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It is a truism that the psychological wounds of battle are as inevitable as their physical counterparts.1 During the Second World War, controversy surrounded not the inevitability of psychiatric casualties but the extent to which they could be minimized by selection, training, morale, and leadership.2 Some like Field-Marshal Lord Gort, who had given evidence to the 1922 War Office inquiry into shell shock, argued that psychological disorders could almost be eliminated: 'in face of strong morale and esprit de corps "shell shock" would be practically non-existent'.3 Whilst commanders trusted traditional military virtues to address the problem of battle exhaustion, a new breed of psychiatrist believed that psychometric tests and a deeper understanding of human behaviour would enable them to identify those at risk of breakdown.4 Such vulnerable individuals could either be discharged from the armed forces or transferred to non-combatant roles, leaving only robust soldiers to engage the enemy. By early 1944, when planning for the D-Day landings was well advanced, the problem of the psychiatric battle casualty was considered manageable by a combination of careful preparation and clinical understanding.
The invasion of Europe by the western Allies was not only a high-profile and vital operation, but it also stretched the British army's resources to the limit. Under no illusions about the fierce fighting ahead, commanders needed a ready supply of aggressive and resourceful infantry. The shell shock epidemic suffered by the British Expeditionary Force during the First World War had taught a salutary lesson: large numbers of front-line troops could be lost to combatant units if psychiatric casualties found their way to base hospitals.5 Return-to-duty rates fell to 20 per cent when soldiers who had broken down were treated any significant distance from war zones. In the knowledge that there were few high-quality combat replacements should the assault on the European mainland prove costly, elaborate preparations were made not only to prevent psychiatric breakdown but also to treat those who succumbed. Indeed, the Directorate of Army Psychiatry (DAP), a new organization set up in April 1942, sought to demonstrate both to commanders and military doctors that it too could make an effective contribution to the war effort. Normandy was the ideal stage...