Patient suffering from war neuroses, shell shock
Patient suffering from war neuroses, shell shock.
Image source: Welcome Images L0023554

The term 'shell shock' was coined by Charles Samuel Myers in 1915 and has now been re-named combat stress disorder or post-traumatic stress disorder (PTSD): the name derived from the fact that it was considered to be brought on by the stress and noise of constant artillery bombardment, although there was a wider range of causative issues. The condition could be acute or chronic.

Symptoms and effects

There are many symptoms, ranging in severity, but sufferers could experience tremors, nightmares, paralysis, blindness, deafness, anguish, inability to control their emotions and many other things. Even when ostensibly recovered, victims could have symptoms re-triggered, as is shown in this extract from a letter to the Hull Daily Mail of 30 June 1919.
'Saturday was Peace Day, but for many it was an awful time. I and I suppose, like many others, had some very startling experiences. I am an ex-soldier, discharged from hospital with shell shock and on the Holderness Road my nerves were so weak that I thought many times I should be laid flat on the pavement.

Crossing Victoria Square on Saturday I had the worst experience of many months. Young lads, it is impossible to call them men, were quite excited at discharging these rockets, not thinking of the many men there are in Hull suffering with shell shock. I only wish that something could have been done to stop this sort of thing.'
The Swindon Advertiser of 25 July 1919 reported the inquest on a Captain Hays of the RASC who had been found shot dead in a garage.
'Evidence showed that Captain Hays, who had been demobilised a month ago, was mentally affected by neurasthenia. He thought he was a poor man, but he was not, and there was no cause for him to worry in regard to financial matters. He was suffering from the effects of shell shock.

... When Captain Hays came back from Italy he was a changed man. The one thing he kept saying was: "Why cannot I have a home for my wife and children?" Medical evidence showed that death was due to a revolver wound, and the coroner recorded a verdict of suicide while of unsound mind.'
There were many newspaper reports of shell-shocked men suffering from delusions, committing crimes that were completely out of character and killing themselves.

Attitude of the authorities

There was a view on the part of the military authorities and some doctors that many cases described as shell shock were in reality cowardice/lack of moral fibre.

Private Harry Farr of the West Yorkshire Regiment had been in hospital on three occasions suffering from shell shock and his commanding officer admitted that the man's nerves had been destroyed. Nevertheless, Farr was returned to duty. On 17 September 1916, during the Battle of the Somme (16,000 men were recorded as shell shock sufferers at this battle), his battalion was moving up to the front line and Farr said he did not feel well, so he was sent to the Medical Officer. He was returned to duty again and later that day refused an order to go to the trenches. His Regimental Sergeant Major is reported to have said, "You are a f.....g coward and you will go to the trenches. I give f..k all for my life and I give f..k all for yours and I'll get you f.....g well shot". Late that night Farr was sent to the trenches under escort, a fracas broke out and the escorts allowed him to escape. The following morning he was arrested and charged with cowardice in the face of the enemy. He was found guilty at court-martial and executed. 90 years after that event the Defence Secretary granted a pardon to Farr and all the others who had been executed for military offences during the First World War.

The Shot at Dawn Memorial
The Shot at Dawn Memorial at the National Memorial Arboretum in Staffordshire.
Photo by Noisette via Wikimedia Commons.

The statue shown above, which commemorates all 306 British and Commonwealth soldiers who were executed in the First World War for cowardice or desertion, was unveiled in 2001 by Mrs Gertrude Harris, daughter of Harry Farr: his wife, also Gertrude, had died in 1993. She and his two young children were left destitute.

Australia had shown a different attitude and announced on entering the war that none of their personnel would be executed for desertion or cowardice. In the UK the death penalty for military offences (except mutiny) was abolished in 1930, largely due to the efforts of Labour MP Ernest Thurtle.

The Yorkshire Evening Post of 9 April 1919 reported as follows.
'The clinical and scientific meeting of the British Medical Association was opened this morning, in London. Dr F W Mott, in a paper on War Neurosis, said shell-shock was an unfortunate term and led to misconception. A great many men, who had been returned as suffering from "shell-shock" would have been more appropriately designated "shell shy". Varied hysterical manifestations were due to the emotional shock and curable by contra-suggestion. The war had produced no new nervous disease.'

It hardly mattered what they called it. The fact remained that the war had exposed men to events and conditions which were beyond the mental endurance of some. The poet Wilfred Owen was sent home from France, suffering from shell-shock, and recuperated at Craiglockhart War Hospital in Edinburgh; he returned to France, where he was killed in action just a week before the Armistice, and was posthumously awarded the Military Cross. His poem 'Mental Cases' describes the reality of shell-shock or whatever we wish to call it.

Who are these? Why sit they here in twilight?
Wherefore rock they, purgatorial shadows,
Drooping tongues from jays that slob their relish,
Baring teeth that leer like skulls' teeth wicked?
Stroke on stroke of pain,- but what slow panic,
Gouged these chasms round their fretted sockets?
Ever from their hair and through their hands' palms
Misery swelters. Surely we have perished
Sleeping, and walk hell; but who these hellish?

-These are men whose minds the Dead have ravished.
Memory fingers in their hair of murders,
Multitudinous murders they once witnessed.
Wading sloughs of flesh these helpless wander,
Treading blood from lungs that had loved laughter.
Always they must see these things and hear them,
Batter of guns and shatter of flying muscles,
Carnage incomparable, and human squander
Rucked too thick for these men's extrication.

Therefore still their eyeballs shrink tormented
Back into their brains, because on their sense
Sunlight seems a blood-smear; night comes blood-black;
Dawn breaks open like a wound that bleeds afresh.
-Thus their heads wear this hilarious, hideous,
Awful falseness of set-smiling corpses.
-Thus their hands are plucking at each other;
Picking at the rope-knouts of their scourging;
Snatching after us who smote them, brother,
Pawing us who dealt them war and madness.
Siegfried Sassoon was another officer who was sent to Craiglockhart suffering from shell shock; he was also awarded the MC but survived the war. This is his poem 'Survivors'.

No doubt they'll soon get well; the shock and strain
Have caused their stammering, disconnected talk.
Of course they're 'longing to go out again,' -
These boys with old, scared faces, learning to walk.
They'll soon forget their haunted nights; their cowed
Subjection to the ghosts of friends who died,-
Their dreams that drip with murder; and they'll be proud
Of glorious war that shatter'd all their pride...
Men who went out to battle, grim and glad;
Children, with eyes that hate you, broken and mad.


In the First World War there was a growing recognition that even apparently normal men could succumb to the stress of service on the front line. Shell shock victims were usually placed in a casualty clearing station for rest and, if they did not recover quickly, were repatriated to the UK. By June 1918 there were 22 specialist hospitals in Britain which treated such cases, including the facility at Ewell. Medical officers of the RAMC were given three months' training on treatment techniques.

Treatments were varied. At one end of the spectrum there was a disciplinary approach (including electric shocks), based on the view that victims could be cured by a regime akin to punishment - having commands shouted at them, isolation and restricted diet. There was a psychological theory behind this, but other doctors felt that the key to recovery was to talk to the patient, encouraging him to confront his experiences and come to terms with them. C S Myers was one of those who favoured the latter approach.

Since the First World War psychologists have identified why so many soldiers, sailors and airmen suffered mental issues during the hostilities. As we know, droves of young men rushed to enlist for various reasons, such as sheer patriotism, adventure, escape from humdrum lives and jobs. They were drilled and trained in repetitive, automatic tasks, pitched into dreadful conditions and became cogs in the vast machine that was presided over by largely faceless generals and politicians. Psychologists note that many men lost their sense of self-worth and became unable to function in a normal way. A lot of returning servicemen would never talk of their experiences when they returned home, even to their loved ones.

(I have a distant relative whose grandfather served overseas in the First World War; he came home considerably changed but told no one in the family what had happened to him. When the Second World War broke out he apparently became increasingly anxious about the possibility that the Germans would invade Britain and in 1941 he shot himself.)

If one positive thing came out of the First World War it was the recognition that any human being could break down in extreme conditions, which gradually led to the development of more enlightened attitudes and treatments.

Although knowledge and understanding of war neuroses has vastly improved since 1918, the problem will still exist for as long as there are wars. The Daily Telegraph reported last year that cases of PTSD were on the rise among personnel who had served in places like Iraq and Afghanistan and that the condition often manifested itself years after the event.

On 1 January 2012 29 year old Lance Sergeant Dan Collins of the Welsh Guards was found hanged in a quarry. Dan had served in Northern Ireland, Bosnia and Iraq and returned from Afghanistan in 2009, a posting which he described as 'hell'. He had been shot, his life being saved by body armour, and had survived two bomb explosions; he had seen two of his comrades, including his best friend, blown to pieces. He was a changed man when he returned home and PTSD was diagnosed in 2010. Dan suffered flashbacks to Helmand, which could be triggered by something as innocuous as an everyday noise, and they reduced him to a wreck. His personal life was in tatters and he made several suicide attempts before the one that succeeded. There were accusations that he had not received sufficient support and treatment and it is telling that a spokesperson said to the BBC that the MOD had committed 7.4 million to ensure there was extensive mental health support in place for everyone who needed it. Not a vast sum in the circumstances.

Researched and written by Linda Jackson © 2014