Barbed Wire Sickness and the Psychology of Disability

I recently finished reading Man’s Search for Meaning by Viktor Frankl, a Holocaust survivor who went on to become one of the most influential psychiatrists, neurologists, and philosophers of the twentieth century. Frankl, who created Logotherapy  (Greek for “healing through meaning”) and later became known as the founder of the “Third Viennese School of Psychotherapy,” held both an MD and PhD from the University of Vienna. He served as a professor at the University of Vienna, taught as a visiting professor at Harvard and Stanford, and authored numerous works on psychology, philosophy, and meaning-making. Over the course of his lifetime, he was awarded 29 honorary doctorates from universities around the world (The Viktor E. Frankl Institute of America, 2024). His book Man’s Search for Meaning continues to shape conversations around suffering, resilience, and the human will to find purpose (Southwick et al., 2014).

In this book, Frankl mentions the concept of “barbed wire sickness.” While not a clinically recognized diagnosis, it is a historical term used during World War I to describe the psychiatric and neurological conditions that affected prisoners of war and internees. Swiss physician Adolf Lukas Vischer studied this phenomenon and published Barbed Wire Disease in 1919, documenting the psychological impact of prolonged captivity. Symptoms included disinterest in life outside the camp, restlessness, confusion, memory loss, apathy, and depression. Prisoners also struggled with concentration and reported a sense of detachment from reality (Ohry & Solomon, 2014). The condition was not officially medicalized but became an early way of understanding how confinement and the loss of autonomy can leave lasting mental scars. Many historians and psychologists now recognize Vischer’s work as a precursor to modern understandings of post-traumatic stress disorder.

Although “barbed wire sickness” originated in the trenches and prison camps of World War I, the concept extends far beyond wartime. Its themes of confinement, loss of agency, and disconnection from society resonate with the experiences of other groups across history, from migrants held in detention centers to individuals who endured the isolation of the COVID-19 pandemic (Sukiasyan, 2024; Hwang et al., 2020). The enduring lesson is clear: prolonged separation from freedom and autonomy profoundly affects human psychology.

Reading Frankl’s description, I could not help but think about how this concept connects to disability. When a person acquires a disability, especially a spinal cord injury, autonomy is often stripped away. Social connections may fracture, and life can begin to feel confined in ways that echo imprisonment. I have written before about isolation and loneliness after disability, but Frankl’s words gave me a new lens to think about it.

It begs the question: are we, in a sense, living in our own prisons? Is quadriplegia similar to being a prisoner? I know this comparison may sound brash, but psychologically, the parallels are striking. Bear with me here:

Paralysis may not place us behind physical barbed wire, yet it often creates invisible boundaries that separate us from the freedom and agency we once knew. At one point (not so long ago) it was illegal to be disabled in public in the United States. The “Ugly Laws” were local ordinances enacted in several U.S. cities between the late 19th and early 20th centuries that prohibited people with visible disabilities or deformities from appearing in public spaces (Schwerin, 2009). Further boundaries might come from inaccessible spaces, dependence on others, or social stigmas that quietly reinforce separation. The result is a life that, at times, mirrors the mental confinement described by Vischer’s “barbed wire disease.” Worse yet: until there is a cure, spinal cord injury is a life sentence.

Perhaps this is why Frankl’s insights resonated so strongly with me. He argued that even in the most restrictive circumstances, meaning could still be found. One of the most powerful phrases he leaned on during the Holocaust comes originally from Friedrich Nietzsche: “He who has a why to live for can bear almost any how.” Reflecting on Nietzsche’s quote and Frankl’s use of it (putting words to power) was eye-opening. This saying expresses that a strong sense of purpose can provide resilience to endure even the harshest circumstances. For those of us navigating life with paralysis or other disabilities, Nietzsche’s message holds true. Our “barbed wire” may be different, but the human need for connection, purpose, and meaning is unchanged. Modern psychiatry continues to draw on Frankl’s work, showing that Logotherapy offers valuable tools for resilience and recovery in the face of chronic adversity (Southwick et al., 2014). These traits are invaluable to those who may be processing grief and trauma or navigating life behind the proverbial “barbed wire”.

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References

Frankl, V. E. (1963). Man’s Search for Meaning: An Introduction to Logotherapy. New York: Washington Square Press.

Hwang, T. J., Rabheru, K., Peisah, C., Reichman, W., & Ikeda, M. (2020). Loneliness and social isolation during the COVID-19 pandemic. International psychogeriatrics, 32(10), 1217–1220. https://doi.org/10.1017/S1041610220000988

Ohry, A., & Solomon, Z. (2014). Dr Adolf Lukas Vischer (1884-1974) and ‘barbed-wire disease’. Journal of medical biography, 22(1), 16–18. https://doi.org/10.1177/0967772013479547

Schweik, S. M. (2009). The ugly laws: Disability in public. New York University Press.

Southwick, S. M., Gilmartin, R., McDonough, P., & Morrissey, P. (2006). Logotherapy as an adjunctive treatment for chronic combat-related PTSD: a meaning-based intervention. American journal of psychotherapy, 60(2). https://doi.org/10.1176/appi.psychotherapy.2006.60.2.161

Sukiasyan S. (2024). The Mental Health of Refugees and Forcibly Displaced People: A Narrative Review. Consortium psychiatricum, 5(4), 78–92. https://doi.org/10.17816/CP15552

The Viktor E. Frankl Institute of America. (2024). The Life of Viktor Frankl. Viktor Frankl Institute of America. https://viktorfranklamerica.com/viktor-frankl-bio/