A Weary Road: Shell Shock in the Canadian Expeditionary Force, 1914–1918 by Mark Osborne Humphries, and: Shell-Shock and Medical Culture in First World War Britain by Tracey Loughran

Abstract

Reviewed by: A Weary Road: Shell Shock in the Canadian Expeditionary Force, 1914–1918 by Mark Osborne Humphries, and: Shell-Shock and Medical Culture in First World War Britain by Tracey Loughran Peter Leese Mark Osborne Humphries. A Weary Road: Shell Shock in the Canadian Expeditionary Force, 1914–1918. Toronto: University of Toronto Press, 2018. xii + 461 pp. Ill. $45.00 (978-1-4426-4471-7). Tracey Loughran. Shell-Shock and Medical Culture in First World War Britain. Cambridge: Cambridge University Press, 2017. x + 279 pp. $105.00 (978-1-107-12890-3). Both of the accounts under review belong to the emerging "third wave" of historical trauma studies that can be characterized, among other things, by close, nuanced attention to the performance of gender; to the historical specificities of psychological injury; to the changing "scripts" of social and medical expectation. Both accounts tackle relatively restricted themes connected to shell shock during the First World War. This close focus pays off in important new insights. Inevitably there is a trade-off in the loss of alternative and complementary perspectives. Tracey Loughran's study gives full attention to published medical discourse in Britain as it emerges and shifts through the war years. Critical to her argument is the view that published wartime medical debate—in military and civilian journals, specialist publications, and textbooks—gives no less a valuable insight than front-line medial diaries or hospital case notes. In this view there was "no disjuncture between published medical discourse and on-the-ground clinical practice" (p. 17). The varieties of medical knowledge that civilian, military, and nonspecialist medics brought to their treatment of psychological disorders, as well as the shifts of opinion before and through the war, become the main focus of attention as a result. The investigation of medical culture that follows gives substantial attention to pre-war developments and training and the ways in which these were inherited and subsequently modified as a result of the war. In the first two chapters of Shell-Shock and Medical Culture, Loughran concentrates on this later nineteenth- and early twentieth-century medical thinking with particular attention to the Darwinian inheritance and the varied origins of diagnostic concepts. Distinctions of body and mind, human and animal, civilized and primitive dominate here and have obvious relevance for the diagnostic preconceptions and categorizations that emerged 1914–18. The central chapters of the study consider first, the varied schools of thinking that emerged under the intense pressure of wartime conditions; and second, why questions of class and gender were rendered invisible in the formal medical discussion on shell shock. Loughran is especially alert to the plurality of thinking, lack of consensus, and contradictory opinion that persisted through the war, and that resists any narrative of straightforward "progress." Loughran's viewpoint also suggests British medical culture functioned very differently than in France or Germany. Rather than enforcing norms and class expectations these were suspended so as to more effectively prosecute the war. The final two chapters concentrate respectively on the notion of will in medical approaches, and on related ideas of instinct and regression. The advantage of [End Page 166] Loughran's method here is that these underlying conceptualizations incorporate both pre-war and wartime thinking, and at the same time cut across a range of potential attitudes and treatments. Will-related treatment concepts, for example, which became more widespread in the latter part of the war, could draw on both psychological approaches as well as on pre-war notions of instinct and social behavior. As Loughran rightly points out, this lack of clarity was beneficial during the war. Existing notions of self-discipline matched many soldiers' own senses of emotional "containment" as a socially sanctioned aid to coping. Loughran's final chapter and conclusion explore how the shifts of wartime thinking turned out to be entirely reversible, as the return to hereditary and constitutional explanations of mental breakdown soon after the war demonstrates. The implementation of wartime "lessons" is here described as much less than some historians have in the past wished for, but viewed within a longer time frame, nevertheless significant. War-related terminology fades out after 1922, but the huge interest in wider notions...