald Reid (who would be co-authors of the Air Ministry reports), Symonds resorted to clinical research to challenge the prevailing practice, believing that evidence was required to support the view that if fear dominated the mind to the exclusion of other emotions it became a morbid and pathological state (Symonds, 1943c).…”

“…But he was concerned about the inability and inaccuracies of clinicians, particularly non-specialists, to make this differentiation. Elaborating on these issues in his third lecture, Symonds (1943c) broadly conceptualized a fear form of anxiety neurosis. The frightened flyer, who had developed fear after a succession of appalling catastrophes, also developed anticipatory fear about operational flying, became preoccupied by situational cues enhancing these emotions, though endured until exhausted and either reported sick or attracted the concerns of superiors or comrades.…”

“…Symonds criticized Southborough's conclusions, highlighted the rarity of cases of lack of confidence, and firmly concluded that these men were not waverers deserving managerial ridicule. Symonds (1943c) acknowledged that what was generally called 'anxiety neurosis in combatants' had its origin in a state of morbid fear, and was an ingrained response to fear. As to how a normal state, that of fear, gave rise to a morbid state, a neurosis, was in that period popularly hypothesized in psychodynamic concepts, the conflict being between the instinctual forces of duty, self-respect and loyalty on the one hand and self-preservation on the other.…”

“…During the previous war, Rivers (1917) had modified the Freudian model of war neurosis, suggesting that it was self-preservation, not sex, that was the frustrated instinct, which was contained by repression and/or sublimation. Symonds (1943c), using the analogy of pain, maintained that an anxiety state may develop as a direct result of overstimulation of the fear mechanism, and commented that this was common in war though rare in civilian life. Furthermore, as observed in acute physiological trauma, an asymptomatic or latency period could occur because of complete or partial inhibition, and reflection and anticipation of danger may also be potent stimuli evoking fear.…”

“…Sir Charles Putnam Symonds (1890Symonds ( -1978, the distinguished London neurologist who worked at Queen Square Hospital, made significant, though under-appreciated, contributions to the psychiatric literature on the consequences of experiencing danger and psychological trauma. During World War II, Symonds published a trilogy of articles based upon his presentations of the Dunham Lectures at Harvard University in March 1943 and two Croonian Lectures before the Royal College of Physicians in May 1943 (Symonds, 1943a(Symonds, , 1943b(Symonds, , 1943c. This body of work was consequent to his wartime medical service which involved psychological investigations of operational aircrews.…”

Symonds on fear and Post Traumatic Stress Disorder (PTSD)

“…In 1941, Symonds' objections to the term LMF encouraged its replacement by 'lack of confidence', a slightly less stigmatizing term (Jones, 2006). With the assistance of his junior colleague, Denis Williams, and a station medical officer in Bomber Command, Donald Reid (who would be co-authors of the Air Ministry reports), Symonds resorted to clinical research to challenge the prevailing practice, believing that evidence was required to support the view that if fear dominated the mind to the exclusion of other emotions it became a morbid and pathological state (Symonds, 1943c).…”

“…But he was concerned about the inability and inaccuracies of clinicians, particularly non-specialists, to make this differentiation. Elaborating on these issues in his third lecture, Symonds (1943c) broadly conceptualized a fear form of anxiety neurosis. The frightened flyer, who had developed fear after a succession of appalling catastrophes, also developed anticipatory fear about operational flying, became preoccupied by situational cues enhancing these emotions, though endured until exhausted and either reported sick or attracted the concerns of superiors or comrades.…”

“…Symonds criticized Southborough's conclusions, highlighted the rarity of cases of lack of confidence, and firmly concluded that these men were not waverers deserving managerial ridicule. Symonds (1943c) acknowledged that what was generally called 'anxiety neurosis in combatants' had its origin in a state of morbid fear, and was an ingrained response to fear. As to how a normal state, that of fear, gave rise to a morbid state, a neurosis, was in that period popularly hypothesized in psychodynamic concepts, the conflict being between the instinctual forces of duty, self-respect and loyalty on the one hand and self-preservation on the other.…”

“…During the previous war, Rivers (1917) had modified the Freudian model of war neurosis, suggesting that it was self-preservation, not sex, that was the frustrated instinct, which was contained by repression and/or sublimation. Symonds (1943c), using the analogy of pain, maintained that an anxiety state may develop as a direct result of overstimulation of the fear mechanism, and commented that this was common in war though rare in civilian life. Furthermore, as observed in acute physiological trauma, an asymptomatic or latency period could occur because of complete or partial inhibition, and reflection and anticipation of danger may also be potent stimuli evoking fear.…”

“…Sir Charles Putnam Symonds (1890Symonds ( -1978, the distinguished London neurologist who worked at Queen Square Hospital, made significant, though under-appreciated, contributions to the psychiatric literature on the consequences of experiencing danger and psychological trauma. During World War II, Symonds published a trilogy of articles based upon his presentations of the Dunham Lectures at Harvard University in March 1943 and two Croonian Lectures before the Royal College of Physicians in May 1943 (Symonds, 1943a(Symonds, , 1943b(Symonds, , 1943c. This body of work was consequent to his wartime medical service which involved psychological investigations of operational aircrews.…”

Symonds on fear and Post Traumatic Stress Disorder (PTSD)

“…In 1941, Symonds' objections to the term LMF encouraged its replacement by 'lack of confidence', a slightly less stigmatizing term (Jones, 2006). With the assistance of his junior colleague, Denis Williams, and a station medical officer in Bomber Command, Donald Reid (who would be co-authors of the Air Ministry reports), Symonds resorted to clinical research to challenge the prevailing practice, believing that evidence was required to support the view that if fear dominated the mind to the exclusion of other emotions it became a morbid and pathological state (Symonds, 1943c).…”

“…But he was concerned about the inability and inaccuracies of clinicians, particularly non-specialists, to make this differentiation. Elaborating on these issues in his third lecture, Symonds (1943c) broadly conceptualized a fear form of anxiety neurosis. The frightened flyer, who had developed fear after a succession of appalling catastrophes, also developed anticipatory fear about operational flying, became preoccupied by situational cues enhancing these emotions, though endured until exhausted and either reported sick or attracted the concerns of superiors or comrades.…”

“…Symonds criticized Southborough's conclusions, highlighted the rarity of cases of lack of confidence, and firmly concluded that these men were not waverers deserving managerial ridicule. Symonds (1943c) acknowledged that what was generally called 'anxiety neurosis in combatants' had its origin in a state of morbid fear, and was an ingrained response to fear. As to how a normal state, that of fear, gave rise to a morbid state, a neurosis, was in that period popularly hypothesized in psychodynamic concepts, the conflict being between the instinctual forces of duty, self-respect and loyalty on the one hand and self-preservation on the other.…”

“…During the previous war, Rivers (1917) had modified the Freudian model of war neurosis, suggesting that it was self-preservation, not sex, that was the frustrated instinct, which was contained by repression and/or sublimation. Symonds (1943c), using the analogy of pain, maintained that an anxiety state may develop as a direct result of overstimulation of the fear mechanism, and commented that this was common in war though rare in civilian life. Furthermore, as observed in acute physiological trauma, an asymptomatic or latency period could occur because of complete or partial inhibition, and reflection and anticipation of danger may also be potent stimuli evoking fear.…”

“…Sir Charles Putnam Symonds (1890Symonds ( -1978, the distinguished London neurologist who worked at Queen Square Hospital, made significant, though under-appreciated, contributions to the psychiatric literature on the consequences of experiencing danger and psychological trauma. During World War II, Symonds published a trilogy of articles based upon his presentations of the Dunham Lectures at Harvard University in March 1943 and two Croonian Lectures before the Royal College of Physicians in May 1943 (Symonds, 1943a(Symonds, , 1943b(Symonds, , 1943c. This body of work was consequent to his wartime medical service which involved psychological investigations of operational aircrews.…”