From “shell shock” to PTSD

If you still wonder about where to go in the countryside of France, you should definitely visit the châteaux of the Loire Valley! Château is a French word for the country house of nobility. The Loire Valley is home to hundreds of châteaux, which were built between the 10th and 20th centuries. On a cloudy and chilly Friday, our whole class visited Château de Chenonceau, a beautiful château that spans the River Cher and located in the south of France. Surprisingly, despite its serenity, Château de Chenonceau was turned into a military hospital during WWI. At that time, 120 beds were set up in Catherine de Medici’s two great galleries and all the walls were whitened and the spaces were adapted to meet the hygiene standard. Moreover, the ground floor of the chateau was also equipped with one of the first x-ray machines in France. Speaking of war, it reminds me of thousands of soldiers who suffered from PTSD. It makes me wonder, how were the soldiers with PTSD diagnosed during WWI?

Military Hospital in Château de Chenonceau

Actually, PTSD was first recognized as “shell shock” disorder during WWI because it was common in soldiers who had concussions. However, some soldiers without concussions also suffered from “shell shock.” Therefore, there was no consensus for the cause of “shell shock.” Some psychologists believed that “shell shock” resulted from emotional problems from the brain and “weak” soldiers were considered to be predisposed to the condition. On the other hand, Sigmund Freund, the famous psychologist, referred to “shell shock” as “war neurosis,” which was resulted from the internal “ego” conflict between soldier’s “war ego” and “peace egos.” Of course, traumatized soldiers were not the only population that suffered from PTSD (World War I, 2011). Modern PTSD diagnostic criteria was included under Trauma- and Stressor- Related Disorders in DSM-5 (DSM-5 Criteria for PTSD, 2018).

Me in the Château de Chenonceau

The treatment of PTSD also changed drastically as psychologists learned more about the etiology of PTSD. During WWI, Freund suggested to treat “war neurosis” using the cathartic method of psychoanalysis rather than electrical shock treatment. However, in a recent research, Dittert et al. (2018) conditioned healthy adults with female faces as conditioned stimuli and female scream as unconditioned stimulus. Then, tDCS was applied to subjects’ vmPFC. Fear response was later assessed using skin conductance responses. Dittert et al. (2018) suggested that Trascranial Direct Current Stimulation (tDCS) can facilitate fear extinction.

I found it fascinating that tDCS could be used to treat PTSD. However, we should still consider the possible ethical concerns in tDCS such as un-expected alternation to personality during tDCS. Anyways, it was an interesting trip to Château de Chenonceau and I hope those soldiers who were unfortunately died in the military hospital rest in peace!

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