From Shell Shock to PTSD

As previously mentioned in You Need To Know You’re Not A Social Stigma, the husband of the protagonist in my book suffers from PTSD. His name is Carl. In my novel, his symptoms display themselves after he is relieved from the war front because of a physical injury. Soon after he arrives home, he is unusually distant, can become temperamental very quickly, and suffers from nightmares and delusions. He is a fictional character whose sufferings are based on the sufferings of real men who lived a century ago.

Today PTSD is now known as emotional and traumatic stress in overdrive. Those who have fought in the war front develop symptoms. Those who have witnessed death or any kind of disturbing imagery can also develop PTSD.

During WWI, PTSD was known as combat trauma, shell shock, or the nerves. Men would show symptoms of slurred speech, sporadic spasms of muscles, memory loss, nightmares, etc. At the beginning stages of the war, the army would shame and even execute an Allied soldier who showed signs of “cowardice.” Yet as the war progressed, execution ceased to be an option as hundreds and thousands of men developed these symptoms.

It was called shell shock because medical personnel believed these symptoms were brought on by the explosive impact of being hit by shells in the trenches. They believed the nerves in the brain had been physically damaged. True, many men who were hit by shells developed these symptoms. Men who were not hit by shells also developed these same symptoms.

Over time, medical staff and psychoanalysts changed their view from thinking it was a physical pain to an emotional and traumatic pain. There were two ways of treating combat trauma during WWI.

First, some treated these symptoms in despicable ways. As mentioned before, execution was one form of dealing with the problem. When that no longer became an option, they heavily shamed the men and used electric shock to “cure” them.

Second, W.H.R. Rivers and likeminded others came up with an effective treatment made of five essential steps.

  1. Immediacy: They would start treatment immediately to deal with the acute stress before it turned into chronic mental incapabilities.
  2. Proximity: They kept suffering soldiers in treatment facilities near the front lines where they could be in communion with their compatriots; they were close enough to hear the din of war.
  3. Expectancy: Sufferers were told told to expect a positive outcome for recovery. This was instilled by positive reinforcement.
  4. Simplicity: The treatment was simple. Rest, sleep, nourishment, and practical psychotherapy.
  5. Centrality: This idea reinforced the effective flow of psychiatric patients from the front lines to the rear and the therapeutic doctrine all medical staff were to adopt when dealing with patients suffering from combat trauma.

Over the last century, PTSD in all its mysteries has slowly been unraveled to reveal what we know today. If you would like to read a thorough history of PTSD, click here.

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