Shell-shock, trauma and the First World War: The making of a diagnosis and its histories

During the First World War, thousands of soldiers were treated for ?shell-shock?, a condition which encompassed a range of physical and psychological symptoms. Shell-shock has most often been located within a ?genealogy of trauma?, and identified as an important marker in the gradual recognition of the psychological afflictions caused by combat. In recent years shell-shock has increasingly been viewed as a powerful emblem of the futility and suffering of the First World War: in this narrative, the experience of shell-shock is the essence of the war itself. This article, which focuses on Britain, extends the analyses of scholars such as Allan Young which question characterisations of shell-shock as proto-PTSD, and also considering the ethical problems raised by re-casting shell-shock as a contemporary medical construction rather than an essentially timeless manifestation of trauma. It argues that shell-shock must be analysed as a diagnosis shaped by a specific set of contemporary concerns, knowledges, and practices. Such an analysis challenges accepted understandings of what shell-shock ?meant? in the First World War (and therefore also what it means today), and also offers new perspectives on the relations of psychology, psychiatry and medicine, and the role of shell-shock in shaping the emergence of these disciplines, in the early part of the twentieth century. The political and ethical issues raised by histories of trauma cannot be resolved by a new, historicised conception of shell-shock; but these issues must be confronted directly if we hope to understand the full extent of the experience and legacy of shell-shock, and to avoid the disorder becoming an empty symbol.