BAT­TLE BREAK­DOWN

Shell shock was a mys­te­ri­ous mal­ady that left sol­diers in­ca­pac­i­tated.

Canada's History - - CONTENTS - –– Brooke Camp­bell

The ter­rors of the trenches left some sol­diers quiv­er­ing and in­ca­pac­i­tated. Grad­u­ally shell shock came to be rec­og­nized not as cow­ardice but as a men­tal ill­ness.

The in­ten­sity and trauma of trench war­fare had pro­found im­pacts on the hu­man mind. Sol­diers ex­posed to the hor­rors of war be­gan to break down, ex­hibit­ing a va­ri­ety of symp­toms that in­cluded shak­ing fits, in­som­nia, am­ne­sia, and the “thou­sand-yard stare.”

The coinage “shell shock” came from the ini­tial be­lief that prox­im­ity to ex­plod­ing shells caused mi­cro­scopic dam­age to the brain, which then caused these re­ac­tions. When those who were nowhere near the front lines also be­gan to show signs of break­down, this ex­pla­na­tion was brought into ques­tion.

Doc­tors were un­cer­tain what trig­gered shell shock, and they de­bated how it should be treated. Med­i­cal treat­ment ranged from en­cour­ag­ing rest to elec­tric shock ther­apy.

The mil­i­tary re­mained skep­ti­cal about the le­git­i­macy of the ill­ness. With­out a phys­i­cal ex­pla­na­tion for shell shock, the blame shifted to per­sonal weak­ness. Those who showed signs of break­down were char­ac­ter­ized as cow­ards. Over the course of the war, roughly ten thou­sand Cana­di­ans were di­ag­nosed with the con­di­tion; many more likely suf­fered but were too ashamed to let their suf­fer­ing be known.

By the Sec­ond World War, the term “shell shock” was re­placed with “bat­tle fa­tigue” or “com­bat stress re­ac­tion.” Over time, the med­i­cal com­mu­nity came to rec­og­nize the ill­ness as a le­git­i­mate psy­cho­log­i­cal con­di­tion. In 1980, vet­er­ans and men­tal-health pro­fes­sion­als suc­cess­fully lob­bied for the in­clu­sion of post-trau­matic stress dis­or­der (PTSD) in the third edi­tion of the Di­ag­nos­tic and Sta­tis­ti­cal Man­ual of Men­tal Disor­ders (DSM-III).

To­day the Cana­dian Forces use the term “op­er­a­tional stress in­jury” (OSI) to de­scribe any “on­go­ing psy­cho­log­i­cal dif­fi­culty that re­sults from du­ties per­formed dur­ing mil­i­tary ser­vice.” This cat­e­gory in­cludes sev­eral disor­ders in­clud­ing PTSD, which we now rec­og­nize as a men­tal-health con­di­tion. De­spite ef­forts to pro­vide aware­ness and bet­ter treat­ment of OSIs, many suf­fer­ers still feel the stigma as­so­ci­ated with men­tal ill­ness.

A nurse ad­min­is­ters elec­trother­apy to a pa­tient suf­fer­ing from “psy­choneu­ro­sis” dur­ing the First World War.

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