Interesting on many levels, a bbc documentary on shell shock, also a brief section with Simon Wessely

[Cinders66]

https://www.bbc.co.uk/iplayer/episode/b0brzl3w/wwis-secret-shame-shell-shock

Interesting and moving in itself, interesting in parallels I saw with Me treatment - eg military believed it had to have physical cause and if not found (with technology available then) it was malingering and also discouraged diagnosis based on idea it was fashionable and could spread - , interesting that budget cuts in military care for veterans in the 90s I realised coincided with the IMO burying of gulf war syndrome (not mentioned), interesting that shell shock is being seen as the psychological predecessor of PTSD with wessely saying cultural changes explain the change in presentation from shaking and spasm to flash backs, I in my humble lay opinion am not sure, Wessely recycling his “syndromes change over time and culture language”.

 

[chrisb]

I cannot imagine why Snow and the BBC imagine this to be secret. Oh, sorry, yes I can.

This comment by, Graham Thomas Brown, one of the expert witnesses to the Royal Commission on Shell-shock is of interest, and casts doubt upon the claims made for the treatments for shell shock:

On October 18, 1916, after a discussion on shell shock at the thirtieth Stationary Hospital in Salonika, Graham Brown noted in his diary that Rivers had previously admitted to him in Maghull that he “didn't think that any of his patients who recovered [from shell shock] benefited from his treatment” and “It looks as if Rivers was frankly dishonest.” River's admission obviously fuelled Graham Brown's long-held scepticism, as one of the few clinical neuroscientists who actually saw such patients, about the extravagant claims made for the wide range of treatments for shell shock.10 (For his later reflections on shell shock, see Graham Brown, 1927)

in
www.ncbi.nlm.nih.gov/pmc/articles/PMC3259622/

I have sometimes wondered whether the strong psychogenic CF|S|school in Liverpool derives from a shared history with Maghull and its neurasthenia cases.

 

[large donner]

I have posted this previously on the forum.

 

[Revel]

wessely saying cultural changes explain the change in presentation from shaking and spasm to flash backs,

. . . and completely ignoring the fact that the face of warfare has altered almost beyond recognition since the trenches of WW1.

I saw the documentary and Wessely implied that "flashbacks" only came into being as a symptom when film and TV arrived on the scene. So, prior to this "cultural change", returning war veterans did not suffer from flashbacks? What nonsense.

The phenomenon may not have been called a "flashback" pre-WW1, but that doesn't mean that it didn't exist.

 

[chrisb]

They certainly still had frequent vivid nightmares 50 or 60 years later. Or that may be an invalid generalisation from one case of which I knew.

 

[Cheshire]

. . . and completely ignoring the fact that the face of warfare has altered almost beyond recognition since the trenches of WW1.

I saw the documentary and Wessely implied that "flashbacks" only came into being as a symptom when film and TV arrived on the scene. So, prior to this "cultural change", returning war veterans did not suffer from flashbacks? What nonsense.

The phenomenon may not have been called a "flashback" pre-WW1, but that doesn't mean that it didn't exist.

I just saw a French documentary on shellshock in WWI, and one of the symptoms they described was that some veterans were having some kind of lively memories of the war.

Wessely is used to twist facts to reinforce his theory of "cultural expression of distress". He once said that there was not such a thing as CFS in France. (Don't know where I and all the other French sufferers caught this so un-French disorder.)

 

[Cinders66]

. . . and completely ignoring the fact that the face of warfare has altered almost beyond recognition since the trenches of WW1.

I saw the documentary and Wessely implied that "flashbacks" only came into being as a symptom when film and TV arrived on the scene. So, prior to this "cultural change", returning war veterans did not suffer from flashbacks? What nonsense.

The phenomenon may not have been called a "flashback" pre-WW1, but that doesn't mean that it didn't exist.

Wessely likes his ideas and studies things he think will fit. He’s not really a biomedical scientist more in interest , I don’t know , sociologist, anthropologist. Very unfortunate he believed ME to be just the illness for his approach of explaining the unexplained through culture, beliefs psychology etc. I was struck how with SS, the breakthrough was supposed to be not just leaving soldiers but getting in with “treatment “ early. It reminded me of the CFS approach, not early diagnosis which we all agree but getting in there with “rehabilitation” before the person becomes lost to it or as they would say too taken in with adopting the sickness behavior, deconditioning and alleged benefits. Similar approach, not surprising with the common factor of Wessely.

 

[chrisb]

The point about early treatment was largely to prevent troops getting too far from back from the front line.

Another similarity was the refusal of diagnosis. There developed a practice of classifying troops as NYDN (Not Yet Diagnosed-Nervous) and sending them back to their units.

Much of the concern was the loss of troops from the battlefield and the possible cost of pensions. A familiar story.

I once thought it so familiar that I suspected that sometime in the 1980's an official at the Department of pensions had the bright idea of getting out the old file to see how things had been dealt with in the past.

 

[Hoopoe]

I believe shell shock was the name used by soldiers. They thought it was caused by explosions.

Today we know that explosions can injure even without any external damage.

In general, primary blast injuries are characterized by the absence of external injuries; thus internal injuries are frequently unrecognized and their severity underestimated. According to the latest experimental results, the extent and types of primary blast-induced injuries depend not only on the peak of the overpressure, but also other parameters such as number of overpressure peaks, time-lag between overpressure peaks, characteristics of the shear fronts between overpressure peaks, frequency resonance, and electromagnetic pulse, among others. There is general agreement that spalling, implosion, inertia, and pressure differentials are the main mechanisms involved in the pathogenesis of primary blast injuries. Thus, the majority of prior research focused on the mechanisms of blast injuries within gas-containing organs and organ systems such as the lungs, while primary blast-induced traumatic brain injury has remained underestimated.

Blast injuries can cause hidden sensory[10] and brain damage, with potential neurological and neurosensory consequences.

https://en.wikipedia.org/wiki/Blast_injury

The first reports of shell shock according to Wikipedia:

Here is the During the early stages of World War I in 1914, soldiers from the British Expeditionary Force began to report medical symptoms after combat, including tinnitus, amnesia, headaches, dizziness, tremors, and hypersensitivity to noise. While these symptoms resembled those that would be expected after a physical wound to the brain, many of those reporting sick showed no signs of head wounds.

At first, shell-shock casualties were rapidly evacuated from the front line – in part because of fear of their unpredictable behaviour.

Symptoms of a blast injury according to Wikipedia

Individuals exposed to blast frequently manifest loss of memory of events before and after explosion, confusion, headache, impaired sense of reality, and reduced decision-making ability.

... The combination of these effects can lead to hearing loss, tinnitus, headache, vertigo (dizziness), and difficulty processing sound.[4]