This book informs the public for the first time about the impact of
American psychiatry on soldiers during World War II.
Breaking Point is the first in-depth history of American psychiatry in
World War II. Drawn from unpublished primary documents, oral histories,
and the author's personal interviews and correspondence over years with
key psychiatric and military policymakers, it begins with Franklin
Roosevelt's endorsement of a universal Selective Service psychiatric
examination followed by Army and Navy pre- and post-induction
examinations. Ultimately, 2.5 million men and women were rejected or
discharged from military service on neuropsychiatric grounds. Never
before or since has the United States engaged in such a program.
In designing Selective Service Medical Circular No. 1, psychiatrist
Harry Stack Sullivan assumed psychiatrists could predict who might break
down or falter in military service or even in civilian life thereafter.
While many American and European psychiatrists questioned this belief,
and huge numbers of American psychiatric casualties soon raised
questions about screening's validity, psychiatric and military leaders
persisted in 1942 and 1943 in endorsing ever tougher screening and
little else. Soon, families complained of fathers and teens being
drafted instead of being identified as psychiatric 4Fs, and Blacks and
Native Americans, among others, complained of bias. A frustrated General
George S. Patton famously slapped two "malingering" neuropsychiatric
patients in Sicily (a sentiment shared by Marshall and Eisenhower,
though they favored a tamer style). Yet psychiatric rejections,
evacuations, and discharges mounted.
While psychiatrist Roy Grinker and a few others treated soldiers close
to the front in Tunisia in early 1943, this was the exception. But as
demand for manpower soared and psychiatrists finally went to the field
and saw that combat itself, not "predisposition," precipitated
breakdown, leading military psychiatrists switched their emphasis from
screening to prevention and treatment. But this switch was too little
too late and slowed by a year-long series of Inspector General
investigations even while numbers of psychiatric casualties soared.
Ironically, despite and even partly because of psychiatrists' wartime
performance, plus the emotional toll of war, postwar America soon
witnessed a dramatic growth in numbers, popularity, and influence of the
profession, culminating in the National Mental Health Act (1946). But
veterans with "PTSD," not recognized until 1980, were largely neglected.
