A thread about PTSD, Shell Shock, and executions in the BEF in the Great War #ww1 #fww #greatwar #ptsd https://twitter.com/war_student/status/1357774834990780416

Shell Shock tended to be viewed negatively as the lack of any physical manifestation of a psychological wound, and thus any way of verifying that the condition existed, and was not being simulated by a man seeking to escape the danger and discomfort of front line duty.

This was compounded by the fact that shell shock had a number of different manifestations including

"..exhaustion, palpitations, shortness of breath, tremor, joint and muscle pain, dizziness, and headache, together with nightmares, persistent anxiety, and difficulty sleeping"

It should be borne in mind that psychological injury was a new phenomenon and the science to diagnose and treat this type of injury was in its infancy.

Indeed, the term ‘Shell Shock’ is indicative of the initial misapprehension of the cause of the condition thought initially to be attributable to concussion caused the blast of explosive ordinance.

This was challenged by CS Myers, whose 1915 Lancet paper ironically formalised the term, as he could find no meaningful link between the condition and proximity to an explosion

Myers proposed a psychological explanation, attributing it instead to a form of nervous exhaustion arising from the trauma of combat. By the end of 1915, this explanation had gained wide traction in both the military and medical spheres.

Nevertheless, the matter remained somewhat vexed as no explanation could be adequately arrived at for why some men succumbed to trauma and others did not. Perhaps we still do not know the answer to this.

Maybe as a result of the inherent prejudices of the age, Shell Shock was widely thought to primarily afflict those of weaker “character”. Lord Gort VC, postulated that Shell Shock was a symptom of poor military discipline.

According to Gort (a Victoria Cross winner), Shell Shock was virtually non-existent in first class divisions and should be considered a form of disgrace, arguing that leadership, training, and espirit de corps were adequate proof against psychological injury.

These opinions persisted long after the war, and indeed into the mid-point of the second war. Concern with the conventional view arose when it was realised that even the most highly regarded men were not immune to psychological injury.

By 1943, studies were carried out showing a clear correlation between the number of psychological injuries and the number of physical casualties i.e. the more intense the combat experience, the more frequent the psychological casualties.

The issue of Shell Shock was not a trivial one for GHQ With around 200,000 cases reported throughout the war, Shell Shock was proving to be drain on the army’s resources.

e British were quick to adopt the French model of ‘Forward Neurology’ centres. The model was attractive as it chimed with the existing British medical doctrine that the further back from the front a casualty was treated, the less likely that man was to return to the frontline.

Officially termed Not Yet Diagnosed Nervous (NYND) centres, they offered the promise of the best possibility of a rapid return to combat of a Shell Shock case.

In fact, NYND centres were not particularly effective. An outcomes analysis of these centres in the vicinity of St Omer in the year till July 1917 indicated that only 17% were returned directly to the front line.

But the salient point here is that Shell Shock was a recognised medical condition, and despite suspicion of malingering, was most emphatically not automatically associated with cowardice.

On the matter of cowardice; there were 240,000 general courts martial during the war, of which 3,080 resulted in a death sentence. Of these 3,080, 346 (11%) were carried out, many of whom would have a history of indiscipline, some on their second or third death sentences.

For cowardice in particular there were 550 courts martial resulting in a death sentence, of which 18 were (3.3%) were carried out. Thus, considering that somewhere in the region of 7million men served in the army, the chances of being executed for cowardice were vanishingly small

A diagnosis of Shell Shock was usually enough to keep a man out of a courts martial, and virtual proof against a death sentence even if the matter did get that far.

The case of Harry Farr is instructive. Farr was a pre-war regular who had spent several months convalescing with a diagnosis of Shell Shock in 1915, and on two occasions again in 1916, each for a day.

Farr was tried for his repeated refusal to go ‘up the line’ in September 1916, bluntly stating to his Sergeant Major that he “could not stand it”.

His Sergeant Major responded with the choice words “You are a fucking coward and you will go to the trenches. I give fuck all for my life and I give fuck all for yours and I'll get you fucking well shot”

Farr sought a diagnosis of Shell Shock, but could not obtain one at this point, saying somewhat unwisely at his courts martial that he felt fine away from the shell fire.

With no diagnosis and his officers and NCO’s unwilling to plead for clemency, Farr was shot at dawn.

The salient point here is that while covered by a current Shell Shock diagnosis, Farr’s case was considered a medical one, rather a disciplinary one.

See also: Important thread on psychological injury in the second war by @ReassessHistory https://twitter.com/ReassessHistory/status/1349347283897380864