Railway spine, nerve prostration, combat neurosis, post-traumatic stress disorder: throughout the twentieth century, a complex array of terms has been codified by cultural, national, and medical institutions to describe a body and mind made dysfunctional by the inability to process intensely disturbing memories. In the wake of World War I, trauma-induced mental illness—diagnosed and treated as “shell-shock” in countless veterans—became an imperative focal point for sociopolitical and medical reform throughout Europe. This essay explores the connections between this historically contextualized psychiatric disorder and the music of Ivor Gurney, a soldier in the British Army whose life and work was significantly affected by his diagnosis in 1918. Through particular disturbances of form, structure, and texture, Gurney’s musical landscapes reenact the conditions of psychic trauma by creating a world in which memories are disruptive, invasive, and ultimately disabling.