Book Review – Julia Barbara Köhne. Kriegshysteriker: Strategische Bilder and mediale Techniken militärpsychiatrischen Wissens (Husum, 2009)
Presented as both as an example of applied media studies and as a contribution to the history of German and Austrian “shell shock” during the First World War, Julia Köhne’s Kriegshysteriker: Strategische Bilder and mediale Techniken militärpsychiatrischen Wissens (Husum, Matthiesen Verlag: 2009) largely reinforces an older strain of historiography that emphasizes coercion as the primary mode of military psychiatry. Köhne praises the more nuanced recent scholarship on the subject by Paul Lerner and Hans-Georg Hofer in her introduction and expresses some misgivings about the strident tone of classic accounts, but she does not integrate the subtleties of Hofer or Lerner’s detailed research into her evaluation. The structural logic of the book—as well as Köhne’s recurring analysis—convey the argument that “war hysteria” was constructed by medical media in order to allow doctors to assert some control over disorderly, chaotic symptoms, using film in particular to great disciplinary effect. Köhne deliberately chooses the phrase “war hysteria” over the more neutral “war neurosis” on the grounds that the term hysteria better conveys the contemporary values and associations of these conditions, in particular the gendered dimension of the diagnosis.
It is through her discussion of the relevance of contemporary mass psychology to war hysteria, and in her detailed critique of the case study in all its forms, especially visual, that Köhne considers her contribution to be original and unique. As she indicates, no published scholarship has yet subjected the rich visual sources on this topic to sustained analysis. Alongside her interpretation of medical photographs and films depicting war hysteria, Köhne also subjects written media to stringent formal analysis, drawing attention to the patient file and the medical case study as genres in a way that is thoughtful and thought provoking and could serve as a useful model for medical historians. This type of careful, methodologically self-aware formal analysis that refuses to accept the meaning of any source as self-evident is a real strength of Köhne’s book.
The book is divided into two unequal parts: the first discusses war hysteria as a mass phenomenon, connecting the medical discourse on troubled soldiers during the war to that on crowd psychology in the late nineteenth century, while the second—much longer—part does the systematic work of examining the various medical media and their construction of the war hysteria diagnosis. Part II includes chapters on written sources and visual sources, as well as a final somewhat incongruous chapter on the marketing of electrical medical devices in the 1920s. Köhne concludes that the war was pivotal in creating the new category of (male) war hysteria and that the “media technologies” of military-psychiatric knowledge were central tools in the creation of the disease. Her argument builds structurally from a discussion of medical anxiety in the face of mass psychological disorder in Part I through analysis of complex and often contradictory written case studies, up to analysis of photographic and finally filmic depictions of war neurosis. Within the discussion of film, Köhne also proceeds from the two shorter German films towards the culminating example of Clovis Vincent’s 1916 film Le Progrès de la Science Française au Profit des Victimes de la Guerre. Une Grande Découverte du Docteur “Vincent”. Vincent’s film most neatly fits her argument about film as a medium of control and an analogy to the new war hysteria diagnosis itself, in which the condition was teleologically defined by the cure the psychiatrist would inevitably enact. Curability was proof of both the hysterical nature of the symptoms and an opportunity to demonstrate the success of medical intervention. The de facto function of the closing chapter on electrical devices is to reinforce the message of psychiatric coercion and Foucauldian discipline.
If Köhne’s discussion in Part II can be heavy on overly detailed methodological excursuses, the insights she offers justify her careful attention to form. One compelling example is her exposition of the genesis of a medical patient file or a case study, the many layers and multiple authors of which combine to create a picture of a condition that is often composite and contradictory, as Köhne demonstrates. Her discussion of medical film is somewhat more problematic, however. While her perceptive formal analysis continues in this chapter and the essential characterization of especially Vincent’s film as an exercise in asserting control and establishing prestige is convincing, the neatness she ascribes to war hysteria film as a genre is somewhat artificial. Not only does she neglect films—in particular multiple French examples—that do not conform to the model she describes, but she also neglects cases within the five included films that complicate her argument, for example the case of Private Preston in the British film War Neuroses, whose cure is not shown or even referenced. If the sole function of the film is to demonstrate the doctors’ capacity to restore their patients to fighting (or working) form, why include a case study like Preston’s that fails to demonstrate such a transformation, and instead shows him cowering beneath a hospital bed in response to the word “bombs”? That said, although she overemphasizes the novelty of the “before and after” format (which is far from unprecedented, at least in psychiatric photography, as Köhne notes herself in her photography chapter), Köhne is accurate in her contention that these films represent the first clear examples of narrative psychiatric films depicting medical intervention, rather than simply a display of symptoms.
A more serious shortcoming from a historian’s perspective, Köhne’s analysis of War Neuroses and of Vincent’s film is further undermined by a very meager selection of accompanying written sources from either Britain or France, leading her to make conjectures about the films that are sometimes false. Köhne also moves too freely between analysis of the French and British films and contemporary German-language sources (the Bavarian army regulations on the wearing of uniforms by disabled patients do not offer much historical insight on the choice to include uniforms in a British film, for example.) For this reason, the book is strongest on the German material, but even here Köhne’s analysis of the two surviving German films could draw more effectively on both contemporary sources and on existing scholarship. Those interested in the Hamburg neurologist Max Nonne and his hypnosis film, for example, will find more of interest—and more exhaustive research—in Paul Lerner’s work. Like many early historians of “shell shock,” Köhne overplays the importance of suggestive treatments based on the application of electricity and often inserts them speculatively into the films (as scenes she supposes were removed in editing or not filmed) where publications in the medical press by their doctor-director state the relative insignificance of such methods in their approach. Köhne’s observation that the frustration expressed by early doctor-filmmakers about the technological limits of the medium to depict their patients’ trembling parallels the frustration evident in their attempts to contain the trembling itself is perceptive, but trembling was only one of a multitude of symptoms from which war neurotics suffered.
In summary, although her formal analysis of written and visual case studies is consistently insightful and instructive, Köhne’s commitment to a Foucauldian approach results in a rather narrow interpretation of the visual material that partially revives certain myths generated by psychoanalytic historiography, without the evidence to fully support those claims. Formal analysis of media can genuinely enrich historical writing, but there are limits to its validity when it is not informed by detailed contextual research. Although it is one very important function of war neurosis films, Köhne’s presentation of these films exclusively as a tool of control has the consequence that she misses the substantial resonances that existed between the discourse surrounding war neurosis as a mass phenomenon and the contemporary discourse on cinema, which was also viewed as a potentially dangerous vector of suggestion. Film was not simply a technological innovation employed by doctors and scientists, but was widely applied in the sphere of entertainment, a significant context that Köhne does not address sufficiently. She is right that film was an important and allusive medium used by doctors to construct an understanding of war neurosis, but it was not merely an attempt to exert control. Instead, film played a fascinating and complex role as a medium of persuasion, extending the charismatic power of the doctor-director to nationally distinct medical and public audiences, employing not only discipline but occasionally spectacle and empathy too.
Juliet Wagner is lecturer in History and Literature, Harvard University. She is currently working on revising for publication her Ph.D. dissertation “Twisted Bodies, Broken Minds: Film and Neuropsychiatry in the First World War” (Harvard University, 2009).
 Eric Leed, No Man’s Land: Combat and Identity in World War 1 (Cambridge, New York: Cambridge University Press 1979); Peter Riedesser und Axel Verderber, Aufrüstung der Seelen: Militärpsychiatrie und Militärpsychologie in Deutschland und Amerika (Freiburg i. Br.: Dreisam-Verlag, 1985); Elaine Showalter, The Female Malady: Women, Madness and English Culture, 1830-1980 (London: Virago, 1987)
 Paul Lerner, Hysterical Men: war, psychiatry and the politics of trauma in Germany, 1890-1930 (Ithaca, N.Y.: Cornell University Press, 2003); Hans-Georg Hofer, Nervenschwäche und Krieg: Modernitätskritik und Krisenbewältigung in der österreichischen Psychiatrie (1880-1920) (Wien: Bohlau, 2004).
 The “before and after” format is also evident in less codified form in Camillo Negro’s Neuropatalogia (1908), in which the shift from documentation of symptoms to narrative of medical intervention was already beginning to take place. See Ute Holl, “Neuropathologie als filmische Inszenierung” in Martina Heßler (ed), Konstruierte Sichtbarkeiten Wissenschafts- und Technikbilder seit der frühen Neuzeit (München, 2006), pp. 217-240