Our Heroes Aren’t Cowards: The Evolution of Shell Shock to PTSD

This is a comparison of two brain scans, one individual with PTSD (left) and the other without (right). | Courtesy of MedicalXpress.

Winner of the Fall 2018 StMU History Media Award for

Best Article in the Category of “Military History”

Best Article in the Category of “Science & Technology”

Charles Meyers, a Medical Officer, introduced the term “Shell Shock” to explain symptoms of Post Traumatic Stress Disorder (PTSD) displayed by military after combat in World War I (WWI). Soldiers often experienced symptoms including fatigue, tremor, confusion, nightmares, impaired sight, and impaired hearing. Meyers assumed that these symptoms were caused by the soldiers’ exposure to exploding shells, not necessarily the trauma they were witnessing or going through. In these years, symptoms of widespread PTSD were considered “weak” traits for soldiers by their colleagues and bosses. Even society as a whole started to view these symptoms negatively, which led to the destruction of their relationships after the Shell Shocked soldiers arrived home.1

Military gave Shell Shock victims no sympathy. When soldiers were dismissed from their duties, they were given labels such as “cowardice” or “emotionally weak.” These labels led to soldiers being targeted for abuse from their own side, as well as mock trials in which they were convicted. The pardons they received weren’t honorable, so they were often ashamed of their disorder, which led to more mental issues among the soldiers like depression, anxiety, and even suicide.2

Arthur Hurst was an army major who developed treatments for shell shock that were very successful. | Courtesy of BBC

New treatments flipped understandings of how World War I caused drastic changes in the behaviors of these men. Treatment for Shell Shocked victims before Arthur Hurst’s “miracle treatments” were very harsh, as they were often treated with Electroconvulsive Therapy, emotional deprivation, shaming, and solitary confinement. Some of the lesser treatments were hypnosis, massage, rest, and dietary treatments.3

Arthur Hurst primarily used occupational therapy to treat Shell Shocked patients, treating them as humanely and sympathetically as possible. This dignified care allowed for the increased numbers of “saved” soldiers, as they found ways to overcome the abuse and the labels given to them after their dishonorable discharges. Hurst’s treatments became iconic after the Newton Abbott’s Seale Hayne in Devon. Hurst’s approach allowed for 90% of Shell Shocked soldiers to be cured after only a single session.4

An example of PTSD being treated by Electroshock Therapy. | Courtesy of The Science Explorer.

Modern day treatments, consist of therapy, as well as new medicines that aid in the control of the symptoms. According to Michael James, a pharmacist, there are Selective Serotonin Reuptake Inhibitors (SSRIs) that block the re-uptake of serotonin in the brain and help with sleep disorders, nightmares, and decreases intrusive thoughts. James also informed me that Serotonin Norepinephrine Reuptake Inhibitors (SNRIs) block the re-uptake of serotonin and norepinephrine in the brain which also decrease intrusive thoughts and provide aid for sleep disorders and nightmares.5

Hurst’s approach led to a change of heart and a consensus to the overall approach by society as a whole. Now, Veterans Affairs, also known as the VA, has a large program that provides aid to veterans with PTSD. However, this evolution of PTSD has not only been beneficial to veterans, but it has also allowed for a more diverse diagnosis of PTSD, in which it is more understood that other people, in addition to veterans, can also experience PTSD. PTSD can be caused from any sort of trauma including car accidents, violent crimes, and domestic violence. Individuals can even develop PTSD from having someone important abandon them as well. The DSM-5 has set a variety of symptoms for PTSD because just like any other disorder, it affects every individual differently. This document allows all individuals to gain access to the tools and help they need to recover from or live with PTSD.6

At Sir William Hospital in England, nurses used experimental medical treatments on soldiers with Shell Shock. | Courtesy of Smithsonian Magazine.


  1. Caroline Alexander, “The Shock of War,” Smithsonian Magazine, September 2010, https://www.smithsonianmag.com/history/the-shock-of-war-55376701/.
  2. “Shell Shock,” BBC Inside Out, March 3, 2004, http://www.bbc.co.uk/insideout/extra/series-1/shell_shocked.shtml.
  3. “Electroconvulsive Therapy: A History of Controversy, but Also of Help,” The Science Explorer, January 13, 2017, http://thescienceexplorer.com/brain-and-body/electroconvulsive-therapy-history-controversy-also-help; “Arthur Hurst: The Man Who Filmed Shell Shock,” BBC Radio 4, http://www.bbc.co.uk/programmes/articles/4VqPtrjsgcPKtgmYc2M5vXz/arthur-hurst-the-man-who-filmed-shell-shock.
  4. “Arthur Hurst: The Man Who Filmed Shell Shock,” BBC Radio 4, http://www.bbc.co.uk/programmes/articles/4VqPtrjsgcPKtgmYc2M5vXz/arthur-hurst-the-man-who-filmed-shell-shock.
  5. Email with Michael James, September 11, 2018.
  6. Pete Walker, From Surviving to Thriving (Scotts Valley, CA: CreateSpace Independent Publishing Platform, 2013), 13-14.
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  • I am surprised men were labeled as weak just because they viewed their time in war as traumatic. After living in a war environment after a while, you grow accustomed to it, but that does not mean that person is completely fine. They get accustomed to it in such a way that they expect to hear loud noises and see horrible things, so much that they are left traumatized.

  • This was a very interesting story to read. As some one that is currently studying psychology, I have learned a lot about post-traumatic stress disorder while in Undergrad. PTSD is a growing problem today and it is unfortunate that so many suffer from this disorder. PTSD was seen as a sign of weakness, which is why it is believed that not as many males are diagnosed than females. Females are diagnosed 2x more than males and it is questioned as too if this is because men are scared of being labeled as ‘weak.’ It is unfortunate that so many people have to suffer from this disorder and there is not near enough resources and help available to those with the disorder.

  • Knowing about PTSD and the effects I never went into research how people are affected by it and how it can truly hurt ones self. It sad to know the bravest people fighting for our country and the ones that have to go through these kinds of things. This article really helped me gain a better understanding of how these soldiers are effected by war. Im so glad that Hurst was able to find treatment for this unfortunate syndrome.

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