THE SELF-INFLICTED INJURY
A Case Report
DAVID J. FLICKER M. D.1
1 Captain, Medical Corps, Camp Blanding, Fla.
According to Karpman(10), "The material for malingering must come from the unconscious reservoir of the individual.....It is a rather frequent observation that malingerers often press into service a minor experience for the purpose of gaining desired ends." It is a reasonable assumption, I believe, to state that the accidental axe cut last year determined the form and nature of this patient's self-inflicted wound.
However, I do not agree with Hulett(3) who says, "It is indeed devastating to recognize as we must that all men are not possessed of manhood and that the yellow streak down the backs of some of our fellows is invisible to the unaided human eye," since I believe more frequently than not that the sufferer of the self-inflicted wound is neither a moral nor a physical coward. He may not agree with what is the accepted community goal. He does show determination and stamina in attaining his personal desire.
We have here a man who after a milder form of malingering had failed attempted to produce the desired end by a self-inflicted wound. It is my impression that the man with the self-inflicted wound is a malingerer of the severest type. This act was not a suicidal gesture nor was it performed to obtain sympathy or compensation, but rather merely to obtain release from what was to him an uncomfortable and intolerable environmental situation.
I believe that henceforth the definition of malingering with reference to the armed forces should stress the intentional production of disease in addition to exaggeration and simulation.
