Roy R. Grinker

Hypothalamic Functions in Psychosomatic Interrelations

THE HYPOTHALAMUS developed from the basal portion of the diencephalon under the influence of the medial forebrain bundle in a position favorable for its role as a central integrator of several important functions. Receiving afferent fibers from the ascending sensory tracts by way of the thalamus and subthalamus, and sending efferent fibers which directly or indirectly affect the activity of the entire autonomic nervous system, the hypothalamus integrates individual activities of viscera, endocrine glands and smooth muscles with reference to the economical needs of the entire organism. Such regulation and integration of the bodys internal milieu serves to maintain what Cannon (12) terms homeostasis. The significance of its position in the sphere of the medial forebrain bundle lies in the fact that the hypothalamus has developed in connection with primitive areas of the forebrain which were concerned in the function of olfaction (50). The sense organs concerned with smell were the first distance receptors evolved and they influenced the development of the most primitive or olfactory cortex. Receiving its afferent impulses from primitive olfactory cortex and the great sensory systems, the

Brief Psychotherapy in War Neuroses

The American people are not satisfied unless a problem or situation new to their cognizance is rapidly treated by some new discovery. Hence when the lay and military minds were rudely awakened to the fact that war neuroses formed such a large proportion of living casualties, they demanded from psychiatrists whose words and writings of the last 25 years had largely gone unheeded, new and rapid methods of prevention and treatment. The publicists seized upon two technics of therapy which seemed to fulfill these requirements. The first, treatment in forward evacuation hospitals with rest, sedation and pursuasion, was used in the last war and completely described by competent observers. The second, narcosis therapy whether in the form of continuous sleep, narcohypnosis or narcosynthesis cannot be called new since it has been used in civilian practice for at least ten years. Without equivocation it can be stated that the only knowledge newly applied to the prevention and treatment of war neuroses up to the present, whether in forward hospitals, general hospitals overseas or at home is a sound, rational understanding of the dynamic conflict between the unconscious sources of anxiety and the ego forces and an understanding of the symptoms produced by psychological defenses, regressions and collapse. Furthermore, based on such knowledge, the only new technic evolved in the treatment of war neuroses is brief psychotherapy derived from psychoanalytic principles. Because of many misuses of the terms war neuroses and psychiatric casualties even by psychiatrists, it is wise to interpolate at this point a rough segregation of neuroses as they are related to phases of military life: 1. Neuroses of war time occurring before or at induction before exposure to military life has had any effect. 2. Neuroses caused by the restriction, complications, hardships and dangers of military training or service in the United States. 3. Neuroses caused by foreign service in which the factors of separation, loneliness, severe climatic conditions, poor living conditions, lack of work, overwork, etc. are important.