JF Ptak Science Books Post 2441
There is an image that I have in my head of a grey train car of WWI. There were trains that would pull into stations of large cities, trains with cars of wounded soldiers back from the front, with Red Cross designations on the car sides. Crowds would come to the station to see and cheer the wounded soldiers.
There were some trains that would pull a car at the very end of the line, a car with no cross. It was in these cars that the shell shocked soldiers would sometimes be brought back home.
"War neurosis" and "combat stress" was generally what was known as "shell shock" (not named until 1917 by Charles Myers), and what we'd more commonly referred to today as post traumatic stress syndrome (PTSD). Shell shock was little understood during the war, and soldiers who manifested the behaviors associated with it were often accused of cowardice, and desertion, and in some cases faced disciplinary action that could end in jail or (in some cases) death. They certainly weren't necessarily treated as "wounded", and so it seems for the most part they were treated as separate cases.
Given what was known of shell shock the treatment to the modern eye can look severe, odd, and austere, and wrong--soldiers were subjected to electro-shock therapy, physical routines leading to exhaustion, solitary confinement, and simple incarceration. In other cases the condition would be recognized as a defense detriment and in order to alleviate it the soldiers would be sent back from the front for a few days' rest. The problem with shell shock though would continue to grow, and could be seen as a threat to a fighting force in general, and therefore some of the official responses to it left no doubt that succumbing to shell shock was a serious business, and that soldiers so afflicted would be treated differently from other wounded soldiers.2
By 1917 though Major Arthur Hurst devised a new method for treating the shell shocked soldier, with a major emphasis establishing the condition as caused by battle, and not a flight-not-fight syndrome. At the Seale-Hayne Hospital, in Devon, Hurst treated some 300 soldiers over the course of 15 months, from April 1918 to July 1919, and seemed to have caused some real improvement. That said, there were many detractors of his methods, and many more who questioned its effectiveness--to that end there seems to be no longitudinal data to support much of a claim for long-term success in Hurst's treatment.
He did however make a major contribution to the treatment of PTSD by attempting to deal with it medically, and also employing a large dose of occupational therapy in additiion to many other proactive responses to shell shock. In another interesting and pioneering move Austin made use of motion picture cameras to record the before/after effects of his treatments. This however has also come into question because some amount of the "before" images were dramatized1.
I found these videos of the Hurst treatments on youtube, and whether some of the "before treatment" footage was acted or not, the images are very jarring:
[Source: Youtube, https://www.youtube.com/watch?v=IWHbF5jGJY0]
There are also a few samples of the magazine/newspaper produced at Seale-Hayner Hospital during this time, with contributions by the patients, some of which is reproduced below:
- More photographs are available here: http://seale-hayne.com/?flagallery=seale-hayne-military-hospital
And more:
http://www.seale-hayne.com/books/mag1st/#p=1
http://www.seale-hayne.com/books/magWW1/#p=2
The poet Siegfried Sassoon (1886–1967) described victims of shell shock in his 1917 poem "Survivors", written while Sassoon was himself being treated for the condition at the more-enlightened Craiglockhart medical facility in Edinburgh, and published in Counter-Attack and Other Poems (1918):
NO doubt they’ll soon get well; the shock and strain
Have caused their stammering, disconnected talk.
Of course they’re ‘longing to go out again,’—
These boys with old, scared faces, learning to walk.
They’ll soon forget their haunted nights; their cowed
Subjection to the ghosts of friends who died,—
Their dreams that drip with murder; and they’ll be proud
Of glorious war that shatter’d all their pride...
Men who went out to battle, grim and glad;
Children, with eyes that hate you, broken and mad.
Notes:
1. "From 1917 to 1918, Major Arthur Hurst filmed shell-shocked patients home from the war in France. Funded by the Medical Research Committee, and using Pathé cameramen, he recorded soldiers who suffered from intractable movement disorders as they underwent treatment at the Royal Victoria Hospital in Netley and undertook programs of occupational therapy at Seale Hayne in Devon. " From: "War Neuroses and Arthur Hurst: A Pioneering Medical Film about the Treatment of Psychiatric Battle Casualties", by Edgar Jones, Journal of the History of Medicine, May 2011, http://jhmas.oxfordjournals.org/content/early/2011/05/19/jhmas.jrr015,
2. "When evacuation to the base hospital is necessary, cases should be treated in a separate hospital or separate sections of a hospital, and not with the ordinary sick and wounded patients. Only in exceptional circumstances should cases be sent to the United Kingdom, as, for instance, men likely to be unfit for further service of any kind with the forces in the field. This policy should be widely known throughout the Force."--Report of the War Office Committee of Enquiry into "Shell-Shock", 1922.
- See also a good entry "War Psychiatry", in WWI Online, http://encyclopedia.1914-1918-online.net/article/war_psychiatry
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