The First World War and approaches to shell shock

Today is the centenary of the start of the First World War for Britain, a war in which seventeen million soldiers and civilians from countries around the world were killed. The horrors of the First World War produced psychological trauma on a scale never before seen in warfare: ‘shell shock’.

The following video from the Wellcome Library shows film clips made of several cases of shell-shocked British soldiers.

The British Army appointed an experimental psychologist called Charles S. Myers to investigate cases of shell shock and, it was hoped, to come up with a way to successfully treat it. At first Myers agreed with many others who thought shell shock was due to physical damage to the brain and nervous system, perhaps caused by concussion from being in the vicinity of an exploding shell. But many patients had no physical injuries, some hadn’t been on the front line of fighting. Myers diagnosed psychological disorders caused as a consequence of the shell-shocked soldier trying to repress traumatic memories.

His recommended treatment followed Freud’s (psychodynamic) approach of seeking to restore the patient’s memory of the repressed event. The belief was that if the patient could be helped to talk about the repressed memory instead of trying to block it or hide it away, especially if they recalled it in detail again and again. Evidence seemed to suggest to Myers and his colleagues too, that this approach worked best if patients were treated as soon as possible after they started to show symptoms. It was much harder to get productive results once the soldier was moved away from the war zone.