Tuesday , September 27 2022

What the First World War learned about PTSD


People often experience trauma during the war. Over time, this can develop into a condition that is now recognized as a post-traumatic stress disorder (PTSD). Birds can experience serious anxiety, fleasbacks, nightmares, insomnia and anger, among other symptoms.

It has a long history. PTSD cases were identified from the description in the ancient Greek history of people who survived the constant nightmares. Other symptoms, such as feeling disturbed and constantly on the brink, are described as a "military heart" during the American Civil War. But this history is sharply reversed over a hundred years ago during the First World War, when the prevalence of what was then known as "shock shock" meant that formal treatment of a psychological trauma was needed.

The battle at Somme.
Vikimedia Commons

The psychological trauma experienced during the war had an unprecedented fall for veterans, many of whom had suffered symptoms for the rest of their lives. They ranged from disturbing memories that the veterans found difficult to forget, extreme episodes of catatonia and terror when they were reminded of their trauma. The full range of veterans who had such symptoms after the First World War led to the definition of a "combat stress reaction", informing our modern PTSD concept.

The public perception of the PTSD is still rooted in the past, and some of the problems detected during the First World War in connection with psychological trauma have not yet been answered. Although much has changed, many of the principles and challenges of PTSD treatment have been identified for the first time during the First World War. If we learned lessons from the war and better recognized the victims of those who served, we must also acknowledge the impact of psychological trauma then and now.


Soldiers described the effects of the trauma as "shock-shock" because they believed they were caused by artillery bombardment. As early as 1915, military hospitals became scared of soldiers who sought treatment for "wounded minds", tension, blurred vision and adherence, a completely surprising military establishment. The military psychiatrist, Charles Miers, subsequently published observations in the Lancet, who performed the term shellfish-shock. Approximately 80,000 British soldiers were treated for a shell attack during the war. Despite its prevalence, the experience of shock shock is often attributed to moral weaknesses and weaknesses, while some soldiers are even charged with cowardice.

An Australian soldier showing signs of shellfish (below left)
Vikimedia Commons

But the concept of shock shock had its limitations. In spite of the fact that the term was clarified, Charles Miers noted that the school shock meant that he had to face the battle directly, although many who were ill from that state were exposed to a trauma that was not related to the battle (such as the risk of injury and death ). Cognitive behavior and trauma symptoms, such as nightmares, hyper-alertness and avoidance of trigger situations, are also neglected in relation to physical symptoms.

Today, these cognitive symptoms and behavioral symptoms are defined by PTSD. Physical symptoms that define school shock are often the consequences of these nephysical symptoms.

Treatment of shellfish shock

The treatments were harsh. As described in the novel Pat Barker regeneration, patients with a hollow shock could receive courses of electrohoc therapy and physical conditioning, with the goal of rapidly ease physical symptoms.

Not only were such treatments brutal, they were usually ineffective, with 80% of those who were treated they can not serve again. They were usually used to treat physical symptoms such as removal and tremor, as shown in the video below. While the person on the video is shown again, it is not known whether the psychological symptoms are facilitated.

(Video, Shellok Patient in Treatment – War Archives from British Pathetic: GRAPHIC)

Due to the ineffectiveness of the prescribed treatments, many soldiers who witnessed a trauma or experienced shellfish have tried to use drugs themselves. The use of alcohol and drugs was the usual method for treating the current symptoms, much like the use of alcohol by Captain Stanhope to deal with the anxiety phenomenon in the novel Journei's End. While prevailing, self-treatment undoubtedly exacerbates untreated cognitive symptoms, such as flashbacks and nightmares, as is commonly found today in PTSD.

However, some shock treatments were very effective: those who focused on cognitive symptoms and behavioral symptoms now associated with PTSD. A military doctor, Arthur Hurst, went to great extent to encourage shock shock patients to reconstruct their traumatic experiences, using films and simulations to deal with their traumatic memories. These "speech remedies", which emphasized the cognitive and behavioral symptoms of the trauma, had a much better degree of success. Although rarely used during the war, many modern PTSD treatments can monitor their development in these speech therapies, departing from the treatment of physical symptoms and directing psychological problems, such as anxiety caused by traumatic memories.

Trauma and PTSD today

Although the shellfish concept shares many functions with PTSD, ideas about what constitute trauma and treatment have changed dramatically since then. The focus on the treatment of basic cognitive symptoms and behavioral symptoms has shown a significant reduction in the physical effects of trauma observed during the First World War. Official staff is routinely hiding for trauma symptoms before and after use; identifying the problem early reduces the risk of PTSD development, while shock-shock treatment focuses on treating symptoms when they become severe.

However, many of the same challenges that have been observed a century ago are equally relevant. Stigma related to mental illness still prevents people from receiving treatment, which leads many to self-medication with alcohol instead of them instead of their symptoms. Such challenges are not unique to veterans; Refugees and victims of sexual assault are also deeply affected by the trauma, but often face barriers to obtain appropriate treatment, which exacerbates their PTSD.

All in all, we better understand what the trauma is because of the First World War. Although modern PTSD treatments are more effective than those for scaly people, problems such as social stigma and alcohol abuse remain. These are lessons from World War I that we still learn. We must not forget the challenges faced by trained service staff, even today, a century ago.

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