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Shell-Shock: The Psychological Impact of War. By Wendy Holden. London: Channel Four Books. 1998. 192 pp. $14.99. ISBN 0-7522-2199-X

Published online by Cambridge University Press:  02 January 2018

James Thompson*
Affiliation:
Department of Psychiatry and Behavioural Sciences, University College, London WC1E 6AU
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Abstract

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Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Copyright © 2000, The Royal College of Psychiatrists

What are shell-shocked soldiers like to dance with? If this seems an odd question, then reflect for a moment on the very limited sample of behaviour available to us in the consulting room, as we interview the seated patient about their experiences, inviting them to describe the most terrible tragedies of war and to explain for our edification the disturbed state of their nervous systems. Listen we may, but observe them at parties, or let alone dance with them, never.

What Wendy Holden has managed to do in this very readable and highly informative book is to broaden the scope of our understanding, and this is no mean achievement for a book written for a popular audience. She has adopted the procedure of using scientific texts as the point of departure into wider enquiry. The broader range of a journalist has allowed her to provide a wider historical context, and to bring in the accounts of the nurses at Northfield who danced with the strange shell-shocked men.

Holden achieves, by careful description, a sobering critique of the many therapies employed and strongly defended by their inventors. In a pattern which is familiar to this day, many novices found a particular method which appeared to work, and then made a dogma and an industry out of it, relying on their own advocacy and the lack of meaningful comparative trials. More disturbing is the catalogue of severe punishments meted out by some experts to soldiers who returned from the front unable to continue because of some psychological incapacity. Electric shocks were applied with vigour to the afflicted part, and many sufferers chose to regain the use of their limbs when subjected to these tortures. These accounts cast a baleful light on the role conflicts involved in being an Army psychiatrist, caught between treating patients and recycling worn out soldiers.

Seen with the comforting detachment of historical hindsight, shell-shock was a solution to an impossible problem. The force of social duty, patriotism and misplaced enthusiasm about a just and short war led men to the Front. There they were confronted not with a romantic victory, but with the certainty of death and injury. Incapacity was both an under-standable reaction and a wise strategem. Millions died because they obeyed foolish orders. Some survived because they were incapable of continuing to function. A few were shot by their own side for cowardice. The survival strategy was therefore complicated: getting away from the front was desirable but not admissible, a ‘Blighty’ wound was a ticket home, but a psychological wound could lead to stigma, to being treated roughly, to being ‘cured’ and sent back to fight or to being shot as a coward.

Holden gives a good account of the history of shell-shock, from the first incomprehension and total lack of preparation for psychological casualties to the coining of the phrase ‘shell-shock’ by Myers in 1915 and the reluctant acceptance by the military authorities that they had to embrace some of the questionable ideas of the ‘mad’ doctors in order to prevent an epidemic. Holden traces the development of treatments up to the present day, showing clearly that the dangers of war are run a close second by the perils of therapy by unsupervised drug and electroconvulsive therapy evangelists. Against this picture of dangerous medical egotists there are many sympathetic portraits of trauma therapists such as W. H. R. Rivers, dealing with a wide variety of disturbed officers and using psychotherapy wisely in a humane treatment milieu.

In all, this is a good book in terms of its broad coverage, and in its willingness to tell the story from the participants' point of view. So what are the shell-shocked like to dance with? Pretty normal on the dance floor, but even more terrified than other men beforehand.

References

London: Channel Four Books. 1998. 192 pp. £14.99. ISBN 0-7522-2199-X

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