Shades of Gray (1948)

pretty tough how did you feel up there I don't I don't know all mixed up in my in my head I just S I lost control you say you've never been like this before never before smoke Bill Brown's anxiety reaction is fairly severe and is characterized by tremer and manifestations of Panic Take It Easy you're all right you don't have to worry now you're safe here you get something to make your sleep tonight then tomorrow you go back to another hospital for a while and get a good rest Kelly yes sir Bill Brown has had it tough but with time and Care his basically sound personality will reassert itself in a second case the anxiety symptoms are milder tell me Soldier what's your trouble well sir up on the line we got into pretty heavy shelling couple of my men were killed then another shell came in broke my rifle picked me up and threw me off a ways yes go ahead I I guess I ran must have had 150 yards ahead of the company then what happened when I came to the uh liutenant was shaking me I I was crying don't remember much after that how do you feel now shaky inside now what do you mean I can't can't exactly explain it feel it more inside than I than I do outside kind of boiling feeling how long have you been in Combat 9 months now sir have you been wounded once how did you feel after you were wounded before I was wounded I I wasn't jumpy after that I was very jumpy guess I haven't got it anymore where I used to you've had a common experience nothing to worry about your nerves nerves are on edge you're frightened we'll see that you get a chance to clean up get some hot chow and rest here reassurance is essential the patient must understand that his case is Not Unusual and that it is nothing to be ashamed of he's told that he will recover soon and completely that's all thank you [Music] sir in the division area the patient rests and relaxes under the supervision of experienced medical personnel here sleep and plentiful regular meals exercise their beneficial effect relaxation and a return to normal social relationships promote a general sense of well-being after a few days the patient is interviewed again let see you've been here three days now how do you feel pretty good I calm down a little bit feel a little bit better I had a fairly good sleep last night have any medicine to make you sleep no sir slept well without it yes sir how do you feel about going back to your unit again think you could do a job well sir I think I can good you'll be ready for that in 4 or 5 days I'm sending you to our retraining unit we'll get some marches exercise and work out with your equipment sound okay yes sir what you've had was like a safety valve a way of letting off steam everybody has it anything else no sir those patients that show a speedy and definite Improvement are moved to an adjacent area here they receive a short course of exercise and combat training then they're ready to rejoin their unit in the field about 40% of all combat Neuropsychiatric casualties were returned to full Duty after short-term treatment near the front lines but what of the remaining patients who are more seriously [Music] sick the further disposition of these C is decided by the examining psychiatrist what's your trouble go ahead you can tell me can't stand seeing people getting killed I can't hear you can't stand seeing people killed where did you see people killed um in front what happened up there men on forward slope Germans started shelling trapped couldn't get out go on what happened I was lucky hit under the bridge started shelling again I went crazy started running how do you feel about that leaving your buddies should be in stock cave how do you feel right now all right nothing wrong with me what were you afraid of everything what in particular what in particular dead dead what dead people I can't hear you can't stand seeing dead people what does that do to you excuse me well dead people can can't hurt you but I've been telling myself for years that can't stand look at her carpel I'm going to send you back to another hospital where you can get some rest and treatment in a couple of days you'll begin feeling better how does that sound to you anything would back up there now look look you're going to be all right when you get back in addition to severe anxiety the patient is deeply depressed his speech and reactions are and he has a characteristic feeling of guilt he will require more extensive observation and treatment in a psychiatric installation farther behind the fighting front often a seasoned Soldier reaches the breaking point after many months of Duty what happened well I've been going quite a long time without any trouble but now the shelling gets me how long have you been in the Army 34 months how much combat I went through Africa B tuno Ando up to there ever lose any combat time no sir mhm you've had about 320 days then yes sir how long have you been a sta Sergeant I think about 4 months have you done a good job at it yes sir until now I'm no good now what do you think's wrong with you now sir I feel I've gone about as far as I can go feel I've taken about not enough do you think you're sick no sir but just no good anymore can't stand shelling last time up there broke down what do you mean broke down didn't know which way to turn ever had this trouble before no sir how do you feel about leaving your men well I feel pretty bad about it but I'm no good to them anymore I can't leave them I might get them killed or get them wounded just no good this is a typical example of chronic anxiety sometimes called the old sergeant syndrome along with other severe casualties he is sent to installations in the Army Zone where additional facilities are available for prolonged psychiatric [Music] treatment in the Army Zone a larger staff of psychiatrists is maintained to afford individual attention to each patient the veteran Sergeant is again interviewed I've been overseas about 30 months just how did the shells affect you Sergeant well they affected me pretty bad it seems I gone as far as I can and cracked up but how do you feel now as long as I'm not under Fire okay Sergeant uh how do you think it'd work out on another job uh say a Depo can you do that I think so sir reassignment is necessary for many of these cases however return to combat is often possible after further [Music] treatment here is Bill Brown after 3 weeks come around nicely bill I thought you would well I didn't oh not for a time anyway by the way you ever hear from any of the men in your old outfit well no male but a well a couple of the fellas did stop in to see me Bill how was it seeing those fellas again did it make you feel that you wanted to get back with them that's a tough question you know after what happened I really don't want to go back but I think it's what I ought to do you feel you'd be all right on full Duty took a lot to knock me out the first time I guess I'll do as well as an next-man Bill Brown's recovery Is Not Unusual although the number of cases returned to combat decreases sharply as treatment is more removed from the front lines but more severe cases require intensive forms of therapy just relax take it easy and do what I tell you here is an Amnesia case who has forgotten everything that happened since he was blown out of his Foxhole this won't hurt you count slowly now 1 2 3 the injection of a sedative allows the patient to relive his battle experiences and with the doctor's help face them [Music] again3 j4 [Music] now Alan you're on the battlefield the shells are coming in what's that shell duck get in the hole shs are bursting all around where are you where are you everybody's dead what happens now take the ridge and lose a lot of men in the company the ger surrender they throw their guns away ask for cigarettes they want to look at our knives say comrades comam rades hell you shoot my best buddy watch the shells get me out of here Tom Tom I'm here what happened after you captured the [Music] ridge well I have to go back there again you'll be all right you're safe now safe now wake up wake up now you were in a lot of trouble you're better now shells didn't hurt you this treat when employed early reduces the danger of chronic Neurosis although not a magic cure all it often produces dramatic results with the acute Neurosis resulting from the stress of battle let's see corpal the patient in later interviews is still depressed and anxious but his depression and feelings of guilt have lifted enough so that he is better able to respond to the interviewer what sort of a person were you as a child wasn't sick much had a inferiority complex are you B just what do you mean well when I was a child I didn't think I was as good as anybody else did you go in for sports and play with other children oh no sir I was a trouble I I couldn't make any friends how did you react as a child to dead people oh I I couldn't look at him how did they make you feel I couldn't stand anything bad did you ever get into a fight oh no sir I never cared for fights I saw a man killed once on a street flight head hit the curb just lay there they covered him up I was scared they scared to tell my parents had nightmar bed for years how old were you then she was about six did anything like that ever happen again not until I got into combat what do you think is wrong with you I don't know so everything seems kind of hopeless well it's not as bad as you think I've seen a lot of people with the same thing it'll take time but you're going to be all right this patient will need extended treatment at a hospital in the communication zone or if necessary in the zone of interior thus he completes the chain of evacuation which started in the combat [Music] area from the front lines the neuros psychiatric casualties were sent to nearby clearing stations for screening and treatment [Music] here approximately 40% of all Neuropsychiatric casualties were returned to full Duty the remaining patients were evacuated to Army installations where intensive treatment salvaged an additional 20% a large number were reassigned to limited service more serious cases were then sent back to the communication Zone own level at this level only 1 to 2% were returned to combat patients reassigned bring the total from base and army level to nearly 30% approximately 10% of the original Neuropsychiatric patients are evacuated to the continental United States this system of Neuropsychiatric treatment afforded early and intensive care it returned a large proportion of soldiers to combat and salvaged many for useful reassignment but for the more serious cases the next step is evacuation and the long Voyage [Music] Home back home the patients that don't need hospital care are sent to Convalescent Hospital where both combat and non-combat cases lead a normal Barrack's life under the supervision of specially trained Personnel the Battalion commanders are medical officers severe cases both combat and non- combat are treated at the general hospitals some of which are devoted exclusively to the care of Neuropsychiatric patients here all techniques of psychotherapy are employed [Music] individual Psychotherapy the personal contact between patient and psychiatrist is the basic element of all treatment well you coming along nicely Corporal I want you to stay in the hospital for a while longer though I want to be sure that you're in really good shape before you leave okay sir I sure do feel better than when I first got here I want to get back explanation and reassurance based upon an understanding of each individual's emotional conflict contribute fundamentally to the patient's recovery sometimes an emotional disturbance shows itself as a physical [Music] ailment here an inner emotional distress has been converted into a form of paralysis in this type of case treatment under Narcosis May yield extraordinary results here again the sedative is employed under the influence of the drug the patient's mind becomes more open and receptive while the patient is in this highly approachable State the doctor employs the power of suggestion to pave the road toward [Music] recovery now you're going to get right up and walk come on now sit up now get off the bed put your feet right down on the floor that's fine all right now stand up isn't that good all right now walk out there walk right over the ward man all by yourself go ahead you're doing fine all right now turn around and come back to meting come on now now I'm going to let you go back to sleep and when you wake up you're going to keep right on walking how about it thanks a lot do I don't a technique which is basically similar hypnosis is effective in treatment of Amnesia this man doesn't even remember his own name a shell burst in okanawa wiped out his memory the experience was unendurable to his conscious mind which rejected it and along with it his entire past but the unconscious memories remain through hypnotic suggestion the psychiatrist will attempt to uncover them you can remember everything you can remember everything they're back in okanawa tell me what you see tell me speak Battery area you're in The Battery area go on tell me what's going on getting our position Jeff's getting your position go on boys got taking away yes yes go on position yes you can remember it now tell me it's all right now you can tell me you can tell me explosion yes you remember an explosion now go on Carry Me cross the field cross the field go on putting me on a stretch yes yes all right go on let still throw let still throwing Shi go on you can see everything clearly now I'm a truck why are you fearful now don't want anymore you don't want anymore you want to forget it but you're going to to remember it because it's gone now it's gone you're back here now you're away from okanawa you have forgotten it but you remember who you are now who are you Bates that's right full name now Donald Bates Donald Bates that's right now your mother's name Margaret father's name Thomas that's fine you know who they all are now all right you're coming back with us now but this is going to stay with you you're going to remember it all you're going to remember about okanawa you're going to remember about the shells and the bombs out there they won't hurt you now you're at ease you're relaxed no fear no anxiety when I wake you you'll be comfortable relaxed no aches no pains but you'll remember everything I've told you you all that you've remembered under the guidance of the psychiatrist he is able to regard his experience in its true perspective as a thing of the past which no longer threatens his safety you can wait now well how are you Prett good now he can remember at the General Hospital all facilities are available for the most advanced treatment electroshock therapy is remarkably effective with certain acute [Music] psychoses The Continuous tub treatment is also an effective method of sedation for severely Disturbed cases the patient relaxes under constant observation in a scientifically regulated bath the wet pack treatment has a similar soothing [Music] [Music] effect individual treatment is supplemented by group activities particularly important is group Psychotherapy let's think of it a little bit like this we want to get you out of your feeling of isolation therefore it is important that you learn to understand something of the basic cause of your distress that you learn to understand the patients are given some information as to the cause of their condition and under skilled Direction discuss their difficulties helping each other to overcome the false sense of shame that often accompanies mental and nervous disorders your inner conflicts are with variations common to all men many of these conflicts start way back in early childhood no doubt you men will find it easy to recall things that disturb your feeling of security in childhood fears hatreds jealousies and soore let's see if you can give some illustrations of this kind well I did anything wrong that I was ashamed of I was always ashamed to go and tell my parents what I'd done well that's about how I felt too I I kept it to myself if I did anything wrong and I I know I used to be in a constant fear that my parents would find out what I was doing well you both did about the same thing in other words you both use the same method to get relief from anxiety in the occupational therapy shop art and craft work establish a new confidence through the satisfaction of a job well done some patients try their hands at Specialized vocational skills in which future employment offers a strong [Music] incentive supervised exercise affords a feeling of help and physical well-being the give and take of competitive Sports rebuilds confidence in badly shaken personalities as a Cooperative member of a group the patient soon begins to feel at home again entertainment and social activities are vital steps in the patient Readjustment to normaly and throughout there is the continued individualized contact between doctor and patient oh hello there come in I was hoping you'd drop in sit down thank you sir I hear you're going to leave today that's right I just stopped by to see you before it was time to go good I'm glad you did how you feeling glad to get away well you know how it is I've been waiting for this for a long time this is a pretty big day in my life of course it is I hate to see my prize patience leaving but what can I do well goodbye and best of luck to you so long captain and thanks summary and discharge note on the patient leaving the hospital after long treatment is an end product of the Army's Neuropsychiatric program this program deals with complex and difficult problems which have their beginning where the Army begins in the induction Center at this early stage the first preventive step is taken to protect the individual as well as the Army careful screening assures that only the healthiest of our civilians enter the service the preventive approach is implemented by an educational program in mental hygiene emphasis is placed on those facts which build and sustain the morale of army Personnel when psychiatric breakdowns threaten or do occur understanding and cooperation plus immediate recog of early symptoms followed by prompt treatment promote a rapid return to health until proven otherwise even the most serious cases are regarded as salvageable all these elements combine to make the most of the human resources that are the backbone of any army [Music] an army is no stronger than the population from which it is [Music] drawn to keep America strong we must strive to improve the physical and mental health of the whole nation through a deeper understanding of those factors which darken or lighten the all important sh waves of pray