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Cited by 30Neurology and Historical StudiesPsychosomatic Disorders and Their TreatmentsHistorical Psychiatry and Medical Practices

Shell shock at Queen Square: Lewis Yealland 100 years on

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Linden, Stefanie C., Jones, Edgar, Lees, Andrew J.·2013·Brain
DOI 10.1093/brain/aws331PMC PMC3673538
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Abstract

This article reviews the treatment of functional neurological symptoms during World War I by Lewis Yealland at the National Hospital for the Paralysed and Epileptic in London. Yealland was among the first doctors in Britain to incorporate electricity in the systematic treatment of shell shock. Our analysis is based on the original case records of his treatment of 196 soldiers with functional motor and sensory symptoms, functional seizures and somatoform disorders. Yealland's treatment approach integrated peripheral and central electrical stimulation with a variety of other--psychological and physical--interventions. A combination of electrical stimulation of affected muscles with suggestion of imminent improvement was the hallmark of his approach. Although his reported success rates were high, Yealland conducted no formal follow-up. Many of the principles of his treatment, including the emphasis on suggestion, demonstration of preserved function and the communication of a physiological illness model, are encountered in current therapeutic approaches to functional motor and sensory symptoms. Yealland has been attacked for his use of electrical stimulation and harsh disciplinary procedures in popular and scientific literature during and after World War I. This criticism reflects changing views on patient autonomy and the social role of doctors and directly impacts on current debates on ethical justification of suggestive therapies. We argue that knowledge of the historical approaches to diagnosis and management of functional neurological syndromes can inform both aetiological models and treatment concepts for these challenging conditions.

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  • A central issue in contemporary discussions of functional neurological disorder has been the extent to which emotions play a mechanistic and aetiological role.

    “A central issue in contemporary discussions has revolved around questioning the extent to which emotions play a mechanistic and aetiological role in FND.23,28,30,31”

    From A new science of emotion: implications for functional neurological disorder (2022) · cites this paper as [31]

    In the Introduction section ‘In skilful and determined hands,’ the paper discusses psychological and physiological processes in the aetiology of functional neurological syndromes. ‘The power of suggestion’ contrasts Yealland’s approach with Myers’s search for an ‘emotional origin.’ These passages support discussion of possible psychological and emotional causes, but do not establish that the mechanistic and aetiological role of emotions is a central issue in contemporary debate. (LLM, conf=0.78)

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Research works printed but not linked: 2

  1. Barker P Regeneration 2008 London Penguin
  2. Shamy MCF Hallett M Land AE Jankovic J Fahn S Halligan PW Voon V Treating psychogenic movement disorders with suggestion Psychogenic movement disorders and other conversion disorders 2012 2nd edn Cambridge Cambridge University Press

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Authors
Linden, S. C., Jones, E., & Lees, A. J.
Affiliations
  • King's College London (GB)
  • National Hospital for Neurology and Neurosurgery (GB)
Corresponding author
Linden, Stefanie C.
ORCID
Venue
Brain
Publisher
Oxford University Press (OUP)
Published
2013-02-04
Volume
136
Issue
6
Pages
1976-1988
ISSN
  • 0006-8950 (ISSN-L)
  • 1460-2156
DOI
10.1093/brain/aws331
PMC
PMC3673538
OpenAlex
W2045897777
Cited by
30
References
59
Citations by year
2023: 1 · 2022: 2 · 2021: 2 · 2020: 2 · 2019: 2 · 2018: 2 · 2017: 2 · 2016: 3 · 2015: 4 · 2014: 9 · 2013: 1
FWCI
3.17
Type
journal article
Language
en
Open access
Licence
cc-by-nc
Locations
  • Brain (publishedVersion, cc-by-nc)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • UCL Discovery (University College London) (submittedVersion)
  • ORCA Online Research @Cardiff (Cardiff University) (submittedVersion)
  • Research Portal (King's College London) (submittedVersion)
Funders
  • Wellcome Trust (086071)
  • King's College London
Topics
  • Life Sciences › Neuroscience › Neurology › Neurology and Historical Studies
  • Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
  • Social Sciences › Psychology › Clinical Psychology › Historical Psychiatry and Medical Practices
Keywords
shell shock, functional neurological symptoms, World War I, electrical stimulation, suggestion therapy, National Hospital for the Paralysed and Epileptic, psychogenic non-epileptic seizures, somatoform disorders, history of neurology, patient autonomy, case records
MeSH terms
Combat Disorders, England, Humans, World War I, History, 20th Century

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