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In fiction, this character went through hell and he has done things that no amount of (fictional) therapy will heal, and it's left him so irrevocably scarred they have trouble feeling, emoting, or caring about the people around them and themselves.
"Shell shock" is a nickname for what was eventually termed post-traumatic stress disorder, a real condition that participants in a war commonly acquire, but that can also be caused by a multitude of other means, often involving high-stress situations.
PTSD develops because the trauma experience was so distressing that we want to avoid any reminder of it.
Our brains don't process the experience into a memory, so the experience stays as a current problem instead of becoming a memory of a past event.
Most Shell Shocked Veterans will, at some point or another, be seen exhibiting the classic Thousand-Yard Stare; with a blank, emotionless expression and unfocused, empty eyes. In an ensemble show or a Five-Man Band, the Shell Shocked Veteran is usually the Quiet Big Guy or Lancer. That idea fit very well to Asukas notions of EVA pilots as an elite fighting troop. Others go on for years, until they lose count of all the battles they have fought in, but even a man who has survived a hundred fights can break in his hundred-and-first.