Shell Shock: Traumatic Neurosis and the British Soldiers of the First World War (review)

Peter Leese's study of Britain's Great War "shell-shock" experience is well founded on an impressive body of primary documents; in particular, Leese makes good use of illustrative anecdotes and arcane notations found in medical case notes to elucidate patterns. He draws, as well, from a wide array of periodical literature, memoirs, medical journals and histories, and solid secondary sources on England's war experience, military medicine, war literature, and cultural contexts. The bibliography will captivate and guide newcomers to the field, and even experienced students of war neuroses may find a new lead or two.

Leese organizes his study into three sections. The first explains how certain adverse reactions to intense First World War combat conditions came to be recognized as psychological casualties; giving brief note to prewar, industrial precedents; and stressing the conflicting perspectives of frontline soldiers, who feared for their sanity, and military authorities, who feared for discipline.

His second section, on wartime diagnostics and treatment strategies, describes the diverse types (and quality) of home-front treatment systems, showing how they evolved out of the competing demands of combat conditions; soldier attitudes; public opinion, especially outrage over execution policies that ignored the condemned's psychiatric condition; political and media interests; conflicting medical theories; and military concerns about discipline, manpower conservation, and pension costs. From Magull, Queen Square, and Craiglockhart hospital records, Leese shows "brusque" treatment (with electric shock, isolation, threats) was atypical, but not entirely absent, for lower ranks, many of whom also endured low-quality facilities. Although officers "were more vulnerable to traumatic neurosis than members of the other ranks" (p. 43), Leese shows they were less likely to be disciplined or executed and more likely to enjoy the best facilities, considerate (even psychoanalytic) therapy, and vague diagnoses that ignored socially disreputable references to functional disorders or defective heredity. Although he compares British practices with those of the Germans and French, Leese does not compare Britain's home-front system closely with that of its own frontline system, which emerged in 1917-18, even though many thousands of English soldiers received only frontline treatment after 1917.

Last, he addresses the lingering effects of shell shock on British civilians and veterans. He notes the economic impact, describing the bitter frustrations of the pension system. And he ably analyses the cultural legacies, giving a good review of artists from Wilfred Owen to Pat Barker crafting shell shock to symbolize the futility of war, the knavery of the leadership class, and the fragility of traditional gender values and roles.

Densely packed with information, at times the narrative sacrifices chronological clarity for in-depth forays into a topical thicket or two; for example, the complex struggle between claimants and dispensers of pension funds. Those willing to pay close attention, however, will be rewarded by this first full-length treatment of Britain's "shell shock" experience.