World War I was the beginning of the time when war’s psychological effects were being seriously considered, and the term for these symptoms at the time was shell shock. The term “shell shock” was coined by soldiers and its symptoms included nightmares, fatigue, confusion and tremors. More severe symptoms were diarrhea and psychosis that caused men to feel the exact pain of the men who they had killed in battle.
In 1914 doctors began to notice soldiers exhibiting these symptoms and were having difficulty understanding the illness. Doctors began using the term shell shock as the diagnosis for soldiers who had become completely unable to function in their duties. A psychologist named Charles Myers was brought in to identify the precise psychological cues of shell shock and to gather information for a formal procedure to identify and treat this condition.
At first Myers noticed soldiers having abnormal perceptions, such as hearing and vision loss. Then he recorded soldiers with loss of balance and fatigue, and reported that these symptoms were not just physical but psychological. He felt that the soldiers survived their experiences through shutting out the memory of the traumatic event. Myers believed that shell shock was treatable and could be cured by integrating and reviving the soldier’s memories inside of their consciousness.
The overwhelming numbers of soldiers with shell shock led Myers to dictate three essentials in their treatment which included responding to the situation as quickly as possible and placing the soldiers in a more stable environment. He also recommended psychotherapy, but given the strains on resources and time, the psychotherapy was limited to reassurance and encouragement of the soldier.
Myers was criticized by those who felt the soldiers were just cowardly, but the British military eventually listened to him and allowed Myers to set up a system that referred acute cases of World War I shell shock victims to a center specializing in treatment of the disorder if the symptoms were severe. He advocated for patients receiving individual attention and persuaded the War office to begin the practice of military psychology.
In 1916 a soldier named Arthur Hubbard had been ordered to kill three German soldiers, and even though the Germans pled for their lives, he shot them for fear of insubordination. Later, in the Battle of the Somme, Hubbard watched almost his entire battalion killed. He retreated, and the horror of the event and subsequent machine gun fire that followed his retreat was too much. He was hospitalized for shell shock.
At the end of World War I there were 80,000 cases of shell shock, and psychological disorders accounted for one-third of discharges. Myers disliked the term “shell shock” because many people who had never been in the front lines facing artillery fire were experiencing the same symptoms. Attitudes of what was considered manhood came into play, and Freudian psychology, which attributed base behavior such as cruelty and murderous impulses to being neurotic disorders, was the method of treatment.
Today shell shock is known as Post Traumatic Stress Disorder (PTSD). The term from the first world war received makeovers, being known in World War II as battle fatigue. Today soldiers returning with the disorder from Iraq and Afghanistan parallel the symptoms of those who had shell shock in World War I. The commonly known term of Post Traumatic Stress Disorder is now cataloged in the Diagnostic and Statistical Manual of Mental Disorders, and is now taken seriously as a disorder, not a weakness.
By Adrianne Hill