Bravery and break-down: a military mystery
WAR OF NERVES: SOLDIERS AND PSYCHIATRISTS by Ben Sheppard Cape, £20, pp. 487 Soldiers invalided from the Western Front in the early stages of the first world war often shocked their doctors and nurses with the grotesque postures and gestures they adopted as a result of their terrible experiences. For the first time this pattern of response was recorded on film, which still exists. Quickly this behaviour was labelled 'shell shock', while other nervous reactions to the war were termed 'neurasthenia'.
Shell shock was believed to have set in when a soldier was blasted by a shell or nearby when one detonated. Soon it was realised that the injury was not caused by physical attack, but the overwhelming sense of threat and destruction. Nor was the phenomenon new. The Norse sagas talk of 'war-weary' warriors turning tail. In the Napoleonic wars and the American civil war, it was called 'nostalgia' — the breakdown in longing for home.
The invention of the term shell shock marks the beginning of the relationship between the military and the psychiatrist. This is the subject of Ben Sheppard's engrossing book. In it he narrates the relationship between psychiatrists and psychologists and soldiers from the Western Front to Vietnam and the Gulf, from shell shock to the current debates about Post-Traumatic Stress Disorder. He depicts brilliantly the fights by pioneers in psychiatry to get decent treatment for the afflicted, and as near to the frontline as possible. And he doesn't duck the fundamental paradox of such care — the shrinks and does were putting men back together again to go back into danger and risk their physical and mental well-being.
In doing so he recognises that he has to navigate a literary and historical minefield. The whole subject of rights and suffering in war is now a victim of fashion, in media pop psychology, the nostalgia novel industry, and the new compensation culture among lawyers.
The story of American and British battle psychology and psychiatry is well told. William Rivers, mentor and friend of Siegfried Sassoon, is a hero; so, too, is Dr Arthur Brock, who successfully helped Wil fred Owen to get back to the Front. In the second world war, the lessons had to be learnt again. Men like 'Jimmy' James with the 8th Army in the Western Desert achieved remarkable results with very meagre resources. At home there were breakthroughs in group therapy, though often in the teeth of the directives of the War Office. Perhaps most remarkable in the British forces were the lone wolves like Captain Paul Davis, the psychiatrist who helped patients just a mile or two from the some of the fiercest battlegrounds in Burma, such as Kohima, for which he earned a gallantry decoration.
Despite the attentions of men like James and Davis, some units would fight and some would run, and often the behaviour is inexplicable. Most startling are some of the book's extraordinary statistics. The British shot some 371 men for desertion or cowardice in the first world war, though the practice was abandoned in the second. The Germans shot 48 soldiers for desertion in the first world war and some 10,000 by the end of 1944 in the second. It is reckoned by Sheppard that a further 5,000 were shot for desertion in the first four months of 1945 alone. The death squads in the rear ensured that a lot of what remained of the Wehrrnacht would fight to the end.
Some 30 years later the Vietnam statistics still astonish, such as the huge incidence of hard drug-taking in the front-line units. Almost one fifth of those in theatre were using the weed and harder stuff at one time, though most managed to get off it when they returned. The story of the care of veterans is very well told, the rows in the Veterans' Association and the emergence of Post-Traumatic Stress Disorder diagnosis and the 'outreach' programmes. In one set of outreach programmes, it was calculated that only 10 per cent of those being helped had seen any combat at all.
It is when the book moves into broader questions of soldiers' behaviour in battle that it begins to lose its way. There is very little first-hand interviewing of veterans themselves, and there are some strange omissions. Good officers and NC0s, and sometimes a strong padre, a 'Woodbine Willie', could hold a unit together in dreadful experiences. The diaries of the remarkable Bickersteth brothers, which give such a vivid and intimate picture of comforting the wounded, dying and condemned on the Western Front, are not mentioned at all.
Interestingly in the discussion of Freud and his ideas (he is seen as a bit of an intel lectual hero) his shabby treatment of Wilhelm Tausk, the disciple who had most direct experience of the fighting with the Central Powers is not mentioned at all.
Repeatedly the book asks why certain units fought and others broke. He questions whether General Slim had anything to do with the high morale among many of the troops Captain Davis treated in the front line in Burma. If he had looked into Defeat Into Victory he would find the essence of modern, humane command, which did in the end deliver victory in perhaps the longest pursuit campaign of the second world war. Slim inspired confidence, and trusted his men, devolving responsibility to the lowest level; this is 'mission command'. 'Men have to trust their leader, that he will deliver what they want and look after them, and they have to have belief in their comrades,' says General Sir Rupert Smith, our most experienced current commander and a devotee of Slim.
With this goes self-respect, that they will be valued for their contribution, and the combination of discipline and self-discipline, which is the antidote to fear. It is not discipline by coercion but the sergeant or corporal gripping the situation so that things are done properly, from camouflage in time to cooking.
It was this attitude, says Smith, that enabled the Royal Welch Fusiliers, the regiment of Graves and Sassoon, to grind on through the Western Front without collapsing, with the remarkable Dr Dunn seeing them through it.
The lack of frontline experience weakens the whole book, and despite its wonderful insights lends it a slight flavour of being a tract of the times. The account of the Falklands campaign reads a bit like a postmodern urban myth. We hear of soldiers not being able to tell incoming from outgoing artillery fire and the difficulties of the Navy as 'British warships, struck by French Exorcet [sic !] missiles, burned like tinderboxes'. It was 'a short but savage' campaign. Nasty it was indeed for some, but it was not Stalingrad or Grozhny.
As the current row over Depleted Uranium, Gulf/Balkans syndrome and PTSD illustrates, the projection of force and profession of arms are now a huge muddle. As this interesting book acknowledges, the issue of arms and armies is now vitiated by the name, shame and claim culture, conducted by the triad of media, science straight and dodgy, and compensation lawyers. In an essay on Falklands war veterans Martin Deahl, Senior Lecturer in Psychological Medicine, St Bartholomew and Royal London Hospital, declares, The sole Royal Navy psychiatrist despatched to the South Atlantic never set foot on land, and there were no Army psychiatrists included in the Task Force. Numerous claims in the civil courts can be expected.
As they say in the best examination circles: Discuss.