WWII differed from previous wars in its use of bigger field weapons and bombs, which placed soldiers at greater risk (PBS, 2003). Additionally, soldiers were placed into smaller combat groups, which reduced the social interaction which may have been a protective factor for psychological afflictions (Marlowe, 2000). Indeed, the war took a tremendous psychological toll on soldiers, despite the extensive use of psychiatric screening for selection (Marlowe, 2000). Medical personnel were puzzled that although over one million soldiers were screened out for psychological reasons, there continued to be staggering numbers of psychiatric casualties in war. In fact, even soldiers who had fought bravely on previous tours were being affected (Scott, 1990).
Overall, 25% of casualties were caused by war trauma, and this rate was even higher– 50%– for soldiers engaged in long, intense fighting (PBS, 2003). In fact, so many soldiers were affected that psychiatrists were confronted with the reality that psychological weakness had little to do with subsequent distress in combat. Thus, terminology changed from “combat neurosis” to “combat exhaustion,” or “battle fatigue” (Bentley, 2005). Reflecting the consensus that all soldiers were vulnerable to battle fatigue due to their environments, the U.S. Army adopted the official slogan, “Every man has his breaking point” (Magee, 2006).
In 1947, the U.S. Army released a documentary, entitled Shades of Gray, about the causes and treatment of mental illness during WWII. This documentary, shown in the following eight YouTube clips, indicates the consensus at that time that no one is immune to mental illness, and that environmental factors play a large role in the development of psychological problems. Combat exhaustion was thought to encompass such symptoms as hypervigilence, paranoia, depression, loss of memory, and conversion.
During WWII, treatment shifted to giving “mental patients” rest in safe areas (PBS, 2003). Other methods used by psychiatrists at this time included administering sodium pentothal (or other barbiturates) to induce repressed battlefield experiences, and even disbursing liquor to soldiers (PBS, 2003)!
The following U.S. Army training video, created in 1945, indicates that due to a shortage of psychiatrists, unspecialized medical officers needed to be trained to recognize the signs of combat exhaustion. The video trains medical officers in the use of various therapies for combat exhaustion, including the administration of sodium pentothal, followed by suggestive therapy, to help soldiers recover from psychosomatic physical complaints.
Although psychiatrists were advancing in their understanding of war trauma, combat exhaustion was not universally accepted. General George Patton was notable in his lack of sympathy for the psychological afflictions of soldiers. He is said to have slapped two soldiers who were recuperating in a military hospital while yelling to a medical officer, “Don’t admit this yellow bastard…There’s nothing the matter with him. I won’t have the hospitals cluttered up with these sons of bitches who haven’t got the guts to fight” (Magee, 2006). President Roosevelt received thousands of letters about the incident, most of which indicated support for Patton. “Ultimately, though, Patton was reprimanded, ordered to apologize, and relieved of command of the Seventh Army” (Magee, 2006).
In 1946, the National Mental Health Act was passed, which provided for the expansion of mental health facilities, including VA centers that would treat mental health problems in veterans (Magee, 2006).
Bentley, S. (2005). Short history of PTSD: From Thermopylae to Hue soldiers have always had a disturbing reaction to war. Vietnam Veterans of America: The Veteran. Retrieved from http://www.vva.org/archive/TheVeteran/2005_03/feature_HistoryPTSD.htm
Magee, D. (2006, May 15). PTSD: Only the name has changed. WCF Courier. Retrieved from http://wcfcourier.com/news/metro/ptsd-only-the-name-has-changed/article_394eabda-6a67-5b42-ab5b-2643c4158f11.html
Marlowe, D. H. (2000). Psychological and psychosocial consequences of combat and deployment with special emphasis on the Gulf War. Retrieved from http://www.gulflink.osd.mil/library/randrep/marlowe_paper/
PBS (2003). The perilous fight: America’s WWII in color. Retrieved from http://www.pbs.org/perilousfight/psychology/
Scott, W. J. (1990). PTSD in DSM-III: A case in the politics of diagnosis and disease. Social Problems, 37(3), 294-310. Retrieved from http://www.jstor.org/stable/800744?seq=3