Progress Derailed: How the Great War Altered the Course of French Psychiatry

Progress Derailed: How the Great War Altered the Course of French PsychiatryThe First World War marked an abrupt halt in the development of French psychology, particularly in the study of trauma.The 1880s and 1890s saw remarkable advancements in neurology, which included Jean-Martin Charcot's new research on hysteria.His studies redefined its origin and inspired many of the neurologists who would become integral in handling the devastating effects of "war neuroses" after the outbreak of the First World War in 1914.These wartime neurologists were faced with an onslaught of soldiers suffering from what were called "functional disorders", which consisted of physical symptoms without a corresponding injury.Symptoms of functional injuries ranged from "paralysis and anaesthesia to mutism and deafness".1 Between the incredible number of cases doctors were presented with and the socio-political environment the War created in France, neurology underwent a shift in ideology away from Charcot's revelatory discoveries regarding hysteria.The priority of neurologists was now to cure the soldiers of their functional problems and return them to a desperate and demanding front line.Though he died over a decade before the outbreak of the war, Jean-Martin Charcot's studies on trauma greatly influenced wartime psychology.In a striking contrast to historical studies on hysteria, Charcot studied the effects of trauma in working class men.For years, 'hysteria' had been associated solely with the "fragile emotions" of women from the upper and middle classes of society.Charcot's groundbreaking case studies introduced a new diagnosis for 1 Gregory M. Thomas, Treating the Trauma of the Great War: Soldiers, Civilians, and Psychiatry in France, 1914-1940, Baton Rouge: Louisiana State University Press, 2009, 20.Shelby Drozdowski men called 'traumatic neurosis' that would alter both public and medical perception. 2 Charcot and his students argued that hysteria (literally meaning "wandering womb") was not an affliction of wayward female anatomy.Charcot believed hysteria was instead a disorder of the nervous system that could affect both women and men. 3 This nervous affliction, as theorized by Charcot, required both a hereditary predisposition and an environmental stimulus in order to generate symptoms of traumatic neuroses.Charcot believed the "traumatic stimuli acted on this prior constitutional susceptibility, and the fact that some individuals developed elaborate neurotic symptoms… [was] explained by the presence or absence of this background".4 Many of Charcot's hysteric patients suffered an injury from a railway or workplace accident.Though the bodily harm done was minor, patients presented with symptoms that could not be attributed to any physical injury.Charcot found that the most common symptoms were "motoric and sensory disturbances of the extremities-anaesthesias, hyperesthesias, paralyses, and contractures of all kinds".Railway and workplace accidents had been studied before, and generally led neurologists to the conclusion that industrialization caused a perceived loss of control and was responsible for these unique symptoms.5 In a small number of Charcot's cases, however, patients suffered from a physical accident outside the workplace.In the case of "Mar", the young man developed neurological symptoms two weeks after he was assaulted and stabbed, while "Greff" almost drowned on a fishing trip and developed an eye twitch and motor

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