September 1916

Psychiatry in wartime: soldiers, civilians and historiography

By Anna Grillini

One of the most powerful images imprinted in the collective memory of the Great War is that of the traumatized soldier; men were often accused of cowardice or lying. To date we still have no definite figures on the number of victims of mental trauma and of violence against civilians.

War neuroses as a whole have been at the centre of the historical debate since the early seventies, with Eric J. Leed’s book, No Man's Land, published in Italy in the mid-eighties, almost at the same time as the work of Paul Fussell, The Great War and Modern Memory. In their different themes and approaches both works place a marked emphasis on the innovative military aspect of the First World War: industrialization. “War will not be understood in traditional terms: the machine gun alone makes it so special and unexampled that it simply can’t be talked about as if it were one of the conventional wars of history.”

The industrialized war is a war of bombardments, of impersonal machine-gun fire, of the disproportion between the means of attack and defence. It is also a conflict involving means of transport which carry troops rapidly to the front, help to carry the wounded away from the front, which scatter a multitude of people at that point homeless and deport prisoners of war to camps far away.

During the first months of war, military doctors welcomed with dismay thousands of traumatized men arriving from the front after each battle. However, they soon began to notice that, in many cases, the symptoms they presented are not so new. The new elements are the quantity, the variety and the insistence of the neurotic symptoms, not the illness in itself. The traumas which, during the war, are called “the burial alive neurosis” or “gas neurosis” can be found even in peacetime - what changes is the disease trigger and those affected. Before the war, hysteria was considered a typically female illness or was observed as a result of disasters such as railway accidents and earthquakes. After the outbreak of war these same types of trauma became the most widespread among the fighters at the front. The question that haunted psychiatrists of the time can be summed up this way: “is it fear which triggers symptoms or more simply do certain categories fall ill due to a predisposition which would, anyway, have led them to develop such disorders?” Physicians of the time mainly agreed that those affected by mental illness during the war were people already predisposed to the disease and that, consequently, the war was not responsible for their condition.

Historiography, however, mostly agrees that these neuroses directly related to the conflict were not an effect of war in general but the direct consequence of a modern and industrialized war. The crucial point on which many historians are divided and on which it is difficult to find a common viewpoint is regarding the intrinsic motivation that lay behind the war neuroses. Antonio Gibelli and Bruna Bianchi were among the first Italian historians to discuss this issue. In their opinion, neuroses can be psychophysical manifestations of discomfort, resulting from the surrounding horror, so great as to be intolerable for the mind. In this interpretation, neurosis is rejection and resistance: refusal of a war not understood and not agreed; resistance towards a value system that makes all men equal in such a ruthless way, conforming them, cancelling their personalities and assimilating them into a system of violence that clashes with everything that makes man human. This vision contrasts with the interpretation of Mario Isnenghi and Giorgio Rochat who emphasize the importance of the position of the soldier in the military institution and in the small group that makes up the platoon. Life in the trenches allows for no other identity than a military one and for no other role than that which is assigned by the institution. This rigid framework can not be considered merely as coercive but also as providing new values ​​and above all human relationships destined to be the psychological mainstay of the soldier in the trenches. 

Although historiographical discussion regarding military psychiatry and mental illness is far from complete, in recent years historiography is gradually shifting its focus towards the civilian population. The experiences of those who suffered bombardments, evacuations, internments and grief can not be considered less fundamental or traumatic than those of the soldiers in the trenches and it is therefore natural to wonder as to the consequences of the war on civilians too.

The asylum of Pergine Valsugana (located near Trento, in the Austrian Empire) is an interesting starting point to investigate the “mental destiny” of the civilian population.

The asylum was evacuated in March 1916 because of the approaching front and the 509 patients in the facility were transferred to various psychiatric facilities in the Empire. The days of the evacuation were the last moments for the second psychiatric hospital of Tyrol. On its reopening, in 1919, Pergine and its institute were Italian.

Only 181 of the patients who were transferred returned to Pergine; all the others perished in the asylums where they were sent: average mortality was 66% but in the institutions of Ybbs and Vienna it reached, respectively, around 90% and 95% while in Kremsier it was 43%.

Three years later, in March 1919, the Pergine psychiatric hospital reopened its doors and changed its name to “Provincial Hospital of Venezia Tridentina”. The “new” institute differed from the pre-war asylum for two main reasons: its hinterland and legislation. The new provincial hospital of Venezia Tridentina had a much wider jurisdiction than the previous Tyrolean asylum thanks to the inclusion of South Tyrol. Before the war patients from South Tyrol usually chose to be admitted to in Hall institute in Tyrol, mostly for language reasons, but the redefinition of state boundaries changed the situation, forcing them to turn to Pergine.



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