The Soldier at the Western Front – Military Psychiatry
Source 4: The Kaufmann-Method
From the vantage point of the present the medical treatment of CSR patients appeared to be cruel, as the following source might prove. The so called Kaufmann-method became famous for the treatment of CSR patients. This method was widely used after 1915, but due to causalities already found its critics during the war.
„Contrary to many it is my opinion that that if possible a fast symptomatic treatment of patients with psychogenic stress- and neurological deficits is called for, as soon as the acute symptoms of fatigue, that almost always can be found when the sick return from the front, are decreased. Even though it is basically right that hysteria isn’t ‘healed’ as soon as the concise symptoms are gone, but there are many patients were the motoric symptoms are the only detectable disorder, while a hysteric character or other hysterical stigmata are missing. […] From every day practice we made the experience the distraction of the innervations caused by a psychological shock very often can be put back on track by another psychological shock. Now we can heal such a patient as the mentioned through the combination of an artificial shock by using strong electric current with the corresponding word suggestion in the form of orders. Our therapy is constituted in 4 components:1. Suggestive preparation
2. Application of strong alternating current with the aid of plenty word suggestion.
3. Strict adherence to the military norms through the utilization of the given subordinated relationship and giving the suggestion in the form of orders
4. Imperturbable consequent forcing of healing within one session. ad 1. [...] It has to be made clear to the sick already during the preparation that even though the electric current will be painful he will be completely healed within one session.
ad 2. It is only possible to cause a psychological shock, when the electric current causes severe pain. […] The current needs 2 to 5 minutes to have an effect than the training is exercised than again the current and so on.
ad 3. The superiority in military rank of the military doctor applying the treatment is a great help because military discipline demands the absolute uncritical subordination to the orders of the higher rank and this prepares the ground for a successful suggestive therapy. […] I order the ones with trembling legs or with pseudo cerebral ataxia- after the respective electrical treatment – to practice a sharp military drill (just like on the barrack square!) the ones with trembling head have to practice the order “eyes right!” and “eyes left!” and so on.
ad 4.: Success can only be achieved by the unrelenting persistence in the practice of the therapy […] the sick has to be convinced with all means that you are capable to force your strong will onto him The method demands absolutely a quite careful indication; especially when the continuous application of painful electric current is necessary over a longer period of time, somehow heroic. The best prove for its necessity in spite of the ruthlessness of the method is that the healed are the most grateful of our patients. […] It cannot be denied that this catch-off-guard therapy is demanding concerning the mental strength of the doctor. But it is worth the effort. Furthermore apart from hypnosis no other therapy is known to me that permit such a fast healing of these complex psychogenic symptoms. […] I think that the second advantage is the fact that the reluctant patient can escape the hypnosis; the catch-off-guard therapy almost always forces even the unwilling sick into healthiness, because the huge impression of pain suppresses all negative imaginative desires. […] It appears advisable not to release the healed immediately within days after their therapy, but to keep them in hand for some more weeks, to be able to counter any possibility of relapse. […] They are not capable for the trench warfare anymore. We have used some of these sick after some weeks of recreation in garrison service or as hospital orderly at home.” Fritz Kaufmann: Die planmässige Heilung komplizierter psychogener Bewegungsstörungen bei Soldaten in einer Sitzung (trans.: The Methodical Healing of Psychogenic Movement Disorders of Soldiers within one Session), in: Münchener Medizinische Wochenschrift, Feldärztliche Beilage 63 (1916), pp. 802-804.
