Institutional Approach to Mental Illness

Traumatic events put people in a flight or fight mode. Shell shock was a culture shock because it had a powerful impact throughout society, specifically because its cruel statement was unimaginable. Shell shock opened the institutional approach to mental illness and modern psychiatric practice. One hundred years later, much of that mixed feelings remain. Researchers around the world are still trying to figure out the complexity of physical, psychological and emotional trauma in veterans, active duty military, and other war-related psychiatric problems. Although there has long discussion about the condition known as shellshock, studies have changed dramatically over the last 100 years concerning the causes and symptoms, and the disagreements about the treatment of the condition.

This topic is important because, it is a condition that has been ongoing for over 100 years and new knowledge keeps arising with it, even today. Ever since World War one it has evolved into something that researchers and doctors have been fascinated with because of the shock that it took place in the military and society. It wasn’t really understood to why soldiers were coming back with symptoms and with a further investigation over the years it has transitioned to a term that was not used back then, which is post-traumatic stress disorder.

First, military members experience intense fear during deployment and it causes strain of combat. In World War 1 across the country, doctors were surprised by a condition that they hadn’t seen before. Medical staff started to realize that there were deeper causes when many men were still suffering without having ever been in the front line. The soldiers were unable to cope with the horrifying strain of combat. At the time, soldiers were treated with no sympathy when they endured shell shock. It was often seen as a sign of weakness and shame (Linden & Jones, 2014, p. 521). Researchers later found out that the disorder might develop after a personal experience or something traumatic such as combat, a natural disaster, or a violent personal assault (Creamer, Wade, Fletcher & Forbes, 2011, p. 161). Posttraumatic stress disorder among military personnel and veterans has been studied for more than 100 years. It causes a heavy amount of distress and interferes with personal and social skills in everyday lives. Deployment-related situations like combat exposure were significantly associated with the causes of post-traumatic stress disorder ( Xue et al. 2015, p. 2).

Also, almost daily men and women encounter attacks with high explosives while being deployed and it is likely they have invited traumatic stress in. In 2001 researchers surveyed 2,525 United States Army infantry soldiers after deployment to Iraq for a year to determine clinical research to exposure blast. It was reported that 44% at the time, soldiers developed post-traumatic stress disorder from exposure blasts (Shively & Pearl, 2012, p. 238 ). Not only is there causes but this condition includes symptoms that much military personnel endure.

Second, shell shock or known today post-traumatic stress disorder can be an intense disorder and its symptoms can have a negative impact on a person’s life. In 1915 a retrospective analysis of 200 randomly selected files of war soldiers with a diagnosis of shellshock showed that the disorder was influenced by; tremor, headaches, nightmares, anxiety, and difficulty sleeping ( Jones & Wessely, 2014, p. 1708). These are often seen as the most common symptoms of traumatic stress and are most commonly the ones that the researchers were interested in. During the Vietnam war in 1954 psychiatrists also worked with many combatants the ones returning to the United States and they noticed they were having symptoms such as anxiety, depression, mood swings, sleep disturbance, substance abuse, and suicide (Shively & Perl, 2012, p. 236). During those time periods, doctors could not figure out to why soldiers were returning with all these symptoms. It was not until 1980 when psychiatrist and researchers were able to find out about why this was happening. It was no longer called shell shock or Vietnam syndrome, but post-traumatic stress disorder and it still is present today. Trauma in the war is that the soldier is haunted by the past horror that they have experienced. People, places, situations, thoughts, feelings, and conversations might bring back the painful memories they have endured (Creamer, Wade, Fletcher & Forbes, 2011, p. 163). It is a complex condition that with an extreme stressor that can be easily triggered by things that remind them of the traumatic event. WHR Rivers was a medically qualified anthropologist with a research interest in psychoanalysis and he argued that the disorder is more intense when soldiers are triggered by repressed memories of being on the battlefield (Jones & Wessely, 2014, p. 1709). Lastly not only are there causes and symptoms, but researchers have different opinions about the treatment for this condition.

Third, treatments use different techniques to help someone process their traumatic experience, but treatment and its effectiveness have been disagreed upon. Once the disorder has developed doctors are on much stronger grounds in terms of effective intervention for post-traumatic stress disorder, and can have different views on treatment (Creamer, Wade, Fletcher & Forbes, 2011, p. 163). Several clinical practices have pushed trauma-focused cognitive behavioral therapies as the first treatment they use for military members and veterans because it focuses on the memory of the traumatic event or its meaning. It helps the person to confront the memories of their traumatic experiences, also feared and external situations that remind them of the events they have gone through (Shively & Perl, 2012, p.235 ). In 1915 Myers believed that the best way for treatment with experiences of traumatic events, is a natural healing process. The natural healing process consisted of forward psychiatry, soldiers were fed and able to rest, and then put on a program for exercise such as marches (Jones & Wessely, 2014, p. 1710). After they graduated the “natural healing process” then they were returned to their units. The healing process claimed that 60–90% of admissions were restored to frontline combat (Jones & Wessely, 2014, p. 1710). Gordon Homes disagreed with the natural healing process because he thought it was not an effective gatekeeper for military personnel.

The fact that post-traumatic stress and shell shock are linked to a stressful experience it ensures that the condition will remain in military war experience. To previous generations, it was known as shell shock and over 100 years it has now become known as post traumatic stress disorder. Not only did it affect increasing numbers of troops serving in World War I and previous war, doctors were struggling to understand what was happening to the soldiers and disagreements about the treatment arose. Some causes of the symptoms were related to military combat, explosions on the battlefield explosive devices, rocket-propelled grenades, landmines, and other high explosives or even just witnessing someone getting killed. People didn’t understand why soldiers were coming home with symptoms such as; intrusive thoughts or images, nightmares, dissociative flashbacks, or severe distress and many more. Researchers would like to further investigate PTSD prevention, early identification, and effective treatment of the condition in our service personnel.