Nursing Men with Psychological Trauma during the First World War

This blog post is based on a recent talk given on 2nd October at the Norfolk Record Office by Dr Claire Chatterton, an Open University lecturer and Chair of the Royal College of Nursing, History of Nursing Society.

The general perception of soldiers suffering from shell shock during the First World War has been coloured by literature, films and TV.  Officers (upper class) were deemed as suffering from shellshock whilst enlisted soldiers (working class) were shot at dawn.

Dr Chatterton’s talk demonstrated that this was not the case, and though 346 soldiers were shot and most of these were suffering from shell shock, it is estimated that 80,000 men suffered shell shock during the First World War, and some effort was made to treat these individuals.

The condition was first described by Dr Charles Myers in 1915, but there is evidence that the condition was experienced by combatants during the Crimean War and earlier conflicts.

There are disturbing films of shell shocked individuals that are available on YouTube. Please note these are disturbing

During the early years of the First World War, individuals were sent home and usually went through the Royal Victoria Hospital, Netley.  However, as the numbers of sufferers increased, more hospitals were required.  Various hospitals and asylums were taken over; and the patients/residents were removed to other institutions, which led to severe overcrowding and death in many cases.  Dr Chatterton described these as the forgotten victims of the First World War.

There was no unified approach to the treatment of the soldiers; it depended on the medical personnel at individual hospitals.  The treatment often followed the Weir Mitchell Cure which advocated isolation, rest, massage and a milk diet. Other psychotherapeutic treatments were based on combinations of baths, massage, drugs, hypnosis, electrical treatments, re-education and occupational treatments.

It proved difficult, however, to treat the large numbers being sent back home.  Therefore a system of Forward Psychiatry was introduced with the acronym PIE

Proximity to battle

Immediacy of Treatment

Expectation of recovery

With the line of evacuation being so long, the increased speed of treatment proved to be efficacious. The principals of this system are still used today for the treatment of Post-Traumatic Stress Disorder (PTSD) in modern warfare.

It seems that there was a class divide evident in the diagnosis of shell shock in that officers were described as suffering from Neurasthenia whilst enlisted soldiers were described as shell shocked.

Dr Chatterton’s talk showed not only the huge numbers of those affected by shell shock but also demonstrated how the treatment of these individuals evolved during the war.

To see other Norfolk Record Office free lunchtime talks, and other events related to the First World War, see our Eventbrite.


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