Shell-shock and psychological medicine in First World War Britain

Historians have viewed the experience of shell-shock in First World War Britain as a crucial episode in the development of ‘modern’ psychological medicine, arguing doctors initially believed shell-shock was caused by the physical effects of shell explosions, and only gradually realised these were psychological disorders, treatable by psychotherapy. This article argues that conceptual frameworks of pre-war medicine provided models of mind-body relations which allowed doctors to recognise the emotional origins of shell-shock on the outbreak of war. Distinct schools of ‘physical’ and ‘psychological’ thought only emerged in 1916; physical theories persisted beyond 1918; and the war had an uneven effect on engagement with psychodynamic theories. Adoption of psychological vocabulary outstripped understanding, and widespread dissemination also resulted in hostility. Shell-shock marked an important moment in the emergence of the distinct disciplines of psychology and psychiatry in Britain, but this did not involve a radical departure from pre-war concepts of mental health