1.2.2 Treatment of shell shock

First of all, there’s simply rest. And soldiers often tried to do this amongst themselves. Hide someone, let them sleep for a few days, maybe they’ll be OK. The men were kept quite close to the front lines, and the belief is that the man will get better.

This is really the basis for forward treatment today based on the principles of PIE, proximity, immediacy, and expectancy. And that’s really what was developed in the First World War. Psychological casualties are treated close to the front and very quickly, with the expectation that they will recover. If men did not recover quickly that was when they were then shipped back to Britain.

In terms of treatments, we’re really not talking about any major drug treatments. It’s too early for that. We’re talking about suggestion, which could mean hypnotism. Now, hypnotism in this period was not considered to be wacky. What it simply meant was someone was put into a sleep. A state of deep relaxation, rather. And then the doctor might suggest to them – you will recover your hearing; you will be able to use your right arm again.

Also distraction. Tasks were very good for men from the ranks. The workshops and so forth. And re-education. The man who was stammering might, for example, be sent for singing lessons. There’s very little psychoanalysis going on. This was not a society in which men were encouraged to talk about their emotions. Not a society like our own where we are used to the idea of counselling. Where we’re used to talking about feelings.

Men were very anxious when asked to talk about their dreams and naturally suspicious. The concern being that you might tell your dream to a medical doctor, and he might say, oh, actually, that indicates that you’re fine. You can go back to the front now. And that raises an important point. Of course, we’re talking about treatment regimes, but we’re also talking about a military hierarchy, and doctors on the whole were committed to the war. And they did want to heal men, but they also wanted to ensure that the British army did not suffer too much wastage. So there’s a conflict in the doctor’s role there.

Craiglockhart Rivers did institute what was known as the talking cure. What he was trying to do was to recognise that some events are so terrible that you cannot forget about them. But what you can do is you can try to turn that memory into something that you can live with. So if your friend is blown to pieces besides you, you can try to think, well, at least he died quickly. At least he didn’t suffer any great pain. It was a recognition that one had to do something a bit more complex with memory than simply try to blot out the unpleasant aspects of it.

But this is not something that was widely carried out by any degree at all. Most men had a sort of mixture of treatments. And some doctors even said, actually, we shouldn’t bother doing anything because you just really have to wait until they get better.