Survivors of the First World War were sometimes described as experiencing “shellshock”, a term used to describe trauma or episodes of anxiety following exposure to the horrors and realities of conflict. German psychiatrist Robert Gaupp observed in a 1917 report that hospitals were filled with scores of “unscathed soldiers presenting with mental disturbances” after returning from the front line.
After the Vietnam conflict, a paper published by the American Psychiatric Association used the term post-traumatic stress disorder for the first time to describe the symptoms and stress that soldiers were likely to experience after their tour of duty ended. A significant minority of veterans needed some form of assistance post-conflict, according to a paper written by Crocq and Crocq more than 20 years ago in the Clinical Research journal.
A year after that paper was published, the September 11 attacks plunged the US into a moment of collective trauma, prompting Dr Steven Hyman, the former director of the US National Institute of Mental Health, to comment about the mental health consequences of the attacks. He said that the events of that day were so visceral and so widely disseminated that even people who were not directly affected by the attacks were found to have begun to experience trauma, including symptoms of depression, irritability and an inability to concentrate on the normal tasks of everyday life. Other people found that their lives suddenly lacked meaning after the attacks.
It also became commonplace during the pandemic, especially during its first months in 2020, to note that the crisis would leave behind a host of complications – mental, emotional, financial, political and more – when it was eventually contained. Now, three years later, few would argue against that suggestion. Most of us are also different people to who we were at the start of 2020, for better or worse.
The common thread among these unconnected stories is our increased ability to recognise the existence of trauma – and to have the appropriate language to describe it. That recognition extends to the possibilities of its multi-layered consequences and trauma’s ability to take hold years after an event may have taken place.
Critics of this increased use of the word “trauma” say that its overuse doesn’t help communities deal with the problem itself, it merely promotes the idea of its existence. And certainly, the argument holds that just because a word becomes popularised, it doesn’t necessarily follow that it becomes better understood. “That meeting was traumatic” might be one of the many wrong uses of the word we can fall into in our working lives, for instance.
This week, the anniversary of two events that had deep consequences on communities in the UK and the US have also been marked.
In Uvalde, Texas, survivors and relatives commemorated a year since 19 children and two teachers were killed in a mass shooting in Robb Elementary School.
While the Uvalde community has been consistently praised, including by US Vice President Kamala Harris on Wednesday, for turning “anguish into advocacy” by pressing for urgent gun control reform, it is also important to note President Joe Biden’s comments on the same day. He said he had spent “hours with grieving families who were broken and will never be the same”. The task for those seeking to support that community is both vast and complex.
It is also six years this week since the Manchester Arena bombing. The May 22, 2017 terror attack killed 22 people and injured hundreds more.
A report published ahead of the anniversary examining the support provided to the many young people who were at the arena that night found they were often “let down” by adults and people of authority.
As The National reported, findings included young people being told they “needed to get over it” soon after the attack, leading to people experiencing trauma and “feeling neglected” or “forgotten about” compared to those with physical injuries. It should also be noted that the 46-page Bee the Difference report did recognise that in some cases young people received an appropriate level of support.
Commenting on its findings, Britain’s Prince William said: "This report makes clear that young people who have experienced the trauma of terrorism have needs unique to their age. These are minds that need the space to have their voices heard and feelings acknowledged.”
As the historical examples at the beginning of this column show, we now have the language to understand and articulate what trauma is and where it may be found. Yet, only 60 per cent of those who survived the Manchester attack were offered post-trauma professional support, the report said. The rest were left to themselves.
Using the right words matters greatly in shaping opinion and perceptions of mental health and making sure they become destigmatised, but that is only half of the sum.
Taking the right actions to properly address trauma is much harder. Until we even out the lopsided views we hold of physical and mental health, societies around the world won’t advance for the better in the ways they should.