Before PTSD was understood WWI Soldiers Suffered from ‘Shell Shock’

The effects of war are not exclusive to the damages of lands and infrastructures, the soldiers who lost their lives, and those who survived who maybe lost a limb or an eye. Some of the impacts cannot be easily seen by our naked eyes, like the psychological damage and trauma that the servicemen experienced in the war field. The horrors of what happened in the war could still haunt them, long even after it is over. In fact, a study conducted by Psychiatric Clinics of North America suggests that about 10% of WWII soldiers had PTSD at some point, affecting the veterans and their families. However, since PTSD was not recognized as an official disorder, it was hard to determine its prevalence. It was even more challenging during WWI when soldiers suffering from PTSD that was at that time called Shell Shock were hugely misunderstood.

PTSD

The National Institute of Mental Health defines Post-Traumatic Stress Disorder as “a disorder that develops in some people who have experienced a shocking, scary, or dangerous event… People who have PTSD may feel stressed or frightened, even when they are not in danger.” Furthermore, they listed its common symptoms:

To be diagnosed with PTSD, an adult must have all of the following for at least one month:

• At least one re-experiencing symptom
• At least one avoidance symptom
• At least two arousal and reactivity symptoms
• At least two cognition and mood symptoms

Some factors that increase the risk for PTSD include:

• Living through dangerous events and traumas
• Getting hurt
• Seeing another person hurt or seeing a dead body
• Childhood trauma
• Feeling horror, helplessness, or extreme fear
• Having little or no social support after the event
• Dealing with extra stress after the event, such as loss of a loved one, pain and injury, or loss of a job or home
• Having a history of mental illness or substance abuse

Although it has always existed, the disorder was only recognized within the past forty-two years in 1980. Before that, it was known as soldier’s heart, irritable heart, combat stress reaction, battle fatigue, or shell shock.

Baffling The Medical Community

Many young men were sent to the trenches of World War I, and 20,000 of them who were lucky enough to return home suffered from shell shock, while some thousands more experienced the disorder while in the service. They would return from war blind, deaf, mute, or paralyzed; the doctors were baffled as they couldn’t find any physical damage that could’ve caused the symptoms, with 80% of them unable to return to the military service.

It was Medical Officer Charles Myers who coined the term “shell shock” in 1917, initially thought to be a result of their exposure to the shell explosions. The theory was that they were suffering from some sort of physical injury to the nerves after being exposed to the heavy bombardment. This was proven wrong as others who were not sent in the front lines also showed the same symptoms— hysteria and/or anxiety, paralysis, blindness and/or deafness, limping or contracting muscles, nightmares that result in insomnia, palpitations, depression, disorientation, loss of appetite.

In one incident, Myers had to treat a 20-year-old soldier who got entangled in some barbed wire and was bombarded by half a dozen shells of the German artillery. When he rejoined the troops, he seemed not to be able to see, started shivering and sweating, and could not empty his bladder or bowels. Thus, the medical community was convinced that the war was creating illnesses that didn’t exist before. In 1915, there weren’t enough hospital beds for soldiers suffering from shell shock, and by 1916, 40% of the casualties had the condition. Eighty thousand cases were passed through the British Army medical facilities at the end of the war.

In an article written by Imperial War Museums titled “Voices of the First World War: Shell Shock,” people who experienced or witnessed shell shock shared their harrowing stories. Here’s one of them:

Stretcher-bearer James Brady found that speechlessness was another way in which a man could be affected.

Well I remember, when I got to the main dressing station I saw a strange object sitting on a boulder at the entrance to the marquee. He was caked with the brown mud or clay from head to feet and he was silent and he wasn’t moving. And I went to him, as one did, to see if one could help. He was completely concussed; he was dumb with shock and he couldn’t speak to me. And he just reminded me of a statue in a garden. He was just a soldier who was completely shattered and shell shocked and I went in and called one of the doctors to come out and they took him in. But he’d been sitting there apparently a long, long time and no-one seemed to have taken much notice of him.

Lack of Understanding, Lack of Sympathy

Perhaps it was the lack of understanding of the illness that resulted in the little to no sympathetic treatment of shell shock sufferers. Victims would go home ashamed, as they were treated as deserters, emotionally weak, and cowardly. Others were shot dead by their own squadron as they were charged with cowardice. The luckier ones (depending on how you see it) were charged with desertion, cowardice, and insubordination, with some of them even subjected to mock trials, charged, and then convicted.

Those treated by the medical officers of the armed forces were “cured” through emotional deprivation, shaming, physical re-education, electric shock treatment, disciplinary treatment, solitary confinement. Others received a milder but ineffective approach like hypnosis, dietary treatments, rest, and massage.

It was Arthur Hurst who was able to cure about 90% of shell-shocked soldiers with just a single session. While there wasn’t much documentation on his technique, what was known was that he took his patients to Devon countryside and cured them through labor treatment— men would work in the field, encouraged to use their energies. Hurst also encouraged them to shoot, and he also reconstructed the Flanders battlefields to help the soldiers relive the experiences. Lastly, they were encouraged to write and produce a magazine.