Themes of mistrust and the posttraumatic stress disorder in Vietnam veterans.

The attitude of mistrust can frequently be observed in survivors of massive trauma, and is particularly pronounced in Vietnam combat veterans. Three interrelated factors that lead to mistrust are described. They are: the harsh realities of fighting in this guerrilla war, society's negative responses to the men after their return, and the psychosocial development of late-adolescent soldiers. When the attitude of cynicism predominates, the psychotherapeutic treatment more clearly focuses on adolescent themes of idealization and disillusionment. Two case studies with pronounced attitudes of mistrust are presented. The first case highlights the special difficulties of working with the veteran who is also profoundly cynical. The second case describes the defensive function that mistrust can serve by keeping out of awareness the images the veteran had of himself prior to the war. The data obtained from the veterans' respective dreams were especially useful in the diagnosis and treatment.