Somatoform Dissociation in Traumatized World War I Combat Soldiers: A Neglected Clinical Heritage

The massive traumatization of World War I combat soldiers led to an unprecedented incidence of somatoform dissociative disorders and symptoms, usually diagnosed as hysterical disorders during the war years. Following a brief overview of the scope of the suffering during this Great War, attention is given to British army psychiatrist Charles S. Myers’ (1940) observations of the alternation between a so-called ‘‘emotional’’ personality and an ‘‘apparently normal’’ personality in traumatized combat soldiers. Somatoform dissociation, further categorized into positive and negative symptoms, is related to this structural dissociation, and to fixation in the trauma and avoidance of the trauma, and may be part of a more encompassing symptomatology. Next, a short overview of diagnostic issues is given. We argue that the DSM-IV category of ‘‘conversion disorder’’ is incorrect. Rather, the findings revealed here support Janet’s classic and Nijenhuis’ more recent views on somatoform dissociation. Finally, treatment issues are briefly presented. [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-342-9678. E-mail address: Website: 2000 by The Haworth Press, Inc. All rights reserved.] Onno van der Hart, Annemieke van Dijke, and Maarten van Son are affiliated with the Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands. Kathy Steele is affiliated with Metropolitan Psychotherapy Associates, Atlanta, GA. Address correspondence to: Onno van der Hart, Department of Clinical Psychology, Utrecht University, Heidelberg 1, 3584 CS Utrecht, The Netherlands (E-mail: [email protected]). Journal of Trauma & Dissociation, Vol. 1(4) 200