Some thought the condition would be better addressed by military discipline. Inevitably, Myers was criticized by those who believed that shell shock was simply cowardice or malingering. During 1917, the battles of Arras, Messines and Passchendaele produced a flood of shell-shock cases, overwhelming the four units. They were designed to manage acute or mild cases, while chronic and severe cases were referred to base hospitals for more intensive therapy. Myers argued that the military should set up specialist units "as remote from the sounds of warfare as is compatible with the preservation of the ‘atmosphere' of the front." The army took his advice and allowed him to set up four specialist units in December 1916. Drawing on ideas developed by French military neuropsychiatrists, Myers identified three essentials in the treatment of shell shock: "promptness of action, suitable environment and psychotherapeutic measures," though those measures were often limited to encouragement and reassurance.
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While Myers believed that he could treat individual patients, the greater problem was how to manage the mass psychiatric casualties that followed major offensives. Myers and McDougall believed a patient could only be cured if his memory were revived and integrated within his consciousness, a process that might require a number of sessions. Symptoms, such as tremor or contracture, were the product of an unconscious process designed to maintain the dissociation. The shell-shocked soldier, they thought, had attempted to manage a traumatic experience by repressing or splitting off any memory of a traumatic event. He concluded that these were psychological rather than physical casualties, and believed that the symptoms were overt manifestations of repressed trauma.Īlong with William McDougall, another psychologist with a medical background, Myers argued that shell shock could be cured through cognitive and affective reintegration. The first cases Myers described exhibited a range of perceptual abnormalities, such as loss of or impaired hearing, sight and sensation, along with other common physical symptoms, such as tremor, loss of balance, headache and fatigue. Once Myers was there, his research credentials made him a natural choice to study the mysteries of shell shock in France. The War Office had turned him down for overseas service because of his age (he was 42), but undeterred, he crossed to France on his own initiative and secured a post at a hospital opened by the Duchess of Westminster in the casino at Le Touquet. However, at the outbreak of the war, Myers felt compelled to return to clinical practice to assist the war effort. Shortly after qualifying as a physician, he took an academic post at Cambridge, running an experimental psychology laboratory. Myers had been educated at Caius College Cambridge and trained in medicine at St. Myers, a medically trained psychologist, as consulting psychologist to the British Expeditionary Force to offer opinions on cases of shell shock and gather data for a policy to address the burgeoning issue of psychiatric battle casualties. In an effort to better understand and treat the condition, the Army appointed Charles S. Shell shock took the British Army by surprise. Because many of the symptoms were physical, it bore little overt resemblance to the modern diagnosis of posttraumatic stress disorder. It was often diagnosed when a soldier was unable to function and no obvious cause could be identified. Symptoms included fatigue, tremor, confusion, nightmares and impaired sight and hearing.
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The term "shell shock" was coined by the soldiers themselves. Not only did it affect increasing numbers of frontline troops serving in World War I, British Army doctors were struggling to understand and treat the disorder. By the winter of 1914–15, "shell shock" had become a pressing medical and military problem.
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