Every November we remember the fallen, those who died in battle whist serving their country. We also remember those who returned but returned forever changed, due to the horrific injuries they sustained on the battlefield, both the physical and the mental. Generations of soldiers for whom the trauma of warfare doesn’t end just because the guns and missiles stop being fired.
What is shell shock
Last year we commemorated 100 years since the beginning of the First World War, this year marks 100 years of Shell Shock. The term used to describe the unfathomable symptoms soldiers were returning from WW1 with. Some returned shaking constantly, with a glazed expression and in a completely non-communicative state. Some soldiers are reported to have come back blind, paralysed or deaf but with no obvious physical cause. Men who had bayonetted the enemy in the stomach would report debilitating stomach cramps, facial tics were developed by those who had injured the enemy in the face, despite suffering no physical injury themselves. It was as if the mental trauma of their actions were haunting them months and years after the event. The condition was four times more common in officers than it was in soldiers.
Initially it was thought these, previously unseen consequences of war, were the effect of the sonic blast from the endless explosions and gun fire which had either somehow altered and damaged the brain, or caused physical damage to the nerves. But the same symptoms were also seen in those who hadn’t been to the front line or exposed to the “sonic waves”.
Shell Shock undoubtedly existed before WW1. It is unlikely that the barbarism seen in WW1 was any worse than any other war, it was just different, however it was only during WW1 the condition started to be recognised, documented and finally treated.
Back then, Military Psychology was in its infancy, and, at a time known for the stiff upper lip, psychologists meddling in the minds of soldiers was met with concern by members of the government. In fact, even Churchill raised concerns saying:
“I am sure it would be possible to restrict as much as possible the work of these gentlemen, who are capable of doing an immense amount of harm with what may very easily degenerate into charlatanry. The tightest hand should be kept over them…It is very wrong to disturb large numbers of healthy, normal men and women by asking the kind of odd questions in which the psychiatrists specialize.”
But, despite concern from the government, treatment facilities were set up with over 80,000 cases having been dealt with by the end of WW1 alone. Although the treatment at the time, which included electric shock treatment and harsh discipline, was often as ineffective as it was cruel.
In modern warfare we don’t hear of soldiers coming back from battle with Shell Shock, we hear of combat trauma and Post Traumatic Stress Disorder, PTSD. The same illness, with the same cause, but with many different symptoms. Gone is the tremor suffered by shell shock victims and the vacant expression, instead PTSD suffers have, amongst other symptoms, flash backs, nightmares and a numbing of emotions. No-one is sure why the expression of the illness has changed, but the change in the way warfare is conducted and a society that is far more open and expressive of their emotions, even within the more emotionally repressive environment of the military, is most likely responsible.
As the manifestation of combat trauma has changed so has the treatment. Now modern psychology uses treatments such as cognitive behavioural therapy, coping skills training such as mindfulness, anxiety and anger management, and activity based rehabilitation, such as outdoor pursuits. The treatment is kinder and the results are better, though many will always carry the mental scars of the battlefield with them.
So whilst we remember the fallen, it is also important this November to remember those that came back. Those who came back not just wth the physical scars of warfare but also with the mental ones, those who came back changed forever.