Post Traumatic Stress Disorder (PTSD) can be seriously debilitating for the sufferer and for everyone who cares for them. Shell-shock, war neuroses, battle fatigue, combat fatigue, combat stress reaction…. By any name, for every soldier, peacekeeper, freedom fighter, victim, fire fighter & anyone suffering extremes of any sort this is a natural reaction to an unnatural situation.
It existed long before the world wars, & has been with human kind for as long as we have fought each other. Modern wars have got louder & more psychologically damaging over time. This is a brief introduction, & states the obvious to a large extent. For many, the effects of PTSD manifest in less obvious ways, & over long periods of time. We know now they can occur for the first time many years after an incident. Symptoms range from making bad choices, to insomnia, mood swings, alcohol dependence & numerous other manifestations – Unique to each individual.
Shell-shock & War Neuroses WW1
During & after the World Wars, many survivors suffered from a condition that was known then as shell-shock, or battle fatigue. The symptoms varied, but often included sensitivity to loud or sudden noises / bright light, waking dreams or hallucinations, fear, involuntary shivering or crying, sleep/memory disturbances & a variety of other symptoms. Some exhibited more obvious symptoms than others, & the condition was not well understood. Treatment was patchy at best & was aimed at getting people back into the war. Treatments often included either rest, hypnosis, water or electrotherapy (shock treatment)
After WW1 the phenomenon was regarded as a psychiatric illness, despite the sheer numbers of people who were affected. The nature of trench warfare & the vast numbers of people who were killed or injured in combat resulted in many suffering long after the war was over, often for the remainder of their lives. So many people suffered from post war problems that society just accepted that some people were either unwell or troubled & life went on as normal for the vast majority of survivors. The ones who were unable to function in society at all & broke down completely were considered to be mentally unwell. The thousand yard stare was observed in people who were physically hurt as well as those who suffered relatively minor or no physical wounds at all. Many families suffered in silence & just got on with things as best as they could. In society, people were proud of their soldiers & the sacrifice they made for king & country. My grandparents often spoke with great respect & sympathy & understanding of people who they had known who had been affected due to the war.
Exhaustion & Combat Fatigue/Stress Reaction WWII
WW11 saw the condition being referred to as exhaustion by the Americans. There were precious few lessons learned from the previous war, but psychiatrists recognised that limiting the time spent in active combat without a break was useful, & some countries like the USA limited this to 180 days. Efforts were made to convince people in the forces that although they were fighting away from home that they were actively protecting their own country. Keeping groups together was thought to build bonds & offer some protection against battle exhaustion. Pilots who flew repeatedly in battle zones away from home were found to be physically unwell, low morale was rife, & medical staff noticed that almost all of the men were listless, lacked expression, thought & spoke slower than normal, & complained of headaches, poor memory & insomnia. Emotionally, they reported feeling fear & hopelessness. British forces seemed to fare better & this was thought to be because their home country was directly threatened & they were therefore more aware that they were fighting for the survival of their homeland, families & future. German forces regarded battle fatigue symptoms to be the result of poor leadership & held leaders responsible for any issues. Sufferers were often considered to be cowards. Other nations had varying attitudes to combat stress. Treatment was scarce during wartime. The Finns dealt with it by bullying & intimidation, while the Israelis regarded the cause as lack of fibre which required swift & short support. Tragically, due to limited will, understanding & resources many men were sent back into the theatres of war whether they were able or not.
Some military leaders like Lieutenant Gen. George S. Patton never accepted that battle fatigue existed at all. Where it was recognised, “PIE” (Proximity, Immediacy, Expectancy) was regarded as the best treatment. This meant treating casualties quickly while ensuring sufferers expected a complete recovery. The aim was to return to combat after rest. Once again, this leveraged the benefits of building military unit relationships and support – Which was the focus of preventing stress while promoting recovery. “PIE” was favoured by the Americans as well as the British military, but resources to manage this was very limited.
War artist Thomas Lea’s 2000 Yard Stare – Public Domain
For those of us that are safe today, let’s be grateful. For the many who live in fear, either because of what is happening today or gone bad in the past, let us be aware that everyone needs love and understanding.
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