Shell Shock, Memory, and Identity 53
assimilable images and experiences, arising from war service, either
in combat or near it, radically disturbs the narrative, the life story, of
individuals, the stories people tell themselves and others about their
lives. Through such stories, we know who we are, or at least we think
we do.
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Shell shock undermines that orientation, that point of refer-
ence from which an individual’s sense of self unfolds. His integrity,
in the sense of his having an integral personality, one with a then and
a now which flowed together, becomes uncertain because of what he
has felt and seen and what he continues to feel and see. In many cases
the visual imagination is central to this condition. Before the eyes of
a shell-shocked man were images frequently of an uncanny, life-
threatening, and terrifying kind, and they endure. Their meaning,
that is, their location alongside other images and experiences, is
unclear or bizarre. These visualized or felt traces of war experience
can tend to live a life of their own, a life at times so vivid and
powerful as to eclipse all others. They can paralyze; in extreme cases,
they can kill. Suicide is the ultimate escape from them.
Fortunately, most of the men who fought did not su√er from this
condition, and most of those who did were able to find a way to live
with it or move beyond it. Their recovery was independent of most
medical care, since the pathways of causality in this area of neuro-
psychology were unknown and patterns of care were unsettled and
highly subjective. Many doctors made informed guesses, but the
initial presumption of a purely organic cause of psychological dis-
turbances had to be discarded over time. What would replace the
initial, purely physical model of psychiatric illness was an open ques-
tion; it remains open today.
Whatever the state of medical knowledge, physicians still had a
task to do. They had thousands of psychologically damaged soldiers
to care for. By 1917, perhaps one quarter of all men sent down the
line in British forces were unfit because of psychological stress of one
kind or another. The breakdown rate was no lower in the German