Product Description

“I wish you could be here,” the Oxford Professor of Medicine wrote to a friend in 1915, “in this orgy of neuroses and psychoses and gaits and paralyses. I cannot imagine what has got into the central nervous system of the men.” A War of Nerves is a history of military psychiatry in the twentieth century - an authoritative, accessible account drawing on a vast range of diaries, interviews, medical papers and official records. It reaches back to the moment when the technologies of modern warfare and the disciplines of mental medicine first confronted each other on the Western Front, and traces their uneasy relationship through the eras of `shell-shock', combat fatigue and `post-traumatic stress disorder'. At once absorbing historical narrative and intellectual detective story, it tells the full story of `shell-shock'; explains the disastrous psychological aftermath of Vietnam; and shows how psychiatrists kept men fighting in Burma. But it also tries to answer recurring questions about the effects of war. Why do some men crack and others not? Are the limits of resistance determined by character, heredity, upbringing, ideology or simple biochemistry? It explores the ethical dilemmas of the military psychiatrist - the `machine gun behind the front', as Freud called him. Finally, it looks at the modern culture of `trauma' and compensation spawned by the Vietnam War. A War of Nerves offers the general reader an indispensable guide to an important and controversial subject.

Product Details

• Amazon Sales Rank: #81289 in Books
• Published on: 2002-02-07
• Binding: Paperback
• 498 pages

Amazon.co.uk Review
War is often described as long periods of boredom punctuated by moments of sheer terror. Reactions to those who have been psychologically traumatised by war have often been equally polarised between "pull yourself together, man" psychiatrists and those of the touchy-feely "It must be post-traumatic stress disorder" persuasion. And as Ben Shephard points out in this well-researched and nicely observed book, both approaches are highly flawed. Given that since the Second World War half of the world has been training to be a counsellor while the other half has been trying to kill each other, you might ask why our understanding of war-related stress is still in its infancy.

The answers are complex, not least because the relationship between psychiatrists and the military has been hopelessly confused, if not compromised, over the years. Put simply, the armed forces have often looked to minimise the problem; all they want are their personnel back on active duty in the shortest possible time frame and at all costs they want to distance themselves from any corporate liability in case they get hit by compensation claims. And given that most of the psychiatrists who worked with shell-shock victims prior to the end of the Vietnam war were military personnel, a great deal of collusion went on. Pat Barker made much of the pioneering work of William Rivers at Craiglockhart Hospital in her wonderful First World War trilogy The Ghost Road but, as Shephard points out, she was also guilty of constructing a few myths of her own. Rivers might have been one of the first to identify shellshock as a psychological condition as opposed to cowardice, but he was still in the dark ages when it came to his attitudes. Like many of his generation, Rivers believed that officers were naturally better equipped to deal with trauma than the ordinary rank and file, and treated them accordingly. So while the likes of Siegfried Sassoon got better under his care, hundreds of foot soldiers were executed for desertion. Even after wars such as 1914 to 1918 and 1939 to 1945, which were fought with popular support, there was a general unexpressed desire to forget the past, and many of those who were left with long-term psychological traumas were often studiously ignored; they were an embarrassment, an unwelcome reminder of past suffering and their illnesses were sidelined with them. After the Vietnam War, when veterans returned home to hostility or indifference, the trauma couldn't be so easily ignored as the shellshock was often acted out in violent or other sociopathic ways. It was in the aftermath of this that a more empathic approach developed among more liberal-thinking psychiatrists.

Interestingly, though, the catharsis of giving full range to a patient's feelings have been no more successful in effecting a long-term cure for patients. Shephard explores the psychiatric treatment of war veterans with both an academic's and a storyteller's eye for detail that makes for a fascinating read. And if he ultimately reaches no firm conclusions himself, perhaps it is only because there are some things that are so extreme they can never be fully understood. --John Crace

John Keegan
`It is the best book I have read on the subject and will endure.'

Synopsis
"I wish you could be here," the Oxford Professor of Medicine wrote to a friend in 1915, "in this orgy of neuroses and psychoses and gaits and paralyses. I cannot imagine what has got into the central nervous system of the men." A War of Nerves is a history of military psychiatry in the twentieth century - an authoritative, accessible account drawing on a vast range of diaries, interviews, medical papers and official records. It reaches back to the moment when the technologies of modern warfare and the disciplines of mental medicine first confronted each other on the Western Front, and traces their uneasy relationship through the eras of 'shell-shock', combat fatigue and 'post-traumatic stress disorder'. At once absorbing historical narrative and intellectual detective story, it tells the full story of 'shell-shock'; explains the disastrous psychological aftermath of Vietnam; and shows how psychiatrists kept men fighting in Burma. But it also tries to answer recurring questions about the effects of war. Why do some men crack and others not? Are the limits of resistance determined by character, heredity, upbringing, ideology or simple biochemistry?

It explores the ethical dilemmas of the military psychiatrist - the 'machine gun behind the front', as Freud called him. Finally, it looks at the modern culture of 'trauma' and compensation spawned by the Vietnam War. A War of Nerves offers the general reader an indispensable guide to an important and controversial subject.

Customer Reviews

A superb history of psychiatry and the military
From shell shock in World War 1 to Post Traumatic Stress Disorder in recent years, this is a brillant and profound examination of changing views on the nature, cause, and treatment of those who broke down mentally as a result of warfare, and of steps to reduce the incidence of such breakdowns. Based, I should guess, on many years of extremely thorough research, it is an utterly fascinating and beautifully written account of this subject and must become the standard work on the history of military psychiatry. I have seldom been so impressed and delighted by anything written recently in the history of medicine and cannot recommend it too highly. Irvine Loudon Medical Historian