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It is perhaps surprising that little is heard about the problems
caused by the levels of stress that crews had to endure. There are
occasional reports such as the crew of HMS Hebe needing to be rested
during the Dunkirk evacuations (see below). Similarly the crew of HMS Hussar
were replaced following constant attacks during East Coast convoys.
The extracts below show that the potential for problems had been
recognised and some measures were in place to deal with them...
'ratings were
trained to take a grip on themselves'!
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Source:
Extract from The Royal Naval Medical Service Vol II, JLS Coulter, P328
Stress in the
Arctic
The Medical Officer of H.M.S. Leda recorded:
'It has been rather interesting to
observe the reactions of people to the abnormal stress and strain
which action in this climate has imposed upon them. The immediate
effect of air attack is one of nervous stimulation coupled with fear
or acute apprehension. This apprehension is minimised for those
whose minds are occupied with a particular job. But for those whose
task it is to watch and wait, it is at a maximum. When a particular
incident is over a variety of reactions are seen. Some men laugh
hilariously and hurl illustrated epithets after the departing enemy.
By contrast, other men reflect despondency. Following a prolonged
period of attacks, there may be a period during which everyone
outwardly appears normal apart from obvious weariness from lack of
sleep. Then the glimmerings of psychoneurosis begin to appear. Most
of those affected are normally of a nervous or anxious disposition,
but a few ostensibly phlegmatic individuals also exhibit signs.
'There are roughly three classes:
(1) The man who comes and says
outright that he is afraid and cannot stand up to things any
longer.
(2) The man who veils his mental
state by assuming a physical malady.
(3) The person who seeks a means of
escape in alcoholic intoxication.
'As an example of the first group may
be quoted the case of a leading seaman, a member of a gun's crew.
This man came to me in great distress and stated that he could not
carry out his duty any longer, as he was so frightened by enemy air
attacks that he feared he might run from his post and seek cover. It
was obvious from the man's general behaviour that he was carrying a
heavy mental burden. His previous record showed that he had
experienced heavy enemy action in other ships.
'In his case suggestion was employed
and he was shown other aspects of his own position and was assisted
to redirect his thoughts from himself and his own personal safety to
the wider implications of his duty as a leading seaman and a gunner.
This suggestion, together with the sedative effects of potassium
bromide, produced marked improvement and he subsequently performed
his duties in action and showed no signs of collapse.
'In cases of the second group there
was a rating who complained that he had a pain in the region of his
heart. He later produced abdominal pains and vomiting, continuously
present and unrelated to meals. Improvement followed the suggestion
and assurance that he was suffering from no organic disease.
'The third group requires no
amplification.
'I have formed the opinion that no
one, except those who desire to stay, should remain in a ship of
this size under the conditions which we have experienced for a
period longer than eighteen months, because:
(1) It
appears to me that reactions are bound to occur, but in many
cases will not manifest themselves until later by which time the
environment associated with unpleasant experience has become the
ship itself from which there is no escape. A period of rest
ashore, or even transfer to a new ship, would mean a change of
environment which would bring forth new mental and psychological
adjustment.
(2)
Despite the fact that sport and entertainment are organised when
opportunity arises, I have yet observed that there is a general
listlessness and apathy of late which is quite foreign to the
nature of our ship's company. This has increased to a marked
degree after the rigorous and exacting winter months spent on
the Northern convoy route, and it certainly militates against
the happiness and efficiency of the ship as a whole. I am not
suggesting that anyone has failed to do his particular duty or
that there is even any tendency for that to happen, but after
living in the ship for eighteen months, I now observe that the
zeal, adventurous spirit, general comradeship and harmony which
once existed among us appear less keen.
(3)
Mental and physical stress are severe. This in turn tends to
upset the equilibrium of normal bodily functions, and lack of
fresh food does little to improve this state of affairs. I feel
that we shall soon once more be facing a rigorous winter in the
knowledge that we have not been fortified by the fruits of
summer to overcome its ills.'
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Source:
Extract from The Royal Naval Medical Service Vol II, JLS Coulter, P328
HMS Hebe at
Dunkirk
Coupled with
the usual background of the incidents of battle, continued loss of
sleep was the factor which contributed most toward psychological
disturbances. It seems probable that, had sleep not been denied to
the crews of so many ships through force of circumstances, there
would have been hardly any hospital admissions for psychiatric
reasons as a result of this operation. In actual fact, there were
probably many more hospital admissions than were warranted by the
number of genuine cases because, under the conditions existing at
Dover, admission to hospital was often the only means of securing
sleep, rest and regular meals for some men who were obviously badly
in need of relief. There came a time when some seamen had been on
almost continuous watch for six days. The type of case in which
exhaustion and not lack of courage was the factor involved is
illustrated by one seaman who showed a marked generalised tremor and
was unable to walk. This man had been on watch for some six days and
nights and had also dived overboard to rescue a drowning soldier.
Individual hysterical manifestations were rare and very few are
recorded. … The need for isolating such few cases as did occur, in
order to avoid others becoming infected by such symptoms, is shown
by events in H.M.S. HEBE. On Saturday June 1 Hebe was damaged by
bombs during the evacuation of Dunkirk. No one in her had slept for
five days and nights. One young officer suddenly had an attack of
hysterical epilepsy on the bridge. Some 30 members of the ship's company
now became similarly affected with generalised clonic movements and
incoherent mumbling. The Medical Officer who had to deal with these
cases himself finally succumbed to this mass suggestion. It is in
point that these psychological manifestations did not appear until
the ship's crew ceased to be actively engaged and found themselves
safely in harbour after a long period of physical and mental fatigue
had culminated in the last severe air attack. It is also on record
that in H.M.S. Hussar, men became hyper‑emotional and broke down and
wept when given an order.
The
measures adopted for controlling threatened psychological breakdown
in these ships varied, but always called for the combined efforts of
Doctor and Commanding Officer working hand in hand. Reassurance by a
Medical Officer frequently proved successful when combined with the
natural leadership of the professional naval officer and senior
rating. In fact, in many ships it called for skilful judgement and
resolution to decide how far it was possible or wise to drive a
ship’s company suffering from prolonged strain.
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Source:
Extract from The Royal Naval Medical Service Vol II, JLS Coulter, P328
The more delayed effects of strain of Arctic Convoys were frequently
to be observed on return to the United Kingdom. The Medical Officer
of H.M.S. Eclipse reported:
'Since our
visit to North Russia, with its action with enemy surface craft and
the unrest of daily bombing attacks, there has been a marked
increase in the sick parade. On one day recently I have had to send
twelve men for medical and surgical consultations. Of these twelve,
eight have already been discharged to hospital and the other four
are awaiting relief. The important point is that these men had been
suffering from their complaints for months, and in some cases for
years without reporting sick. The reasons given were that they
desired to remain on duty, on war service, and they were afraid that
their complaints, if reported, might mean that they would have to
leave the ship.
'The extreme
cold off North Russia, combined with prolonged action conditions had
a most marked effect on our crew. In action, two guns were frozen
solid, spray froze on the men, and the leather sea‑boots of one
officer were literally frozen to his feet.
'These
conditions greatly affected the nerves of the crew, with the
consequent results that complaints which they previously hid have
become aggravated, and are now disclosed.
'These twelve
men were good, conscientious workers who had been in the ship since
before the outbreak of war. It is only now that they feel the strain
on their nervous systems to such an extent that they must report
sick with a long standing physical disability.
'In any case
I feel that when officers and men have completed eighteen months to
two years under these conditions, their efficiency becomes impaired
and this tends to get worse as time goes on.'
Intermittent strain operated more
often than that of continuous and prolonged action. But it proved
equally exacting and was held by some to be harder to endure.
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ROYAL NAVAL PSYCHIATRY: ORGANIZATION,
METHODS AND OUTCOMES, 1900–1945
By Edgar Jones and Neil Greenberg
Breakdown at sea: surface vessels
Low levels of psychiatric
casualties in the navy was considered a function in part of
selection ‘since the Navy and the Air Force get the first pick of
recruits, whereas the Army must take all that remain and
consequently the average level of intelligence in Army recruits
tends to be lower than in the other two services’. The
protective effect of high morale was predicated on two distinctive
factors: first, the notion of the ship’s company united by their
loyalty to each other, and secondly, the fact that once at sea there
was no opportunity for evacuation. Reporting sick to the ship’s
doctor did not improve a sailor’s chances of survival and jumping
overboard often resulted in almost certain death. In naval action,
Surgeon Captain C. H. Joynt observed, ‘the safest activity is
steady devotion to duty rather than flight’.....
.....For the Royal Navy, hazardous operations such as Arctic
convoys, which carried a significant risk of death in testing
conditions, saw a significant number of stress related disorders.
The medical officer of HMS Eclipse recorded on his return to the UK:
‘since our visit to North Russia, with its action with enemy
surface craft and the unrest of daily bombing attacks, there has
been a marked increase in the sick parade’.
The medical officer
of HMS Leda concluded that because of the mental and physical
demands of these convoys no one should sail them for longer than
eighteen months. One medical officer recorded that the ‘prolonged
and repeated stress and strain’ led to an
‘increase in the
numbers attending the sick bay and, collectively, by the development
of apathy and listlessness which had previously been quite foreign
to the nature of the ship’s company’.
Senior officers appear to have been at particular risk. At the end
of a year’s service in Arctic waters, for example, nine officers,
all with good records, were invalided from a single warship. By 1943
it was recognized that for a number of destroyers and smaller
vessels, captains had been left in command beyond the point at which
they were effective leaders. Studies of soldiers have shown that
rank is a protector against psychological disorders. However, for
the navy this was not necessarily true. As a general rule the higher
the rank in the army, the further the soldier found himself from the
front-line. Hazards were shared more equitably on warships, while
senior officers also carried the heaviest burden of responsibility.
Mid-way through the conflict, the navy accepted that even
experienced sailors had a breaking point and introduced the term
‘fatigue’ for those who earlier in the war might have been diagnosed
as suffering from an anxiety state. This was designed to avoid any
stigmatizing label and to encourage natural recovery...
....The apparently low
rate of breakdown aboard warships during the First and Second World
Wars may conceal more than it revealed. First, the sailor who feared
for his life had no safe escape route, while adopting the sick role
conferred no obvious benefit. In fact, if he had a vital task to
perform, such as closing a watertight door or securing a magazine,
deserting his post may have increased the risk that the ship could
be damaged or sunk. Naval personnel were well aware that the sea,
irrespective of war, was a hostile environment. The closed space of
a warship may be analogous to some aspects of modern combat where
there is no clear front-line and hence no obvious escape route. A
further reason for the low rate of breakdown at sea was the decision
to deploy psychiatrists to shore establishments. Doctors on board
ships may have not detected psychological disorders as long as a
sailor continued to perform his duties. Not labelling someone who
somatized their distress, whether as a deliberate policy or by
chance, may have allowed them to continue at duty and, in turn,
prevent the emergence of recalcitrant psychological symptoms...
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