Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-23T04:28:17.918Z Has data issue: false hasContentIssue false

BATTLE EXHAUSTION: THE DILEMMA OF PSYCHIATRIC CASUALTIES IN NORMANDY, JUNE–AUGUST 1944

Published online by Cambridge University Press:  29 January 2010

EDGAR JONES*
Affiliation:
King's Centre for Military Health Research, King's CollegeLondon
STEPHEN IRONSIDE*
Affiliation:
King's Centre for Military Health Research, King's CollegeLondon
*
King's Centre for Military Health Research, Institute of Psychiatry, Weston Education Centre, 10 Cutcombe Road, London SE5 9RJ[email protected]
King's Centre for Military Health Research, Institute of Psychiatry, Weston Education Centre, 10 Cutcombe Road, London SE5 9RJ[email protected]

Abstract

During the Second World War, controversy surrounded not the inevitability of psychiatric casualties but the extent to which they could be minimized by selection, training, morale, and leadership. By early 1944, when planning for the D-Day landings was advanced, the problem of the psychiatric battle casualty was considered manageable by careful preparation and clinical understanding. The campaign to liberate Europe offered the newly formed Directorate of Army Psychiatry an opportunity to demonstrate its effectiveness. Psychiatric services were deployed to Normandy to maximize the return of front-line troops to duty. Commanders, however, entertained doubts about the value of military psychiatrists. By offering a sanctioned escape route from battle, some believed that their mere presence undermined the fighting spirit of combat troops. The records of 32 General (Psychiatric) Hospital have been analysed to discover categories of troops most vulnerable to breakdown and to assess the impact of front-line treatments. Infantry soldiers, those most likely to be killed, were disproportionately represented amongst admissions. Senior non-commissioned officers were also at elevated risk of breakdown, some being war weary from earlier campaigns. Probably 36 per cent of admissions returned to combatant duty, and 53 per cent were evacuated to the UK. The scale of psychiatric casualties revealed failures in pre-deployment screening.

Type
Research Article
Copyright
Copyright © Cambridge University Press 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Richard Holmes, Acts of war: the behaviour of men in battle (London, 2003), pp. 254–69; S. L. A. Marshall, Men against fire: the problem of battle command (New York, NY, 1947), pp. 192–4; John Keegan, The face of battle: a study of Agincourt, Waterloo and the Somme (London, 1976), pp. 334–6.

2 Shephard, Ben, ‘“Pitiless psychology”: the role of prevention in British military psychiatry in the Second World War’, History of Psychiatry, 10 (1999), pp. 491542CrossRefGoogle Scholar; idem, A war of nerves: soldiers and psychiatrists, 1914–1994 (London, 2000), pp. 187–203.

3 Lord Southborough, Report of the War Office committee of enquiry into ‘Shell Shock’ (London, 1922), evidence of Viscount Gort, p. 50.

4 Jones, Edgar, Kenneth, Hyams, and Simon, Wessely, ‘Screening for vulnerability to psychological disorders in the military: an historical survey’, Journal of Medical Screening, 10 (2003), pp. 40–6CrossRefGoogle Scholar.

5 Shephard, War of nerves, pp. 21–32.

6 F. A. E. Crew, The army medical services, iv: North West Europe (London, 1962), p. 209.

7 R. H. Ahrenfeldt, Psychiatry in the British army in the Second World War (London, 1958), p. 177.

8 Mark Harrison, Medicine and victory: British military medicine in the Second World War (Oxford, 2004), p. 279.

9 J. Terry Copp, ‘Battle exhaustion and the Canadian soldier in Normandy’, British Army Review 85 (1987), pp. 46–54.

10 Shephard, War of nerves, pp. 249–55.

11 The National Archives (TNA), PREM4/15/2, minute by Winston Churchill, Dec. 1942.

12 Quoted from Terry Copp and Bill McAndrew, Battle exhaustion: soldiers and psychiatrists in the Canadian army, 1939–1945 (Montreal and Kingston, 1990), p. 109.

13 Wellcome Archives (WA), GC/135/B1/100, ‘Report by Majors J. W. Wishart and C. Kenton on their work in North Africa’, p. 1; Ahrenfeldt, Psychiatry in the British army, p. 183.

14 Shephard, War of nerves, pp. 211–12, 234.

15 WA, GC/135/B1/31, Brigadier J. R. Rees, ‘Report of the consulting psychiatrist to the army on a visit to the overseas forces in Gibraltar, North Africa and Middle East’, 4 July 1943, p. 6; Main, T. F., ‘Forward psychiatry in the army’, Proceedings of the Royal Society of Medicine, 39 (1946), pp. 137–42Google Scholar, at p. 142.

16 Holmes, Acts of war, p. 258.

17 Patrick de Maré, interview (former captain in the Royal Army Medical Corps in charge of an Exhaustion Centre at 50 Field Dressing Station), 18 May 1998.

18 WA, RAMC 466/49, Major J. W. Wishart, ‘Experiences as a psychiatrist with BNAF and CMF, 23 January 1944’, p. 1.

19 Edgar Jones and Simon Wessely, ‘“Forward psychiatry” in the military: its origins and effectiveness’, Journal of Traumatic Stress, 16 (2003), pp. 411–19.

20 Edgar Jones and Simon Wessely, Shell shock to PTSD: military psychiatry from 1900 to the Gulf War (Hove, 2005), p. 78.

21 Harrison, Medicine and victory, pp. 121–2.

22 David French, Raising Churchill's army: the British army and the war against Germany, 1919–1945 (Oxford, 2000), p. 244.

23 Terry Copp, ‘First Canadian army, February to March 1945’, in Paul Addison and Angus Calder, eds., Time to kill: the soldier's experience of war in the west (London, 1997), p. 149; David Fraser, Wars and shadows: memoirs of General Sir David Fraser (London, 2002), p. 204.

24 WA, RAMC755/2/7, War Office, Psychiatric disorders in Battle (London, 1951), p. 1; Copp and McAndrew, Battle exhaustion, p. 110; John Ellis, World War II: the sharp end (London, 1990), p. 246.

25 TNA, WO165/129, war diaries of AMD11, Jan. 1942 to Dec. 1945.

26 Ahrenfeldt, Psychiatry in the British army, p. 21.

27 Jones, Hyams, and Wessely, ‘Screening for vulnerability to psychological disorders’, pp. 40–6.

28 TNA, WO177/343, Major R. J. Phillips, ‘8 Corps psychiatrist monthly report, May 1944’.

29 Copp and McAndrew, Battle exhaustion, p. 109.

30 TNA, WO177/321, Major D. J. Watterson, ‘Monthly report for June 1944 by psychiatrist attached to 2nd Army’, 7 July 1944, p. 1.

31 TNA, WO 177/321, Major J. W. Wishart, ‘Psychiatric summary week ending 18 June 1944’.

32 TNA, WO177/321, Major J. W. Wishart, ‘30 Corps exhaustion centre summary week ending 18 June 1944’.

33 TNA, WO177/321, ‘Casualty return’, 11 July 1944.

34 TNA, WO177/321, Major D. J. Watterson, ‘Psychiatric summary, 19 June 1944’.

35 TNA, WO177/316, Colonel R. F. Walker, ‘Notes on a visit to Beachhead, 4 July 1944’, p. 4.

36 TNA, WO177/1262, war diary of 32 General (Psychiatric) Hospital, July 1940 to Dec. 1944, 6 July 1944.

37 Jones and Wessely, ‘“Forward psychiatry”’, pp. 411–19.

38 Captain Patrick B. de Maré, ‘Exhaustion centre’ (typescript, Aug. 1944), p. 1.

39 French, David, ‘“Tommy is no soldier”: the morale of the Second British Army in Normandy, June–August 1944’, Journal of Strategic Studies, 19 (1996), pp. 154–78CrossRefGoogle Scholar.

40 TNA, WO177/316, war diary of the deputy director medical services 21 Army Group July 1943 to December 1944, ‘A’ Sitrep, 1 Aug. 1944.

41 Copp and McAndrew, Battle exhaustion, pp. 114–15.

42 TNA, WO177/321, Major D. J. Watterson, ‘Report by psychiatrist attached to 2nd Army for month of July 1944, 5 August 1944’, p. 1.

43 TNA, WO177/321, ‘Hygiene report, 20 July 1944’, p. 1.

44 TNA, WO177/316, Lt Colonel T. F. Main, ‘Psychiatry, notes on consultants and advisers weekly meeting’, 3 Sept. 1944, p. 3.

45 TNA, WO177/316, Lt Colonel T. F. Main, ‘Notes on consultants and advisors weekly meeting, 27 Aug. 1944’, p. 2.

46 TNA, WO177/316, Brigadier E. Bulmer, ‘Quarterly report of consulting physician 21 Army Group, 4 November 1944’.

47 TNA, WO165/129, diaries of AMD11, report by Major Copeland, 31 July to 2 Aug. 1944.

48 TNA, WO177/321, Major D. J. Watterson, ‘Report by psychiatrist attached to 2nd Army for month of July 1944, 5 August 1944’, p. 5; TNA, WO177/32, Brigadier E. Phillips, ‘Disposal of psychiatric cases’, 1 July 1944.

49 TNA WO177/321, Major D. J. Watterson, ‘Monthly report for June 1944 by psychiatrist attached to 2nd Army, 7 July 1944’, p. 1.

50 Harrison, Medicine and victory, p. 287.

51 TNA, WO177/316, Lt Colonel T. F. Main, ‘Psychiatry, notes on consultants and advisers weekly meeting’, 27 Aug. 1944, p. 2.

52 Michael D. Doubler, Closing with the enemy: how GIs fought the war in Europe, 1944–1945 (Lawrence, KA, 1994), p. 242.

53 Main, ‘Forward psychiatry in the army’, p. 141.

54 French, ‘Tommy is no soldier’, p. 163.

55 Doubler, Closing with the enemy, p. 239.

56 TNA, WO177/321, Major D. J. Watterson, ‘Monthly report for June 1944 by psychiatrist attached to 2 Army, 7 July 1944’.

57 French, Raising Churchill's army, p. 148.

58 Ellis, The sharp end, p. 162.

59 Anderson, C., M., Jeffrey, and M., N. Pai, ‘Psychiatric casualties from the Normandy beach-head’, Lancet, 2 (1944), pp. 218–21CrossRefGoogle Scholar, at p. 219.

60 S. A. Stouffer, Arthur A. Lumsdaine, Marion Harper Lumsdaine, Robin M. Williams, M. Brewster Smith, Irving L. Janis, Shirley A. Star, and Leonard S. Cottrell, The American soldier: combat and its aftermath, ii (Princeton, NJ, 1949), p. 446.

61 WA, GC/135/B1/112, Major R. J. Phillips, ‘Psychiatry at corps level, September 1944’, pp. 12–13.

62 TNA, WO177/321, Major D. J. Watterson, ‘Monthly report for June 1944 by psychiatrist attached to 2 Army, 7 July 1944’.

63 Edgar Jones and Simon Wessely, ‘Psychiatric battle casualties: an intra- and inter-war comparison’, British Journal of Psychiatry, 178 (2001), pp. 242–7.

64 TNA, WO177/321, Sitrep no. 7, 26 July 1944, Appendix A.

65 Fraser, Wars and shadows, p. 200.

66 WA, GC/135/B1/112, Phillips, ‘Psychiatry at corps level’, p. 13.

67 French, Raising Churchill's Army, p. 142.

68 Britain's modern army illustrated (London, 1945), pp. 162, 171.

69 Doubler, Closing with the enemy, p. 237.

70 R. Sobel, ‘Anxiety-depressive reactions after prolonged combat experience: the “old sergeant syndrome”’, Bulletin of the US Army Medical Department, 9 (1949), pp. 137–46.

71 Edgar Jones, Andrew Thomas, and Stephen Ironside, ‘Shell shock: an outcome study of a First World War “PIE” unit’, Psychological Medicine, 37 (2007), pp. 215–23, at p. 217.

72 A. C. Iversen, N. T. Fear, A. Ehlers, J. Hacker Hughes, L. Hull, M. Earnshaw, N. Greenberg, R. Rona, S. Wessely, and M. Hotopf, ‘Risk factors for post-traumatic stress disorder among UK Armed Forces personnel’, Psychological Medicine, 38 (2008), pp. 511–22.

73 TNA, WO177/1262, war diary of 32 General (Psychiatric) Hospital, July 1940 to Dec. 1944, 27 July 1944.

74 David French, Military identities: the regimental system, the British army, and the British people c. 1870–2000 (Oxford, 2005), p. 148.

75 TNA, WO177/343, Major R. J. Phillips, ‘Cases admitted to Exhaustion Centre (No. 1 Field Dressing Station) period 7 July 1944 to 13 July 1944’.

76 Nicholas Mosley, Time at war (London, 2006), p. 116.

77 Richard Holmes, ‘Five armies in Italy, 1943–1945’, in Addison and Calder, eds., Time to kill, p. 218.

78 S. A. MacKeith, ‘Lasting lessons of overseas military psychiatry’, Journal of Mental Health, 92 (1946), pp. 548–9; Millais Culpin, ‘Clinical psychology and some forgotten episodes’, British Medical Journal, 2 (1952), p. 956; J. A. Hadfield, ‘War neurosis: a year in a neuropathic hospital’, British Medical Journal, 1 (1942), pp. 281–5, 320–3.

79 Jones, Thomas, and Ironside, ‘Shell shock’, p. 217.

80 WA, GC/135/B/109, T. F. Main, ‘Quarterly report by the adviser in psychiatry, 21 Army Group, October 1944’, p. 2.

81 French, ‘Tommy is no soldier’, p. 165.

82 TNA, WO177/321, Major D. J. Watterson, ‘Monthly report for June 1944 by psychiatrist attached to 2nd Army’, 7 July 1944.

83 TNA, WO177/316, Brigadier E. Bulmer, ‘Quarterly report of consulting physician 21 Army Group, 4 November 1944’.

84 H. B. Craigie, ‘Two years of military psychiatry in the Middle East’, British Medical Journal, 2 (1944), pp. 105–9.

85 H. B. Craigie, ‘Military psychiatry’, British Medical Journal, 2 (1944), pp. 288–9.

86 Harold Palmer, ‘Forward psychiatry in the army’, Proceedings of the Royal Society of Medicine, 39 (1945), pp. 137–42.

87 Shephard, War of nerves, p. 217.

88 Edgar Jones, ‘War and the practice of psychotherapy: the UK experience 1939–1960’, Medical History, 48 (2004), pp. 493–510.

89 Jones, Thomas, and Ironside, ‘Shell shock’, p. 220.

90 TNA, WO177/316, T. F. Main, ‘Notes on consultants and advisers weekly meeting, 27 August 1944’, p. 2.

91 De Maré, ‘Exhaustion centre’, p. 1.

92 TNA, WO177/321, D. J. Watterson, ‘Monthly report for June 1944 by psychiatrist attached to 2nd Army, 7 July 1944’.

93 F. M. Richardson, The fighting spirit: psychological factors in war (London, 1978), p. 106.

94 WA, PP/CMW/H19/3, Major A. E. Moll, ‘Army psychiatry in the field’ (c. 1945), p. 9.

95 Copp, ‘Battle exhaustion’, p. 52.

96 E. L. Cooper and A. J. M. Sinclair, ‘War neuroses in Tobruk: a report on 207 patients from the Australian Imperial Force units in Tobruk’, Medical Journal of Australia, 2 (1942), pp. 74–7, at p. 77.

97 Alfred Torrie, ‘Psychosomatic casualties in the Middle East’, Lancet, 1 (1944), pp. 139–43, at p. 142.

98 Editorial, ‘Psychiatric casualties in battle’, Lancet, 1 (1944), pp. 505–6, at p. 506.

99 Southborough, War Office committee of inquiry, pp. 92–3.

100 Jones, ‘War and the practice of psychotherapy’, pp. 502–3.

101 De Maré, ‘Exhaustion centre’, p. 2.

102 TNA, WO32/11550, Brigadier H. A. Sandiford, ‘Psychiatric service in operational theatres, report on visit to 21 Army Group’, 18 Oct. 1944, p. 1.

103 TNA, WO165/129, war diaries of AMD11, memo from H. A. Sandiford, 6 Dec. 1943.

104 Edgar Jones, ‘“LMF”: the use of psychiatric stigma in the Royal Air Force during the Second World War’, Journal of Military History, 70 (2006), pp. 439–58, at pp. 452–3.

105 Edgar Jones and Neil Greenberg, ‘Royal naval psychiatry: organization, methods and outcomes, 1900–1945’, Mariner's Mirror, 92 (2006), pp. 190–203, at pp. 198–9.

106 TNA, WO165/129, war diaries of AMD11, Jan. 1942 to Dec. 1945.