At the risk of revealing too much material from the proposed print title of collected essays, balanced against the desire to have some fresh content to keep my audience warm while I look after things in the real world, I've decided to publish here, for the first time a brand new essay I wrote for inclusion to the print version. I'm still not on board with any publisher so far, and I hope to get back into more frequent and regular posts (I've been promising to write about chaplains in WWI for some time now, but haven't gotten down to it.)
What follows is a brief understanding of one of the most difficult to understand aspect of the War, the idea of Shell Shock.
The title of this essay is, without a doubt, an offensive phrase. In its modern meaning, it is applied to
someone who appears frazzled or mentally unstable; incapable of proper action
due to emotional stress. The phrase itself
is supposedly linked to the First World War due to arts and crafts therapy
undertaken by patients who had been diagnosed with nervous conditions. These men were given simple, repetitive tasks
such as basket weaving in the hope it would distract them from the strange and
misunderstood symptoms of their condition.
It was commonly referred to at the time as “Shell
Shock”, which in itself comes from a medical misunderstanding of its
cause. As much as physiological medicine
of the age may appear ignorant or backward to us today, psychiatric medicine
was much further behind, as it still is.
Mental illness is difficult to diagnose and even now there exists very
few fully effective treatments for psychological disorders, and the general
stigma of public feeling towards the mentally ill; as objects of pity, fear or
weakness still surrounds our understanding of these ailments. Such attitudes only harms the sufferer
further, even to the point of suffering in silence rather than to seek
treatment lest they be thought of poorly.
The medical misunderstanding at the time was that
close proximity to concussive force of explosions somehow jarred and disordered
the brain. The term was intended quite
literally and was applied in a generic sense to a variety of mental illness.
The mildest cases could almost go unrecognised,
usually noticed in a slight change of demeanour or a depressive or melancholy
state; to more obvious signs such as complete despondency, mania, loss of
sensibility or relation to surroundings, shaking or twitching, making
nonsensical sounds or animalistic screaming.
In extreme cases this produced “hysterical conversion syndromes in which
a mental condition had physical symptoms like paralysed limbs, blindness or
deafness.” (Holmes, 484)
By December 1914 the British had noted that 3-4 per
cent of enlisted personnel and as many as 10 per cent of officers were displaying
neurological symptoms. (Meyer 393) Much
misunderstood by military commanders and army physicians as cowardice or
malingering, sufferers were often punished by military law. This included several cases of execution by
firing squad for cowardice even in the face of medical evidence supporting the
existence of a nervous condition. This
was the standard practice rather than properly diagnosing, as much as was
possible with medical knowledge at the time, and if not even diagnosed, no type
of treatment, effective or otherwise could be applied.
It wasn’t until the mid –point of the war that a
better understanding began to take hold:
“Charles Myers, a young English psychiatrist, decided... shell shock was a ‘singularly ill-chosen
term’....It rose out of the particular conditions of trench warfare, an
experience beyond anything the human psyche was built to endure.” (Meyer 396)
It was found that quick removal from the combat area
and treatment behind the lines was most effective, not of curing the condition
necessarily but enough to return the patient to active duty. This may sound harsh, and does need to be
tempered with contemporary understandings of such conditions partnered with the
military necessity of returning all recuperated wounded, physical or
psychological, whenever practicable, back to the line. Conversely the treatments could be just as
terrible as the disease- extremes we wouldn’t think of today such as applying
electric shocks or submerging in ice water were just as common as gentle
recuperation.
It is estimated that after the war about 65 000
British soldiers were on pension for ‘neurasthenia’ (as cases
We know better today that cases of psychological
stress were not solely a First World War phenomenon. An official report of American forces in the
North West European Theatre of World War II stated that all men were
susceptible to such breakdowns, and an average individual would begin to lose
effectiveness after ninety days in the combat area (Ambrose, 203)
Even then, during the Second World War, there were
still those unconvinced that such illnesses were legitimate. The incidences of the American General George
S Patton Jr. striking private soldiers who had been admitted to hospital for
nervous disorders are among the most well known examples.
Today,
we give the term “Post Traumatic Stress Disorder” to such illnesses, and even
understand that they can occur in all cases of mental trauma and are not
specific to the military or combat.
However, modern medicine still has no comprehensive treatment of PTSD;
and as long as the fear and stigma of mental illness persist, some who might
benefit from treatment will remain undiagnosed from the shame, and those who
admit their condition to seek help can still be handled in a marginalised way.
Souces:
