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Am J Psychiatry 1948;105:286-291.
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Department of Psychiatry and Mental Hygiene, Yale University School of Medicine

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A description of patients seen in an Army psychiatric clinic in Germany can give only a general idea of the personality problems encountered. A great many patients with fundamentally psychiatric problems are treated in other clinics. Perhaps even more important in regard to the dependent and War Department civilian population is that the majority of individuals with neurotic tendencies fostered by occupation life probably do not seek medical attention at all.The somewhat artificial pattern of occupation life encourages the development of latent neurotic potentialities. The diminished force of such restrictive and inhibiting factors as home and church influences, social pressures exerted by other community groups, and the precariously balanced moral and ethical feelings imbued during early life is not compensated for by the rather rigid, paternalistic, impersonal, often frustrating framework of Army organization. This, and the lack of accustomed recreational and intellectual outlets, often stimulate the development of behavior such as heavy drinking or sexual promiscuity. Such behavior, although basically maladaptive, serves its function in the given situation. Another factor is the continual frustration with regard to normally minor aspects of daily life, such as transportation, and the obtaining of commodities and services through legal Army channels, as neither of these are legally obtainable to any degree from the German economy. In addition, the constant, though often unnoticed, underlying tension incident to living in a hostile country, surrounded by the most desolate ruins, may give rise to a sense of imprisonment, poorly controlled irritability, or other symptoms not sufficient to warrant a clinic visit.The innate hostility of Americans to anyone "foreign" is a complicating factor contributing to the relative social insularity of the Americans and the lack of opportunity for social interplay of a normal variety between the average American and Germans of corresponding class. The distinction between conqueror and conquered is a sharp one, emphasized not only by obvious differences in nutritional state, clothing, shelter, and transportation, but also by the frequent signs forbidding German use of certain facilities. The social distance between the two groups is such that, except for a minority, contact with the native population is usually at the level of the "putzfrau," and the "fraulein," and the blackmarketeer. The American leaving the Occupied Zone often feels that he knows little more about the psychology of the Germans than he did shortly after his arrival.Certain efforts have been made to stabilize American community life. In place of an enforced bachelorhood of several months, during which the husband is alone in Germany, the Army is transporting married couples overseas together. The commodity-dispensing system is being operated more efficiently. Rail transport is improving, and there is an increasing number of private vehicles. Dependents are becoming more active in such civic-minded affairs as the German Youth Activity, and the Army is attempting to encourage educational pursuits among troops. A strenuous effort is also being made to curb the blackmarket. However, these things have not as yet materially affected the interpersonal exchange between members of the various groups in the Zone, or the basic tensions and conflict-breeding situations that are present. It is to be expected, therefore, that psychiatric problems associated with the social and psychological environment of Occupied Germany will continue to be seen in occupational personnel.

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