Combat Stress (charitable organisation)

Soldiers (and other frontline personnel) returning home from World War I suffered greatly from the horrors of war that they had witnessed. Many returning veterans suffered from what was then known as shell shock; now known as post traumatic stress disorder (PTSD).

In 1915, the British Army in France was instructed that:

Shell-shock and shell concussion cases should have the letter 'W' prefixed to the report of the casualty, if it were due to the enemy; in that case the patient would be entitled to rank as 'wounded' and to wear on his arm a 'wound stripe'. If, however, the man’s breakdown did not follow a shell explosion, it was not thought to be ‘due to the enemy’, and he was to [be] labelled 'shell-shock' or 'S' (for sickness) and was not entitled to a wound stripe or a pension.[5]

In August 1916, Charles Myers was made Consulting Psychologist to the Army. He hammered home the notion that it was necessary to create special centres near the line using treatment based on:

• Promptness of action;
• Suitable environment;
• Psychotherapeutic measures.

He also used hypnosis with limited success.

In December 1916, Gordon Holmes was put in charge of the northern, and more important, part of the western front. He had much more of the tough attitudes of the Army, and suited the prevailing military mindset, and so his view prevailed. By June 1917, all British cases of 'shell-shock' were evacuated to a nearby neurological centre, and were labelled as NYDN – 'not yet diagnosed nervous'. "But, because of the Adjutant-General's distrust of doctors, no patient could receive that specialist attention until Form AF 3436 had been sent off to the man’s unit and filled in by his commanding officer."[5] This created significant delays, but demonstrated that between 4-10% of shell-shock W cases were 'commotional' (due to physical causes), and the rest were 'emotional'. This killed off shell-shock as a valid disease, and it was abolished in September 1918.

During the war, 306 British soldiers were executed for cowardice; many of whom were victims of shell shock.[6] On 7 November 2006, the Government of the United Kingdom gave them all a posthumous conditional pardon. The Shot at Dawn Memorial at the National Memorial Arboretum in Staffordshire commemorates these men.[7]