Social History of Medicine Advance Access published online on February 1, 2009
Social History of Medicine, doi:10.1093/shm/hkn093
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Shell-Shock and Psychological Medicine in First World War Britain
* Lecturer in History, School of History and Archaeology, Cardiff University, Humanities Building, Colum Drive, Cardiff, CF10 3EU, UK. E-mail: LoughranTL{at}cardiff.ac.uk
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Summary Historians have viewed the experience of shell-shock in First World War Britain as a crucial episode in the development of modern psychological medicine, arguing doctors initially believed shell-shock was caused by the physical effects of shell explosions, and only gradually realised these were psychological disorders, treatable by psychotherapy. This article argues that conceptual frameworks of pre-war medicine provided models of mind-body relations which allowed doctors to recognise the emotional origins of shell-shock on the outbreak of war. Distinct schools of physical and psychological thought only emerged in 1916; physical theories persisted beyond 1918; and the war had an uneven effect on engagement with psychodynamic theories. Adoption of psychological vocabulary outstripped understanding, and widespread dissemination also resulted in hostility. Shell-shock marked an important moment in the emergence of the distinct disciplines of psychology and psychiatry in Britain, but this did not involve a radical departure from pre-war concepts of mental health.
Keywords: First World War; shell-shock; psychology; psychoanalysis; psychiatry