22. Military Authorities Thought PTSD Was a Form of Malingering, and Did Not Want to Reward It
We now know that adequate rest and relaxation are among the most effective means of treating PTSD. During WWI, however, shell-shock was often seen as a scam or attempt by cowards to con their way out of combat. As a result, military authorities were reluctant to “reward” shell-shocked soldiers – presumed to be malingering – with rest and relaxation. They saw that as a bad idea because it would encourage others to malinger and come down with shell-shock. The goal was to send shell-shocked soldiers back to the front as quickly as possible, so an unpleasant treatment such as electric shock was deemed an appropriate coercive therapy.
As devised by Edgar Adrian, electric shock for treating shell shock had three goals: suggestion, reeducation, and discipline. The focus was greater on the “discipline” part, to the point that shell-shock treatment often crossed the line into torture. As Adrian put it: “The current can be made extremely painful if it is necessary to supply the disciplinary element which must be invoked if the patient is one of those who prefer not to recover, and it can be made strong enough to break down the unconscious barriers to sensation in the most profound functional anesthesia“.
