Shell Shock: The First World War, masculinity and mental health

Article by Eleanor Stokes

The First World War commenced during the summer of 1914 as a result of the assassination of Archduke Franz Ferdinand. Six months into the international conflict the term ‘shell shock’ first appeared in the medical journal The Lancet. Although soldiers themselves had utilized the phrase, Captain Charles Myers of the Royal Army Medical Corps was the first medical professional to publicly coin ‘shell shock’. Myers had been appointed by the British Army to form a sounder understanding of the unprecedented phenomenon that was in some cases rendering soldiers incapacitated.

Symptoms of shell shock varied. Soldiers were often diagnosed with the condition if they exhibited signs of: impaired hearing and vision, loss of balance, anxiety, insomnia and headaches. Visible symptoms were evidently of a physical nature, encouraging professionals alike Myers to conclude shell shock was the result of a physical trauma. Hence, it was presumed shell shock was triggered by physical conduct of war, such as repetitive shelling. This thesis illuminated why the soldiers nerves had suffered physical injury. 

However, following Myers’ publication, news of soldiers displaying similar symptoms without having experienced physical trauma arose. Shell shock went from being widely understood as a legitimate physical injury to an indication of weakness. Men experiencing shell shock were considered to be cowards, on the frontline and at home. Nevertheless, from 1917 Medical Officers were instructed to label shell-shocked men with Not Yet Diagnosed Nervousness (NYDN), indicating a medical movement towards understanding the trauma as a mental illness.

The soldiers’ anxieties of being shelled and actually experiencing the atrocities of war had detrimental repercussions on their mental health. William Collins, of the Royal Army Medical Corps described what dealing with shell shocked soldiers on the frontline was like: “I mean, they were just laying, gibbering idiots. I’ve seen a soldier laying on a stretcher, gibbering like an idiot just from the shell shock, being blown unconscious”. 

Collins strongly believed that men experiencing shell shock were exhibiting weakness. Such attitudes were typical of society; the phenomenon incited a moral panic regarding masculinity. Sympathy amongst comrades was subsequently uncommon. Soldiers exposing anxieties were labelled cowards and frequently charged with malingering, (feigning illness to escape military duty). On a broader scale, the societal inability to accept shell shock as a mental illness reflected a genuine fear of the erosion of traditional gender roles. As, contemporaries’ forged parallels between shell-shocked men and effeminacy, soldiers’ mental breakdowns became associated with ‘hysterical’ behaviour, a typical connotation of femininity during the Victorian era. 

Treatments were based on the understanding that men had lost sight of their manhood, with many professionals believing shell shock could be cured with harsh discipline, (treatments were not dissimilar to those used to ‘cure’ men of homosexuality in the 1950s). Therefore, clinicians such as Lewis Yealland adopted brutal treatments. He stated in his Hysterical Disorders of Warfare, 1918, that shell shock was a form of personal failure regarding a man’s masculinity and thus required harsh measures to restore the soldiers back to their former self. Yealland enforced treatments such as electroshock therapy, cigarettes put out on patients tongues and hot plates burning the back of patients throats. He triumphantly proclaimed electroshock therapy to be successful when a patient whispered, “I want a drink of water” following being shocked. However, over the course of the war inhumane treatments proved typically ineffective. Around 80% of the soldiers treated with physical conditioning were unable to serve again, many resorted to alcohol and drug abuse.

Gender paradigms were greatly challenged during the First World War, with the majority of women taking on traditional male jobs to support the war effort. However, the notion of the subversion of masculinity was exclusively unfathomable, especially during wartime. Men were stigmatised for displaying symptoms of what we would now perceive as mental health issues. Specialists conclude shell shock would perhaps now be diagnosed as Post Traumatic Stress Disorder (PTSD). Although the invisible trauma of shell shock was not taken seriously at the time, it did commence a long discussion on the mental repercussions of war and its affect on men’s mental health.