Medical case notes made by doctors who worked in one of London’s lunatic asylums, held in the London Metropolitan Archives, reference the case of a 52 year old woman who was brought to St. Luke’s Hospital in London by her husband in February of 1916.* In describing his wife’s case to doctors, the woman’s husband noted that she “will not undress at night goes to bed in her boots, ready for a Zeppelin raid. Will not take her meals. Harks on above ideas all day long.”  Doctors noted that “during the air-raid on Dec. 13th she became greatly alarmed and not been [sic] the same since. She refused to take off her clothes at night for fear there would be another.”  Despite her frequent references to her fear of air raids and her statement that she believed “The Germans will kill everybody,” doctors diagnosed the woman with a hereditary form of insanity, blaming her condition on her own poor health, rather than on the wartime conditions surrounding them all. She remained at St. Luke’s Hospital for six months.

Women at work during the First World War- Munitions Production, Chilwell, Nottinghamshire, England, UK, c 1917 | Wikimedia Commons

The First World War redefined combat tactics, weaponry, and the experience of war itself.  Soldiers around the world were forced to endure traumatizing fear, helplessness, and disorientation as they grappled with the unfamiliar world into which they had been sent. But the changes wrought by the First World War also redefined the lived experiences of civilians. In fact, our contemporary understanding of what it meant to be a ‘civilian’ on a ‘home front’ was defined during the First World War. The absolute hunger of total war for arms, supplies, money, and soldiers meant that every single person in a combatant nation had to be focused on, and participating in, the war to some extent. These roles, and the political implications of those roles, were highly gendered: while men went off to the battlefront to fight, women were expected to support the war at home — where they were supposed to be safe.

Even as modern war created an imagined distance between civilians and the battlefront, it also destroyed it. Advancements in aerial weaponry and transport led to the first air-raids, which were intended to destroy supply lines and damage morale, both among the civilian targets at home, and the soldiers at the front. Beginning in January, 1915, and continuing sporadically until May, 1918, German airships and Zeppelins conducted over 50 bombing raids on the United Kingdom.  While these raids were not terribly successful in terms of destroying military sites, they caused enormous destruction to residential and community areas –– and caused an enormous amount of emotional trauma to those who were forced to endure them. The distinct roles that men and women were expected to perform in wartime would help determine whose wartime suffering was considered valid and worthy of medical study, and whose would be overlooked, even though many of the fears and dangers they faced were startlingly similar.


The absolute hunger of total war for arms, supplies, money, and soldiers meant that every single person in a combatant nation had to be focused on, and participating in, the war to some extent. These roles, and the political implications of those roles, were highly gendered: while men went off to the battlefront to fight, women were expected to support the war at home — where they were supposed to be safe.

Daily lives, schedules, social interactions, and even fashion, were affected by the threat of air raids. In order to diminish targets from the air, strict blackouts were enforced across London, causing widespread disorientation, even for long-time residents. Women who worked were forced to make their way home in the dark. Curfews meant that they were unable to take part in social activities that may have fostered some feelings of security. Nighttime was filled with preparations for further raids, from keeping buckets of sand near beds to donning the latest in “air raid fashions.” As Lucie Whittmore explains, pajamas were advertised in newspapers as an air raid precaution that would make it “convenient to be able to run out into the street at all hours.”

In many ways, women’s lives on the home front were filled with the same kind of work, fear, and stress as their male counterparts in the trenches. They devoted their labor to the war effort, their money to war bonds and other fund drives; they spent their days and nights living in fear of massive destruction and death from mechanized, industrial warfare. Yet, because they were specifically not soldiers, women were excluded from considerations of war-neurosis and trauma.  The study of war trauma during this time represents a watershed moment in the history of psychology. But medical investigations into the effects of war, violence, and stress on human minds were largely limited to the study of combatant men. Their service permitted expressions of suffering in ways that were unavailable to civilian women, for a number of reasons, both scientific and political.

Newspaper reports of German air-raids tended to be very strategic about how they described the harm sustained by humans. Where suffering was publicized, it was intended to highlight the death or maiming of the most “innocent” victims, especially children and the elderly, in order to drive home the image of the German “barbarian.” Discussions of “air raid shock” often focused on children and the elderly. Apart from these groups, at least according to newspapers and propaganda, the escalation of aerial warfare was met with indefatigable British stoicism. For example, in a June, 1918 report on the London air raids, the Linlithgowshire Gazette reported:

Wherever we go and to whomsoever we talk, we hear nothing but praise of the behavior of the women in the air raid of Whit Sunday night … who displayed the utmost coolness and resource …They stand at their posts like the soldiers that they are, and brave and share every danger.

These kinds of news stories were intended to assure men at the front that their loved ones were safe, but they were also intended to inform women on the home front about how they should act in the face of further impending danger. Like soldiers, women were supposed to remain calm and devoted to their war-work and family. But these media portrayals obscure the fact that civilian women’s lives were completely overturned by air raids, and the fear they were forced to endure as a result could sometimes be overwhelming.

The representation of women’s minds by contemporary science and medicine influenced the how their expressions of suffering were interpreted. Women were assumed to be predisposed to mental and emotional instability, which changed the context in which their breakdowns were perceived. As Hannah Groch-Begley has noted, it was not that civilian women’s trauma wasn’t recognized, but instead that it wasn’t valued in the same way as combatants men’s trauma.

When women broke down as a result of the overwhelming stress and fear of war, doctors tended to rely on older notions of women’s emotional instability and natural tendencies towards hysteria, rather than on their lived experiences. This representation not only exempted women from discussions of war trauma, but also exonerated the state for failing to protect them from the effects of this new kind of warfare. This failure to consider women’s trauma alongside men’s, despite the similarities in their experiences, has left a gap in the historical record about women’s emotional and psychological reactions to the unique war that they were forced to endure.

The representation of women as civilians, and therefore exempt from the immediate danger of war, also made it politically contentious to discuss their trauma publicly. Women’s breakdown as a result of war trauma reflected the failure of the state to provide adequate protection for civilians on this new home front. Admitting that women were psychologically affected by air raids would expose such failures, and threatened to lower morale, both at home and at the front. Diagnosing women’s symptoms as hereditary, or caused by their own personal instability, exonerated the state, and also contributed further to the notion of emotional women as hysterical, unstable, and potentially dangerous.


When women broke down as a result of the overwhelming stress and fear of war, doctors tended to rely on older notions of women’s emotional instability and natural tendencies towards hysteria, rather than on their lived experiences. This representation not only exempted women from discussions of war trauma, but also exonerated the state for failing to protect them from the effects of this new kind of warfare. 

In the treatment of “air raid shock,” it is also possible to understand the ways psychology specifically, and medicine more generally, was used to reinforce gender and culture norms. Even though trauma related to air raids was a widespread and prevalent cause of incarceration in asylums, there is no indication that air-raid related trauma was treated with anything like the same concern or immediacy that “shell shock” was. When and if women’s trauma was connected by doctors or the media to their involvement in the war, the fact that women’s contributions to the war were not valued as highly as men’s meant that their suffering was got given the same worth or consideration.

When the stress of war and the fear of air raids caused women to break down, their expressions of pain and trauma were generally discounted or overlooked. The First World War was a critical time for the advancement in our understanding of mental trauma and psychological suffering, but it is critical to understand whose trauma, whose pain, and whose experiences were valued — and what the implications were for those left behind. In circumstances where women behaved according to social and cultural expectations — remaining quiet and working in the service of enlisted men — their value to the war effort was promoted and celebrated. Ultimately, the representation of women in wartime, as non-combatants, as supporters of heroic combatant men, and as gendered bodies within a strictly controlled patriarchy all affected the ways that their mental health was understood, and how their pain was heard and respected.

*These case notes are restricted and were accessed with permission from the London Metropolitan Archives.  

Further Reading

Susan R. Grayzel and Tammy M. Proctor, eds., Gender and the Great War (Oxford University Press, 2017).

Tammy M. Proctor, Civilians in a World at War 1914-1918 (New York University Press, 2010).

Peter Leese, Shell Shock: Traumatic Neurosis and the British Soldiers of the First World War (Palgrave MacMillan, 2002).

Tracey Loughran, Shell-Shock and Medical Culture in First World War Britain (Cambridge University Press, 2017).

This essay was originally published by Lady Science in collaboration with The New InquiryRead the original copy here.


Bridget Keown is a PhD candidate at Northeastern University. Her work focuses on British and Irish women and their experience of war trauma during the First World War and Irish War of Independence. She has been awarded the Larkin Research Fellowship in Irish Studies from the American Conference for Irish Studies to continue this research. She is currently a contributing writer to Nursing Clio.

Featured image: Female munition workers crying at the funeral of a colleague killed by an accident at work in Swansea in August 1917; Wikimedia Commons.

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