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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 --This text refers to an out of print or unavailable edition of this title.
Review
"An utterly absorbing study of the century-long relationship between psychiatry and the military... The richness of his story derives from the sheer variety of experiences and personalities that it incorporates." - Richard Overy, "Literary Review"
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