Losing the world is used because it seems to be the most accurate description of the total subjective loss of one's reality, and because during their twelve or thirteen month rotation through Vietnam, veterans referred to home as "The World." Rich Mollica (1988) observes that the major psychological aspects of losing the world are:

Losing the world conforms closely to catastrophic trauma. Krystal (1978) in his description of the psychology of trauma, distinguishes between partial trauma and catastrophic trauma. He states, "The psychic experience of catastrophic trauma consists of a numbing of self-reflective functions, followed by a paralysis of cognitive and self-preserving mental functions."

Primo Levi (1986) has stated that individuals who have lost the world, lie at the bottom.

"Imagine how a man feels who is deprived of everyone he loves, and at the same time of his house, his habits, his clothes, in short of everything he possesses: he will be a hollow man, reduced to suffering and needs, forgetful of dignity and restraint, for he who loses all, often loses himself. He will be a man whose life or death can be lightly decided with no sense of human affinity, in the most fortunate of cases, on the basis of pure judgement of utility. It is in this way one can understand the double sense of the term extermination camp, and it is now clear what we seek to express with the phrase: to lie on the bottom."

Lying on the bottom means to be abandoned by society or government, friends and often relatives. Social isolation often characterizes the most traumatized Vietnam veterans. Initially the therapist may be the only social contact these patients have. However, contact with the therapist may be sporadic because of the general lack of trust veterans have for anyone in a perceived position of authority who hasn't been in "The Nam."

Once a vet has lost the world, he can become bound to the trauma story. Vietnam veterans may become the trauma story because it is the core identity that developed at a crucial stage of their lives. These individuals fear that if they let go of the story, they will cease to exist. This terrifying emptiness is similar to the Void described by Gersten (Atlantis, 1989).

When it is recognized that the average age of the soldier in Vietnam was nineteen, as compared to twenty-six in World War II and Korea, it is understandable that, for many, the stress of the war taxed their ability to form a clear, coherent sense of personal identity.

In our next issue we bring you part II by Pamela Hicks, R.N.- -the imagery treatment for Vietnam Veterans..."The Grave, the Talisman and the Walking Dead."