Shell-shock

A term for traumatic neurosis that was widely used during the First World War to describe various neurotic syndromes which are now recognised as anxiety states and anxiety hysterias.

Its invention and adoption may well have been facilitated by the preoccupation of the public mind at that time with the recently learned effects of high explosive. While it is true that the onset of symptoms was, in some cases, associated with some specific incident, such as proximity to a shell-burst, many more occurred in areas remote from shell-fire. The suggestion, seemingly implicit in such a term, than an important, or even essential, causal part was played by concussive trauma was as inaccurate as the picture which it tended to convey of a previously perfectly healthy individual being stricken down with dramatic suddenness. In the majority of cases the appearance of symptoms merely marked the point where the breaking stress had been reached after a prolonged period of tension, even if the latter had been unsuspected. The role played by any special incident was merely precipitant, and the true cause lay in conflict between the individual's instinct of self-preservation and the demands of patriotic duty, loyalty and self-respect. The heavy emotional charge investing such a conflict finally become too strong, was dissociated from it, and erupted into consciousness as 'free' anxiety. The latter, or its somatic 'attachments', accounted for a variety of signs and symptoms, such as tremor, inability to talk, paralysis, insomnia, and amnesia. These rendered the individual unfit for further service in the danger zone, revealing thereby their unconscious purposive aspect. Thus the original conflict had been solved in a manner involving no conscious guilt or loss of honour.

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