Military psychiatry: a social and clinical examination of shellshock and post-traumatic stress disorder

From ancient times, fatal injuries and casualties have been associated with the concept of waging war. However, as a result of the mechanisation and mass mobilisation of warfare during World War I, casualties with psychological damage have been increasingly reported, not only during the Great War itself, but also during World War II and numerous conflicts since. Shellshock affected not only those at the front line, but also many servicemen at the rear, including medical corps personnel, commanding officers, and soldiers in divisional control units. It is the purpose of this paper to examine shellshock, by assessing the social and clinical aspects of the disorder as it existed during the Great War, as well as in subsequent conflicts up to the present day. It will be shown that the basic medical treatment of the men who experienced shellshock was inherently inappropriate, based on the idealised social norms and ingrained concepts of masculinity prevalent during the years leading up to the Great War. Clinical features will also be discussed, as well as the social milieu and its relevance to the treatment of both men and disease. Finally, a contemporary theory and its modern successor will be considered.