He posited that repetitive exposure to concussive blasts caused brain trauma that resulted in this strange grouping of symptoms. There were plenty of veterans who had not been exposed to the concussive blasts of trench warfare, for example, who were still experiencing the symptoms of shell-shock.
And certainly not all veterans who had seen this kind of battle returned with symptoms. We now know that what these combat veterans were facing was likely what today we call post-traumatic stress disorder, or PTSD.
The medical community and society at large are accustomed to looking for the most simple cause and cure for any given ailment. This results in a system where symptoms are discovered and cataloged and then matched with therapies that will alleviate them. Though this method works in many cases, for the past years, PTSD has been resisting. We are three scholars in the humanities who have individually studied PTSD — the framework through which people conceptualize it, the ways researchers investigate it, the therapies the medical community devises for it.
Through our research, each of us has seen how the medical model alone fails to adequately account for the ever-changing nature of PTSD. Once it became clear that not everyone who suffered from shell-shock in the wake of WWI had experienced brain injuries, the British Medical Journal provided alternate nonphysical explanations for its prevalence. Shell-shock went from being considered a legitimate physical injury to being a sign of weakness, of both the battalion and the soldiers within it.
One historian estimates at least 20 percent of men developed shell-shock, though the figures are murky due to physician reluctance at the time to brand veterans with a psychological diagnosis that could affect disability compensation. Soldiers were archetypically heroic and strong. When they came home unable to speak, walk or remember, with no physical reason for those shortcomings, the only possible explanation was personal weakness.
Treatment methods were based on the idea that the soldier who had entered into war as a hero was now behaving as a coward and needed to be snapped out of it. Yealland then applied an electric shock to the throat so strong that it sent the patient reeling backwards, unhooking the battery from the machine. Yealland reported this encounter triumphantly — the breakthrough meant his theory was correct and his method worked.
Post-war anger also motivated a committee of investigation into shell-shock treatment in Austria, in this case, the specific use of electrotherapy.
In the autumn of Julius Wagner-Jauregg , Professor of Psychiatry at the University of Vienna, was accused of treating soldier patients brutally with electric currents.
Individual patients had resisted treatment during the war and there were even patient revolts in some hospitals. As a result, Wagner-Jauregg and six others had to justify their use of electrotherapy in court. Here there are clear parallels with the case of Vincent and Deschamps in France but there are also important racial differences.
The German-speaking medical elite was often suspicious of the "foreign-speaking" soldier patients in the multi-ethnic Austro-Hungarian armies. Unlike hypnosis or suggestion therapy, electric treatment was a way of exposing malingerers with only limited recourse to language: it could be a virtually "speechless therapy".
The British authorities insisted that troops from southern Ireland were especially prone to mental weakness; the German authorities had similar attitudes towards Jews in the German army; French specialists perceived black troops, especially those from Senegal, as especially prone to psychiatric disorders. High-profile anxieties about patient treatment existed alongside a growing suspicion of shell-shocked men in the post-war period. This was most obvious in the new Weimar Republic which was scarred by the defeat of war and continually marred by political violence.
The fledgling welfare state, initially established by the Social Democratic Party SPD , should have ensured adequate health care and pensions for psychologically damaged veterans. In the early s the SPD saw war neurosis as a universal experience that was shared by all German citizens and so could unite the post-war Volksstaat. Yet this unity was far from realised. Men who had fought resented being categorised alongside women and civilians whose wartime stresses had been limited to the home front; the welfare system was administered by cost-cutting officials in the Labour Ministry; the whole process relied upon the advice of psychiatrists, most of whom were highly conservative nationalists who blamed weak or degenerate men for losing their nerve in and bringing Germany to defeat and revolution.
As a result men did not find it easy to access support and the situation grew worse as pensions were cut throughout the s. The SPD failed the psychologically damaged veterans they sought to protect and state welfare was inadequate. Their opponents further to the left — the German Communists KPD — had never believed that the bourgeois state could serve the needs of the working-class soldier and was most vocal in attacking the highly conservative psychiatric establishment.
As far as the KPD was concerned, the state-hired psychiatrist was no more than "a businessman disguised as a doctor" and, like all members of the ruling class, it was in his interest to deny the trauma of the last war so as to prepare the proletariat for yet another one.
KPD activists were opposed to state-sponsored welfare measures which they saw as turning men into helpless dependants, and they argued that neurotic men needed to "find healing in active class struggle and revolution", not handouts from the bourgeois state. Conservative doctors castigated the Weimar welfare state for "coddling" neurotics with pensions, and Nazis were similarly hostile because the very existence of war neurotics challenged the Nazi glorification of the war experience.
In consequence, the National Pension Law of cut off all pensions for mentally disabled veterans. The history of wartime and post-war shell shock is both ambiguous and paradoxical. During the war medical officers, soldiers and civilians displayed sympathy and understanding to shell-shock victims in all combatant armies. At the same time the military code prevailed, as did the medical belief in predisposition and the importance of will; some military medics were hostile to the very idea of war neurosis.
As a result wartime medicine was often found wanting and could be described as more disciplinary than therapeutic.
After the war many shell-shocked men were forgotten or discredited, or — in Britain — became idealised hero-victims. The political issues provoked by shell shock varied across Europe but all of the issues which made shell shock politically important — courts-martial, lunatic asylums, electrotherapy, pension disputes — indicate the extent to which shell-shock treatment was constantly entwined with discipline. Yet shell-shocked men were not simply victims of total war , mental collapse and punitive treatment regimes.
Both during the war and afterwards, formally and informally, patients and their families consistently demanded proper treatment and adequate pensions. They did not always succeed but men refused to be stigmatised by a mental war wound: the history of shell shock is a history of trauma and psychiatry but it is also history of patient protest.
International Encyclopedia of the First World War, ed. DOI : Version 2. War Psychiatry and Shell Shock. By Fiona Reid. It is some sixteen days now since it happened [ I never remembered anything more until I came onto the boat [ The officer in charge called for the medical officer, Lieutenant George Kirkwood , who later issued a certificate testifying to collective mental breakdown amongst the men: In view of the bombing attack to be carried out by 11 th Border Regiment, I must hereby testify to their unfitness for such an operation as few, if any, are not suffering from some degree of shell shock.
While acknowledging that men could suffer mental collapse as a result of the strains of war it also insisted upon the importance of predisposition; while recognising that shell-shocked men should be properly treated, contributors concluded that treatment should be based on military experience and common sense rather than medical knowledge, as the following comments attest: I would rather have an experienced man about 35 years of age, a man of the world rather than a youthful medical officer with some special bee in his bonnet.
Dr Wilson He should get to know the soldier and to live with him. He need not know much medicine — a smattering of neurology would be useful. He should not be a peacetime psychologist, this would be a great disadvantage. Major Adie [66] Wartime mental-health specialists had clearly not made themselves appear indispensable in the British army. Military Psychiatry from to the Gulf War, Hove et al. Emotional Survival in the Great War, Manchester Society, Politics and Psychological Trauma, , Exeter Weimar Culture and the Wounds of War, Princeton et al.
Women, Madness and English Culture, , London Moran, Charles: Handwritten notes for book on shell shock undated. Kirkwood, G. Society, politics and psychological trauma, , Exeter University of Exeter Press. Harrison, Mark: The medical war.
Kaes, Anton: Shell shock cinema. Weimar culture and the wounds of war , Princeton Princeton University Press. Leed, Eric J. Lerner, Paul Frederick: Hysterical men. War, psychiatry, and the politics of trauma in Germany, , Ithaca Cornell University Press.
Reid, Fiona: Broken men. Roper, Michael: The secret battle. Shephard, Ben: A war of nerves. Soldiers and psychiatrists, , London Pimlico. In September , at the very outset of the great war, a dreadful rumor arose. It was said that at the Battle of the Marne, east of Paris, soldiers on the front line had been discovered standing at their posts in all the dutiful military postures—but not alive.
That such an outlandish story could gain credence was not surprising: notwithstanding the massive cannon fire of previous ages, and even automatic weaponry unveiled in the American Civil War, nothing like this thunderous new artillery firepower had been seen before. A battery of mobile 75mm field guns, the pride of the French Army, could, for example, sweep ten acres of terrain, yards deep, in less than 50 seconds; , shells had been fired in a five-day period of the September engagement on the Marne.
The rumor emanating from there reflected the instinctive dread aroused by such monstrous innovation. Shrapnel from mortars, grenades and, above all, artillery projectile bombs, or shells, would account for an estimated 60 percent of the 9.
And, eerily mirroring the mythic premonition of the Marne, it was soon observed that many soldiers arriving at the casualty clearing stations who had been exposed to exploding shells, although clearly damaged, bore no visible wounds. Rather, they appeared to be suffering from a remarkable state of shock caused by blast force. In a landmark article, Capt. Organic injury from blast force? Or neurasthenia, a psychiatric disorder inflicted by the terrors of modern warfare?
Yet it was a nervous age, the early 20th century, for the still-recent assault of industrial technology upon age-old sensibilities had given rise to a variety of nervous afflictions.
As the war dragged on, medical opinion increasingly came to reflect recent advances in psychiatry, and the majority of shell shock cases were perceived as emotional collapse in the face of the unprecedented and hardly imaginable horrors of trench warfare.
There was a convenient practical outcome to this assessment; if the disorder was nervous and not physical, the shellshocked soldier did not warrant a wound stripe, and if unwounded, could be returned to the front. Then when it seemed right on top of us, it did, with a shattering crash that made the earth tremble. It was terrible. The concussion felt like a blow in the face, the stomach and all over; it was like being struck unexpectedly by a huge wave in the ocean.
Transferred to a treatment center in Britain or France, the invalided soldier was placed under the care of neurology specialists and recuperated until discharged or returned to the front. Officers might enjoy a final period of convalescence before being disgorged back into the maw of the war or the working world, gaining strength at some smaller, often privately funded treatment center—some quiet, remote place such as Lennel House, in Coldstream, in the Scottish Borders country.
The Lennel Auxiliary Hospital, a private convalescent home for officers, was a country estate owned by Maj.
Walter and Lady Clementine Waring that had been transformed, as had many private homes throughout Britain, into a treatment center. The estate included the country house, several farms, and woodlands; before the war, Lennel was celebrated for having the finest Italianate gardens in Britain.
Lennel House is of interest today, however, not for its gardens, but because it preserved a small cache of medical case notes pertaining to shell shock from the First World War. Similarly, 80 percent of U. Army service records from to were lost in a fire at the National Personnel Records Office in St.
0コメント