Psychiatry and War

This article provides an overview of the historiographical—and to some extent, anthropological—literature on psychiatry and war. While the psychological and behavioral sequelae of war have been documented since antiquity, it was in the nineteenth century that these manifestations began to be rearticulated in psychological terms. This medicalization or psychologization of the discourse started to become more visible with the so-called war neuroses, a loosely defined category that peaked during the Second World War, and then was displaced by other conditions, such as shell shock during the Great War (World War I) and the recognition of post-traumatic stress disorder (PTSD) in 1980. While PTSD remains the emblematic war-related psychiatric diagnosis, many other postwar syndromes continue to be the foci of current research. This article traces the emergence and legacies of such diagnostic categories, examining key figures and social and cultural forces that shaped their development. There is a substantial body of clinical literature by psychiatrists, psychologists, neurologists, and psychoanalysts addressing the psychiatric and psychological sequelae of war. The article brings together seminal papers from this clinical literature with crucial secondary scholarship to demonstrate how these diagnoses came to be recognized and what they would eventually mean for the discipline. The piece eschews a strictly chronological narrative, opting instead to trace how wars seem to continuously produce real, yet intangible, symptoms that, once labeled and legitimized, become focal points in subsequent scholarship. Each war, rather than producing a straightforward progression in psychiatric knowledge, instead led to unique sets of symptoms that mental health professionals documented, labeled, and treated, often with great difficulty. The fascination with shell shock and its aftermath reflects both the devastating impact of World War I and the lasting influence of these diagnoses. An important aspect of the scholarship on war and psychiatry is the crucial role of mental health professionals in shaping narratives, including its political meanings and cultural legacies. First, clinicians documented the psychological and emotional impact of war on soldiers, contributing a clinical understanding of wartime trauma. Second, their work helped create a new field: military psychiatry. Third, they authored some of the earliest historical essays on war’s impact, chronicling the evolution of mental health concepts, the rise of military psychiatry, and efforts to address war’s detrimental psychological effects. Strikingly, mental health professionals played a key role—and often led the way—in challenging the practices of psychiatry, particularly during the 1960s and 1970s. These critiques intensified in the 1980s in the face of a rising tide of skepticism regarding PTSD. The relationship between war and psychiatry in this article is hence explored in an interdisciplinary manner to try to make sense of how our understanding about mental health has changed, as it was crafted over time by clinical practices, societal attitudes, and shifting ideas about trauma in relation to war.