Huge numbers of men experienced psychological trauma after the so-called Great War. Producer Chris Chambers explores the symptoms, causes and what the military tried to do about it.

When World War I began in the Autumn of 1914, men from all sides queued up to serve in a fever of patriotism. Within months armies were haemorrhaging men from the front line in unprecedented numbers. Many were killed or wounded, and thousands of others were showing signs of nervous disorders.

"It must have been a horrible experience,” says Hans Binneveld, professor of history at Erasmus University. “It's rather difficult to understand why it kept going on. There were big battles but no progress. And conditions in the trenches were terrible of course. They had a lot of stress."

Psychiatry was a still a young and controversial profession in the early years of the twentieth century. Although treated with both caution and disdain by the army, it was recognised very early on in the war that psychiatrists would play an essential role. So many men were being invalided out of the fighting because of 'nervous fatigue' that military leaders realised that the flow had to be stemmed, otherwise the war would be lost. The problem was, how could men who were clearly unfit to go back to the frontline be made to do so?

Shell shock

Men were showing all kinds of nervous symptoms. From paralysis in legs or arms, to blindness and deafness. It was originally thought that exploding shells, a new feature in warfare, were to blame, creating airwaves which damaged the brain. The term shell-shock was subsequently coined. However, a new explanation was soon sought after it was found that even people away from the frontline were showing symptoms. This prompted experts to consider a psychological explanation.

During the First World War, there was no common opinion about the use of psychiatry. The main tendency was to ignore the problem and to consider the soldier as a malingerer, simulating the condition to avoid fighting. One very common practice used was electroshock treatment. Strong currents were administered to the part of the body affected, a paralysed arm, for example, and the patient would simply be ordered to move it. The aim of most therapies was to get the soldier back to the front as soon as possible.

Frontline psychiatry

Nowadays, the military psychiatrist is seen as an essential member of any company or battalion and is constantly on the lookout for those soldiers who may not be coping well with their situation - the so-called frontline psychiatry. However, it's only a recent development. When the Dutch army sent young recruits to the Lebanon in 1981 as part of a peace-keeping force, there was very little attention paid to the possible psychological effects of such a deployment.

Chris Laarhoven was just nineteen when he was sent to the front zone in Lebanon. More than 20 years later he is still psychologically handicapped by his time there. He spent two years in a mental institution and continues to suffer from nightmares almost every night: “I don’t want to go to sleep to avoid the coming of the images because when I’m weak – and that’s un my sleep – they just come. That’s what I hate about it. I cannot control them and that’s terrible.”

The extreme symptoms of what is now called "post traumatic stress disorder" or PTSD are no longer seen in modern warfare and for the ordinary soldier, working conditions have improved dramatically since the horrors of World War I. However, psychiatrists are constantly on their guard. They know that a war zone pushes the mind and body to its limits and that the body can react in extraordinary ways as a consequence.

A War Requiem was produced by Chris Chamber. The documentary was originally broadcast in November 2005.