Shell-Shock: A History of the Changing Attitudes to War Neurosis  – ★★★★
“…They broke his body and his mind/And yet They made him live,/And They asked more of My Mother’s Son/Than any man could give...” (from Rudyard Kipling’s poem The Mother’s Son).
“…Men who went out to battle, grim and glad;/ Children, with eyes that hate you, broken and mad…” (Siegfried Sassoon, October 1917).
This is an insightful book about the history of “shell-shock”, a type of post-traumatic stress disorder suffered by soldiers after a prolonged combat. Anthony Babington is neither a medical professional nor strictly a trained historian, but his book still provides a thought-provoking overview of a very misunderstood illness. From wars described by Herodotus (484-425 BC) to the Gulf War of 1990/91, the account touches on every major war conflict to explain how “shell-shock” and combat stress were perceived and treated through history.
Babington’s story starts with the fact that on 12 March 1915 (during the First World War), British Army’s Lance-Sergeant Walton, aged 26, was court-martialled for desertion and executed by his own regiment two months later. One “small” fact, however, is that Walton was, in fact, suffering from a severe nervous breakdown from the moment of his desertion, and, in all likelihood, was even too sick to understand the nature of his actions.
Writing in 1676, Swiss physician Johannes Hofer referred to a mysterious illness affecting soldiers. They exhibited signs of despair and “nostalgia”. In the 19th century, this was described as having “a soldier’s heart”, a condition whereby a person suffers from breathlessness, racing pulse and exhaustion. A person may also display “absence of imagination, no curiosity about the future and no recollection of “the past stirring events in which they had taken part”, as well as obsessive thoughts, mental anguish and nervous mannerism” [Babington, 1997: 44].
Babington’s book is strong in providing an overview of various medical professionals’ contributions to demystifying one strange illness that had started to plague soldiers from the wars of the 1870s onwards. For example, there was in 1904 Dr Paul Jacoby, operating in Russia, who saw a large number of soldiers involved in either the Franco-Prussian War of 1870/71 or the Russo-Turkish War of 1877/1878 exhibiting strange symptoms of “insanity”. He was one of the first to “attribute the high incidence of derangement” to the fact that “the privations and fatigue of active service produces a nervous tension caused by ever-present danger and frequent mental shocks” [Babington, 1997: 21]. Jacoby was also one of the first to call for “a special psychiatric service” to be established so that soldiers suffering from this disease could receive specialised care, while saying that “recent advances of weapon technology had added greatly to the nervous strain of the combatants” [Babington, 1997: 34].
Babington actually makes an interesting observation here about the greater prevalence of shell shock in our modern times. In the past, a battle hardly lasted three days, and a three days’ battle was an unusual one. While Gettysburg “endured three days”, but the “middle of the First World War, [any battle] could last months”. Needless to say, prolonged strain and expectations of being killed over a long period of time put much pressure on the psyche, causing increased anxiety, paranoia, depression and hopelessness. There was also a new war policy entering the battlefield during the First World War – “gathering every man and gun, and wearing down the enemy by constant and, if possible, ceaseless attacks”. This attrition warfare can undoubtedly have a severe psychological and emotional impact both on the attackers and on the defenders.
Charles Samuel Myers (1873 – 1946) was one of the first British physicians to document shell-shock, and Thomas William Salmon (1876 – 1927), a leader of the mental hygiene movement in America, made a study of shell-shock, too. Dr Salmon was of the opinion that the high rate of “insanity” during previous wars was “due, in part at least, to the failure to recognise the true nature of severe neurosis” [Babington, 1997: 21]. The sad fact was that, when the first British soldiers suffering from war neurosis started returning to England in September 1914, many of them were regarded as “insane” and no special arrangements were made for them since they were sent to ordinary hospitals. At this point, war neurosis was still treated as a blast-concussion and not as a purely psychological illness.
In fact, the British were most puzzled and reluctant to admit “shell-shock” in their personnel, shaming soldiers who complained of it, and branding them as “cowards” and “ones without character or resilience” (this can be contrasted with a more understandable and humane approach taken by the US in this period [1997: 105]). The shortage of men during the First World War was also one of the contributing factors to ignore any psychiatric symptoms – if you still have four functioning limbs, off to war you go, again. As late as May 1916, Myers, then a Consulting Psychologist for the Army, wrote that “from a military standpoint, a deserter was either “insane” and destined for the “mad house”, or responsible and should be shot” [Babington, 1997: 57]. It is for this reason, cases of “shell-shock” were so severely under-reported, and it is particularly painful to read the accounts of so-called deserters, who were in fact men suffering from extreme forms of “shell-shock”, being executed for their “betrayals” and inability to perform services.
It was only in 1920 that the British government set up an inquiry “to get to the bottom of the hysteria” plaguing soldiers in recent wars, and uneasiness about the past executions for desertion started to spread among the public. The book then provides an account of the Second World War events, when there was greater awareness of the disorder, with special trained medical staff allocated to deal with psychiatric causalities. Their prevalence did not abate. Babington writers: “during the first ten days’ fighting after the landing in Normandy, more than 10 percent of the British battle casualties were psychiatric. In the struggle to break out of the bridgehead, the figure increased to 20 percent” [Babington, 1997: 156].
Perhaps Babington’s book has some needless repetition and provides more of a British perspective on the issue, as well as primarily focuses on the First World War, but the way it presents its material is still engaging and the book overall is well-researched.