The application of psychiatry to war and terrorism is highly topical and a source of intense media interest. Shell Shock to PTSD explores the central issues involved in maintaining the mental health of the armed forces and treating those who succumb to the intense stress of combat. Drawing on historical records, recent findings and interviews with veterans and psychiatrists, Edgar Jones and Simon Wessely present a comprehensive analysis of the evolution of military psychiatry. The psychological disorders suffered by servicemen and women from 1900 to the present are discussed and related to contemporary medical priorities and health concerns. This book provides a thought-provoking evaluation of the history and practice of military psychiatry, and places its findings in the context of advancing medical knowledge and the developing technology of warfare. It will be of interest to practicing military psychiatrists and those studying psychiatry, military history, war studies or medical history.

To the British soldiers of the Great War who heard about it, 'shell shock' was uncanny, amusing and sad. To those who experienced it, the condition was shameful, unjustly stigmatized and life-changing. The first full-length study of the British 'shell shocked' soldiers of the Great War combines social and medical history to investigate the experience of psychological casualties on the Western Front, in hospitals, and through their postwar lives. It also investigates the condition's origin and consequences within British culture.

Shell shock, combat fatigue, Vietnam Syndrome--whatever the name, post traumatic stress disorder (PTSD) has been with us since ancient Greece. With 20 percent of the veterans of Afghanistan and Iraq exhibiting PTSD symptoms, the United States military has a strong interest in combating the condition. Navy psychiatrist Robert N. McLay has been at the forefront of these efforts, using virtual reality to treat service members and veterans with PTSD. So far, the virtual reality program shows more promise than traditional therapies. Several years into the project, McLay recounts openly and with bleak honesty the successes, failures, and limits of virtual reality treatment--but his experiences hold out hope.--From publisher description.

A comprehensive history of PTSD. Post-traumatic stress disorder—and its predecessor diagnoses, including soldier’s heart, railroad spine, and shell shock—was recognized as a psychiatric disorder in the latter part of the nineteenth century. The psychic impacts of train crashes, wars, and sexual shocks among children first drew psychiatric attention. Later, enormous numbers of soldiers suffering from battlefield traumas returned from the world wars. It was not until the 1980s that PTSD became a formal diagnosis, in part to recognize the intense psychic suffering of Vietnam War veterans and women with trauma-related personality disorders. PTSD now occupies a dominant place in not only the mental health professions but also major social institutions and mainstream culture, making it the signature mental disorder of the early twenty-first century. In PTSD, Allan V. Horwitz traces the fluctuations in definitions of and responses to traumatic psychic conditions. Arguing that PTSD, perhaps more than any other diagnostic category, is a lens for showing major historical changes in conceptions of mental illness, he surveys the conditions most likely to produce traumas, the results of those traumas, and how to evaluate the claims of trauma victims. Illuminating a number of central issues about psychic disturbances more generally—including the relative importance of external stressors and internal vulnerabilities in causing mental illness, the benefits and costs of mental illness labels, and the influence of gender on expressions of mental disturbance—PTSD is a compact yet comprehensive survey. The book will appeal to diverse audiences, including the educated public, students across the psychological and social sciences, and trauma victims who are interested in socio-historical approaches to their condition. Praise for Allan V. Horwitz’s Anxiety: A Short History “The definitive overview of the history of anxiety.”—Bulletin of the History of Medicine “A lucid, erudite and brisk intellectual history driven by a clear and persuasive central argument.”—Social History of Medicine “An enlightening tour of anxiety, set at a sensible pace, with an exceptional scholar and writer leading the way.”—Library Journal

2012 Reprint of 1941 Edition. Exact facsimile of the original edition, not reproduced with Optical Recognition Software. Most PTSD authors agree that Abram Kardiner's "Traumatic Neuroses of War" is the seminal psychological work on PTSD. In this work Kardiner distilled much psychiatric thought on the traumatic syndrome resulting from World War II, with what he had termed "neurosis of war." The symptoms of this syndrome included features such as fixation on the trauma, constriction of personality functioning and atypical dream life. Kardiner provided powerful new insights in these classic texts on the phenomenology, nosology, and treatment of war-related stress, thereby anticipating virtually every aspect of contemporary research on PTSD. Although Kardiner had observed war neuroses since 1925, when he was attending specialist at the U.S. Veterans Hospital, he was only able to theorize them to his satisfaction after he had written "The Individual and His Society," which dealt with the problems of adaptation. He came to see that in the traumatic neurosis of the war the defensive maneuver to ward off the trauma sometimes destroyed the individual's adaptive capacity. Thus, the traumatic neurosis of war was the result of an adaptive failure, not a conflictual illness. So concluding, Kardiner re-introduced the concept of traumatic neurosis into psychoanalytic theory.

As far back as we know, there have been individuals incapacitated by memories that have filled them with sadness and remorse, fright and horror, or a sense of irreparable loss. Only recently, however, have people tormented with such recollections been diagnosed as suffering from "post-traumatic stress disorder." Here Allan Young traces this malady, particularly as it is suffered by Vietnam veterans, to its beginnings in the emergence of ideas about the unconscious mind and to earlier manifestations of traumatic memory like shell shock or traumatic hysteria. In Young's view, PTSD is not a timeless or universal phenomenon newly discovered. Rather, it is a "harmony of illusions," a cultural product gradually put together by the practices, technologies, and narratives with which it is diagnosed, studied, and treated and by the various interests, institutions, and moral arguments mobilizing these efforts. This book is part history and part ethnography, and it includes a detailed account of everyday life in the treatment of Vietnam veterans with PTSD. To illustrate his points, Young presents a number of fascinating transcripts of the group therapy and diagnostic sessions that he observed firsthand over a period of two years. Through his comments and the transcripts themselves, the reader becomes familiar with the individual hospital personnel and clients and their struggle to make sense of life after a tragic war. One observes that everyone on the unit is heavily invested in the PTSD diagnosis: boundaries between therapist and patient are as unclear as were the distinctions between victim and victimizer in the jungles of Southeast Asia.

Gender roles are nowhere more prominent than in war. Yet contentious debates, and the scattering of scholarship across academic disciplines, have obscured understanding of how gender affects war and vice versa. In this authoritative and lively review of our state of knowledge, Joshua Goldstein assesses the possible explanations for the near-total exclusion of women from combat forces, through history and across cultures. Topics covered include the history of women who did fight and fought well, the complex role of testosterone in men's social behaviours, and the construction of masculinity and femininity in the shadow of war. Goldstein concludes that killing in war does not come naturally for either gender, and that gender norms often shape men, women, and children to the needs of the war system. lllustrated with photographs, drawings, and graphics, and drawing from scholarship spanning six academic disciplines, this book provides a unique study of a fascinating issue.

PTSD is in no way an easy diagnosis for the patient, the provider, or the therapist. It is a diagnosis developed at the border of our capacity to handle extreme stress, a marker diagnosis denoting the limits of our capacity for functioning in the stress of this modern world. For both individuals and society, PTSD marks the limits of our available compassion and our capacity to protect ourselves from the dangers of the environment and other humans. PTSD is often a chronic disease, forming at a place where mind sometimes no longer equals the brain, a point at which individual patient requirements often trump theory and belief. There are treatments for PTSD that work, and many that do not. This book presents evidence, rather than theory, anecdote, or case report. Psychological approaches including prolonged exposure, imagery rehearsal therapy and EMDR have a greater than 75% positive short-term response when used to treat PTSD. Yet these treatments vary markedly and have different, even contradictory underlying theory and objectives for treatment. Medications, rarely indicated as primary therapy, can be used to treat symptoms and address comorbid PTSD diagnoses. Treatment of sleep apnea in the PTSD population produces a positive effect on symptoms and a reduction in morbidity and mortality across the span of life. Complementary treatments offer the many individuals chronically affected by PTSD assistance in coping with symptoms and opportunities to attempt to functionally integrate their experience of trauma.

Stories of soldiers suffering from Post-Traumatic Stress Disorder dominate news coverage of the return from wars in the Middle East. On the surface, the stories call our attention to psychic trauma and the need for mental health services for veterans; scratch that surface and we see that PTSD has morphed from a diagnostic category into a cultural trope with broad societal implications. In PTSD: Diagnosis and Identity in Post-empire America, Jerry Lembcke exposes those implications. Lembcke reprises PTSD’s formulation following the war in Vietnam, examining how its medical discourse provided a psychological alternative to the political interpretations of veterans’ opposition to the war— psychiatrists said veteran dissent was cathartic, a form of acting-out. Lembcke drills deeply into the modern history of war-trauma treatment, picking up the threads left by nineteenth-century work on men and hysteria, and following them into the treatment of “shell shock” in World War I. With great originality, Lembcke also shows how art and the media led the “science” of war trauma, and then how the followers of Sigmund Freud showed that shell-shock symptoms were as likely to be expressions of fears and conflicts internal to the patients as the effects of exploding shells. The line drawn by the Freudian critique of the medical/neurological model would resurface in debates leading to PTSD’s inclusion in the DSM in 1980 and on-going deliberations over the definition and meaning of Traumatic Brain Injury. In core chapters, Lembcke shows the influence of film, theater, television, and news coverage on public and professional thinking about war trauma. The inglorious nature of recent wars, from Vietnam through Iraq and Afghanistan, leaves Americans searching for meaning in those conflicts and finding it in loss and sacrifice. Lembcke warns that the image of damaged war veterans is working metaphorically in these dangerous times to construct a national self-image of defeat and damage that needs to be avenged. It is a dangerous end-of-empire narrative that needs to be engaged, he says, lest its dangers reach fruition in more war. The insights found in this book make it an invaluable resource for scholars of sociology, medical sociology, psychology, military studies, gender studies, and history of psychiatry, and a riveting read for anyone interested in the subjects it treats.