3.2.1 Shell shock since the First World War
By 1939, with the prospect of another war on the horizon, the issue of war trauma resurfaced. Again the payment of pensions was a major cause for concern, but the general attitude to nervous complaints had not changed hugely: the belief in the supposed links between shell shock and cowardice persisted. In 1939, Dr Francis Prideaux, the British Ministry of Pensions psychiatric expert, suggested that only those soldiers who had demonstrated bravery in battle and had been through genuinely disturbing events were deserving of pensions. It was believed that many men allowed themselves to break down because they felt it was the easy way out. The issue of predisposition also remained a source of contention.
The Second World War ultimately did not bring about anywhere near as many psychiatric casualties in the British army as the First World War, partly due to improved medical practices. Soldiers were more effectively screened before they entered the army to ensure that those already suffering from psychological problems were not admitted. Cases of mental breakdown were addressed more swiftly, closer to the front line. Military training and leadership had also greatly improved since the First World War. Perhaps most significantly, however, the nature of combat during the Second World War may also have helped to reduce the frequency of psychological breakdowns. Whereas the First World War, with the static and degrading conditions of trench warfare, could engender a sense of powerlessness, the Second World War was largely a war of movement, during which soldiers felt they had more control over their own destiny.
Despite this, the Second World War did of course give rise to psychological casualties. For the US Army, for example, the Second World War was far more costly than the previous conflict (as you will remember from our enquiry into casualty figures in Week 1), and the psychological toll was a major cause for concern. The Americans, however, took a more sympathetic approach than the British, removing the stigma from war neurosis. Rather than associating the condition with cowardice, American military and medical experts suggested that in fact every man had his breaking point, and that even the bravest man would eventually break down if exposed to sufficiently traumatic incidents. Rather than the term ‘shell shock’, the terms ‘combat exhaustion’ or ‘combat fatigue’ were more frequently used.