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Published Online:https://doi.org/10.1176/ajp.104.4.259

The rehabilitation techniques used in this Veterans' Clinic varied from case to case. The success was not dependent on the type of psychiatric diagnosis but rather on the psychodynamics in each individual case. Effective help was given to veterans suffering from paranoid, homosexual or other severe conflicts provided these were closely related to the present situation. This could be achieved even in cases with serious pre-war problems. A thorough knowledge of the service experiences, the reactions to discharge and the immediate adjustment situation as well as the family background was necessary for intensive therapy. In other cases, the aim of treatment had to be limited to problems of readjustment, to giving immediate but limited support, or to protecting the veterans from harming themselves under emergency conditions. The earlier the veterans came after discharge, the better were the conditions for help. Where there was no stability in at least one area of the veterans' environment—his home, his job, his friends —rehabilitation became extremely difficult. In such cases the secondary gain from illness might become a serious obstacle. The same applied to some cases suffering from purely physical complaints covering up their need for dependency. Only 3 cases developed a real compensation neurosis.

The success of rehabilitation depended largely on the degree to which the disability was related to the present situation and also on our ability to discover the proper point of attack. Many veterans came in for treatment of their long standing or revived problems such as stuttering, alcoholism, homosexuality, psychopathic maladjustment, etc. Close analysis always revealed some new and hidden conflict, related to the present situation, which could be dealt with.

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