>> after working as a visiting assistant profess sore or at university of california she serves ads the dean at lamar community college. her research focuses on the history of psychological war trauma. st stagner's presentation will highlight how in 1916 the public began to understand the devastating complications of shell shock epidemic. she will address how various attempts were made to replicate the damage it rocked on countless soldiers and others involved in the war. on this anniversary, 1916 stag ner's presentation is a talk that is both timely and ir refutably relevant to our world today. it is my pleasure to introduce annessa stag ner. [ applause ] >> as we have already heard this morning the first world war marked if more the modern industrial war. as we have heard, total war. with it came construction on a massive scale. mines killed hundreds in single explosions. gas seemingly melted lungs and eyes. machine guns signals slaughter for those ordered to charge. 1916 marked a turning point in which nations and militaries were forced to confront the destruction the war was causing on human minds. i would like to explain how they attempted to mitigate the war's damage. i would like to turn our attention to the ways beyond the medical history of the war. this is the british journal. he argued the impact could impair the senses. he hearing, sight, smell and taste. the symptoms doctors soon placed there were cases ranging from starring eyes and nightmares not long after myers many doctors did come to understand the distinction between what we would call physical brain injury and psychological mind wounds. cases were often difficult to distinguish. i would like to provide you one here. this is frederick motts work. this is a published book. this is a case of what he called functional facial paralysis. you can see that one side of his face is completely operational and the other side is not. here is the story on this individual. they were in an old german dugout. it all but completely covered him by the left side of his face. he was unconscious for three day sz. he knew nothing of what had happened himself and the above information is the result of what he was told by a comrade who had not been buried but had his arm blown off. there is nothing physically wrong with the muscles in his face and he has been in a shell explosion. he has suffered concussion and yet she also experienced the trauma of war. we can see in this case how that happens. i want to emphasize that my contention is wartime trauma is connected with culture and local politics. each nation experienced trauma during the first world war i am blurring those lines for purposes of emphasizing the year 1916. early in the war many failed to recognize the existence of war injuries of the mind. dr. charles wilson who served in the royal army medical in those early days we did not bother about mens minds. we did what we could for their bodies. we did not ask whether he was wearing well or he would last. of course he would last, why wouldn't he? military officers and doctors accusations lead soldiers to commit suicide. at best shell shocked soldier might be sent home to an asylum. military officials couched their descriptions of shell shock in language suggesting the soldier's lack of courage. they described soldiers cracking up and losing their nerve. these were sighs of emasculating fear. as one soldier explained, i mustn't show them i was afraid. by 1916 large numbers of shell shocked soldiers had become too significant to be ignored. as he observed, no medical military problem of the war are more striking than those growing out of the extraordinary incident of shell shock. these disorders accounted for one seventh. as attention grew so did. shell shock was perhaps the best diagnosis one could get. it signalled at least a physical cause and thus gave the soldier who was diagnosed with it a sense of legitimacy. psychological causes were sen as legitimate in the unconscious mind of seld yore who remained unable to control the flight instin instinct. other times it was considered illegitimate all together. perhaps the soldier was exhibiting feminine weakness. often which diagnosis and the meaning of that diagnosis depended on time, circumstance, commanding officer and doctor. treatments for shell shock and associated disorders took a variety of forms. some times punishment, some times shown here hydro therapy. others included hypnosis, what we would describe as physical therapy, talk therapy and relaxation. mixed with a sense of obligation it is what masculine men should be and do. these are attempts to underlie shell shock. the most controversial treatments was electrical practiced widely in units and to a lesser degree among british, french and others. it relied on a message to identify active methods bru to use pain to convention a soldier of his ability to use his paralyzed limb. debates continued throughout the war. no less than 223 american journal articles appeared in the war years regarding this topic. german, french, british and other publications number even higher. 1916 proved especially crucial for american doctors who would come to europe, observe treatments and develop their own approach to treatment when the u.s. entered the war in 1917. discourse shifted under various names as a legitimate war wound. there is a notion is legitimate war wound will enable physicians to heal soldiers. it is a policy that legitimizes the soldiers wounds, provides specialized care and emphasizes cure. shell shock remained a medical military problem. it is significant consequences in terms of permanently wounded in the aftermath. what is clear is cultural significance and europeans inability to recover from it. this national trauma was expressed in public news in the years following the war. i want to give you two examples of this. one is the commission into violations military duty in the us a tr parliment who had to trial revealed applied painful electrical shocks to nipples and genitals. nervous illnesses were treated. in this case we get a sense of what punishment could mean it its very worst, isolation cells, cold showers, naked exposure and public humiliation. similar debates arose in great britain and continued into the post war era. the british war committee held into shell shock. this was really central in british news. such discussions did not end with the immediate end of the war. this memorial in great britain was completed in 2001 and honors the legacy of shell shock as a symbol of war. again, i want to emphasize the importance of 1916 to all of this discussion. it notes specifically 346 soldiers that were executed for along those lines. we see that the greatest numbers of soldiers were executed in 1916. this begs the question for me, what would have -- this is really bad to do. what would have happened if the war ended in 1916. we see this period that really happens in 1916 with the treatment of shell shocked soldiers. the national trauma also became visible in literature and art. this is a picture of craig lockhart hospital. sasoon was noted by many as a distinguished fighter. he was present and it was shortly after in 1917 that he became disillusioned with war. h it accompanied what they saw as a failed victory. a glorious war that shattered all their pride. men who went out to battle, grim and glad, children with eyes that hate you, broken and mad. pains and light as under a green sea. i saw him drowning. in all of my dreams he plunges at me guttering, choking, drowning. if you too could pace behind the wagon and watch the white eyes in his hanging face, like a devil's sick of sin. if you could hear the blood come gargle from the corrupted lungs. incurable sores on innocent tongues. it continues, this idea of the trauma and magnitude that soldiers are experiencing because of the war. it becomes very real in this literatu literature. he eventually earned the iron cross. was transferred to the eastern front and back in 1918. we see here the face, the expressions of the hands and the fingers. both here in physical pain and in the mental anguish of war eric was mentioned earlier this morning. he was transferred to the western front in 1917. i'm showing a picture the film that was made afterwards. as a young recruit looses control it results in a physical injury and later dies of those wounds. it is which they believed they would never recover. many are visiting in 1917 after years of fighting, years of experiencing these kinds of trauma. it deepened the shell shocked soldiers regarding shell shocked nations. it was as one historian pointed out regarded in much of the literature as a mental state which mered a social disease and national degeneration. she reit ratd the theories of many of her peers that society was literally a more or less organized mental system and that beginning in roughly 1889 individual men inan dated by nerve stimulation had begun losing their ability to reason it had caused these men to initiate what she labeled an insane war. there was no doubt she said that the pace of life had effected mens minds in a disasterous way judging by their temper. it was especially apparent where ever men were collected in clusters, in concourses, parties, self-conscious groups. for these groups these collectives were so excited their emotions were out of hand, uncontrolled and uncontrollable. they became possessed of manias and ruled by anxiety fear. it is no figure out speech. it is justified exhibited by various group minds. they are exhibited in the literature in the art of the time, in political action, in the mentality and behavior of leaders and nations, in the teaching of inspirers of groups. they argued a saner world could have avoided the war. instead europe lost its progressive movement and became irritable. it is worth noting, as i did earlier that the united states stood distinct in treatment and as well as national understandings. the united states at least for some and far short period of time believed they had done it right. they had used progressive psychological practices to heal soldiers and with the help of wilson avoided war in 1914. if we were to compare the literature and art that i have showed you about europe we would see a very stark difference, oftentimes in american literature the shell shocked individual in the story is the heroin. all it takes is a crack over the head with a frying pan or holding their infant child for the first time. the soldiers are instantly cured. they turn out to be the great heros of the story. sit a very optimistic tone when compared to some of the works that we discussed. the united states had this progressive mind set. think appeared optimistic and in control of both american medicine and of politics. the central question would become who could repair the damage brought by years of war? who could restore europe from the shell shocked state? today as we gather here for the 1916 centennial event at the museum and memorial i challenge in the medical and cultural effects. it has become on important part of the museum. let us also remember the extensive debates regarding the definition of shell shock and how it could be treated. let us remember how the initial assumption that strong men would survive war proved false. for us never forget the common saying we often link should also remind us of our past attempts to treat war's mental trauma and of the great inevitable mental toll war takes on individuals and nations. thank you. [ applause ] >> ladies and gentlemen, i would invite you to either microphone for our time of q and a. >> thank you for the great talk. i assume you're familiar with pat barker's about the war. they are characters in the first and second novel. two-part question. one, obviously it's a novel. it's not supposed to be accurate. it is based on real events. i wonder if i want to reflect on treatment. also, both of them obviously go back to the front after they are treated there. i wonder how common that was among, you know, whatever you want to talk about. >> it has done so well, and i think so many people have read it. i think it's a wonderful work of literature. i think sassoon and owens experience was quite unique when compa compared to other individuals. william rivers was at craig lockhart for a particular moment in time when it did have a sympathetic and understanding approach to shell shock. we see that in the relationship with sassoon. he is a decorated officer at the time he goes there. i think that the story does a good job of capturing that, but not necessarily of what it might have been like to have shell shock if you were someone other than sassoon. >> yeah. >> so i hope that sort of answers that part of the question. for them to both go back to the front, i find sassoon is a very interesting case. it is sort of clear he doesn't really have shell shock. he becomes so upset by a length of the war and what he begins to perceive as political bodies that are that are pressing this war onwards when individuals are just dying. i think he had a real sort of moerl conscience in terms of the men under his leadership. i think what happens at craig lockhart is he is essentially convinced to go back and that the patriotism is worth fighting for. what exactly that experience was like for him, i can't really speak to a lot of detail. i can say a lot of his writings occurred well after the war. i was looking that even late in life he was writing about the w horrors of war and being dissatisfied with the social network he was returning into. it think it gives us a glimpse. i think he holds onto that throughout his life. >> are there statistics about how many people returned to the front after -- >> after treatment. after treatment. there are not a lot of statistics about those who return. great britain for the majority of the war, has their treatment facilities in england. they don't do the front line clinic. most people i would argue that sort of have a -- this is a bad way to say it, a more distinctive shell shock. they stay in france or in great britain. in the american case i think many were sent back. i think that they did a lot of single day treatments in the field right behind lines and they sent them back out. the goal was to send very few back to the united states. i think they accomplished that fairly well. >> thank you. >> i'm curious if you have any information about what people felt like at home both during the war and after the war about soldiers that were effected by shell shock, whether they were treated properly or not, and kind of the background is i think of famous incidents of using soldiers. >> right. >> yeah. >> and the fact that also that i believe in the raf during the second world war there was the lack of moral fiber category. so it seems like the lesson didn't stick at least in some quarters. >> uh-huh. yeah. yeah. >> i think what people thought i think really varied depending on the nation. that's your duty is to fight. you need to be over there. i think that's really pervasive. i think public understanding and concern for the way soldiers were treated increases with public d public dissas faction and i think there's a correlation there with how they perceive the individual soldiers. in the united states it's a little bit different because they really are honored as heros. if someone is shell shocked it is kind of cool. it is almost like better than a physical wound because it shows true bravery that you put yourself in some kind of condition and trauma and that you pushed through and done this for your country. so there's the kind of honor there associated with it in the u.s. contacts that doesn't exist so much in europe. the world war ii, that's really fascinating story. in my work i argue that what happens, it's very specific to the u.s. context. shell shock is used in the u.s. context. it is a diagnosis. it is a term. it is a valid war injury. you can be diagnosed with shell shock. you're taken to a hospital. you're treated by a certain series of steps. it's the most comprehensive system they will use until well into the vietnam war. the reason i think there's this moment in world war ii is because the u.s. military invested so heavily in world war i treatments they have the best doctors in the united states on the western front. they are treating soldiers. there has been money poured into these field hospitals and they are doing everything they can. yet after the war there is still this very large, and the population grows of individual who return who claim to be shell shocked and become permanent s disabled. so i think for the u.s. military there's always most this feeling that well, we tried treatment and it didn't work, therefore shell shock must be caused by something else. if we try treatment and it doesn't work it must be because it is hby the time we get to world war ii they do not include psychologists or psychiatrists in the military units as they had in world war i. they invest very heavily in screening. the idea is we have already screened out all of those people who would suffer from shell shock, so if you suffer in the fields it must be because you're just being a pansy, right? and you need a good slap because shell shock is h-- >> your next question will come from this side. >> hi. is there any distinction in the literature between the idea of what you might call an acute or single incident versus cumulative? you see these going up at a time these guys have been in the western front for a year or two years, which is very different than somebody involved in one attack. not to say it might not be terribly traumatic and did it result in any management in terms of rotating units to try to reduce cumulative stress. it is the pressures that want as they might say. they haven't slept and they have been under bombardment and this traumatic thing happens. in the literature they are very careful to document everything that happened before the onset of symptoms and i think that's why. i think that doctors are at a loss as to what that combination is, certainly time on the western front makes -- i would argue tremendous difference in how they are treated. yeah. and you asked a second part to your question that i have forgotten. >> did they have any rotation of units -- >> yeah. yeah. >> so there is in the american, which i'm most familiar with, there are psychologists placed with each unit, and they -- they are responsible for pulling men out when they begin to see signs. so they will pull those men out. they will take them back to a field hospital or maybe further back somewhere quiet and let them rest for a few weeks and send them back to the front. so there does become a preventive strategy for trying to recognize that early and not letting the condition worsen. i'm writing an article about a vietnam war veteran who discovered he had -- basically discovered he had ptsd some time after the war. he went to the veterans hospital and they told him to write his trauma. that sounds a little bit like what happened with sassoon and the other gentleman. i'm wondering if it was something he did on his own and is there some sort of -- it doesn't sountd like -- i don't think it happened after world war i before modern diagnoses of ptsd did he do that on his own or was it something that doctors prescribed and even in america did they prescribe. they had soldiers painting and doing sort of occupational therapy, doing things with their hands, crafts, put them in farms to help them try to heal. they doing talk therapy. there is a lot of attempts to remember the event fully in order to be able to process it, if that makes sense. >> it sounds like the modern ptsd treatments are a trip back to the future? >> yeah. it is interesting that -- so once i talked about this period in world war ii where they are like we don't need treatment. let's just get rid of it. all of that is brought back during the vietnam war. they refer back to his writings. he is the one who designed the treatments and processes for world war i. there is a direct correlation there between what happens during vietnam and what happened in world war i. >> thank you for this very dramatic presentation. it is very interesting to see how people with their unsophisticated knowledge grappled with this subject. i have always been curious to know with our sophistication whether some scientist has done the definitive explanation for exactly what happened to these individuals that suffered from shell shock. that's the first part of the question. i would love to know why it happened to some and not others. my grandfather was buried by shells and gas. he was a quiet farmer from pennsylvania. i would also like to know whether the germans sustained as many as the english and french? did one present with more cases of shell shock so ultimately why did it happen to some and not to others? i would like to know if there's a modern explanation for this. >> so i'll answer the second part first about jer plgerman c. paul has done and in part what he argues is that interpretations become very different based on the national context in which is soldier is placed. so after the first world war there are many shell shock cases in germany, what they refer to as male hysteria. they are deemed cured when they can again work, so the de definition of cure is your ability to be a sufficient worker and participate in the state. so many of those soldiers never returned to their families. they developed sort of group homes, barracks for them to live in. those soldiers are deemed cure because of their ability to work. what constitutes cure, how many are diagnosed definitely has that national component. there are large numbers of german cases. as far as the clinical definitions of shell shock and a definitive study there are definitely some cases that have tried to look at shell shock in a lot of detail and really play out what individual cases and what happened then. anthony is one that looked at the british case. i always caution about studies that use and placed onto another time period. the whole concept of that shell sholk was it's so culturally embedded it's hard to make those comparisons. certainly people do, and historians have done great work doing that. yeah, so there are some individuals that argue, well, if we look back at achilles there's signs of shell shock. we look at civil war and world war i. there are -- there is certainly to what i believe there's trauma running through every war. the way in which is body exhibits trauma i think is very culturally based. if we were to look at films under shell shock treatment that the stills i took are from a film and thoeld soldiers exhibit trauma differently than soldiers today with ptsd. so yeah, it's an interesting comparison there trying to figure out what actually buwas going on. >> and our last question will come from this gentleman. >> it sounds like you're quite familiar with current ptsd for iraq and all that, soldiers there are quote kvolunteers, unquote. has anybody looked at that in vietnam and world war ii and world war i and civil war, i particularly emphasize civil war. we also remember this post-traumatic stress disorder are wastebasket terms medically speaking. what about looking at brain chemicals in response to stress and we certainly know they are certainly in different people. has anybody looked atpeople. has anyone looked at some of those issues? you sort of alluded to them. >> yes. thank you for that question. i think it's a good one bringing what happened in world war i to the present day. i think that it's really interesting to look at how definitions of shell shock sort of changed from this exploding shell to understanding that there's a real psychological component going on. and i think even in present wars we're still dealing with this distinction between post-traumatic stress disorder, ptsd, and ptbi, post-traumatic brain injury, when do they overlap, what is the brain doing, what does the brain do under stress, what does the brain do under the impact of an explosion, and i think that there has been a lot of work done on brain chemicals as you suggested. and i think that work is continuing now in -- i think i saw a recent article in the "new york times" that talked about doing mris of soldiers' brains and seeing how being in an explosion had affected the brain and might even affect behavior and emotions and stuff like that. so i think that the interesting thing for me, the volunteer versus con strippive versus conscription, i don't think there's a difference in the type of individual affected. i think it's really based on time, circumstance, the number of traumas that soldier has experienced. it's just you were at the wrong moment at the right time and these symptoms develop. what's interesting is that i wonder if our sympathy for ptsd and ptbi will be as great as it was in great britain and germany after the wars because they are volunteers. and that's something that i find really interesting to think about. does volunteering, what does that do to our understandings of what a soldier should experience or what the consequence of that volunteering is. >> please join me in thanking dr. stadler. >> thank you. [ applause ] this weekend on american history tv on c-span 3, this saturday morning at 9:30 eastern, we're live from the library of virginia in richmond for an all-day symposium on civil war monuments, the history of their construction in the north and south and how public perception of confederate monuments has changed. then at 8:00 on "lectures in history," hamptons sydney college professor john coombs on how the rise of tobacco consolidated the power of wealthy virginia planters and london merchants in the 17th century. >> instead of just accepting the price that this random ship captain might have to offer me i'm instead going to send the tobacco over to england on my own account and i'm going to pay a commission to someone to market it there for me. right? this developing consignment trade ties larger planters of virginia and maryland to these english merchants. most of them in london. >> sunday at noon on oral histories, we continue with our series of interviews with prominent african-american women from the explorations in black leadership oral history collection. dorothy height served as president of the national council of negro women from 1957 to 1998 and received the presidential medal of freedom and congressional gold medal. >> i grew up and even in my religious experience growing one people of different religious backgrounds with the feeling of openness and how much each one contributes to the other. there's no superior, no inferior. >> and at 8:00 on "the presidency," historyian catherine clinton talks about what happened to president lincoln's family after his assassination. >> the morning of may 19th convinced that his mother might do herself harm and prodded by a team of medical and legal ethic robert lincoln files a motion that she can be held against her will -- >> for our complete schedule go to c-span.org. watch c-span as president donald trump delivers his first address to a joint session of congress. >> this congress is going to be the busiest congress we've had in decades. live tuesday at 9:00 p.m. eastern on c-span and c-span.org and listen live on the free c-span radio app. the national archives in college park, maryland houses hundreds of photos of artwork created during world war i. next on "american artifacts" we look at drawings by eight combat artists with archives valentine jan hodges. she has showcased the art and the stories of the artists on the archives blog, the unwritten record. >> when i first came to the archives i had