How General Semantics was Used to Treat World War II Veterans
An early rational psychotherapy used by Douglas M. Kelley, the psychiatrist featured in Nuremberg (2025)
Rami Malek recently portrayed the psychiatrist Dr. Douglas Kelley in the movie Nuremberg (2025). Kelley was the chief psychiatrist tasked with evaluating the Nazi high command before they stood trial for war crimes. He died tragically years later, after returning home and trying to warn his fellow countrymen that there was nothing “special” about the Nazis. America, he said, was full of men just like them.
22 Cells in Nuremberg (1947), Kelley’s book, was controversial, and faced a hostile reception. He wrote bluntly: “I am convinced that there is little in America today which could prevent the establishment of a Nazi-like state”, adding:
As far as the leaders go, the Hitlers and the Goerings, the Goebbels and all the rest of them were not special types. Their personality patterns indicate that, while they are not socially desirable individuals, their like could very easily be found in America. Neurotic individuals like Adolf Hitler, suffering from hysterical disorders and obsessive complaints, can be found in any psychiatric clinic. And there are countless hundreds of similar ones, thwarted, discouraged, determined to do great deeds, roaming the streets of any American city at this very moment.
The film covers Kelley’s time at Nuremberg, one of the most dramatic moments in his life. However, in this article, I’m going to discuss something it barely mentions: his pioneering work as a psychotherapist.
In the mid 1950s, Albert Ellis invented what would later become known as Rational Emotive Behaviour Therapy (REBT), the earliest form of modern cognitive-behavioural therapy (CBT). Over a decade before Ellis, though, in the heyday of psychoanalysis, a number of psychiatrists had already adopted “rational” approaches to psychotherapy. They found that psychoanalysis, which typically took hundreds of sessions, was of little or no value in treating soldiers suffering from so-called “war neuroses”, who needed faster results. Kelley and others began to experiment with short-term and more directive or psycho-educational approaches, which focused upon rational thinking and a basic scientific understanding of the nervous system.
Prior to being sent to work at Nuremberg, Dr. Kelley, then a Lieutenant Colonel in the US Medical Corps, served as Chief Consultant in Clinical Psychology and Assistant Consultant in Psychiatry for the European Theatre of Operations, between 1943 and 1945. In that role, he treated thousands of military personnel, using group and individual methods. Kelley’s approach derived mainly from General Semantics, a school of thought founded in the 1930s by Alfred Korzybski, a Polish engineer who had emigrated to America. Ellis would later assimilate certain aspects of General Semantics into REBT, although its influence is now largely forgotten in the field of psychotherapy. In 1948, however, Kelley published a detailed report on his use of General Semantics in the psychotherapy of war neuroses titled ‘The Use of General Semantics and Korzybskian Principles as an Extensional Method of Group Psychotherapy in Traumatic Neuroses’.
In my experience with over seven thousand cases in the European Theater of Operations, these basic principles were daily employed…
The same year, in the third edition of Science and Sanity (1933/1948), Korzybski had included a Preface penned in October 1947, which states: “Perhaps the most telling applications [of the methods of General Semantics] were those on the battlefields of World War II, as reported by members of the armed forces, including psychiatrists on all fronts, and especially by Dr. Douglas M. Kelley, formerly Lieutenant Colonel in the Medical Corps,” adding the following report by Kelley:
General semantics, as a modern scientific method, offers techniques which are of extreme value both in the prevention and cure of such [pathological] reactive patterns. In my experience with over seven thousand cases in the European Theater of Operations, these basic principles were daily employed as methods of group psychotherapy and as methods of psychiatric prevention. It is obvious that the earlier the case is treated the better the prognosis, and consequently hundreds of battalion-aid surgeons were trained in principles of general semantics. These principles were applied (as individual therapies and as group therapies) at every treatment level from the forward area to the rear-most echelon, in front-line aid stations, in exhaustion centers and in general hospitals. That they were employed with success is demonstrated by the fact that psychiatric evacuations from the European Theater were held to a minimum.
That quote originally appeared in the article that I’m going to discuss here, which was published a year earlier, in 1946. It contains a report from a veteran of the Pacific War, with a foreword by Kelley and notes by Korzybski. (At the end of this article, there’s a link from which you can download the PDF of the original report.)
The US Veteran’s Experience
I’ve chosen this report because it provides a very vivid and compelling example of how the General Semantic approach to rational psychotherapy could actually help individuals suffering from war neuroses. The report came from an anonymous veteran of four South Pacific campaigns, who was discharged from the army due to “nervous disability”. He describes feeling physically tense, in a constant state of anxiety and alertness, ready “to move quickly should it be necessary”, which we would call hypervigilance for threat. In retrospect, we can recognise these as well-known symptoms of what is now labelled posttraumatic stress disorder (PTSD). Although we can’t be certain that he would meet that diagnosis, it does seem likely. In the 1940s, no such formal diagnosis existed, although similar clusters of symptoms were recognized, and commonly referred to as “battle fatigue”, “combat stress”, or “war neurosis”.
Kelley thought that the traumatic effects of war could best be understood on the basis of Pavlovian conditioning and, as we’ll see, the veteran understood his symptoms in more or less the same way. Kelley states of his report:
No human being can conceive of a more adequate mechanism for twisting human emotion and for developing organismal responses to specific stimuli than is achieved in an active battle zone.
Although Kelley wrote the preface to the report, the veteran in question did not actually attend his psychotherapy workshops but classes in General Semantics given by Professor Elwood Murray at the University of Denver. From what Korzybski says, the veteran seems to have attended one hour-long lecture each week, for ten weeks, i.e., ten hours of training. He describes the use of “extensionalizing” methods from General Semantics as a therapy for his symptoms of war neurosis, and Kelley seems to think this resembles what he was also training his patients to do in the field.
Korzybski’s Comments
Korzybski himself had served on the eastern front, during World War I, as a language and psychology expert attached to the General Staff Intelligence Department of the Second Russian Army. He received a bullet wound to his knee, and at another time his horse was shot and fell on him crushing his hip, injuries which meant he later required a cane to walk. His experience of constant artillery fire made it difficult for him to sleep for several months after arriving in New York, where, paradoxically, he found the relative quiet of the city unnerving. He was therefore very familiar with the psychological impact of warfare, and sympathetic to the US veteran’s experience.
Let me repeat that this veteran is probably not psychiatrically ill; he simply reacts as most living human beings would react to his experiences, which certainly were not happy, to say the least. On the battlefronts one cannot help but see the dead and dying, hear the screams, curses and prayers, smell the blood and stench of decaying flesh, etc., and so feel personally the indescribable terrors of war. These horrors become impressed on our nervous systems and so naturally we respond to them for some time to come.
Korzybski reflects on his own military career in his preface to the veteran’s report because he wants to emphasize that the real problem is not usually our emotional reactions to war, which are natural, but how we react to those reactions.
I have recounted some of my own experiences and reactions to reassure veterans as well as the public that many little disturbances as a result of war experiences are not always serious and often disappear after some rest and return to civilian life . What should be avoided are second order reactions, such as fear of fear, nervous- . ness about nervousness, worry about worry, etc., which may seriously aggravate the originally normal reactions under abnormal conditions.
Regarding the method of training, he writes:
The main point in connection with general semantics, or, if you wish, a nonaristotelian orientation, is in the fact that non-medical men giving group classroom training in scientific method can convey through extensionalization (i.e., evaluating in terms of facts), constructive techniques which do work.
General Semantics was not a psychotherapy, in other words, but it nevertheless had therapeutic benefits. It makes a basic distinction between “extensional” thinking, which consists in orientation to facts, grounded in concrete experience, and “intensional” thinking, which depends more on abstract verbal definitions. Korzybski claims that concrete thinking is natural and that all effective psychotherapy consists, in some sense, in restoring our basic orientation toward reality.
Let us recall that in general children are born extensional, and we eventually do endless harm by training them in intension, for which they usually pay the price later in life. Non-aristotelian extensional methods are not a medical discipline, but any psychotherapist in retraining the patients in adjustment to ‘facts’ or ‘reality’ must knowingly or unknowingly depend on some sort of extensionalization.
Korzybski notes the way in which General Semantics can seem at first glance to be “common sense”, and yet it is quite “uncommon” and alien to our normal habits.
Superficially it may seem ‘all so simple’ —`common sense,’ some may say — but experience shows that this is not ‘common’ at all today. […] In our work we are trying to make this modern ‘uncommon sense’ ‘common’ and workable.
He rightly points out that positive “falsehoods” are usually more easily detected than errors of omission.
‘False’ theories are less dangerous than inadequate ones. The former involve commission of errors, comparatively obvious, and simply discovered. The inadequate theories are much more harmful, as they often pass superficial inspection and require creative work to reconstruct them. They do not involve erroneous commissions, but pernicious omissions by default with their inevitably paralyzing effects.
This is a profoundly important point in modern cognitive approaches to therapy, where clients fall into the trap of believing something that appears true, from a certain perspective, but misses out crucial information — for instance, they focus on real mistakes or character flaws, selectively, while ignoring the bigger picture.
The veteran employed several methods of training himself in “extensional” thinking, described below. These were designed to improve “consciousness of abstracting” or awareness of how our words, and evaluations, are abstract and incomplete (non-allness) and how experiences differ from one another (non-identity). His honest first-hand account provides a good example of how General Semantics could help with emotional disturbances, and even quite severe traumatic anxiety.
The Veteran’s Report
The veteran said it was difficult for him to face putting some of his experiences into words, in order to write the report. However, he hoped that doing so might help him with his anxiety, and he found it beneficial as a way of continuing his training exercises in General Semantics.
In summary, the veteran’s General Semantics training involved several recurring moves: noticing the trigger; pausing before reacting; distinguishing present stimulus from past combat stimulus; indexing similar-but-different cases by numbering them; and deliberately re-entering ordinary civilian situations while maintaining his consciousness of abstraction, or the awareness that the “map is not the territory”.
Fear of Darkness
The first problem he describes is that as a civilian in the US, he experienced “fear of darkness”, which evoked memories of hearing enemy fire after sunset and feeling unsafe. At first he was reluctant to leave his home in the evenings because of this anxiety. Over time, though, he forced himself to go for long walks down side streets at night. He used this early form of what we now call “exposure therapy” to rehearse a simple cognitive strategy derived from General Semantics, called the principle of non-identity. No two things, or experiences, are truly identical. Even what we tend to refer to as the “same” things, actually change, and therefore differ over time. In other words, even though two experiences may appear to be the same they are never completely identical in reality.
The veteran therefore described using this technique by “keeping in mind that the darkness he then encountered was entirely different from that in combat.” I think Korzybski might say that it would potentially suffice for him to remind himself each time that “The darkness now (1946), walking down this side street in Denver, Colorado, is not identical to the darkness I experienced back then (1942-1945) in the South Pacific jungles.”
Repeatedly confronting feared situations has long been a strategy used by psychotherapists but what’s unique here is the incorporation of General Semantics, such as the emphasis on non-identity. This might be described today as a form of exposure combined with “inhibitory learning”, correcting faulty appraisals of how dangerous the situation really is. The veteran, for instance, trained himself to realize that “this darkness is not that darkness” and there is therefore no reason to feel afraid in the current situation. This very simple strategy can, as the veteran repeatedly attests throughout his report, be very effective. He says that after a week or so of facing his fears in this way, he became less tense, and was able once more to take part in activities outdoors in the evenings.
Anger Toward Others
The veteran reports also having a great fear of crowds, the origin of which he does not fully understand, although he thinks it could be related to certain periods of isolation that he experienced while on campaign in the South Pacific. He trained himself to overcome this in a similar manner to his fear of darkness, by taking walks downtown where he forced himself to mingle with other people. At the time of writing, he said he had made partial progress but still had some work to do.
He added that his anxiety about mingling with crowds of people may be triggered by the idea that they have expressed “silly conceptions” of war.
At first, he lost his temper quickly and made many cutting remarks to people. Later he developed a sullen silence refusing to comment on or discuss the situation except with those he felt were interested and were making an attempt to ease the situation.
He had learned, however, to cope by adopting an objective point of view, influenced by General Semantics, and remaining conscious of the fact that although the “silly” remarks of others about war may irritate him, there is no way he could reasonably expect strangers to understand what it was like during the Pacific War without having experienced the same conditions themselves.
Using this method of silence mentioned has helped a great deal with delay of reactions as an aid to evaluation. Though at first he reacted within himself, and carried all the marks of ill-will, at present he uses this period entirely for evaluation.
This part of the report is a little ambiguous but he appears to be referring to the General Semantic technique known as “silence on the objective level”. I take him to mean that he learned to pause and remain silent outwardly for a moment, in order to gradually practice a form of inner silence as well, or at least to reduce angry internal chatter.
He is using this semantic pause to pay more attention to how he evaluates the situation and presumably to develop what Korzybski called “consciousness of abstracting”, i.e., in this case perhaps to keep reminding himself that his initial evaluation of people in the crowd as having “silly conceptions about war” is abstract and incomplete (non-allness). “The map is not the terrain”, as Korzybski said. The label “silly conceptions about war”, which the veteran initially added to his experience, is not identical with the underlying reality of the conversation.
He probably also reminded himself that the person before him was not identical to individuals in the past with whom he became angry, and turned his attention from his angry preconceptions toward the concrete observable facts of their real behaviour. Indeed, he says that he eventually noticed that his constant alertness and feeling on edge was due to conflating movements among the crowds in Denver, no matter how slight, with his memories of “movements in trees and bushes that might be those of the enemy in combat”. He felt more at ease when he realized that he was falsely identifying these two distant experiences.
Watching the News
While watching movies, the veteran used to always leave during the newsreel. He found himself reacting to battle scenes as though he were actually present in the conflict once again, which left him with great anxiety and what he calls “fresh combat fatigue”, i.e., a sudden return of his initial symptoms. At the time of the report, he was still working on challenging his identification of the movie reel with the real events.
In doing so, he remains in his seat and tries to keep in mind that it is just a screen with black and white pictures, rather than actual battle. There has been a noted improvement in regard to after-effect; however, while witnessing the scenes, he sweats profusely.
Again, this is a form of exposure therapy avant la lettre. This example is striking because it deals with an image rather than a real event. Korzybski’s “map-terrain” distinction fits this very clearly. The newsreel is merely a depiction of the war, an abstraction or representation, and not the real thing. As Magritte’s famous painting, The Treachery of Images, reminds us, a picture of a pipe is not a pipe, but we easily lapse into talking about it as if it were. Moreover, our nervous system, as the veteran’s example shows, will readily confuse appearance with reality, unless we train ourselves to remain conscious of this distinction.
Sirens and Planes
When the veteran heard sirens from fire engines, etc., he would break into a sweat and experience a powerful urge to drop to the ground.
The veteran, to make this a proper evaluation, visited a fire station and examined the sirens on the engines. Seeing them as they were and for the purpose they are now used has contributed to more self-control.
In other words, he developed his awareness of the non-identity of the fire-engine sirens with the air-raid sirens he heard during the Pacific War.
The veteran lived through a bombing early in the war. Out of a group of sixteen men, he had been the sole survivor that day. This may have been one of the main factors contributing to his later PTSD-like symptoms. Low-flying planes therefore triggered acute anxiety and flashbacks to this traumatic event. He also tried to address this using a form of early exposure therapy, combined with extensionalizing.
He stood close to the runway when planes came in. This has not helped too much, but he believes in time he can train himself to picture peaceful maneuvers of friendly planes landing on an airstrip rather than death-dealing Jap [sic.] bombers.
He also mentions suffering from nightmares which cause insomnia, another common symptom of PTSD. He had made no progress dealing with these through General Semantics, though.
Aversion to Rice
The veteran gives an example of another problem he describes as “pure identification”. He became disgusted by rice, for the following reason.
His first view of the enemy dead was that of a Jap soldier which was in the process of deterioration. The bag of rice the soldier had been carrying was torn open and grains of rice were scattered over the body mixed in with maggots. When the veteran, to this day, sees rice, the above described scene is vivid and he imagines grains of rice moving in his dish.
Again, he described employing a similar exposure therapy method, combined with reminders of non-identity, focusing on the differences in the real experience.
To overcome this, he has eaten rice several times trying to remember the rice before him is not the same as that on the body. Though the food is not relished, he has succeeded in overcoming the vomiting reflex at the sight of rice.
A similar method was employed by him to overcome his aversion to dogs.
When first returned, the veteran had a great dislike for dogs resulting from experiences with native dogs. These native dogs were seen to devour bodies of both American and Jap soldiers, which, of course, was most distasteful to the observer.
He forced himself to pet mongrels in the US while reminding himself that “these dogs were quite different from those on the islands.” He notes that this was effective and he has become “fairly well adjusted” to the dogs in America.
He describes a number of other triggers for his anger toward other people or aversion and anxiety in response to certain triggers, all of which he appears to have treated himself, with reasonable overall success, using the same exposure therapy and extensionalizing methods described above.
Dislike for Elderly Women
The veteran uses his aversion toward all elderly women as an example of the General Semantics method called “indexing”. On one occasion, two weeks after returning home from the South Pacific, he and his wife were visited by an elderly woman who had been a friend of the family. As he was leaving the room, he overheard her ask his wife pointedly “Why isn’t your husband in the army?” He was offended, marched back into the room, and “not too politely” informed the visitor that he had been discharged for medical reasons. “This”, he says, “led to a grave dislike for all elderly women.”
“Since,” he adds, “he has tried to bear in mind that all elderly women are not the same as the one described.” Moreover, recognizing that he had a habit of viewing elderly women in a limited way, and only seeing one side of the situation, helped him to change his reaction. He would constantly remind himself instead that “no two people act or think alike” and that “this woman is not that woman”, etc. Korzybski’s method of “indexing”, when used more formally, would involve numbering different instances of a class, such as “elderly women”, in subscript, borrowing a convention from mathematics. So elderly woman₁ is not identical with elderly woman₂ or elderly woman₃, and so on.
I find it surprisingly helpful to have clients imagine it were possible to enumerate each instance in this way and then simply ask, e.g., “So when you say you find ‘elderly women’ unbearable, if we’re being precise, to which instances are you referring?” These sorts of “extensional” devices are what the veteran appears to have in mind when he writes:
Seeing only similarities is a result of neglecting differences, resulting in identification mechanisms. Devices giving a sense of difference in evaluations are most beneficial.
The veteran also mentions the concept of “non-allness”, a term used in General Semantics to refer to the fact that there is always more to say about objects or events than our words capture. The map, that is, does not represent all there is to know about the terrain. In explaining this method the veteran quotes from a popular book on General Semantics by I.J. Lee called Language Habits in Human Affairs (1941).
“The assumption of allness leads to tension and conflict, the preservation of ignorance and blockage of further learning.”
The veteran states that he actually applied this principle of non-allness to each of the problems described in his report.
Semantic Relaxation
The veteran has started learning a technique called “semantic relaxation” but had not yet had an opportunity to report much progress.
It has been a very short time since he started, however, since he began he finds tension relieved during the application and is earnestly working with [it] in hopes of complete success soon.
Korzybski refers to this technique as “Neuro-semantic relaxation”, and he developed it as a means of heightening awareness of tension and its role in our evaluative reactions. Korzybski believed it was capable of normalizing blood pressure, which he considered very important for healthy neurological functioning.
The best-known description of the technique, to which Korzybski refers, is in Wendell Johnson’s People in Quandaries.
The technique of semantic relaxation is strikingly different from this sort of massage. In fact, it does not involve massage at all. With one hand you simply feel the palm and fingers of the other, holding the hand gently without pinching or squeezing it, slowly and with light pressure bending the fingers under and back again, noting how the hand feels. Is it soft, warm, and dry, or stiff, cold, and moist? Do the fingers bend readily? You hold the hand with firm but light pressure for a few seconds, then release even this light pressure, then apply it again. Now you bend the fingers gently again two or three times. You reverse hands and repeat the process. That is essentially all there is to it.
Later he adds that this can be applied to the face or forearm as well and that the main purpose of the technique is to heighten awareness of physical tension.
What it amounts to is simply feeling with one hand the state of tension of the other, and ‘loosening up’ the one with the other, not so much by physical pressure and active massage as by direct manual expression of calmness, ease, warmth, reassurance. It is the semantic rather than the mechanical aspect that is important.
Through the hand, however, one can directly feel the state of tension in the face, or the forearm, for example, and so become more acutely aware of it. This heightened awareness of tension through feeling it with the hand and fingers is probably responsible, in large measure, for the relaxation that follows. Everyone is doubtless familiar with the fact that when we become aware that we are tense we tend to relax.
And he comments:
The method tends to produce not the deep relaxation that is conducive to sleep or profound restfulness, but simply an optimal degree of tension […] its chief advantage lies in the fact that it gives one relaxation for work, so to speak. It counteracts our common tendency to make hard work of whatever we do, to frown and grimace unduly, to overreact, to carry on our daily activities with a greater degree of tension than is necessary.
I believe you can achieve a similar effect just by slowing down, noticing your facial expression and breathing, and perhaps letting go of about 10-20% of the tension from them, while you continue to think about or respond to situations. In other words, it’s mainly a means of increasing self-awareness of muscular tension, and noticing how that is coming into play in our emotional reactions.
Conclusion
In addition to applying the principle of non-identity to various triggers, such as low-flying planes, rice, and elderly women, the veteran benefited from applying it to his thinking about himself.
The veteran’s status is changed. He is now a civilian, not in a combat zone but in the United States. The fact that he has changed, as well as his surroundings, should be foremost in his mind. That there is constant change in all matter and situations should be kept in mind.
He is no longer exactly the same man he was yesterday, or the same man he was back in the jungles of the South Pacific. Tomorrow, he will be a slightly different version of himself again. Applying the principle of non-identity to yourself in this way, can be surprisingly helpful. This is how the veteran sums up the benefits he experienced as a result of applying General Semantics to his traumatic neurosis.
It has been observed by the family of the veteran, and his outside associates, that in the past three months there has been a marked improvement in his attitudes and reactions. There is a more general easiness, expressed in both his actions and his physical appearance. The veteran himself admits more confidence in all he undertakes and relief of the absolute tension he previously experienced. He also feels, that though he was unwilling in the beginning to try to write about his identifications, this procedure has been most beneficial.
Hopefully, this has provided a vivid example of one veteran’s experience of applying General Semantics in a therapeutic manner. Finally, to return to where we started with Dr. Kelley, I hope to write another article, in the near future, discussing the more detailed and systematic account of psychotherapy, based on General Semantics, that he provided in his own writings.
Reference
Alfred Korzybski, “A Veteran’s Re-Adjustment and Extensional Methods,” ETC: A Review of General Semantics, Vol. 3, No. 4, Summer 1946. Reprint available via Internet Archive; listed there as released for public distribution by the Alfred Korzybski Literary Estate.