Featured Exhibition

Shell Shocked

The Long Road to Recovery

Image: “13th Bn. men having a meal outside their dug-out. December, 1917” Canada. Dept. of National Defence/Library and Archives Canada/O-2332

Image: “Our Brave Boys at the Front” Canadian Centre for the Great War Collection
/ 2016-1-1-37

6 min

At the beginning of the First World War, mental illnesses and nervous conditions were believed to result from an individual’s “weak” mind or character, rather than a legitimate reaction to an overwhelming event. The evolution of the conflict and its mechanization and brutalization added a different dimension to the understanding and treatment of what was known among soldiers as “shell shock”.

By the end of the war, over 10,000 Canadian soldiers would be diagnosed with a “war neurosis” — what we know today as Post-traumatic stress disorder — and many more suffered without ever receiving an official diagnosis.

(image) “Battle of Courcelette”, 1916
Oil on canvas, By Louis Alexander Weirter
Beaverbrook Collection of War Art
Canadian War Museum
CWM 19710261-0788

"Shell Shock"

In the Trenches

Image: "Passchendaele [ASE label]" Photograph of what Alfred Soden English describes as his (14th) battalion. / 2016.3.1.1-44

Diverse Symptoms and Unclear Treatment

In the trenches, “shell shock” could take different forms, from tremors, confusion, or nightmares to sight and hearing difficulty, or paralysis. Many soldiers experienced mild symptoms such as headaches or insomnia, but chose not to report them for various reasons, including the fear of being seen as cowardly.

Private Eric Bradford

From Black’s Harbour New Brunswick, Bradford served with the 26th Battalion. One of four brothers to serve with the Canadian Expeditionary Force (CEF), he was wounded at the Battle of Hill 70 in 1917. He experienced flashbacks, nightmares and other “shell shock” symptoms from the head injury he sustained, and died from his wounds on May 24, 1919.

Crayon enlargement of Pte. Eric A. Bradford (#743041)
Date unknown
Provincial Archives of New Brunswick
Item P638-4

Crayon enlargement of Pte. Eric A. Bradford (#743041)
Date unknown
Provincial Archives of New Brunswick
Item P638-4

Crayon enlargement of Pte. Eric A. Bradford (#743041)
Date unknown
Provincial Archives of New Brunswick
Item P638-4

"It was a nerve-wracking place, you were always looking for something to happen. I've seen some of the boys shaking here, they could not stop it."

Deward Barnes, 5 April 1918

Many front-line soldiers experienced symptoms of "shell shock", but continued with their duties. Those who experienced debilitating symptoms were usually evacuated for medical treatment. Frequently, these men were perceived as cowards by the military authorities, who believed their symptoms were a physical expression of their weak mind or character, rather than a medical condition. Fellow soldiers were often more understanding, especially those who had spent many months in the trenches and had experienced firsthand the horrors of the conflict.

Divisional Rest Stations were established in early 1915 to give soldiers experiencing mild symptoms of "shell shock" a chance to spend a few days recuperating behind the lines without being formally evacuated or reassigned from front-line duty. This allowed exhausted and nervous men to rest without the added stigma of diagnosis.

Resting in Reserve Trenches, 2nd Canadian Field Ambulance. June 1916
Department of National Defence
Library and Archives Canada
Item 3194769

Managing "Shell Shock"
at the Front

Treatment

War Neurosis

Image: "A Field Hospital [ASE label]" A candid panorama shot of Canadian soldiers with various war-related injuries / 2016.3.1.1-55

Understanding and Treatment of War Neurosis

The term “shell shock” or neurasthenia emerged because military doctors believed the symptoms were caused by injuries to the nervous system resulting from the explosion of nearby artillery shells. As the war progressed and cases of “shell shocked” soldiers rose, it became clear that this was not the case. Many patients had no combat experience, or had not been under direct fire at the time of injury.

"It became evident that the shell explosions or other event which forms the immediate antecedent of the illness is only the spark [...] for which the mental stresses and strains of warfare have long prepared the ground."

Instinct and the Unconscious, W.H.R. Rivers

Physical treatments like electric shock therapy to send soldiers back to the front as quickly as possible were favoured. In strictest terms, these harsher methods were more efficient in returning men to the trenches; they took less time and had immediate effects on physical symptoms, but it is not known how many patients relapsed once they were back in combat.

"Shell shock" was believed to happen when a soldier's mental strength ran out. Medical professionals thought it could be exhausted by stressful situations such as intense combat, artillery barrages, or prolonged time in the trenches.

Views taken on Christmas Day, 1917
at Granville Special Hospital, Buxton
December 1917
Canadian War Museum
Item CWM 19930003-607

Understanding and Treatment of War
Neurosis by the Canadian Army Medical Corps

Opposing Views and Methods

W.H.R. Rivers

A British psychologist, Rivers served as a Captain in the Royal Army Medical Corps. Favouring a more humane approach to treatment, he developed a "talking cure" to help affected soldiers process their repressed memories of the war and overcome their condition.

Crayon enlargement of Pte. Eric A. Bradford (#743041)
Date unknown
Provincial Archives of New Brunswick
Item P638-4

Portrait of William Halse Rivers Rivers By Maull & Fox,
Date unknown. The Royal Society, Item IM/Maull/003835

Portrait of William Halse Rivers Rivers By Maull & Fox,
Date unknown. The Royal Society, Item IM/Maull/003835

Clarence B. Farrar

The Chief Psychiatrist for the Department of Soldiers' Civil Re-establishment (Canada) between 1916 and 1923. He claimed that mental disorders, including "shell shock" were biological and hereditary, and the result of a weak mind.

Crayon enlargement of Pte. Eric A. Bradford (#743041)
Date unknown
Provincial Archives of New Brunswick
Item P638-4

Portrait of Clarence B. Farrar. Clarence B. Farrar (Fonds 1260),
University of Toronto Archives, Item B1999-0011-002P-01

Portrait of Clarence B. Farrar. Clarence B. Farrar (Fonds 1260),
University of Toronto Archives, Item B1999-0011-002P-01

Malingerers

& the Honourably Wounded

Image: "Canadian Ambulance. Hit by shell [ASE label]" filling in a shell hole beside a damaged ambulance at the Battle of Passchendaele / 2016.3.1.1-126

Cowards and
Heroes?

With the rising numbers of “shell shock” cases on the Western Front, military authorities became worried about the effects of these on morale. They feared that, seeing their comrades report their symptoms of “shell shock” to the Medical Officers and being evacuated away from the front, others would feign nervous symptoms, or malinger, in order to avoid their duty.

Throughout the course of
the great war 203 Canadian soldiers were sentenced to death on grounds of desertion or cowardice

22 executed by firing squad

181 sentenced to penal labour

Men executed for cowardice were excluded from their regiment's Roll of Honour.

Their names did not appear in Canada's Books of Remembrance until 2001.

"Well, a fellow out on a working party fell to pieces and went insane. [...] They, of course, consider the possibility that he may be pulling one big 'swinging the lead' stunt; some darned queer things have been done here to get to Blighty or Canada"

Letter of an anonymous canadian stretcher bearer
to his wife, 5 January 1917

Malingering may not have been as common as the authorities feared, but many neurosis patients were suspected of faking or exaggerating their condition, both by doctors and fellow soldiers. Serving troops tended to have varied opinions of "shell shocked" men, sometimes seeing them as cowards or sometimes being more understanding if they experienced the brutality of the conflict for themselves.

As soldiers deserted or refused to carry out their duties, however, military authorities were quick to deem them cowards, or malingerers if they claimed to be "shell shocked". While some were let off with a warning, court-martials were not uncommon and authorities generally did not consider "shell shock" an explanation for desertion.

Officer helping a battered Canadian to Dressing Station. September 1916
Department of National Defence
Library and Archives Canada
Item 3395791

Cowardice or Neurosis:
Court Martials and Executions

After the Armistice

Long-Term Effects of Shell Shock
and Veterans’ Fight for Recognition

Image: "24th Battalion Victoria Rifles" / Collection CCGW

Veterans’ Fight for Recognition

After the Armistice in 1918, soldiers were demobilised and the Canadian Expeditionary Force dissolved, leaving veterans to reintegrate civilian society. Those who were left injured by the conflict were granted a pension, but for those suffering from “shell shock” support from the military authorities was often difficult to find.

Private Clarence Booth

Booth saw action at the Battle of St. Eloi in April 1916 and was later admitted to hospital for "shell shock" first in May, then June 1916. He reports in his diary on May 19, "Went to Line (Got Lost) near quators hid in shell holes ... Got back OK My nerves Gone," then on June 14th, "(Buried by Shell) Gone bad again sent to pass a bord/Sent to Hspital" [sic]. Following his second stay in hospital, Booth was transferred to the 2nd Division Head Quarters, where he worked as a cook.

Clarence Booth (Front row, farthest left)
Enlisted with the 24th Battalion Victoria Rifles in November 1914 - Collection CCGW

Clarence Booth (Front row, farthest left)
Enlisted with the 24th Battalion Victoria Rifles in November 1914 - Collection CCGW

Clarence Booth (Front row, farthest left)
Enlisted with the 24th Battalion Victoria Rifles in November 1914 - Collection CCGW

"The neurosis is neither a reason for vocational training nor the basis of a pension claim."

Chief psychiatrist to the Department of Soldiers' Civil Re-establishment, Clarence B. Farrar

"Shell Shock" and the Canadian
Pension Commission

The impact of "shell shock" was not limited to employment difficulties; many veterans developed related conditions such as alcoholism or difficulties maintaining relationships. Whole families were impacted, and the stigma of mental illness remained deeply ingrained in Canadian society. Reports of veterans' suicides in Canadian newspapers post-war often mentioned "shell shock" symptoms.

Many men affected by war neuroses were left without financial support from the Board of Pension Commissioners and often had difficulty holding a job to support themselves and their families.

The Pension Commission considered that "shell shock" originated from a genetic predisposition. Large numbers of veterans were denied a pension, particularly those who started experiencing nervous symptoms years after the end of the war. Their claims for a pension were almost always rejected, as the Pension Board ruled that the elapsed time meant their condition was not attributable to service.

Basket-making at Military Hospital in Cobourg, 1917
Department of Soldier's Civil Re-establishment
University of Toronto Archives
Item B1999-0011-003P-11-B

From "Shell Shock" to PTSD

Combat Trauma through
a Century of Conflict

Image: "Canadian Ambulance. Hit by shell [ASE label]" filling in a shell hole beside a damaged ambulance at the Battle of Passchendaele / 2016.3.1.1-126

Combat Trauma Through a Century of Conflict

War neurosis and “shell shock” would remain important issues for military and medical authorities long after the end of the Great War. Pensions and treatment for affected soldiers were subject to great debate in the decades following the Second World War and the Korean War. The idea that “shell shock”, battle exhaustion, or combat stress response, was the result of the soldier’s personal failure, remained dominant in diagnosis and treatment.

16.4 %
of regular force veterans who left the canadian armed forces beween 1998 and 2015 were diagnosed with PTSD.

In comparison, about 8 % of Canadians who experience a traumatic event develop PTSD.

"it's by talking that you jar your memory, but there are a lot of things that I shouldn't talk about. I will take them to my grave. i will never tell anyone. I try to forget. If I have trouble sleeping at night, I don't want to think of those things, because one thing leads to another, and it just keeps going... I'd rather have peace of mind."

Second World War and Korean War Veteran, Jean-Émile Paillé

Mental health issues also remain a delicate subject in medical circles, both civilian and military. Active soldiers and veterans alike have advocated for recognition, treatment and pensions for disabilities and symptoms associated with combat trauma. Post-traumatic stress disorder (PTSD) was only recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM) in 1980. This was a turning point in the recognition of the stress disorders affecting military personnel, formally recognizing that symptoms of long-term psychological trauma associated with combat and warfare were not caused by a predisposition to mental illness.

St. Anne's Hospital was founded in 1917 to treat wounded personnel and veterans of the Great War. Purchased in 1950 by Veterans Affairs Canada and transferred to provincial jurisdiction in 2012, it primarily serves veterans of the Canadian Armed Forces, specialising in long-term care as well as post-traumatic stress disorder.

St. Anne's Hospital, St. Anne de Bellevue, Quebec.

Curtiss-Reid Flying Service Co. Ltd., 1926-1940

Collection Pierre Monette

National Library and Archives of Quebec
000558894

The Fight for Recognition and Treatment

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Shell Shocked

The Long Road to Recovery