Protecting the UK public from COVID-19: what policy lessons can we learn from the Blitz?

The COVID-19 pandemic and the Blitz both exposed the civilian population to a sustained threat. Risk, whether from exposure to viral load or the density of the bombing, led to a range of protective measures and behavioural regulations being implemented. Edgar Jones (King’s College London) outlines key policy lessons from the 1939-45 experience that may prove useful today

War and the Practice of Psychotherapy: The UK Experience 1939–1960

During the Second World War, it is argued, “the neuroses of battle” not only deepened an understanding of “psychopathological mechanisms”, but also created opportunities for the practice of psychotherapy, while its perceived efficacy led to a broader acceptance within medicine and society once peace had returned. This recognition is contrasted with the aftermath of the First World War when a network of outpatient clinics, set up by the Ministry of Pensions to treat veterans with shell shock, were closed within a few years in response to financial pressures and doubts about their therapeutic value. In the private sector, psychoanalysis under the leadership of Ernest Jones remained an idiosyncratic activity confined largely to the affluent middle classes of London. According to Gregorio Kohon, “it was strongly opposed by the general public, the Church, the medical and psychiatric establishment, and the press”. The Medico-Psychological Clinic of London, originally set up in 1913, offered psychotherapy on three afternoons a week in premises at 30 Brunswick Square under the direction of Dr James Glover. However, it closed in 1923 after Glover and his brother Edward had both become psychoanalysts. As the First World War drew to a close, Maurice Craig helped to persuade Sir Ernest Cassel to fund a hospital for ‘Functional and Nervous Disorders’ at Penshurst, Kent, to treat neuroses in the civilian population. Although moved to permanent premises near Richmond, it remained small-scale and at the time no attempt was made to establish a network of similar institutions throughout the UK. The Tavistock Clinic, opened in Bloomsbury in 1920, struggled to secure funding throughout the interwar period and its efforts to win official recognition from the University of London were consistently rebutted. Thus, despite the epidemic of shell shock and other so-called war neuroses, psychotherapy remained a marginal activity during the 1920s and 1930s.</jats:p

Protecting the UK public against covid-19: what policy lessons can be learned from the experience of the Blitz?

The COVID-19 pandemic and the Second World War aerial bombing campaign against the UK both exposed the civilian population to a sustained threat. Risk, whether from exposure to viral load or the density of the bombing, led to a range of protective measures and behavioural regulations being implemented. Edgar Jones outlines key policy lessons from from the 1939-45 experience that may prove useful today

War Syndromes: The Impact of Culture on Medically Unexplained Symptoms

The general principle that the experience of combat damages servicemen's long-term physical and mental health is recognized. However, controversy has raged over the nature of particular post-combat disorders such as shell shock, disordered action of the heart (DAH), effort syndrome, effects of Agent Orange and, not least, Gulf War syndrome. We, among many others, have argued that they should be classified as functional syndromes characterized by medically unexplained symptoms, which include: fatigue, weakness, sleep difficulties, headache, muscle ache and joint pain, problems with memory, attention and concentration, nausea and other gastro-intestinal symptoms, anxiety, depression, irritability, palpitations, shortness of breath, dizziness, sore throat and dry mouth. Despite popular claims to the contrary, no simple biomedical aetiology has been discovered to account for these disorders, hence the term “medically unexplained”. Furthermore, they are not easily interpreted using accepted psychiatric classifications. Without demonstrable organic cause, war syndromes have attracted diverse causal explanations, ranging from pressure on the arteries of the chest, constitutional inferiority, toxic exposure, bacterial infection to microscopic cerebral haemorrhage.</jats:p