Booknotes: Invisible Wounds

New Arrival:
• Invisible Wounds: Mental Illness and Civil War Soldiers by Dillon Carroll (LSU Press, 2021).

From the description: Dillon Carroll’s Invisible Wounds "examines the effects of military service, particularly combat, on the psyches and emotional well-being of Civil War soldiers―Black and white, North and South. Soldiers faced harsh military discipline, arduous marches, poor rations, debilitating diseases, and the terror of battle, all of which took a severe psychological toll. While mental collapses sometimes occurred during the war, the emotional damage soldiers incurred more often became apparent in the postwar years, when it manifested itself in disturbing and self-destructive behavior."

Of course, it has always been recognized that the Civil War experience was deeply traumatic on both fighting and home fronts, but, according to Carroll, it wasn't until the 1997 publication of Eric Dean's Shook Over Hell that a scholar seriously addressed in Civil War soldiers what we identify today as post-traumatic stress disorder. Dean's comparison of Vietnam and Civil War veterans argues that members of the latter group indeed experienced much of the same emotional and psychological wounding that the former did. Since then, scholars have examined other medical, social, and cultural aspects of the war's traumas, including amputation, addiction, and suicide.

Carroll self-describes his book as "a hybrid study: part history of medicine, part social history, and part military and institutional history." The first two chapters describe and contrast the military service experiences of white and black Civil War soldiers. The institutional history referenced above is St. Elizabeth's Government Hospital for the Insane, and Carroll uses that place and the experiences of its staff as a way to show how the Union Army attempted to rehabilitate psychologically incapacitated soldiers (around 1,500 entered the hospital during the war itself). With a nod to the 'self-care' concept developed earlier by Kathryn Shively Meier, coping mechanisms of a psychological nature are also explored in the study.

Subsequent chapters examine the postwar lives of Union veterans (white and black) and ex-Confederate soldiers. Also addressed is how poverty, substance abuse, violence, and other challenges affected the families of mentally ill veterans. Finally, returning to St. Elizabeth's, the study looks at how medical professionals diagnosed and treated mental disorders in veterans and discusses how by the 1880s the emerging field of neurology developed a "deepened and more complex view of mental illness" that finally recognized etiologies based more upon science and less upon moral judgments.

In the end, Invisible Wounds provides "a sweeping reevaluation of the mental damage inflicted by the nation’s most tragic conflict."