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During the Great War of 1914-1918 nearly 9 million men lost their lives. This compares to an estimated 14 million deaths during all wars in the previous century. The heroism and sacrifice of troops in the trenches is probably without parallel. However, during world war 1, 306 British and Commonwealth soldiers were shot on the orders of military senior officers. By contrast, the Germans only executed 25 of their own. The Americans executed none.
The pretexts for execution for British soldiers had a common theme, many were suffering shell shock (also called "war neurosis" or "combat stress" and now recognised as Post Traumatic Stress Disorder or PTSD), and most were deliberately picked out and convicted "as a lesson to others". Charges included desertion (walking around dazed and confused suffering from PTSD), cowardice (ditto), or insubordination (any minor action that could be pressed into service as an excuse for execution). Some were simply obeying orders to carry information from one trench to another. Most of those shot were young, defenceless and vulnerable teenagers who had enthusiastically volunteered for duty. They were selected, charged, and subjected to a field trial often without defence, convicted one day, then shot at dawn the next . Eye-witness accounts suggest that many of these men faced death with a gallantry absent in their accusers.
“When the politicians fail good men are marched into war.”
There were very few scientific studies of what we today call Post Traumatic Stress Disorder (PTSD).
During the early 1800’s military doctors began diagnosing soldiers with "exhaustion" following the stress of battle. This "exhaustion" was characterized by mental shutdown due to individual or group trauma. Like today, soldiers during the 1800’s were not supposed to be afraid or show any fear in the heat of battle. The only treatment for this "exhaustion" was to bring the afflicted soldiers to the rear for a while then send them back into battle. Through extreme and often repeated stress, the soldiers became fatigued as a part of their body’s natural shock reaction.
During that time, in England, there was a syndrome know as "railway spine" or "railway hysteria" that bore a remarkable resemblance to what we call PTSD today, exhibited by people who had been in the catastrophic railway accidents of the period. In 1876 DR. Mendez DaCosta published a paper diagnosing Civil War combat veterans with "Soldiers Heart": The symptoms included startle responses, hyper-vigilance, and heart arrhythmia's.
The 1900’s During WWI overwhelming mental fatigue was diagnosed as "soldier’s heart" and "the effort syndrome". An article published on a now restricted Internet web site maintained by Med. Access entitled "Chronic Fatigue Syndrome" states that "...some 60,000 of the British forces were diagnosed with the problem and 44,000 of these were retired from the military because they could no longer function in combat". (www.medaccess.com/cfs/cfs_02.htm (this page is no longer accessible))
As a side note all 306 soldiers executed for cowardice during the 1914 / 18 war have since been pardoned as the evidence suggests that the majority of these men were suffering from PTSD
The term "shell shock" emerged during WWI followed in WWII by the term "combat fatigue." These terms were used to describe those veterans who exhibited stress and anxiety as the result of combat trauma. The official designation of "Post Traumatic Stress Disorder" did not come about until 1980 when the Third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) was published.
You may have noticed above that what started out as a "syndrome" turned into a "disorder". According to Taber’s Cyclopedic Medical Dictionary a "syndrome" is "a group of signs and symptoms that collectively characterize or indicate a particular disease or abnormal condition" and a "disorder" is an illness. PTSD changed from being part of a collective indicator to a singular illness, a significant medical distinction.
With few exceptions, up until DSM-IV, most combat veterans were diagnosed with "shell shock", which didn’t warrant long term treatment. Other combat veterans were merely diagnosed with "bad nerves" which not only didn’t warrant long term treatment, but also induced a "get over it" attitude from the military and medical communities.
The initial definition of PTSD described a psychological condition experienced by a person who had faced a traumatic event which caused a catastrophic stressor outside the range of usual human experience (an event such as war, torture, rape, or natural disaster). This definition separated PTSD stressors from the "ordinary stressors" that were characterized in DSM-III as "Adjustment Disorders", such as divorce, failure, rejection and financial problems.
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