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Combat Stress in the 20th Century: The Commonwealth Perspective.

Combat Stress in the 20th Century: The Commonwealth Perspective. By Terry Copp and Mark Osborne Humphries. Kingston, Ontario: Canadian Defence Academy Press, 2010. Tables. Diagrams. Photographs. Notes. Appendices. Glossary. Bibliography. Index. Pp. xiii, 594. Free from Canadian Government website ISBN: 978-1-100-12726-2

Melancholia, shell shock, combat fatigue, post traumatic stress disorder: the names have changed over the years, but the issue of war's psychological toll has been a constant throughout history. A host of questions surround this contentious issue. What is it really? How do you identify it? How does it affect people? Why does it affect some a great deal, others very little and others seemingly not at all? What can and should be done to treat those diagnosed? This book examines the approaches to the issue and practices in dealing with this difficult problem by British Commonwealth forces throughout the 20th century. The historian authors are not psychiatrists and make no claims to provide definitive answers either in defining the problem or its treatment. Instead, they approach the problem through comparative analysis using the original sources to review the practices and beliefs of Commonwealth military and medical professionals who attempted to address this challenging issue. Readers are left to reach their own conclusions.

Copp and Humphries make no effort to decide the merits of any one approach. Instead, they frame the discussion separated by time periods and then let medical and military professionals speak through contemporary literature. It is an interesting approach and provides unique insight into the evolving understanding of this complex topic. The book is divided chronologically with chapters covering time periods that roughly correspond to the two World Wars and the times of peace before, between, and after. The first chapter starts with a discussion of "railway spine" (the 19th century term describing post traumatic symptoms following railway accidents) and the concept of traumatic psychosis that started developing in the middle of the 19th century. This chapter extends the discussion through the development of the well-known concept of "shell shock" from the First World War. The next chapter discusses psychological injury and its treatment for veterans in the interwar period. The final two chapters cover World War II and the post-war period through the First Gulf War.

The historians limit their discussions at the beginning of each chapter to between fifteen and twenty pages, where they provide the issue's historical context, identify trends in diagnosis and treatment, and discuss the changing atmosphere in both the medical community and society at large. They then use an unusual method to present the source material. Rather than citing the material in the course of their own discussions, they append the original reports and articles in their entirety. Each appendix (there are forty-one articles and reports) has only a one- or two-sentence introduction identifying the author and the circumstances surrounding the document's creation. The reader is thus given the unfiltered original discussion. The material isn't too technical in nature and allows laymen to grasp the issues and the authors' perspective and draw their own conclusions. The primary drawback isn't the organization, but rather the sometimes limited context provided in the chapters introducing the original material. The authors assume a level of familiarity with Canadian or Commonwealth history that sometimes falls flat with a non-Canadian reader. But a visit to the internet helps fix this and doesn't detract from the book's overall usefulness.

This is the third book I've reviewed from the Canadian Defence Academy Press on ethics, leadership, and combat stress--all of the same high quality. Typical of compilations of many writers is the expected variation in the prose quality, but overall this book is very readable. The chapters introducing each section are clear and generally provide sufficient background on the medical issues involved. The book is very well documented with extensive end notes and an excellent bibliography. Its scope is greater than the title suggests. The medical professionals cited were leaders in their fields and bring in sources and opinions far beyond their immediate responsibilities and experience with Commonwealth forces. This book is an excellent source for those interested in the ever-evolving and often confusing subject of combat stress and its effects.

Lt. Col. Golda Eldridge, USAF (Ret.), EdD, Fredericksburg, Virginia
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Author:Eldridge, Golda
Publication:Air Power History
Article Type:Book review
Date:Mar 22, 2012
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