This article was originally published in “Understanding Our Timing” n°3

Élodie Charié is a doctoral student at the Centre for History

On 15 March 1949, a soldier described as ‘Senegalese’ boarded the hospital ship Le Chantilly in the port of Saigon to leave Indochina for good. After sixty-four days of observation in the psychiatric ward of the Choquan hospital of Saigon, in what is now Viet Nam, the doctor decided that his ‘hallucinatory state’ precluded his ability to remain with the Second Colonial Infantry Regiment of the Far East Expeditionary Corps. 
How did this 23-year-old Guinean, born in the small village of Rogbane on the Atlantic coast of the former French West Africa, end up hospitalized for mental health problems in the heart of Cochinchina? His case was not unusual among French troops fighting in the Indochina War between 1945 and 1954. Among these troops, comprised of men and women from the French colonial empire and individuals from other European countries, 21,000 people were treated for mental disorders in a specialized department, either at the Lanessan hospital in Hanoi or at the Choquan hospital. Mental illnesses were the main cause for repatriation throughout the conflict. Alcoholism featured prominently. This ‘dominant disease’ of the Expeditionary Force was treated by psychiatrists, and it was often difficult to distinguish it from other illnesses in the diagnoses. For example, in the first seven months of 1952, when 661 so-called mentally ill patients were repatriated, mental disorders were the leading reason given, ahead of tropical diseases. Adding in the 248 ’alcoholics’, they represented a total of 909 patients, that is, as many as the 910 physically war-wounded who were repatriated. Overall, psychiatric illnesses accounted for a quarter of medical repatriations. These particularly high figures – yet partly underestimated according to the people involved – were of concern to the Army Medical Corps in Indochina and the Command. Far from being a marginal phenomenon of the Indochina War, mental disorders represented a major challenge for the French army. A closer look at male and female combatants treated in psychiatric hospitals is therefore key to understanding not only the conflict, but also its memory.

Bringing mental disorders out of oblivion

Eclipsed by World War II and the Algerian War of Independence on the one hand, and overshadowed by the United States war in Viet Nam on the other, this first war of French decolonisation is a veritable ‘blind spot’ of the second half of the twentieth century, and has been overlooked by the historical community. From the outset, the conflict was dismissed by some as a ‘dirty war’, and simply ignored by most contemporaries, who had little interest in a distant colonial campaign involving only professional soldiers and volunteers. As a result, an archetypal image emerged of the Indochina veteran as a bloodthirsty, murderous madman, like the assassin in Claude Chabrol's 1970 film The Butcher. In contrast to this topos was a different view forged from the testimonies of veterans, casting the soldiers as heroes and romanticising the combat to the detriment of the reality of war experiences. Historiography, long confined to diplomatic and military history, has not always succeeded in eschewing these pitfalls and biased memories.
The study of mental disorders therefore enables a new understanding of the conflict that can transcend these conflicting visions. This approach involves working from primary sources such as administrative, hospital and medical archives, which are largely unpublished and which, for the most part, are not yet freely released because of the sensitive data they are likely to contain. Quantitative and qualitative analysis of psychiatric hospital admission and discharge registers and individual medical records shed light on the experiences of soldiers treated for mental disorders.

Disparate diagnoses representative of the times

The analysis provides a window into psychiatry as it was practiced at the time, with disparate diagnoses borrowed from sometimes contradictory classifications, with shock therapies (electroshock, sleep cures, Cardiazol shock, insulin shock), and innovations from the introduction of neuroleptics (such as Largactil, the commercial name of chlorpromazine). The diversity of the patients also shows how gender and racial stereotypes, fed by the theories of colonial psychiatry, shaped care. Among the diagnoses ascribed to colonised people, race was not an uncommon factor used to explain and often minimise disorders, classified as ‘African psychosis’, ‘ethnic hysteria’, ‘psychosis of the lazy North African’, or ‘ethnic simulation’.
More specifically, these archives testify to the development of a specifically military psychiatry that paradoxically paid little attention to the fact that war also broke people's spirits. Despite the high number of mental illnesses, the resources provided to treat them remained extremely limited. While the chronic lack of resources and staff were an inherent problem in the Indochina War, psychiatry was the weakest link in the health system. Reports and inspections deplore the dilapidated state of buildings, precarious conditions for treatments, lack of trained staff and overcrowded wards. A statistical study of diagnoses in registers and medical records shows that psychiatrists rarely referred to the war and colonial context to explain mental problems. Even though the issue of war-related mental disorders was not new, the French authorities were struck by ‘a kind of blindness’ since World War II. Surprisingly, in the Choquan psychiatric department, war, even when mentioned initially as a cause, was then generally dismissed. For example, in 1953, a psychiatrist concluded that one trooper did not have a disorder, but was simply drunk, even though his clinical chart indicated that, while he was sleeping, ‘he was suddenly seized by tremors all over his body and, kneeling on his bed, simulated the action of shooting imaginary enemies’. The downplaying of the importance of the war and colonial context in the nature of disorders can also be explained by the specific nature of military psychiatry, which is affected not only by therapeutic issues, but also by administrative and legal issues relating to the rehabilitation of soldiers and the awarding of pensions 
Percolating through the psychiatrists' notes in the medical records, however, are the voices of the patients, who speak of ‘feeling deluded or ‘feeling depressed’, and clearly link these feelings to combat or the Indochinese environment. The guerrilla warfare, fear of an invisible yet omnipresent enemy, anguish about jungle patrols, the vicissitudes of power struggles, waiting and boredom, absurdity of colonial war, disorientation in an unfamiliar environment, the oppressive climate, and strangeness of the flora and fauna, were not only physical but also mental challenges. The experiences were all the more stressful because the conflict in Indochina was a particularly violent – perhaps the most violent – war of decolonisation, and many patients' accounts dwell on the brutality of combat and the horror of the atrocities perpetrated against civilians and military alike.

A troop selection problem

A social history of the issue must contextualise this high level of psychiatric morbidity at a broader level than uniquely the Indochina War. As the conflict clearly became a colonial war, volunteers became scarce and selection criteria were loosened. In 1945, the medical officer in charge of the health services wrote: ‘Many patients should never have been recruited for a colonial campaign, let alone the army: the disabled, epileptics, people with old head injuries, those suffering from anxiety or who had already been institutionalised one or more times.’ In their diagnoses, the psychiatrists not only expressed their frustration with the failure to detect disorders during recruitment, but also, and primarily, their incredulity that military authorities most often knew these servicemen and women had psychiatric disorders, whether in civilian life, during previous operations or, worse still, during prior service in Indochina. For example, a soldier in the colonial infantry had already been institutionalised for six years, from 1944 to 1950, for the same diagnosis that led to his hospitalisation at Choquan for more than two months in 1952, namely ‘mental disability’ and ‘alcoholism’. One legionnaire was placed under psychiatric observation for the third time in three tours of duty for the same disorders, with the same prescription: repatriation. These cases, far from being anecdotal, are representative of the more general sociology of the Expeditionary Corps.

A long history of violence

A study of the lives of patients prior to the Indochina War shows that most of them were troubled in civilian life or as a result of previous war experiences. Many were already physically and mentally traumatised by extreme violence, particularly from World War II. Sources frequently mentioned their past as veterans, prisoners of war, resistance fighters, deportees or even Nazis, fascists and collaborators. One young man from northern France who joined the army in 1945 and was hospitalised several times for alcoholism explained: ‘Ever since I went to Poland (March 1943), I've been drinking,’ tracing his illness back to his compulsory labour service in Auschwitz. This was even more the case among legionnaires, for whom the French army offered an escape from a Europe in ruins. For example, a Hungarian patient joined the Foreign Legion to escape Soviet occupation and persecution. After being held captive in the USSR, he crossed the continent westwards and joined the ranks of the legionnaires. He then took part in ‘operations’ to reestablish colonial authority in Madagascar from 1947 to 1949 after the great revolt of spring 1947, before landing in Indochina in 1949. Analysis of the experiences of former Indochinese soldiers shows that many others were also veterans of World War II, Madagascar, Korea or the Indonesian War of Independence, requiring us to consider their trauma on the scale of the wars that raged during the first half of the twentieth century. As a result, geographical and chronological aspects can be identified, allowing us to discern the transnational movements of combatants and long-term injuries, well beyond the Indochina War, as the following case study suggests.
On 7 July 1946, a legionnaire was sent to a psychiatric hospital by his commanding officer because of his ‘very nervous’ behaviour and ‘numerous eccentricities’. The young corporal was admitted to Choquan for ‘mental confusion’. Born in 1923 in Erfurt, Germany, he was a former paratrooper in the German army. He enlisted in the Legion in 1945 with his three brothers, like many of his compatriots. One might wonder about the reasons for his enlistment: was it a way of escaping his responsibilities at the end of the war? Or was it a sign of his inability to return to civilian life? Whatever the case, the new patient was symptomatic of these servicemen who were scarred in body and spirit even before the fighting in Indochina. A physical description highlights his many scars: notably, he had been shot in the chest in 1944, and the bullet was still lodged near his heart. At Choquan hospital, he tried to strangle another patient, a Frenchman, whom he accused of being his brother's executioner. It is difficult to move from one war to another and to deconstruct the figure of the former enemy. His behaviour was so violent and uncontrollable that he had to be temporarily institutionalised at the Bien Hoa civil asylum pending his repatriation. On 13 March 1947, he embarked on the Pasteur as a medical repatriate, for schizophrenia. This did not prevent him from returning to Indochina in 1952, with the rank of first sergeant, before he was once more repatriated after being shot and wounded while attempting with his platoon to conquer the village of Phú Th?, in northern Viet Nam. His whereabouts were finally traced to Algeria in 1957: he had ‘died for France’ in the fighting during the Algerian War of Independence.

This journey through the conflicts of the twentieth century was not uncommon among those who, as members of the Expeditionary Corps, were treated for mental disorders in Indochina. Understanding these frequently marginalised individuals by recognising their personal wartime experiences helps shed light on the reality of France's first decolonisation conflict, as opposed to its myths and stereotypes. More broadly, these combatants' stories call for reflection on the consequences of war over a longer period of time, and on the difficulties, and sometimes impossibility, of overcoming them.

Élodie Charié, a doctoral student, is a graduate of the Master's programme in history at Sciences Po and holds an agrégation in history. Her thesis, entitled ‘Les troubles psychiques durant la guerre d’Indochine (1945-1954) : une histoire médicale, sociale et culturelle de la psychiatrie en contexte guerrier et colonial’ (Mental disorders during the Indochina War (1945–1954): A medical, social, and cultural history of psychiatry in the context of war and colonialism), is supervised by Guillaume Piketty (Centre for History) and Claire Edington (University of San Diego). Élodie Charié also teaches a number of courses, including the methodology module, ‘Narratives, representations and uses of the past’ at Sciences Po.