Most people have heard of the term “shell shock”, although many researchers and observers of World War One history do actually state that it is not an accurate moniker for this particular condition.
An awareness of mental health and the vagaries of the psyche has become more prevalent in recent years with those suffering with conditions like depression, PTSD and others being treated with much more of a sympathetic hand, but why then does a stigma still attach itself to these conditions?
I wrote recently about Dirk Bogarde, and his experiences when he was one of the early visitors to a newly liberated Bergen Belsen concentration camp in 1945, the things that people experience during war are definitely horrendous but why was it only in the 20th century that it seemed to affect people on a psychological level quite so much?
If you look at battles pre 1914, they did not involve some of the killing machines that were to come, yes cannon balls would cause a lot of damage and ultimately death, but maybe it was not quite so overpowering? The difference in 1914 and onwards was the sheer madness and wanton destruction that would come from mechanised warfare, can you imagine being told to walk into a storm of machine gun fire? Can you picture not knowing if the projectile that had been launched from a mile away was going to obliterate where you were standing? Can you feel the terror that a soldier would have felt being buried alive in a crater and knowing that the chances of being rescued were virtually zero whilst the fighting continued?
Most of these were volunteers, they were not hardened military men, they were normal Joe’s who had either been conscripted or stepped forward to fight for their country, and for some, the mental injuries they were to suffer was possibly worse than death.
One of the most well-known Psychiatric pioneers of the Great War was the amazing WHR Rivers, who had his own military heritage in that his Uncle was on the HMS Victory and the same Uncle also purported to have been the one to shoot the enemy combatant who caused the fatal injury to Nelson.
WHR Rivers was a multi-talented man, not only was he a psychiatrist, he also worked as a neurologist, ethnologist and an anthropologist. It was after a research tour as the latter in Melanesia (Fiji, Solomon Islands etc) that he returned to Blighty in March 1915 and discovered a world at war. He immediately applied to the powers that be to offer his medical services and was posted to Maghull Military Hospital (also known as Moss Side) in Liverpool which was called “the centre of abnormal psychology”. Maghull was the first of its kind and by specialising in the area of shellshock, it managed to stop a large number of military personnel being sent to asylums where their treatment would not have been so targeted to their particular needs.
After a year, Rivers moved on the infamous Craiglockhart Hospital near Edinburgh, where not only was he able to achieve a childhood dream of being accepted into the military as a Captain with the Royal Army Medical Corps (something denied to him previously due to weaknesses from a protracted bout of typhoid as a teenager) but he also began a friendship that was to continue well after 1918 with poet Siegfried Sassoon.
His methods of treatment were not limited to the conventional ways of treating shellshock, psychoanalysis, dream interpretation and hypnosis being the norm, he also promoted talking cures, believing that by revisiting the events which triggered the persons mental break would be cathartic and help to heal them.
What I find most rewarding about Rivers’ attitude was that he did not see those who suffered with shell shock (or war neuroses as it was also known) as being cowards or malingerers, snipers who had suddenly lost their sight, men who had gone over the top and were now unable to walk, others who would lose all senses if they heard certain noises and trash everything in sight in an uncontrollable panic – these were not fakers, they were unwell.
Many of those suffering with shellshock were never able to return to duty, and this was something that Rivers’ struggled with during his time at Craiglockhart, he knew that by “healing” these men he could give them a modicum of a normal life, but he also was cognisant of the fact that they could also be sent back to the front and be met with their death…or a relapse.
The British Army is believed to have treated over eighty thousand cases of shell shock, but I would wager that the number was far higher and many would rather end their life than admit what they were conditioned to see as weakness.