Post traumatic stress - why ? MJ Cooney

[scrimnet]

If someone was invalided out of the army with Shell Shock / "PTSD" he would have been known on his records as a "Service Patient"

Here is some int from Prof Ian Palmer late Prof of Defence Psychiatry...

One of the interesting facts of mental breakdown in the First World War was that although in the field there were 30 men to an officer, as many as one in six shell shock cases were officers. To ordinary soldiers shell shock had all the appearance of a privileged diagnosis and treatment system in which patients were regarded as recoverable, whereas other ranks were more likely to be written off as ‘hopeless’ cases.

Then, as now, mental illness carried a stigma despite its ubiquity. The First World War saw partial understanding of human mental reactions to severe stress move from the social [external explanations of moral degeneration i.e. bad] towards the medical [internal, psychological i.e. mad]. Social and political ideologies of social efficiency, class degeneration and racial purity were played out with those suffering mental illness following combat. The problem with the medical paradigm however was any soldier assessed as mad, would pass into the Lunatic Asylum system, generally a one-way process. In 1914, being a lunatic meant being a pauper and subject to Poor Laws provision. To be a pauper was to not exist. Paupers’ graves for example, were unmarked and a number of ‘soldier lunatics’ were interred in paupers’ pits requiring later re-internment and a marked grave. It may be difficult for us today to understand the fears of a generation not only of mental illness but also of its management. Such fears were so prevalent that there was a public outcry at the way the Services were managing their mental casualties which led to changes, admittedly slow and faltering, in the management of the mentally ill soldier; the forgotten community of marginalized and disenfranchised individuals, the flotsam of the Great War.

[scrimnet]

The Service Patient became part of an emerging agenda of human and social rights. The First World War forced the government, and society, to consider, perhaps for the first time in any depth, the welfare of the humblest citizen soldier. Before 1914 there was little sense of entitlement amongst the citizenry and psychiatry had, in the asylum doctors at least, come to represent the Government &/or Society rather neglecting the individual and their rights. The plight of the Service Patient may be said to be the first skirmishes in a battle to develop a more humane and therapeutic relationship between psychiatric patient and doctor. This was not the only, or perhaps the most important battle facing the Service Patients. After the war there was great pressure on the Government to minimise its pension bill only recent research has revealed the players involved and the tortuous nature of their deliberations; and the maze of rules and regulations which War disability pensioners and their families had to negotiate in order to access their entitlements and maintain their dignity.

[scrimnet]

In 1937, there were about 35,000 pensions still in payment for ex-servicemen with mental disabilities. As many as 10,300 [about 30% of the total] bore the label ‘psychosis’. Although not necessarily the most common mental outcome of military service, this group of patients accounted for about 60% of the entire pension budget related to mental illness. The vast [and disproportionate] majority of these were other ranks. Their plight, has been largely neglected and their presence made invisible, as the mental health historiography of the Great War has focussed on the "neurasthenic" officer. However in the ‘club of war psychotics’ it turns out that there are rather more ‘mad captains, barking brigadiers and other brass hats lurking in the psychiatric undergrowth than first meets the eye’; some of whom may have been more disadvantaged than even the soldier lunatics.

In the inter-war years the Government was endeavouring to diminish the burden of war pensions, to ‘avoid a repetition of such profligacy’. The Psychiatric Establishment came to view the war pensioners in asylum wards as ‘some sort of rubbish awaiting collection’. The link between combat and an individual’s condition seemed to ‘melt away’ with a return to the focus on predisposition, encouraged by the Ministry of Pensions as it allowed, or open the door for a review [curtailment] of an individual’s entitlement. Meanwhile, the public wanted to remember heroes whilst at the same time trying to understand how war had shattered so many men and the term shell shock helps to bridge this dichotomy, that and the focus on the Officer/Hero.

[scrimnet]

The issues are as resonant today as they were during and after the First World War. Evident throughout the discourse from the middle of the nineteenth century onwards, is the clash of technology, the [frail] human form and the inevitable insurance and pension debates. Currently the debate involves the state, the media, corporations, the legislature, philosophers, religious leaders as well as the medical, psychological, nursing and social welfare professions. And issues relating to entitlement, ‘worthy causes’, advocacy and malingering remain as important today as ever.

Latterly, current orthodoxy states that Vietnam Veterans were the ‘first traumatic victims to demand collective recognition’. We  should be affording the epithet to the ‘mad soldiers’ of the Great War, ‘even though after the war their rebellion was defused, and War psychotics [or War psychosis claimants] were subjected to a process of creeping marginalization, like a fog descending’.

[ursula glover]

Thank you to everyone who replied to my post.  I think the answer is that my grandfather must have been affected by the Battle of Jutland which looks like the most significant.

Who knows, I cannot find one person who even remembers him, as I said he just seemed to disappear.  I can't even find a record of his death.

It sounds like a sad tale, but he did manage to have five children, and I like to think that his musical ability will emerge in one of the family one day.

Thanks for all your help, your links have given me a lot to research.

Ursula