By Stephanie Neuner
Interest in the subject „War and Psychiatry“ amongst historians today encompasses a field of study broader than merely an analysis of the development of military psychiatry. Accordingly, this collection focuses on the multilayered interactions between psychiatric science, warfare and politics before, during and after the Second World War. It focuses on the concrete practice of military psychiatry and underscores the radicalization and the ethical paradigm shift in psychiatry during the Second World War in Germany. At the same time, it examines the common social discourses and overarching ideas that served the purpose of processing the individual and collective psychological effects of the war. It becomes especially clear through international comparison that psychiatric science serves as an important authority that lends structure and order to a military as well as a civilian society.
It is the methodological goal of the authors, by accessing recently discovered sources such as medical records, to shed light upon the treatment of people with psychological (also war related) disorders by looking „from below“, namely from the patient‘s perspective. Certainly an examination of these sources gives a more intimate portrayal of the daily treatment regime; however, the prevailing source material consists of recordings of medical assessments and medical histories from the „doctors‘ perspective“ (M. Foucault) and not from the experiences of the patients. Nevertheless, it is the insight gained through the examination of the day-to-day psychiatric practice that makes the volume so interesting and readable. It is a testimony to the authors‘ merit that through intensive research into the psychiatric practice during and after the war that such an exemplary portrayal has been achieved and new research findings have been presented.
Beginning with the problematic heritage of the First World War, Jason Crouthamel offers interesting snapshots of the struggle of shell-shocked veterans to receive not only their war pensions but also recognition for their war service after 1933. He offers evidence that veterans sympathetic to National Socialist ideals were more likely to be awarded health and retirement benefits after 1933, but only for those who had sustained somatic war injuries or veterans who sustained psychological damage due to the societal upheaval caused by the Revolution of 1918. Certainly, the conflict over recognizing the legitimacy of psychological war wounds escalated during the National Socialist regime; and of course, this can be interpreted as a conflict between different ways of remembering the war that fluctuated between hero worship on one side and an admonition of the power of destruction on the other. Nevertheless, one may want to add, that the fate of the war neurotics was largely determined by National Socialist bureaucracy when casting judgment upon an individual’s ability to work and so-called „Erbgesundheit“ (hereditary health). Accounting for the strictly organized system of retirement benefits in cases of psychologically disabled people after 1934 one must ask the question: how much room was left for negotiating retirement benefits?
Philip Rauh follows the fate of shell-shocked soldiers who were hospitalized or institutionalized during National Socialism and killed through „Euthanasia“ or so-called „T4 Actions“. Contrary to the policy that veterans should be „spared“ from being dispatched in the end, wartime service was not a guarantee against finally being condemned to death. The same selection criteria applied to veterans, namely: ability to work, discipline and clinical prognosis. Much later in the book, we find the thematically well linked article by Sascha Topp about euthanasia of children and the author‘s detailed descriptions of the case of a four-year-old girl, and especially the role her parents played in the dispute surrounding her killing.
The „Annihilation of Unworthy Lives“ within Germany was also continued in the occupied territories during the course of the war. Gerrit Hohendorf and Ulrike Winckler exemplify this with the psychiatric ward in Mogilew, Belorussia. In 1941/1942 all the patients were killed with the cooperation of the Army and the SS. The annihilation of the inmates in Mogilew followed the same scheme by which patients in other clinics and handicapped institutions were eliminated. First, patients were malnourished, then those unable to work were killed, and finally, all others remaining were annihilated. The liquidation of the patients followed primarily utilitarian motives, above all, in order to secure supplies for the army.
This is followed by Henning Tümmers’ exploration of the military psychiatric discourse and practice in Germany after 1939. Central to the understanding of the political and scientific approach to psychological disorders like shell-shock, he initially thematizes the term psychopathy, which has had a major influence upon the discourse as to whether such disorders should be considered an “illness” and deemed worthy of treatment. The assumption of a psychopathic disposition in war neurotics would make financial compensation pointless because these disorders were declared hereditary, and furthermore the persons concerned were branded as delinquents and criminals. Their disorders were primarily considered a result of a lack of initiative to work and a substandard character. Furthermore, Tümmers analyzes the psychiatric practice of the army hospital in Tübingen during World War II. He arrives at the conclusion that the psychiatrists had considerable flexibility in decision making in the treatment of psychologically damaged soldiers. The psychiatrists used their professional authority for the benefit of their patients – largely independent from the overarching demands of the army and the ideological doctrines of the NS leadership. These findings underline firstly the necessity to scrutinize the daily treatment regimen in addition to the theoretical methodology of scientific elites and the field of military psychiatry, and secondly, that all psychiatrists should not be considered a homogenous group that acted against the patients’ welfare to serve political interests.
Tümmers’ exploration into German military psychiatry is followed by the articles by Hans Pols and Gerald N. Grob that complement each other thematically. The aim, as already pointed out in the introduction, is a comparison between German and American military psychiatry. American military psychiatry underwent a complete reorganization in 1942/43 because of the US military intervention in Tunisia. After the attempt to remove the mentally labile turned out to be disastrous for military operations (11% unfit for service, p. 132; up to 35% losses due to psychotic breakdowns, p. 134), US psychiatry adopted psychotherapeutic methods developed by Roy R. Grinker and John P. Spiegel. Unfortunately, however, no explicit point of comparison is made between the German and American military psychiatry.
This volume concludes with Bram Enning and Helen Grevers, who focus on the post war treatment of those Dutch citizens who collaborated with the German occupiers during the war. They analyze selected documents of the so-called „Special Jurisdiction“ concerning cases of voluntary membership in the Armed-SS. Similar to other political prisoners these people were to be judged under special consideration of the circumstances by their actions and their mental history. The psychiatric experts testifying in court, who often had to judge whether a delinquent could be held responsible for his actions, sometimes attested to his „mental incapacity“. The psychiatrists stated that such incapacities were also to be found with members of the Dutch resistance. Enning and Grevers‘ contribution not only points to the important topic of coming to terms with the consequences of war in a post war society, but also to the role of the courts as important institutions in dealing with this all encompassing societal process.
As it has already become apparent, this volume addresses a host of different aspects surrounding the theme: Psychiatry and War. The essays differ considerably – some are summaries, some are based on a broad analysis of the sources – and they are sometimes positioned without a relationship to one another. As a reader, one misses more sharply formulated overarching questions; posing these in the introduction would have helped to forge connections among the diverse subtopics discussed in the book.
Stephanie Neuner is a historian working at the Deutsches Hygiene-Museum Dresden, Germany. She studied history and politics at the Ludwig-Maximilians-University Munich and Edinburgh University. Her research interests focus on the cultural history of psychiatry. Her forthcoming book, Politik und Psychiatrie. Die staatliche Versorgung psychisch Kriegsbeschädigter in Deutschland 1920-39 (Vandenhoeck & Ruprecht 2011) deals with compensation policies towards psychologically disabled veterans of WWI in the Weimar Republic and the Nazi State.