Shell-shock CLAUSTROPHOBIA: Preferred shell exposure to shell-proof tunnel.
Case 182. (Steiner, October, 1915.)
A colleague of Steiner, an army physician, 35 years of age, with strong hereditary taint, having two sick sisters (one dementia praecox), had been incapacitated for work through a neurasthenia a few months before mobilization. However, at first he felt very well, marching through Belgium and into Northern France.
On the night of the 17th of October, 1914, a shell struck the house next where he was and startled him up out of sleep. After that, especially at nightfall, upon entering a cellar he would have the feeling of the ceiling falling down, and he would go restlessly from one space to another. Afterwards, any closed room, however secure or distant from the front and free from shells, would give him the feeling of the ceiling about to fall down. He could no longer sit quietly anywhere, but walked about and avoided the company of others.
A characteristic observation is the following as described by the physician himself: There was an absolutely shell-proof tunnel running to the position at the front where he was on duty. It took about 25 minutes to go through the tunnel, but on account of his feelings he could not bring himself to use this tunnel but walked over the exposed hill which was frequently shelled. Curiously enough, after the appearance of the first symptoms, a shell exploded nearby without any marked psychical effect. This happened about noon. The obsessions were stronger in the evening. Objectively, there were neurasthenic symptoms of a bodily nature; there was vasomotor excitability. He was depressed, wept easily, and showed lack of decision; he had tormenting thoughts that he had not fulfilled his duty.