Shell Shock and Anachronistic Diagnosis: The life of Charles S. Myers
The following is a story I wrote for the Melbourne science/storytelling night ‘the Laborastory.’ It was delivered on Wednesday July 6th. Each story focuses on the biography of your ‘science hero’.
Charles S Myers was a psychologist in Britain at the turn of the century and one of the fathers of British Psychology. His friends described him as a quiet man whose brilliance was only obvious to his closest colleagues. His academic work reveals him as a man who cared more about data than he did about people.
He’s like a Dr. House if he had manners. You know, like if Hugh Laurie was British.
He was a true intellectual scion of the Enlightenment. He showed talent in anthropology, music, archaeology, and philosophy, but eventually settled in Psychology. He had an honours degree in Natural Sciences and a medical degree from Cambridge. In 1898 he went on an anthropological field study to Sarawak and the Torres Strait, where he wrote a study on the music of indigenous people. By the time of the publication of his most famous book, the “Text Book of Experimental Psychology” in 1911, he was a Lecturer at Cambridge, a Professor at King’s College, London, and the founding Director of Cambridge’s Experimental Psychology Laboratory.
In the early years of the 20th century, the Enlightenment’s long shadow and Freud’s new theories shaped the new Science. It was half about the rational collection of data, and half about the messy, unconscious mind. Myers was a product of that time. He was very interested in the nerves as a mechanical system, rather like muscles. He took a middle road between Freudian psychoanalysis and the mass data gathering of his contemporaries. He cared about the accuracy of his data.
Freud would probably have called him ‘anally retentive’.
He felt that the ends always justified the means. In 1904 he wrote a dispassionate defence of live vivisection, arguing that any pain caused by the procedure was of secondary importance to the scientific data gathered. He had some worrying ideas about race. He was an advocate of anthropometrics, which meant trying to catalogue racial difference by measuring bits of people’s bodies.
This was, after all, a period of history where learned men published serious articles about the African macrophallus and the Asian microphallus, in the process revealing less about their subjects and more about themselves. Myers was a product of the 19th century — a time where men were real men, facts were real facts, and it was a good day if you managed to get to breakfast without causing genocide.
But the ordered and rational world that Myers cherished was lurching towards its darkest hour. The war didn’t start out as the ‘War to End All Wars’ — that name came later. Young men marched off to the front hoping to show they had nerves of steel. The War was meant to make boys into men and craft the next generation of British leaders. Instead, it threatened to destroy Enlightenment itself.
Myers put himself right in the thick of it. Just before Christmas 1914 our quiet genius joined the Royal Medical Corps and travelled to France. At the Duchess of Westminster’s War Hospital, Myers watched the unbelievable human cost of the war begin to mount. Like many others, he started to see a new medical condition amongst the casualties, something nobody had the words to describe yet.
He was the first to use the term ‘Shell-shock’ in an academic article, though he later claimed that he did not invent the term and that he hated it. Between 1915 and 1919 he published four articles for the Lancet, drawing on more than 20 case studies of soldiers psychologically affected by the industrialized warfare on the Western Front.
Because he was interested in the senses, Myers first noticed significant loss of vision and smell, some loss of hearing, and partial or total memory loss in his patients. Later, he concentrated almost entirely on the onset of hyperaesthesia, or a heightened sense of touch. He tortured men with pin-pricks and cotton wool, meticulously recording their descriptions of the sensations thus produced.
In line with pre-war theories about the nerves, Myers argued that the new condition was the result of a physical disruption of the delicate tissues of the brain and spine, caused by concussive shock from shells. He wasn’t alone in this theory. In 1916, the Royal Society held a conference on Shell-shock. One speaker claimed that the condition was the result of tiny, scattered haemorrhages throughout the brain. But there were other theories. Another speaker argued that it was possible that prior conditions or shocks — which they called ‘predispositions’ — could be re-awakened by a shell blast. A third argued that this was preposterous.
This argument really mattered. Men died, or their lives changed, as a result of it. The Army’s Medical Corps had noticed very quickly that some men arrived with shell shock symptoms but no physical wounds, while others had both. At first, they categorised the physically wounded as wounded, and treated the others as malingerers — men faking it so they wouldn’t have to fight. Various armies did different things to the malingerers. The British shot them. The Germans electrocuted them, hoping to make hospital less appealing than the battlefield. Once they realised the scale of the problem, most armies reclassified the malingerers as Sick men. But in Britain, the ‘Wounded’ men — with physical scars — got pensions, and the ‘Sick’ men — with only mental trauma — didn’t.
Myers published an article in 1919 that reclassified the condition into Commotional Shell Shock, which came from a shell blast, and Emotional Shell Shock, which came from some prior condition. Myers led the charge in finding new ways to treat these men, offering hypnosis and suggestion in place of electrocution and execution.
Myers was pushing against stiff resistance. The War Office’s own 1922 Report on Shell Shock shows us the stigma that these men faced. It listed the types of conditions that predisposed men to emotional shell shock. The list included Alcoholism, opium abuse, syphilis, sexual excess, and feeble-mindedness. According to the army, shell shock was a moral failing, not a mental one.
I don’t mean to convince you that Myers was a compassionate man. He wasn’t. That’s not why I chose him as my scientific hero. He named and shamed ex-patients as malingerers in the pages of the pre-eminent medical journal of the day, so he was actually a bit of a bastard.
I picked him to talk about tonight because he built a brand new way of understanding the mind, almost from scratch, and in the face of one of the most catastrophic human disasters in history. His meticulous esteem for the truth meant that he was not happy to assume that the vast bulk of young men he saw were cowards. When confronted by overwhelming data — even without a language to explain what he was seeing — he rose to the challenges it presented.
I also chose him because I’m a historian, not a scientist. Most people these days think that Shell Shock was just a primitive form of PTSD. That the assumptions of the day were wrong, and Myers was thus ill-equipped to explain what he was seeing. That he was groping around in the dark with a very dim flashlight. That we know better now, because we know more.
Myers is my hero because he shows us the fallacy of thinking we always know better than people in the past. Across his four articles for the Lancet, in conversation with his peers, he changed his mind several times about what the disease was and what its symptoms were. If you compare the lists of symptoms from his articles with the description of PTSD in the DSM-III, IV or V, there is overlap — but there is also considerable difference.
Some symptoms of shell shock have not been seen in men suffering from combat trauma since the Great War. Myers and others reported fits of uncontrollable shaking — not just tremors, but seizure-like involuntary movements that made walking or even standing impossible. The two conditions share hallucinations and some memory loss, but Myers noted complete amnesia in many men. Men were struck blind and deaf in both World Wars without physical trauma, but not to the same extent in Vietnam. PTSD is not just an update of shell shock. They are different conditions.
In history there’s a thing called ‘anachronistic diagnosis’. Historians use it to criticise scientists who try to write history. It’s our way of saying, “get off our lawn”. Yes, I see the irony.
We’re mostly jealous of the attention Scientists get. Where you guys get to talk about sending a probe to Jupiter or re-writing the human genome with CRISPR, all we get is constant complaints about how we don’t write about how great straight white men are or how awesome war is. Imagine if climate denialism was the only response you ever got from the public — that’s what it’s like being a historian.
But anachronistic diagnosis is important because it reminds us that scientific knowledge isn’t just a process of discovering more of the truth. In the 19th century scientists thought they stood on an island of light in an ocean of darkness. The two world wars, nuclear weapons and the Holocaust showed us the pallid forms of menacing things lurking in the depths of that sea, and they do not care for our survival.
The history of mental illness is not just about illuminating the dark recesses of our minds. We know ideas change over time, otherwise we’d have the same attitudes to race and gender and surgery without anesthetic as men in Myers time did. We know bodies change over time too, even in shorter-than-evolutionary timescales, otherwise I wouldn’t bump my head walking through doorways in places like Pompeii or the quainter parts of England. We also know diseases change over time, otherwise antibiotic resistance would be impossible.
The point is that diseases, like ideas and people, aren’t historical constants. We’ll never know if Abraham Lincoln had Marfan’s Syndrome, because it didn’t exist in 1865. Every time Chopin gets a new diagnosis it’s because that disease has just been invented. There’s a whole debate over whether Socrates had epilepsy, or whether he was experiencing the divine — you can see how that might start to matter. If we call Myers’ methods primitive, we’re no better than those in a century who will laugh at our efforts now, and they’ll eventually be wrong too.
The history of medicine is kind of like an episode of House, but one that takes centuries. There are no right or wrong diagnoses, there are just ones that work at that moment in time, and ones that don’t. To quote one expert in this field, you don’t die of a disease, you die of what your doctor says you die of.
If Shell shock and PTSD are different conditions, it lets us ask a really exciting question: what if diagnosis is not evidence about a human body that is unchanging through time, but evidence about the way we think about the world? What does that say about the difference between the world in 1915 and the world in 1965? What does it say about us, now, that anorexia or depression did not exist as a diagnosis only two hundred years ago?
Myers is my scientific hero because he wasn’t constrained by the assumption that he was right. What happens if, like Myers, we abandon what we think we know? Like Myers, I think we would see the worst excesses of our day more clearly — like shooting men for cowardice — and our best results for what they are: a guess that will soon be wrong. Myers is my hero because he’s a reminder that human knowledge is not a journey out of the dark and into the light. He shows us that we’ll never reach a perfect understanding of the world, but that is not a reason to stop trying.