In the ranks of World War II's foot soldiers, there were always the iron men —tough noncoms who stood out as the most efficient, best disciplined men in their outfits. But sometimes even the iron men cracked up and had to be carted to the rear muttering the confused soliloquies of soldiers suddenly smitten with combat fatigue.
Last week in a special report distributed to all its medical officers, the U.S. Army Medical Department told why some of the old reliables broke down. The explanation gave some insight into how most soldiers managed to survive the psychological strains of modern combat. Writing in a supplement to the Department's Bulletin, Major Raymond Sobel analyzed the crack-ups of 50 seasoned men who had fought battle after battle without a misstep. The aggregation of symptoms was so similar in each case that Psychiatrist Sobel and his colleagues gave it a name—the "Old Sergeant Syndrome."
"The question was not, 'Why did they break?'" explained Major Sobel, "but 'Why did they continue to endure?' " Sobel and his associates found that a five-layer cushion of psychological defenses had protected the old sergeants—and presumably all soldiers who survived long stretches of combat in good mental health —from caving in. As the layers were peeled away, normal combat anxiety eventually turned into psychoneurosis and the old sergeant became a casualty: ¶ "Distant ideals"—a reliance on such intangibles as "the four freedoms," democracy, and the desire for "keeping the enemy out of the United States"—were the first to dissolve.
¶ "Hatred of the enemy was the next defense to go ... These soldiers had a much higher degree of directed hatred than the other psychiatric casualties seen in combat . . . However, it was not of sufficient force to counteract the effects of long-sustained combat." ¶ The soldier then lost faith in short-term objectives—his hope that once a given hill was taken or a given town was entered he would be relieved.
¶ Next went pride in himself. Pride was a "mainstay" of the old sergeants' personalities, "but once a break in efficiency occurred, their self-confidence weakened progressively."
¶ "Loyalty to the group in these men was the last and most important line of defense . . . Even this . . . weakens with the passage of time."
With his last defense broken through, the old reliable was sent to the rear. But once the patient was out of combat, Army psychiatrists found that the old sergeant syndrome was easy to treat. By giving him a job out of shellfire range but close to the front, the Army found it could cure him and still get a lot of good service out of a rusty iron man.