Silent veterans trapped in the ruins of a dead war

Many of those who experienced the second world war's horrors are still suffering psychologically. Stephen Davies and Nick Hunt believe we should now acknowledge their traumas and treat them

In 1940 Andrew was a ten-year-old walking along a seaside promenade eating an ice cream when a German fighter aircraft strafed two women strolling towards him. He watched them disintegrate and was spattered with their remains. Later in the war he watched an air raid on a street his mother had just walked down. When I saw him he had suffered 50 years of anxiety and was often depressed. His children knew him as a moody man who avoided public places and shouted in his sleep.

Eva came to Britain after three years in Auschwitz where her family disappeared into the maw of the Holocaust. She recalled pushing sick people to the front of parades in the camp so they would die rather than her. She did this to her friends and to her sister. After the war she embarked on a "psychiatric career'', spending long periods in mental hospitals. She avoided relationships with others, feeling they would be soiled by her experiences and revolted by her "sins''. She would become furious on hearing about the children of other patients. She died in hospital five years ago, filled with despair.

Here is some recognition that the psychological corrosion produced by war has long-term psychological effects on individuals and upon the society in which they live. It is a dangerous myth that people experience mental health problems merely because their "character'' dictates it. Mental health problems usually arise in people because bad things happen to them. War is one of those bad things. Popular historical opinion would have us believe that it was "a lovely war'' - a time of adventure. My conversations with older people have told me this was rarely the case.

Mrs Jones was a recently bereaved widow who came for help with problems of anxiety. She left school just before the second world war broke out and went to work in a munitions factory in London. She remembered sitting in a shelter underneath a warehouse packed full of explosives "hysterical with fear''. She started sleeping and eating poorly and found herself making mistakes at work. She was relieved of munitions work. Two years later she left a department store a few minutes before it was hit by a V1 "flying bomb''. She recalled seeing a severed leg lying in the road and was puzzled that it had a neat shoe and stocking on it. She had nightmares about the leg for five years after the war. They returned when the 50-year commemorations of the war began in 1989.

On September 1 1939, the largest single movement of the civilian population ever seen in Britain took place. It was known officially as "E'' (Evacuation) Day. It was meticulously planned by government officials for months in anticipation of the outbreak of war. Over a million people were moved from Britain's towns and cities to areas of the countryside deemed to be safe from enemy bombers. The uprooting and separation were commented on at the time but have never been systematically investigated.

John, aged 9, was evacuated to a remote farm in North Wales where he was used as "slave labour'', enduring frequent beatings, sleeping in a open barn and eating pig slops. One day his host came into the barn, dropped his trousers and "asked for service''. A catalogue of sexual abuse ensued. John was removed to a kinder billet when he collapsed in a field and was found by a passer-by. He refuses to visit Wales and becomes agitated if he hears a Welsh accent. He has not spoken to his son since he married a woman with a Welsh-sounding name. He has never seen his grandchildren.

Six years after the war began, its end brought a sudden return to now unfamiliar people and places for veterans and civilians alike. Some had "a good war'' with little exposure to violence and easily put it to one side. Most people in Britain were touched by the conflict. Children had adjustments to make to emotional attachments to parents they had not seen for years. Most experienced some trauma of which others were unaware, for this was a time when discussion of war experiences was discouraged. Psychological assistance was virtually non-existent as physical rebuilding was often considered the only priority. People's experiences were locked away only to return many years later when images of the war were paraded again. Some would never be able to lock away what they had seen and limped through the years, permanently damaged.

The most worrying aspect of recent research is that the long-term psychological effects of traumatic experiences could possibly be transmitted across generations. In Britain the maintenance of morale in the civilian population was seen as a task of paramount importance and psychological trauma interpreted as a sign of constitutional weakness rather than a reaction to difficult life events. There are virtually no systematic studies of psychological trauma in Britain during or since the second world war.

I believe that the lack of psychological sophistication in the evacuation and demobbing process contributed to long-term psychological damage. We have no coordinated, response to the effects of war such as seen in the American Department of Veteran Affairs. Good work is done by ex-service and other organisations but on a shoestring and without government involvement. We continue to have little research into this area.

There are people in my family that I never got to meet because of the second world war. I cannot do anything about that but I can care for the living and, by remembering, try to stop such events from happening again. For all Britain's citizens to contribute to the means for coping with wartime experiences is now the challenge.

Stephen Davies is a consultant clinical psychologist and head of clinical psychology services for older people with the Essex and Herts Community NHS Trust.