The first studies that focused on the effects that traumatic stress can have on people date back to the First World War and, in particular, the attention paid to the reactions of recruited officers and soldiers, who presented states of anxiety. , depressives, heart problems and fears. In fact, the conflict had not yet completely ended that psychoanalysts, at a conference held in Budapest in September 1918, spoke of a medical problem that had arisen when treating soldiers at the front: war neurosis. With this Psychology-Online article we will see in detail What is war neurosis syndrome, its symptoms, causes and possible treatments of the time.
What is shell shock syndrome?
The war neurosisalso known as trench madness, soldier’s disease or soldier’s syndrome, is nothing more than one of the first names with which it was defined. current post-traumatic stress disorder: Historically, the term war neurosis was eliminated in the 1968 edition of the DSM-II and then reintroduced a few years later as “Post-Vietnam Syndrome”, until, in 1980, the DSM-III introduced precisely the term concept of , applying this term not only to war neuroses, but to a whole series of events classified as traumatic.
Causes of shell shock
The horrors and atrocities of the First World War ended up causing serious damage even to the psyche of the combatants: the global dimension of this conflict and its static nature meant that the rate of psychological problems among troops remained constantly high. During World War I, four clinical entities were identified:
- The battle hypnosisis characterized by the almost hypnotic state of stupor reported by the survivors of the first battles in Belgian territory.
- The howitzer either “pomegranate wind”, refers to the soldiers thrown into the air from the explosion of the bombs or covered by the earth always after the explosion; The international psychiatric community will immediately recognize this syndrome, calling it by the English expression “shell-shock.”
- Anxiety due to neurasthenia.
- The war hysteriawhich defines a very broad clinical picture that includes motor crises, amnesias, false blindness, mutism, tics, false anesthesia and paralysis, and stuttering.
In 1918, all the pathological states described so far will be grouped under the label of “war neuroses” or, rather, “war psychoneurosis”, to emphasize that its pathogenesis is of psychic origin. We owe this definition to the German doctor Honigman, the first to coin the term “war neurosis” (kriegsneurose) in 1907, also known as trench madness and soldier’s syndrome.
Symptoms of war neurosis
How do these war neuroses manifest themselves concretely? It was suggested that the symptoms were due to the strong sensory stimulation associated with the roar of the explosions, and later it was noted that some soldiers developed the same symptoms, without having been involved in particular incidents and explosions: under the definition of “shock by bombing”, therefore, the various psychiatric experiences generated by the combats were grouped together, whose symptoms ranged from paralysis and the wander without destination until the incontinence urinary and intestinal. At the first symptoms, mutism and apathywe must add serious forms of distress, amnesia, persecution manias and hypersensitivity to noise (At the slightest sudden sound, many inmates assume defensive positions, as if they were on the verge of an attack).
According to the reports of many veterans, there is a feeling of being trapped: on the one hand, death at the hands of the enemy and, on the other, in the event of escape, death at the hands of the military tribunal. The nightmare of a death always lurking, the deafening noise of the bombs, the blinding light of the flares and rockets provoked hallucinations, motor dysfunctions, loss of control and psychic aberrations.
Therefore, war neurosis seems to become – analytically speaking – an escape from an unbearable situation: it is a kind of last resort for that survival instinct buried under the repressive authority of military life.
Freud and war neurosis
Sigmund Freud leaves some important considerations in the introduction to the book Psychoanalysis of War Neuroses and in a Memorandum on the Electrical Treatment of War Neurotics, where he describes war neuroses as traumatic neuroses, facilitated by a pre-existing conflict in the Self. According to , the father of psychoanalysis, In the traumatic state of war the Ego feels a danger to itself, provoked by a new Self, the warlike one of the soldier, which puts him before death; and from this internal enemy he defends himself by taking refuge in a traumatic neurosis. The war forced Freud to reconsider the environmental element, the weight of external reality at the origin of psychological sufferingthus redesigning the profile of the trauma by shifting the emphasis on the external world, after having laboriously taken it to the internal one.
War neurosis treatment
The sick of the First World War, accused of cowardice and betrayal, cruelly called “war fools”, were taken to asylums where they met psychiatrists who, in addition to not knowing how to deal with a hitherto unknown pathology, often They applied quick therapies (almost always) with a single objective: to delay, even return, the soldiers to the front to fight in the shortest possible time.
What to do, then, with men affected by paralysis, amnesia, tremors and other symptoms, but in the absence of organic lesions? The few doctors who followed an analytical orientation recognized in war neurosis the symptoms of an internal conflict and With the help of hypnosis they tried to cure patientsbringing up the triggering events.
But, rather than being truly sick, in the eyes of the specialists of the time they seemed to be cunning simulators, and the therapy to which they were mostly subjected was a “painful electrical treatment.” Disciplinary treatment was similar in the armies of different countries and was based on the administration of electric shocks, screams, isolation, food restrictions, threats… From a military point of view, the neurotic was treated as a coward who escaped from his duties as a citizen. The purpose of this inhumane cure was to force the patient to abandon his illness, which had guaranteed his removal from the front, inducing a fear even worse than electricity; But even when the treatment was successful, once he returned to the front, subjected to enemy fire and the unbearable life of the trench, the patient would relapse.
In this article we talk about it.
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