World War I was the first “modern war” that soldiers experienced with explosives, mass warfare, and hands-off combat. This was very different from previous wars, and within six months of the start of war, the term “shell shock” had already become popularized among soldiers and in the media. Thousands upon thousands of soldiers ended up in medical wards with hearing and vision loss, tremors, confusion, and fatigue, with no physical wounds. One British medical report said that shell shock appeared to be “the result of the actual explosion itself, and not merely of the missiles set in motion by it.” Military doctors did not know how to treat these symptoms, and so Charles Myers, a trained psychologist of the Royal Army Medical Corps, was assigned to offer opinions on reported cases of shell shock. As Myers began to examine cases, he discovered how similar the cases were. In one report, Myers even mentioned that “commenting on these cases seems superfluous” because the cause of each case involved a soldier being exposed to exploding shells, and each case resulted in the same effects.

Myers continued his research, but early-war medical professionals decided that shell shock was a physical injury that resulted when the soldier’s brain was “shaken” inside his skull, resulting in a sort of concussion. This initially allowed for soldiers to receive a “wound stripe” on their uniforms and be dismissed with pension. However, by the time the war was halfway over, medical personnel came to the conclusion that shell shock was, after all, a nervous breakdown resulting from exposure to traumatic events of war. Rather than receiving treatment for shell shock, soldiers were deemed “uninjured” and sent back to the frontlines. Those who did receive treatment for shell shock were often treated with electric shock therapy, meal restriction, isolation, and other disciplinary treatment to try and suppress tremors and stammers.

As Myers did more research, he discovered that the best treatment for shell shock wasn’t physical, but sympathetic. Many people who believed that shell shock was a manifestation of cowardice criticized Myers for his therapy treatments. However, Myers insisted that treatment required “psychotherapeutic” measures and individual attention. The idea behind this was that the traumatic events had been repressed, and could only be “cured” by uncovering the memories of trauma. But with thousands of soldiers returning with psychological conditions, medical wards were not equipped to provide this care. Myers suggested a doctor to patient ratio of 1 to 50, and convinced the War Office to provide training courses for how to treat shell shock.

Even though Myers was one of the pioneering forces behind treating shell shock with therapy, most of his method was based around encouragement and reassurance, rather than getting to the root of the problem. Eventually, other psychologists devised methods of treating shell shock that are similar to current treatment methods for PTSD. These early treatment methods included the following:

  • Prompt treatment after the traumatic event, which can be seen today in critical incident stress management protocols
  • The need to re-experience the event by acknowledging the trauma
  • Individual-based psychological treatment to determine why this event affects this particular person
  • The importance of the traumatic experience in determining triggers and stressors that might cause adverse reactions

Shell Shock Vs. PTSD

Many people wonder if PTSD is the same as shell shock. Most experts agree that they are essentially the same, and the term post-traumatic stress disorder developed after WWII and the Korean War when experts realized that the symptoms of shell shock could last for years, and sometimes a lifetime, after the war. However, it wasn’t until after the Vietnam War that veterans themselves began to advocate for better mental health options. In 1967, a small march took place in New York where veterans redefined “shell shock” as a normal response to trauma, rather than a sign of cowardice or weakness. This march, as well as Americans better understanding the atrocities of war, helped to get PTSD classified as a legitimate mental health disorder.

Ongoing Progress For PTSD Treatment

Treatment of PTSD and mental health care coverage for veterans continues to improve, but there is still a long way to go to get every veteran the help that he or she needs. Peer Support Central offers peer support specialist training and critical incident stress management training where veterans can get help from people who share their experiences, who are empathetic, and who can serve as role models who show that a return to civilian life is possible. Contact Peer Support Central today to learn more about our peer to peer support for PTSD for veterans and active duty military personnel.