1. INTRODUCTION Medical Officer Royal Navy 1965-1996

3. The Role of the Military Psychiatrist 1.Personnel selection 2.Officer selection 3.Mental dullness 4.Treatment and disposal of psychiatric cases 5.Forward psychiatry 6.Morale and discipline 7.Rehabilitation and repatriation of POWs 8.Organisation of military psychiatry at home and overseas Ahrenfeldt: “Psychiatry in the British Army in WWII” (1958)

5. 21 Neuro Psychiatric 4.1% 70 Trench Foot (NFCI) 14.6% 112 Burns 21.7% Battle Injuries in British Casualties Total 516 43 Non-Penetrating 8.3% 270 Penetrating 52.3%

6. The Coping Spectrum COPING NOT COPING

7. SELECTION “If screening is to weed out all those likely to develop a psychiatric disorder, all should be weeded out” Anderson R. S. (Ed) Neuropsychiatry in World War II, (Vol. I ). Washington, DC: Office of the Surgeon General 1996, p. 391

8. Training Basic Team Realistic Retraining / Reselection?

11. STRESS “The confusion created when one’s mind overrides the body’s basic desire to choke the living s1t out of some asshole who richly deserves it”

12. PTSD Post Traumatic Stress Disorder 1980+: an evolving concept History: Nostalgia etc Incidence: variable Recognition: comrades and family Co-morbid disorders: Alcohol, somatic symptoms, depression.

14. Coping with Stress after Combat Normal feelings and emotions Which may be experienced Memories Loss of control Distress Numbing Anger Shame Avoidance Guilt Arousal Sadness Family and social relationships What you can do When to seek help Where to find help

15. Morale “The general sense of well-being felt by the group with confidence in their own ability to survive environmental stress, faith in their leader, and an overall sense of cohesiveness amongst their number.” Labuc

16. Groups at Risk 1.Injured survivors 2.Non-injured survivors 3.Those who might have been there 4.Relatives of the dead 5.Relatives of 1, 2 and 3 6.Rescuers 7.Witnesses 8.Medical teams 9.Command 10.Carers 11.Correspondents 12.Retraumatised 13.ANO?

18. QUESTIONS