Tuesday , May 30 2023

What did World War I teach us about PTSD?


During the war, people often experience trauma. Over time, this can develop into a condition that is recognized as post-traumatic stress disorder (PTSD). Patients may experience severe anxiety, flashbacks, nightmares, insomnia and anger among other symptoms.

It has a long history. The case of PTSD turned out to have been portrayed in the ancient Greek history of those who experienced ancient villains. Other symptoms, such as unsteady and constantly felt, were described as "soldier's heart" during the American Civil War. This history, however, was an important turning point, meaning that the spread of what was known as the "shell-shock" of World War I a century ago required formal treatment of psychological trauma.

Battle of cotton.
Wikimedia Commons

The psychological trauma experienced during the war was an unprecedented victim, and many of them suffered symptoms throughout their lives. Ranging from miserable memories that veterans seemed hard to forget, to extreme fashions and phobias when reminded of trauma. The vast majority of veterans who have experienced these symptoms since World War I reveal the concept of modern PTSD by drawing the definition of "battle stress response".

The public perception of PTSD is still rooted in the past, and some of the problems found in psychological trauma during World War I have not been answered yet. While there have been many changes, many of the principles and challenges of PTSD treatment were first identified during World War I. In order to better understand the sacrifices of those who have learned and learned the war, we must acknowledge the effects of psychological trauma. Past and present.

Shell shock

Soldiers described it as "shell-shock" because they believed that the impact of the trauma was due to shell impact. In early 1915, Army hospitals were flooded with soldiers who needed a "wounded heart", trembling, blurred vision, and appropriate remedies, and the military facilities were completely astounding. Army psychiatrist Charles Myers used the term shell-shock in Lancet. Approximately 80,000 British troops were treated as shell shocks during the war. Despite the epidemic, experiencing shell shock was often due to moral failure and weakness, and some soldiers were accused of cowardice.

Australian soldiers showing signs of a shell shock (bottom left)
Wikimedia Commons

However, the concept of shell shock was limited. Despite the use of this term, Charles Myers concluded that shell-shock should be directly exposed to combat, even though many suffering from the disease were exposed to non-combat traumas such as injuries and death threats. . Cognitive and behavioral symptoms of trauma such as nightmares, excessive boundaries, and fatigue were also overlooked compared to physical symptoms.

Today, defining PTSD is a symptom of cognition and behavior. Physical symptoms that define shell shock are often the result of these non-physical symptoms.

Shell Shock Therapy

The treatments were harsh. As described in Pat Barker's new regeneration, patients with shell shock can undergo an electrical shock therapy and a physical conditioning process to quickly relieve physical symptoms.

Such treatments are not only cruel, but generally ineffective because 80% of untreated people can not be cured again. As can be seen in the video below, it is very commonly used to treat physical symptoms such as ankles or tremors. While the man in the video walked again, it was not known whether the psychological symptoms were alleviated.

(British Pathé, War Archives: GRAPHIC, GRAPHIC)

Because of the ineffectiveness of the prescribed treatment, many soldiers who witnessed trauma or experienced shell shock tried to treat their symptoms themselves. Drinking and drug use was a common way to treat immediate symptoms as Captain Stanhope uses alcohol to cope with the onset of anxiety in the novel's Journey's End. During the epidemic, self medication undoubtedly aggravated untreated cognitive symptoms such as flashbacks and nightmares as they are commonly present in PTSD today.

However, some shell shock treatments were very effective. It is a treatment focused on cognitive and behavioral symptoms associated with PTSD. A military surgeon, Arthur Hurst, spent a lot of time encouraging trauma patients to use movies and simulations to rebuild their traumatic experiences to cope with traumatic experiences. This "speech therapy" which emphasizes the cognitive and behavioral symptoms of trauma has a much better success rate. Though rarely used during the war, many modern PTSD therapies can track the progression of these conversational therapies from the treatment of physical symptoms and breaking away from psychological problems such as pain caused by traumatic memory.

Trauma and PTSD Today

The concept of shell shock shared many features with PTSD, but the idea of ​​trauma and the components that make up the treatment has changed significantly since then. The focus on treating basic cognitive and behavioral symptoms has been shown to greatly reduce the physical consequences of trauma observed during World War I. Service personnel are routinely screened for signs of trauma before and after deployment. Early detection of a problem will reduce the risk of PTSD, but shellshock treatment focuses on treating symptoms when symptoms become severe.

Nonetheless, many of the same challenges observed a century ago are equally relevant today. The stigma associated with mental illness still prevents people from getting treatment, and many people treat themselves with alcohol to alleviate symptoms. These challenges are not limited to veterans. Refugees and victims of sexual violence are also seriously affected by trauma, but they often interfere with proper treatment and often aggravate PTSD.

Overall, we understand better what trauma is due to World War I. Modern therapies for PTSD are more effective than shell shock, but problems such as social arrogance and alcohol abuse still remain. This is the lesson of World War I that we are still learning. We must not forget the difficulties faced by servicemen exposed to trauma today and a century ago.

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