Recovering From the Trauma of the Civil War: Mental Health

Dillon J. Carroll, history instructor at Butte Community College in California, is the author of the forthcoming book “Invisible Wounds: Mental Illness and Veterans of the American Civil War.” He has an article today in the Washington Post on the mental health impacts of the Civil War.

Here are substantial excerpts from his article:

Consider the experience of the Civil War, an extraordinarily traumatic experience. Although it often isn’t remembered that way, the Civil War was primarily a health disaster. Disease was rampant — two men died of illness for every one man killed on the battlefield. “There is a great deal of sickness here,” Confederate Benjamin Moody presciently observed in a letter to his wife from Richmond, “and more men dying with it than ever will get killed in the battles of the Confederacy.”

For those who survived brushes with illness, the challenges of the soldier experience awaited them. Men endured strict military discipline, poor rations and the strain of combat. Battle was a hellish experience that threatened to annihilate men in the worst imaginable way: anonymously. Hugging the earth during a Confederate artillery bombardment, Union soldier Thomas Chamberlain wished “that the ground would open and let me down.”

Soldiers watched friends and relatives shot and mutilated in the worst ways imaginable. “I have seen some of the most awful sights since I have been here that ever any man was permitted to look at,” a Confederate soldier wrote to his wife. Many struggled through the conflict, increasingly aware the war was taking them to unfathomable places. “I feel as if my present life was a disagreeable and painful dream, and not a reality,” Confederate William Nugent wrote his wife while in North Georgia in 1864.

But soldiers, North and South, displayed a remarkable ability to cope. Take, for example, Mobile, Ala., resident James Williams, who volunteered in October 1861 and became a soldier in the 21st Alabama Infantry Regiment. Williams and his unit fought in the bloody Battle of Shiloh. The Confederates entered the fight with over 40,000 soldiers — a staggering 9,000-plus falling dead or wounded on April 6 and 7, 1862. The experience left a permanent scar in Williams’s mind. “[I]t will take me months to describe what I saw on that terrible field,” he wrote his wife, Eliza, the day after the battle.

By the end of April, his agonizing was intruding upon his dreams, depriving him of sleep. Confessing his struggles to his comrades would be tantamount to an admission of weakness — anathema in the Southern male culture — but he hinted at them in his letters home. “I’ve had great and exciting times at night with my dreams since the battle,” he wrote, “some of them are tragedies and frighten me more than ever the fight did when I was awake.”

It is possible Williams suffered with post-traumatic stress disorder — which didn’t officially exist as a diagnosis at the time — or something like it, as invasive nightmares of the traumatic event are one of PTSD’s signature symptoms. At the time, psychology was in its infancy. In this pre-Freud era, asylum doctors theorized that mental illness had physical causes and moral causes. Physical causes included a head injury, serious illness, exposure to the elements and accidents. Moral causes included alcoholism, masturbation and excessive jealousy, envy or ambition.

To cope with the invasive nightmares of the battle that were throwing his mental health off balance, Williams turned to religion. The idea that an omnipotent deity continued to watch over him gave Williams comfort and set his mind at ease. The chaos of the battle suddenly made sense, for God had guided everything. And the thought of future battles no longer gave him anxiety, for God continued to control everything. As he contemplated future hostilities he wrote Eliza: “The God who shielded me before, yet watches over us all.” Believing in God and His omnipotent power gave order to chaos. Wrapped in a heavenly cloak of sorts, Williams came to believe that God would literally protect him in battle, giving him the peace of mind necessary to sustain his mental health. He never wrote about nightmares of battle again.

Instead of religion, some Civil War soldiers turned to medical professionals for treatment, or sometimes just for a warm meal and a sympathetic ear.

In 1864, John Jackson, a native of Maine, joined the 32nd Maine Volunteer Infantry. That summer, Jackson and his unit were drawn into Ulysses S. Grant’s vicious Overland Campaign in Virginia and the brutal battles of the Wilderness, Spotsylvania and Cold Harbor. “I look upon war as I never did before,” Jackson wrote his father. “I always knew it was a horrid thing, but each hour reveals new horrors.” In early August, Jackson wrote his parents describing the effects combat was having on his mind. In a stunning admission, he outlined that he was himself feeling played out — a 19th century term for strung out — by the war and he recognized that “my mind I think suffers more of the two than my body even though I get very tired and feel almost exhausted.”

Spiraling into what could have been a mental breakdown, Jackson fled from the front lines in search of self-care. Somehow, he made his way to a Union hospital in Petersburg, Va. While he was not physically ill, he was, it seems, emotionally and psychologically suffering and he needed a respite from the fighting. Surprisingly, Jackson admitted to his mother: “I have got sort of tired out. All I need is a chance to rest and I will be all right in a few days.”

This is another remarkable admission: Jackson had purposefully shirked his duty on the front lines to practice self-care. Illegally leaving his position with his unit put Jackson at risk of official punishment, not to mention the judgment of his peers. Some of those who fled the front lines were painted as effeminate cowards by their comrades. This was not an unserious risk at the time, for character was everything in the 19th century, and such a charge could lead to social isolation. But apparently that risk was worth it for Jackson, who needed a respite from the fighting.

He spent the next few months at Union hospitals in Virginia, where he enjoyed plenty of rest. By November, he was ready to return to the front lines and continue his work as a soldier. As he returned to his unit near Petersburg, he wrote his mother: “I begin to feel in a hurry to be with the boys. It almost seems as if I was going home.”

The Civil War revealed the resiliency of Americans amid crises — and their ability to develop a variety of ways to survive the crushing trauma. Today our challenges and coping mechanisms are very different — psychiatry and therapy, along with wellness, mediation and more, are far more developed parts of American culture and medicine, for example. Mental health is a very real concern in these trying times, something that needs to receive attention, understanding and resources. But the Civil War experience suggests Americans will develop their own unique coping mechanisms for enduring the seemingly endless blows plaguing our society.

 

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