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February 1974

When the Patient Reports Atrocities: Specific Treatment Considerations of the Vietnam Veteran

Author Affiliations

From the Veterans Administration Outpatient Clinic, Mental Hygiene Service, Boston.

Arch Gen Psychiatry. 1974;30(2):191-196. doi:10.1001/archpsyc.1974.01760080051008

All wars are "hell." Certain aspects of the Vietnam War, however, differentiated it from World War II and the Korean Conflict: guerrilla tactics predominated; this war was undeclared and became increasingly unpopular; and for the first time the exposure of war atrocities committed by Americans became a national issue. Many Vietnam veterans reflect the impact of these differences in their conflictual attitudes toward their combat experiences and in their psychopathology.

The Vietnam combat veteran who reports atrocities presents a special therapeutic challenge. The therapist's countertransference and real, natural response to the realities of the patient's experience must be continually monitored and confronted. If the therapist is honest with him/herself, a therapeutic relationship becomes possible for men whom many therapists are, or would be, repulsed and frightened by and would never treat.

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