Perceptions of Shellshock in World War I
A Thesis
The Department of History
The Colorado College
In Partial Fulfillment for the Degree
Bachelor of Arts
By
Daniel Norton
April/ 2016
2
Abstract
Each modern war seems to have its own version of combat stress. Today, PTSD is a serious issues that many soldiers and veterans face. However, in WWI, soldiers were diagnosed with a unique form of combat stress called shellshock. British scientific understanding of shellshock was fragmented and unstandardized. This paper examines the different understandings and treatments of shellshock and argues that the soldiers’ perception of shellshock was highly influenced by psychologists and the scientific understanding of the time
3
One of the greatest challenges soldiers face today is combat stress. Posttraumatic Stress
Disorder (PTSD), as it is known today, is a debilitating mental response to the stress of combat that can last for the rest of a veteran’s life. It’s very real and serious form of combat injury, but thankfully there is a standardized understanding of the disorder and process for treating patients.
Unfortunately, this has not always been the case. Instances of combat stress have emerged during combat throughout history, and were much less understood then today. World War I was the first major war that faced a serious issue of mental breakdowns. Shellshock, as it was known then, affected large numbers of British soldiers and was initially misunderstood by medical experts and soldiers. Understandings of shellshock progressed throughout the war and treatment was administered, but it was highly fragmented and disorganized. This paper seeks to examine the different understandings of shellshock during the Great War. I shall first examine the concept of combat stress and some of the current theories on the manifestations of combat stress in different cultures and time. I will then examine British military psychology and British perceptions of psychology leading up to the war. An understanding of the pre-war science will help examine the understanding and treatment of shellshock during the war. From there we will examine the soldiers’ culture and the military’s attitudes towards soldiers with shellshock. After these multiple dialogs and experiences we will focus in on the poetry of Wilfred Owen and Siegfried
Sassoon. Owen and Sassoon are considered two of the best poets from the war, and both were treated for shellshock. Each man had their own background, but met and influenced each other during their treatment at Craiglockhart Was Hospital. This paper argues that the time under treatment of W.H.R Rivers and Arthur Brock was pivotal in shaping each of their poetry.
Sassoon and Owen’s differing interpretations of shellshock appeared to be correlated with the brand of treatment their psychologists used during treatment. 4
Before diving into the Owen and Sassoon’s specific cases of shellshock, it is important to have a general understanding of combat stress and shellshock in particular. Combat stress is essentially any psychological trauma that affects soldiers during and after combat. Scientists and anthropologists debate heavily about the origins and proper diagnosis of combat stress, but it is safe to say for a general reader that the modern day equivalent of shellshock is posttraumatic stress disorder (PTSD). Today for American soldiers fighting in the Global War on Terror, PTDS is the main medical issue veterans face while home and issues surrounding PTSD are widely publicized to a sympathetic civilian population.1 Many aspects of PTSD do overlap with shellshock. Both occur after a soldier experiences a traumatic event or are exposed to traumatic memories of others. Both are notable for night tares, depression, suicidal thoughts, and uncontrollable recurring memories of the traumatic event. However, some reported aspects of shellshock during World War I are not to be found in PTSD today. For example: muteness, deafness, paralysis, and locatable physical pain were all common occurrences.2 These unique symptoms of shellshock and not found in PTSD or other combat stress disorders suggests that each major conflict produces its own post-combat disorders that differ from others. In other words, the manifestation of psychological trauma is real, but tied to the culture, technology, and medicine of the time.3 That is to say, the PTSD as an analogy to shellshock is appropriate for the modern reader to begin understanding shellshock, but one must remember shellshock was a actually a unique disorder and distinct from PTSD.
While World War I and shell shock were the catalysts for the formation of modern military psychiatry, it was not the first time the British military faced psychological aliments in their ranks. Chatman Lunatic Hospital was established in 1859, roughly 50 years before the
1 Sarah Hautzinger Beyond Post-Traumatic Stress: Homefront Struggles with the Wars on Terror. (Walnut Creek: 2 Edgar Jones, Simon Wessely. Shell Shock to PTSD. (New York: Psychology Press, 2005), 23. 3 Jones, xvi 5 outbreak of World War I, for service men primarily returning from India. Some modern scholars venture to diagnosis the majority of these patients with major depression or learning disabilities, two disorders considered common today, but were instead misdiagnosed by the psychiatrists at the time. In 1860 only 12% of the patient population from Chatman returned to duty.4 Discharge was a controversial subject because the majority of patients at Chatman diagnosed with ‘chronic’ psychological disorders. Psychology before World War I did not differentiate between chronic and temporary disorders. It was not until shellshock was better understood that the psychology community full accepted mental trauma as an injury that could affect someone who was not already insane or morale weak. Of those discharged, Dr. J Balfour Cockburn estimated most of them relapsed within two years.5
This discussion of Chatman Hospital is not intended to belittle British psychiatry. Rather, in the context of British society and psychological as a science, the establishment of a psychiatric program can be seen as progressive. Darwinism dominated nineteenth century British society and the growing population sent to asylums for psychiatric treatment was seen as the degeneration of society. Many viewed asylums and lunatic hospitals as perpetuating the eugenic degradation rather then allowing natural selection to enhance society. The British military aligned with the Darwinist mentality with its emphasis on the soldier’s individual moral character. However, the prioritization of soldiers’ health over the possible scrutiny for supporting a stigmatized population shows that the British military had a history of protecting its soldiers and grappling with psychiatric issues.
While Chatman and other asylums were designated specifically for patients understood to be insane, the military faced other problems of combat stress. DAH (disordered action of the
4 Jones, 15 5 Jones, 6 6 heart) affected many soldiers during the nineteenth century British occupation of India and it can be considered the version of combat stress unique to pre-WWI soldiers. DAH was characterized with weak and dysrythmic heart palpitations with no know cause. It was a debilitating disorder from which only 16.8% returned to duty.6 Many doctors attributed it to exhaustion from the
Indian tropical climate and general manual labor. Scholars today suggest DAH was the physiological manifestation of a psychological stress problem, but the British doctors did not interpret DAH as psychological problem due to the belief that mental disorders could only be hereditary. However, in 1902 the Lancet journal suggested these inexplicable physiological aliments had psychological origins due to stress and a lack of acceptable emotional outlets.7 It was the first step towards understanding combat stress.
This psychological versus physiological debate characterized the medical community in the early stages of World War I. Soldiers stationed in France claimed to have frost bite yet did not exhibit any physical symptoms. Other doctors noted in general many of their patients were peculiarly jumpy and emotional.8 Throughout ranks soldiers exhibited an array of unusual symptoms including jumpiness, nightmares, insomnia, fatigue, paralysis, loss of voice and hearing, and more.9 At first, physicians treated patients under the Fredrick Mott’s hypothesis, which used the term ‘shellshock’ to describe the microscopic brain hemorrhaging and carbon monoxide poisoning physically damaged the brain, both which were physiological explanations.
Then in 1915 psychologist Dr. Charles Myers suggested that shellshock was instead a psychological issue, which explained the French frost bite patients and other instance where soldiers showed symptoms of shellshock but did not experience the direct combat to cause brain
6 Jones, 10 7 Jones, 24 8 Jones, 22 9 Jones, 23 7 damage.10 This new psychological approach to shellshock allowed the military alter its treatment away from the physiological and focus on the psychological for the alarming number of patients showing symptoms of shellshock.
Indeed, it was the scale rather then the nature of shell shock that caught the military by surprise. The magnitude of the entire war from the new technology to the draft was unlike any before it. The new industrial developments allowed countries to produce weapons and war material at an unprecedented level. Further British conscription in 1916 ensured a larger body of soldiers that inevitably required medical attention. At the beginning of the was Dr. Albert Wilson boldly claimed, “I do not think psychologists will get many cases.”11 However, later that same year the British Medical Journal stated, “there are a good many men suffering from mental and nervous shock, and it is true that such cases are not suitable for general hospitals.”12 The past military responses to combat stress issues were not enough to address the new scale of World
War I.
The number of shell-shocked soldiers quickly exceeded the Royal Army Medical Cores
(RAMC) treatment abilities. Meyer’s contribution to the scientific community that shellshock was indeed psychological disorder was a significant step towards proper treatment, but the exact type of psychiatric treatment needed was still unknown. The RAMC had no official definition of shellshock in the early parts of the war. However, the military was in no position to move delicately forward. The mentally injured population required immediate treatment but lacked the number military psychiatrists to treat the amount of shell-shocked soldiers.13 Like in other aspects of the war, the military drew heavily on the civilian sector to compensate for the
10 Jones, 21 11 Jones, 19 12 Jones, 19 13 Jones, 16 8 disparity. Civilian psychologists, who began to dominate the RAMC, brought a diversity of opinions and treatments to an already unstandardized process. The civilians had a verity of training backgrounds that did not match the standard RAMC military training, and basically none followed military operation guidelines. This added new ideas to the understanding of shellshock, but it also created tension between the military and psychologists. Some civilian had a strong sense of patriotism and took great, even oppressive, measures to return the soldiers to combat.
Others identified as caretakers with a strong sense for saving lives and felt it wrong to send men back to the front. The different backgrounds in psychology simultaneously promoted new ideas and prevented consistent treatment for the patients.
Psychiatric training at Mughall Hospital in London after the war had begun created a degree of unity amongst the psychologists who passed through the hospital. Mughall trained the most psychologists during the war and acted as a gathering point for like-minded specialists.14
Most specialists remained in England and worked in hospitals or asylums. Even still, the treatment methods still remained closely tied to the individual psychologist’s personality despite a common understanding of the psychological problem.
Historian Ben Shephard categorizes the types of psychotherapy into two general camps: the Realists and the Dramatists. Realists were stereotypical masculine psychologists whose main goal was to return the soldiers to duty as quickly as possible.15 The emotional comfort of the patient was not always considered a primary concern for the realists. For example, Yealland was a neurologist who prided himself on the speed of his therapy. He used faradism, or electric shock therapy, in conjunction with suggestions as a possible fear tactic to force patients out of shellshock. One patient was “strapped in a chair for twenty minutes at a time while strong
14 Jones, 29 15 Ben Shephard. A War of Nerves. (London: Jonathan Cape, 2000). xii
9 electricity was applied to his neck and throat; lighted cigarettes had been applied to the tip of his tongue and ‘hot plates’ had been placed at the back of his mouth” and was told he could not leave the room until he was cured.16 Yealland claimed a high treatment rate, but faradism was shown by others to be ineffective. His reputation was later tarnished for his practices during the war.
The Dramatists contrasted the Realists with more tender or human treatment. These psychologists were curious about the complexities of each individual patient. Talk therapy and other forms of psychoanalysis that required extended periods of report building characterized the
Dramatists therapy.17 Shehpard does not address this, but the dramatists were likely influenced
Paul Dubois ‘persuasion’ therapy. Derived from theories on hypnosis in 1904, Dubois stated that the report from the doctor-patient relationship could be utilized to persuade the patient to other models of thinking through rational or emotional reasoning.18 Shephard argues that the dramatists are greatly overrepresented in the historical analysis of shellshock therapy. He argues that the majority of therapy was actually Realist, but that the Dramatists approach has an overwhelming appeal and is disproportionally discussed in historical narratives today.19
Other sources of evidence point to the prevalent Realist view in treatment. The British military was careful to align completely with the civilian specialists in England and psychologists heavily debated the preferable location of the treatment. Soldiers could be treated back in England at hospitals or in France miles from the combat zone. The majority of RAMC psychiatrists operated in France. Doctor George Guillain believed many “disorders [were] perfectly curable at the onset…such patients must not be evacuated behind the lines, they must
16 Jones, 39 17 Shephard, xvi 18 Arthur Anderson ed. "Anxiety-Panic History." Anxiety, Disorders and Treatments Throughout the Ages. (N.p., 17 Aug. 2007. Web. 5 Dec. 2015.) 19 Shepard, xvi 10 be kept in the militarized zones.”20 Indeed, some medical reports claimed that 30-40% of soldiers treated in France returned to duty while only 3-4% treated in England returned.21 Guillain and
Meyers spearheaded the development of forward-psychology, which was characterized as immediate and brief therapy conducted close to combat. By 1916 only chronic shellshock cases were referred to England. Treatment at a specialist hospital, where the majority of Dramatist psychologists operated, was therefor a much more rare occurrence.
Disagreements continued amongst psychologists as the war continued and the number of referred patients rose rather then declined. Concerns of relapse and a lack of follow-up patient reports tarnished the work at the front. Many forward-psychologists claimed great success.
Andree Leri of the Second Army claimed to have cured 2,000 patients over a two-year period.22
However, Dr. Joseph Grasset doubted the medical reports claiming the success of forward- psychology, instead believing, “It seems proven that too often [neurologists] are content merely to whitewash trauma victims and to send them back to the front incompletely cured.”23 His skepticism becomes understandable whence one considers the momentous size of treating soldiers in France. The forward-psychology operations were called NYDN (Not Yet Diagnosed
Nervous) and were essentially large fields with tents where one psychologist oversaw hundreds of patients. Eventually LT Col Gordon Holmes shut down NYDNs after questions on relapse continued. Instead, treatment sites moved away from the front and relocated on the French coast.
Operations there appeared much more successful and roughly 20,000 soldiers were treated during the remainder of the war.24
The debate in the psychological community, while inconclusive, did have an affect on
20Jones, 25 21 Jones, 29 22 Jones, 25 23 Jones, 26 24 Jones, 42 11
British society as a whole and progressed the general publics view on psychology, mental illness, and specifically shellshock. Psychology as a scientific field was poorly understood by general society before 1914. The massive amounts of psychological casualties forced the general public to become aware of psychology, but the pre-war notions heavily influenced newly forming ideas of shellshock. Previously British culture had a taboo about mental breakdowns. The number of
‘insane’ cases was on the rise, which some psychologists believed was due to the rise of modern industrialism because the individual’s identity was distorted by the inhuman labor practices. It became a common theory. An issue of the magazine, Labor Leaders, directly addressed how to properly manage breakdowns in the workforce.25 These instances of insanity were common enough to be recognizable, but were still not acceptable. Many people attuned to the Victorian era ‘stiff upper lip’ mentality that each individual ought to care for themselves without assistance from others. Just like one ought to care for ones physical health, so should they care for their
‘mental health’, or as it was understood then, their character.26 Mental health is a distinctly modern concept, in which a the mind is a fluid, changing thing, in which a generally healthy person could be subjugated to mental troubles depending on their situation in life. Instead,
‘mental health’ for pre-war Britain was combination of genetics and choice. In line with the understanding that insanity was a chronic disease, the ecumenists viewed the rise of mental breakdowns as an issue of the larger genetic population. Mrs. Tweedie of Eugenics Education
Society “The brain of this country is not keeping pace with the growth of the imbecility and vice.”27 Others viewed it as a lack of character development. Popular bodybuilder, Eugene
25 Fiona Reid . Broken Men: Shell Shock, Treatment and Recovery in Britain. (New York: Continuum International, 2010), 15. 26 Reid, 15 27 Shephard, 17 12
Sandow, spoke out against the “weakness [of] crime today”.28 Lack of self-control and discipline, two virtues at the heart of Victorian Britain, were to blame.
Studying and practicing psychology and psychiatry were therefore viewed as “intellectual death”.29 Interestingly, the field was not distrusted because it opposed popular beliefs and affirmed mental disorders as something more then genetics or lack of character. Quiet the contrary. British psychologists for the most part believed insanity was a chronic disorder until cases of shellshock suggested otherwise. Rather, these burgeoning fields were shunned before the war because of their lack of nuance.30 There were relatively few terminologies used to describe psychiatric conditions. ‘Hysteria’ and ‘neurosis’ were used as blanket diagnosis for variety of possible issues. The primary responsibility of a practicing psychiatrist was to “identify the insane person”, which for some legitimate chronic disorders, like our modern understanding of schizophrenia, could be easily identified within seconds.31 Psychology students quickly reached the limits of their education because there was not extensive material to cover at the time. Further, the asylums at which psychologists worked were often in remote locations to keep the insane patients distant from the general public.32 Pre-war civilian psychology was at the best minimal, and what was there was heavily influenced by prevailing societal norms.
Simultaneously, the lack of scientific understanding added to the societal misconceptions, further promoting the stigma against the insane and psychology as a scientific field.
Inside the larger taboo of insanity, the stigmatization against mental breakdown for men played a large role in shaping people’s view of shellshock. The 1910 addition of the
28 Reid, 15 29 Reid, 57 30 Reid, 57 31 Reid, 57 32 Reid, 58 13
Encyclopedia Britannica described hysteria as effecting primarily women, Jews, and Slavs.33
Mental breakdowns were associated more with women then men, resulting a questioning of masculinity for male soldier’s struggling with shellshock.
The start of the war changed many notions about psychology. Public awareness to shellshock was high due to the large number of causalities. Initially, the public’s perception of shellshock was mostly positive, thanks in large part to effort of Lord Knutsford. Starting in 1914,
Knutsford campaigned for military asylums and veterans rights. He highlighted the soldiers’ masculinity and presented shellshocked soldiers as wounded, not weak.34 The publics understanding of shellshock however remained crude and oversimplified. Military asylums were established to separate and distinguish shellshocked soldiers from civilians dubbed insane. Some civilian patients were removed from treatment when the causality count increased passed the capacity of the military asylums. Initially Knutsford’s PR campaign worked and the public was sympathetic towards shellshocked soldiers. However, as the war continued the sympathy diminished as pre-war stigmas returned.35 Towards the end of the war Recall to Life magazine published an article stating, “These patients easily get into trouble; they issue false cheques, are hopelessly unreliable and extravagant etc and yet are not sufficiently irresponsible always to justify confinement. Moreover they have such a poor make up that psychological treatment is very difficult. All psychological treatment depends upon the essential moral worth of the individual.”36 The public perception by the end of the war was more varied than that expressed in
Recall to Life, but the negative view become more widely present. Some understood shellshock as cowardice while others remained sympathetic, but still taboo. The scrutiny of shellshock did
33 Reid, 12 34 Reid, 24 35 Reid, 107 36 Reid, 107 14 not prevent people from caring about the soldiers. Breakdowns for returning soldiers were not ignored, and were largely treated through the efforts of the individual and family.37 Knutsford efforts at this time had slowed, and there was a lack of public forums for discussing mental breakdowns.38 And there were other avenues besides open discussion for supporting the veterans.
The Ex-Services’ Welfare Society provided charity work for mental veterans starting in the
1919. The government however was less supportive of the mental veterans. Welfare was considered a form of socialism, so many veterans remained unemployed with poor medical treatment.39 The public protested the government’s policy, showing a support of the soldiers regardless of their mental state. Through all the controversy, the returning soldiers did not breakdown alone. There was little discussion about it because its taboo nature, but for the most part each individual soldier found private support.
Soldiers in combat likewise had conflicting views of shellshock. Part of their perception derived from the societal conventions of masculinity. Men were expected to perform well not only as a testament to their character, but also as part of their responsibility towards the rest of the platoon. However, trench warfare redefined courage and the horrors of modern combat were not lost on fellow soldiers. Journal accounts from soldiers describe moments of sympathy rather then rejection of soldiers who broke down. Private Esler wrote, “That was a case of shock that he’d seen so much of that, that he’d seen so many killed by it that he expected every shell that came to kill him. He threw himself down on the ground at once.”40 When a young nineteen-year- old boy was too afraid to go over the trenches “the other men [stood] round looked rather
37 Reid, 6 38 Reid, 5 39 Reid, 7 40 Reid, 62 15 sympathetic than disgusted."41 In the end the soldiers did rally to make the boy go over. Most soldiers viewed mental breakdown or even pure cowardice as an understandable reaction to combat, but one that could not be tolerated for the good of the platoon. Only a battle-warn soldier who ‘did his bit’ was able to mentally collapse with respect. A soldier could earn sympathy if they showed courage during combat and the psychological collapse occurred afterwards.42
The soldiers’ sympathy towards genuine mental issues was matched with an equal distrust of those who exploited it. As a real but not visible disorder, diagnoses of shellshock were difficult to determine and some soldiers pretended to have mental breakdowns to be removed from duty. The military’s policy and stance on shellshock initially reflected the distrust of the diagnosis. Early on the military maintained that shellshock was not form of madness until the
Myers and other psychologists provided suitable enough evidence to the contrary. It was not until 1917 that the War Department accepted the diagnosis as a legitimate casualty.43 Military court cases on desertion and cowardice reflect a less accepting side of the military. Thirty-two court-martial cases were held be between June and October 1917, and of those only three soldiers had psychological evaluations.44 A guilty verdict for desertion or cowardice was execution. It is difficult for historians to determine how many shellshocked soldiers were found executed because many did not get the proper evaluations. Nevertheless, it is not presumptuous to assume many soldiers who did not respond to battle commands and were court-martialed for doing so were actually inhibited by psychological trauma.45 While the official stance of the military showed understanding of mental breakdowns, actual practices in the military did not
41 Reid, 69 42 Reid, 69 43 Shephard, 67 44 Shephard, 67 45 Shephard, 69 16 reflect those policies.
The de facto non-compliance of the military with psychological trauma effected soldiers’ responses to fellow shellshocked soldiers. Under the pressures of the court, the performance of soldiers was a necessity not only for the platoon, but also to protect the individual from possible court-marshal and execution for cowardice.46 Poor performance and a misdiagnosis could become fatal. And yet, even a proper diagnosis did not appeal to soldiers. Treatment at RAMC or asylums were not viewed much better then facing the courts. Even officers were reluctant to
‘send a man down’ to the psychologist.47 Soldiers often attempted to ‘cure’ their comrade in the platoon before any external parties became involved. They primarily attempted to reverse-shock the disabled soldier out of the combat shock. It was a very similar approach to Yealland’s faradism electrocution, and it was better then being “hurried away to the base to a shell shock hospital with a rabble of misshapen creatures from the towns.”48 Reverse-shock often consisted of anything from tickling to beatings. One soldier remembered, “They were apt to be rather stern.
I remember one man came in…shaking with shell shock and I was amazed, the colonel lifted his heavy stick and hit him across the head…to give him another shock and he used the words ‘You’re a bloody fool, pull yourself together.” But that couldn’t put the man strait and he could see he really had gone beyond, so of course he was taken care of and he went down.”49
The ‘cures’ were really only attempts to protect the fellow soldier from possible worse outcomes.
The platoon understood the men, and there was a real distrust about the capabilities and procedures of other sections of the military. However justifiable this sense of distrust, their reaction to the individual affected soldiers reveals some of the soldiers’ common beliefs and
46 Reid, 56 47 Reid, 64 48 Reid, 65 49 Reid, 65 17 understanding of shellshock as a disorder. The prevailing notions about shellshock for soldiers in combat borrowed heavily from military psychiatry and pre-war ideas of psychology. First, there was a distrust of psychology as a practice, as shown by the reverse-shock self-therapy. Second, shellshock was dealt with for immediate results, and in very Realistic ways. The soldiers did not attempt to understand the trauma by talking with the disabled. They wanted to quickly return them to their former state, which they attempted to do through physical means rather then purely psychological. Pre-war notions of character did not play as heavy of a role. The notion that one could be shocked out of shellshock suggests a perspective of the mind that is fluid and capable of change. This differs from the pre-war notion that any mental aliment was chronic. A soldier could be temporarily insane, then snapped back into reality. However, soldiers during combat did not seem to present a nuanced understanding of shellshock or the mind, but they saw no reason to have a nuanced understanding either. Mental breakdowns were not to be explored for understanding. Mental breakdowns needed to be resolved quickly for the safety of the group and the individual.
Of the many soldiers who suffered from shellshock, Wilfred Owen and Siegfried Sassoon are perhaps the most famous. Both were diagnosed with shellshock and treated at Craiglockhart
War Hospital in 1918 where they became exposed to aspects and scientific interpretations of shellshock that were not readily available for other soldier. These two war-poets have become the quintessential shellshock patients for many people today because of their accessibility to the modern reader. One can read their poetry or fictionalized accounts in novels, like Pat Barkers
The Regeneration Trilogy published in 1995. Their stories and writings are compelling and should be appreciated, but it is important to note that their experience with shellshock differed greatly from the average soldier. 18
Before arriving at Craiglockhart, Owen and Sassoon shared very little in common. Owen was born in 1893 to Tom and Susan Owen. His family was poor and moved frequently during
Owen’s childhood. He had a close relationship with his mother, who he addressed most of his letters to during the war. From an early age she encouraged a strong Christian faith, and his interest in biblical stories continued into adulthood, although he lost faith as a young adult away from home.50 He was closely tied to academia before the outbreak of the war. He studied botany at the University of Reading and later worked as a tutor. When the war broke out he enlisted as an officer due to his education, but was diagnosed with shellshock early in his service and sent to
Craiglockhart war asylum in 1917.51 During his time at Craiglockhart, he began writing war- poetry for the first time. These poems would become some of the most influential pieces of literature of the war. Owen was eventually released from Craiglockhart and returned to duty in
1918. He was killed in combat one week before the end of the war.
Sassoon’s childhood and military career differed greatly from that of Owen’s, and was highly unusual in its own rights. Sassoon was born in 1886 to two notable member of British society. His Anglo-Catholic mother, Thereasa, came from the Thornycroft family who were well known as artists and sculptors. His father, Alfred Ezra, was from the wealthy Baghdadi Jewish
Sassoon family. Their marriage was considered controversial for both sides of the family.
Nevertheless, Sassoon grew up in a mansion and influenced by great artists from his mother’s family.52 When Europe broke out into war Sassoon enlisted, motivated by his sense of patriotism. He served as a second lieutenant and quickly captured his soldier’s respect for acts of braver. His acts verged on suicidal at times, and he simultaneously earned himself medals for
50 Dominic Hibbered. Wilfred Owen: A New Biography. (Chicago: Ivan R. Dee, 2003), 23. 51 Hibbered, xviii 52 Jean Wilson. Siegfried Sassoon: The Making of a War Poet. (New York: Routledge, 1998), 30. 19 bravery and the nickname ‘Mad Jack’.53 However, his ‘madness’ was not the cause of his inpatient status at Craiglockhart. Rather, his initial patriotism had faded to a disillusionment of the war, which he began to actively protest. After distributing a letter titled Finished with the
War: a Soldier’s Declaration, he was threatened with a court-martial, which he avoided by being declared unfit for service and sent to Craiglockhart.54 A healthy Sassoon arrived at Craiglockhart in 1917. Yet, his time there greatly influenced his perception of shellshock and his portrayal of a soldier’s experience of the war in his poetry, even though he did not actually suffer from proper shellshock. Others, however, are not so quick to dismiss Sassoon’s psychological state as healthy and unwarranted of therapy.55 His combat experience exposed him to tremendous horrors.
During one battle he remand under fire for one and a half hours while carrying several of his wounded soldiers to safety. Later that year he lost both his brother and best friend to combat, which were shortly after met with his disenchantment of the war.56 Even though his psychologist,
Rivers, noted that Sassoon likely did not have shellshock during his time at Craiglockhart, there are notes of his terrible dreams at night and feelings of guilt for abandoning his men.57 Therefor, while Sassoon might not have experienced mental trauma and symptoms to the same degree of other shellshock patients, it appears that he did suffer. Sick or not, Sassoon was released from
Craiglockhart in 1918 and served the rest of his duty in England.
Owen and Sassoon met at Craiglockhart, which Sassoon affectionately referred to as
“Dottyville”.58 Located in the Scottish hills near Edinburgh, the military hospital was established
53 Daniel Hipp. The Poetry of Shellshock: Wartime Trauma and Healing in Wilfred Owen, Ivor Gurney, and Siegfried Sassoon. (North Carolina: McFarland & Company, 2005), 152. 54 Thomas Webb. "'Dottyville' - Craiglockhart War Hospital and shell-shock treatment in the First World War." Journal of the Royal Society of Medicine 99 (2006). 343. 55 Hipp, 167 56 Annabelle Slingerland. "Craiglockhart Hospital, Head above the Parapet." Hektoen Institute of Medicine. (N.p., Dec. 2015. Web. 6 Feb. 2016.)
Sassoon were treated very differently from the soldiers in at the front.
Officers were considered to be the most vulnerable group to mental breakdowns. One in six officers were reported to have some degree of mental collapse, while only one in thirty men were reported as having problems.60 Others reports suggested the number of men affected were lower, around 7-10% for officers and 3-5% for all other ranks, which was still a sizable portion of the population.61 The comparative percentages between officers and men are particularly odd when considering that officers made for a smaller segment of the military population. It appeared that a small specific group of the population was highly susceptible to mental breakdown compared to others. This is not to mean that officer accounted for a larger portion of the total number of men with shellshock. The lower ranked soldiers may have had a smaller comparative percentage, but they were a larger group overall. Those who sympathized with the officers attributed the asymmetrical findings as a result of officers’ unique leadership position that required them to care for their soldiers, but also knowingly order them into dangerous situations.
Some officers may have felt that a soldier’s death was partially to blame on their leadership.62
However, others argue that while officer’s experiences were very traumatic, so were the soldiers’ experiences, and that the asymmetric clinical reports were likely due to classism in the military.63 The reports may have been skewed because officers were more likely to get proper diagnosis of shellshock, whereas the lower ranked soldiers went unnoticed except for those few
59 Slingerland 60 Shephard, 75 61 Shephard, 23 62 Shephard, 75 63 Reid, 17 21 who had obvious symptoms. This may be speculation on the part of historians, but it is grounded in the different treatments for officers and soldiers, which was heavily classist. First, the officers were diagnosed with a different term, neurasthenia, which was much less stigmatized then shellshock. Neurasthenia diagnosis were reserved for the educated soldiers, primarily officers, because of the held view that a refined educated mind would not breakdown in the same manner as an uneducated mind.64 Further, the treatment location of officers and soldiers differed. While most soldiers were treated at the front with under Forward Psychology, most officers returned to
England for specialized treatments at war hospitals.65 Craiglockhart was therefor only one of several hospitals that treated exclusively officers. The conditions at officer hospitals were of notably higher quality then the tents near combat in France. One officer wrote of his time at
Palace Green, “It would not be easy to find a more sequestered and restful spot in the midst of a great city. Within sight are lofty trees, green spaces and the time mellowed brick of Kensington
Palace - as much tranquil old world charm, perhaps as survives anywhere in London.”66
Highlighting the class differences is not to say one group was ‘more affected’ by shellshock and suffered greater mental trauma. The experiences of both officers and other ranks were very real, but it is important to note that the external realities during the treatment process were very different and led to different ends.
As officers, Owen and Sassoon’s treatment varied greatly from that of the ordinary soldier. While the lower ranked soldiers were concerned with avoiding court-martials and lower quality care at the NYDN, Sassoon and Owen were given higher quality, specialized care that gave them alternate perceptions of shellshock. And in turn, their time at Craiglockhart greatly influenced their poetic style and subject matter. One of the shifts in subject matter is the
64 Reid, 17 65 Jones, 20 66 Reid, 33 22 representation of the war experience and contains a new psychological awareness. Historians often look at their friendship as the predominant influence of the poetry and greatly attribute as for why their time at Craiglockhart changed their poetry, and is done rightfully so. In particular,
Sassoon convinced Owen to abandon his Keatsian poetic style to address the war.67 But there were other influencing factors at Craiglockhart. In particular, it seems that their individual psychologist played a significant role in shaping their poetry and how the poets represent, and therefor understand, the psychological process of trauma.
At Craiglockhart both Sassoon and Owen were exposed to perhaps the most significant and unique aspect of their treatment, their individual psychologists. Owen and Sassoon quickly became friends and had a great deal of influence over each other’s poetry and mental health, but they did not share the same psychologist, and because of which, their individual treatment did not greatly overlap. Just like the eclectic mix of therapy styles from psychologist to psychologist at the Front, so too was there differing definitions and treatment of shellshock at Craiglockhart.
The most famous psychologist of the war was W.H.R Rivers, thanks largely to his portrayal in
Pat Barker’s novel. He treated Sassoon and, as according to the novel, they did become good friends beyond their treatment sessions. Of less notoriety was Owen’s psychologist, Arthur
Brock. Both psychologist approached their treatment in very different ways, and both inevitably shaped Owen and Sassoon’s perception of shellshock and in doing so, shaped their poetry of shellshock and the war experience.
W.H.R River’s treatment of Sassoon has become the quintessential patient-psychologist relationship of WWI. Rivers is, for the most part, portrayed in a positive light and, for the most part, rightfully so. He approached his treatment in an intimate way and embodied the civilian,
Dramatist form of psychologist and he cared deeply about the mental health of his patient as
67 Hipp, 45 23 something more then treatment to ensure the soldier could return to duty.68 Before arriving at
Craiglockhart, Rivers trained to become a physician before switching over to psychology, which he later abandoned for anthropologic work in the Indian highlands. The outbreak of the war brought him back to England where he treated patients at Maghull Hospital and then
Craiglockhart.69 There Rivers used primarily talk therapy to treat his patients, which was in stark contrast to the methods used at the Front. Talk therapy was notorious for it’s long duration, but it was also more likely to fully allow the patient to heal.70 During these long therapy sessions together, Rivers and Sassoon developed a close friendship. However, Rivers was a psychologist of his time and some of his ideas seem antiquated today. He adhered to the classist notion that the educated were evolutionarily superior to the non-educated and he therefor only treated officers.71 Further, Rivers was heavily influenced by Freud, whose use of psychoanalysis and psychosexual theories had become popular shortly before the war. Rivers once remarked about treatment, “[there is] not a day of clinical experience in which Freud’s theory may not be of direct practical use in diagnosis and treatment.”72 A significant portion of his talk therapy was given to Freudian dream analysis. Yet, it is important to note that he did not blindly follow
Freud’s theories. He did not believe shellshock had a psychosexual origin, but rather was the individual’s subconscious struggle between a sense of duty and self-preservation.73 From this
Freudian theoretical base, Rivers put forth other interpretations on the nature of shellshock. His most notable contribution was The Repression of the War Experience, which expanded on
Freud’s notion of the subconscious to suggest “subjects of [shellshock were] not the necessary
68 Jones, 14 69 Adams, C. E. "William Halse Rivers (1864-1922). JLL Bulletin: Commentaries on the history of treatment evaluation."
River’s perspectives and interpretations on shellshock become prevalent in Sassoon’s poetry.
Before arriving at Craiglockhart, Sassoon published a collection of poems in The Old
Huntsman and Other Poems. Many of the poems were written in the trenches of France and the subject matter deal directly with the war experience. The earliest poems highlight the physical and visible aspects like the lights and sounds of the modern warfare. He describes the “vivid green/ Where sun and quivering foliage meet” of France and the “blaze of light” of fire fights.77
The experiences of the men are also described in a physical manner. The One-Legged Man
74 W. H. R. Rivers “The Repression of War Experience.” Proceedings of the Royal Society of Medicine (Sect Psych, 1918), 3. 75 Jones, 14-17 76 Hipp, 177 77 Siegfried Sassoon. Collected Poems. (London: Faber & Faber, 1947), 12, 14. 25 describes a soldier grappling with a physical injury and the struggle of returning home.78 Indeed,
Sassoon approaches the concept of wounds with terms like “elbow or shoulder, hips or knees,/ two arms, two legs, though all were lost” as purely physical with no mention of mental injuries.
Death is another subject that Sassoon deals with in these early poems. Death is often personified with “And death, who’d stepped toward him, paused and/ stared…/death replied: ‘I choose him.’”79 Here death is externalized and viewed as an entity beyond the soldier, rather then a state of being for the soldier. Further, the remembrances of the dead are presented in an external manner. Past soldiers are depicted as ghosts who come to visit the narrator In The Last Meeting the narrator “speaks with him before his ghost has flown/ Far from the earth that might not keep him long.”80 While Sassoon’s poetry before Craiglockhart is beautiful and ought to be appreciated, it does not capture the internal and psychological nature of the war experience.
Instead it focuses on the physical and grapples with abstract concepts like death and memory through external, physical arbitrations.
Sassoon’s arrival at Craiglockhart marked the shift in his poetry from physical to psychological. From reading his collection of poems from Craiglockhart, Counter-Attack and
Other Short Poems, one can notice an immediate change in the poetic style from The Old
Huntsman. There is a nightmarish quality to the subject matter with descriptions like “furtive eyes and grappling fists,/ Flounders in mud. O Jesus, make it stop!”81 Further, these descriptions are directly linked to a psychological state and “sweat of horrors in in his hair” rather then a mere narrative observation.82 Sassoon’s adjective usage also directs the reader to contemplate the internal state of the solider. “Moaned, shouted, sobbed, and choked, while he was kneeling” are
78 Sassoon, 25-26 79 Sassoon, 35 80 Sassoon, 35 81 Sassoon, 71 82 Sassoon, 70 26 all descriptions of physical actions, but instead of highlighting an external sensory experience, it brings the reader closer to the soldier’s mental torment. Does It Matter? acts as a comparison piece to The One-Legged Man by drawing a comparison between physical and psychological wounds with “Does it matter-Losing you leg?/…Does it matter-Losing your sight?/…Does it matter- Those dreams from the pit?”83 The irony of the questions brings attention to one’s perception of mental trauma as an aliment suffered long after the war. The latter poems in the collection become even more explicitly psychological. Suicide in the Trenches describes a soldier who “put a bullet through his head.”84 Trench Duty tells of disturbing images from the trench only to end with “Starlight overhead-/ Blank stars. I’m Wide-awake; and some chap’s dead”, indicating that was nightmare or traumatic flashback.”85 Unlike the externalized ghosts of
The Old Huntsman, here the dead are shown to be relived through mind and memory of the individual. The ‘ghost’ or the dead soldier is no longer something separable from the individual’s mind, but is rather repressed deep into the mind of those who lived. Indeed, one of Sassoon’s final poems in this collection is titled Repression of the War Experience, presumably after
River’s article of the same name. The poem delineates the progression into madness through recursion of traumatizing memories in its closing stanza.
You’re quiet and peaceful, summering safe at home; You’d never think there was a blood war on!... O yes, you would… why, you can hear the guns. Hark! Thud, thud, thud, - quiet soft…they never cease- Those whispering guns – O Christ, I want to go out And screech at them to stop – I’m going crazy; I’m going stark, staring mad because of the guns.86
83 Sassoon, 80 84 Sassoon, 78 85 Sassoon, 81 86 Sassoon, 84 27
The psychological emphasis was prevalent throughout Sassoon’s poetry at Craiglockhart. This makes considering his vicinity in a hospital for shellshock patients. However, it is important to note how closely Sassoon’s poetry mirrors the trajectory of the psychological debate on the nature of shellshock. Both Sassoon and early psychologist focused primarily on the physical and only later acknowledged the psychological and mental aspects. As Sassoon’s psychologist,
Rivers was likely the one who exposed Sassoon to the psychological interpretation of the war experience. This is shown explicitly through Sassoon’s use of the idea of repression, which was not only the title of one of his poems, but points to the theme of difficult memories which act as an underlying theme throughout the rest of the collection.
Unlike the well-known Rivers, psychologist Arthur Brock is hardly known nor mentioned in historical narratives except for treating Owen and translating several ancient medical writings.
He was very tall, stern, and considered much less approachable then his charismatic counterpart,
Rivers. Brock was particularly interested in ancient cultures like the Greeks and Scottish Gaels, and revered them in a non-patronizing way for their harmonious, organic society and medicine.87
This appreciation of antiquity heavily influenced Brock’s psychiatric treatment. One of the central pillars of his therapy was nature, which he believed helped “rediscover [the patient’s] links with an environment from which they had become detached.”88 Another pillar was one’s function in a larger society. Termed ergotherapy, Brock would wake his patients in the early morning to begin work on varies projects. Ergotherapy is more commonly referred to as ‘work therapy’ today, where a patient finds recovery through useful and applicable functions.89 Of particular success was his establishment of Craiglockhart’s hospital magazine, The Hydra,
87 Cantour, David. "Between Galen, Geddes, and the Gael: Arthur Brock, Modernity, and Medical Humanism in Early-Twentieth-Century Scotland." Journal of the History of Medicine and Allied Sciences 60.1 (2005), 4. 88 Webb, 343 89 Cantour, 7 28 named after the many-headed monster that Hercules defeated. The name itself acted as an analogy for the patients’ experiences, and writing for the magazine was an act to defeat their monsters.90 Owen was an early and common contributor to The Hydra and spent much of his therapy time as an editor. In fact, Brock pushed Owen to channel his writing into a larger voice about the war as a form of ergotherapy. Before arriving at Craiglockhart, Owen only wrote poems in a Keatsian style and specifically did not write poetry about the war experience.91
Sassoon is largely contributed for turning Owen into a war-poet, which is true, but Brock’s influence is largely understated. When Brock discovered Owen’s interest in poetry, he insisted that Owen contribute pieces about the war to The Hydra. Along the lines of ergotherapy, Brock warned against “art for arts sake.”92 Instead, Owen’s poetry ought to serve a larger function in the Craiglockhart community as a way for soldiers to approach and understand their shellshock and treatment. Owen wrote a poem on the Greek mythological heroes, Hercules and Antaeus, as an analogy to the shellshock experience. Owen analyzed the piece with, “Now surely every officer who comes to Craiglockhart recognizes that, in a way, he is himself an Antaeus who has been taken from his Mother Earth and well-nigh crushed to death by the war giant or military machine.”93 The content of the poetry may have only indirectly examined the war experience, but it was a first step towards becoming one of the greatest war-poets. Sassoon from there would take over in influencing Owen’s poetry. Sassoon directed Owen’s poetic tone and use of irony, but more significantly, had Owen directly approach and describe the war experience rather then
Brock’s analogous approach. However, Brock established a purpose for Owen’s poetry to function as something greater then art, which followed the main principles of the ergotherapy.
90 Webb, 344 91 Hipp, 45 92 Hipp, 60 93 Hipp, 61 29
This gave purpose to Owen’s poetry, but it did not expose Owen to the alternative psychological interpretations that Rivers gave Sassoon. In the end, Brock’s treatment appeared to be successful.
Owen was released from Craiglockhart in 1918 and returned to the front. He was killed in action one week before the Armistice singing that ended the war.
The poems that Owen wrote at Craiglockhart are considered to be some of the best pieces of literature produced during the war. Owen was primarily influenced by Keats and avoided writing about the war completely before meeting Sassoon and Brock. His arrival at Craiglockhart marked a drastic change in his poetry’s subject matter and style. While Brock gave a function to the poetry, Sassoon truly pushed Owen to directly address the war. However, influences
Sassoon’s psychological writing, which Sassoon developed at Craiglockhart, do not appear in
Owen’s poetry at Craiglockhart. Rather, Owen language often focuses on the physical experiences of the war. He implements incredible turns of phrases like “Eyeballs, huge-bulged like squids” and “the wild chattering of his broken teeth” to make the images come to surreal life.94 One of his most famous poems, Dulce et Decorum Est, exposes the reader to the chaotic nature of warfare with, “Gas! Gas! Quick, boys! – An ecstasy of fumbling,/ Fitting the helmets on just in time.”95 His style of prose seems to bring the reader into the action right next to the soldiers. Yet, this is similar to the Sassoon’s pre-Craiglockhart work, which externalized the experience. Owen’s readers are along side the external soldiers, but Sassoon’s readers are inside the soldiers’ heads. Indeed, much of Owen’s poetry parallels with Sassoon’s earlier work. Owen expresses death in a physical, personified way with “This time, Death did not miss”, resembling the personification of death in Sassoon’s The Death Bed.96 Owen’s poem Disabled describes on injured soldier who is “Legless, sewn short at the elbow” and his experience returning to
94 Jon Stallworthy, ed. The Poems of Wilfred Owen. (London: Norton & Company, 1985.), 165. 95 Stallworthy, 117 96 Stallworthy, 137 30
England as an amputee.97 This focus on the physical injuries resembles Sassoon’s The One-
Legged Man, which was written pre-Craiglockhart, and not Sassoon’s Does It Matter written at
Craiglockhart, which highlighted mental injuries. In other words, Owen never seemed to develop a psychological focus to his poems during his stay at Craiglockhart. In fact, the only poem that deals directly with the subject of shellshock is Mental Cases. In it he describes a scene of men with “Drooping tongues from jays that slob their relish,/ Baring teeth that leer like skulls’ teeth wicked”. Who are these men? “These are men whose minds the Dead have ravished./ Memory fingers in their hairs of murders,/ Multitudinous murders they once witnessed./… Always they must see these things and hear them”.98 Owen concludes the poem with, “Thus their heads wear this hilarious, hideous,/ Awful falseness of set-smiling corpses.”99 As the one poem that focuses on a psychological subject matter, it is notably external. The narrator acts as a person who is almost walking down a hospital corridor and observing these men. The observations are of only physical attributes that suggest a mental state beyond recognition. The men are themselves depicted as grotesquely cartoonish beings that one could never understand, let alone sympathize.
Owen establishes a clear separation between the reader and the men, which presents the men as foreign and bizarre entities. Mental Cases differs greatly from Sassoon’s depiction of the same subject matter in Repression of the War Experience. Sassoon brings the reader into the experience of the soldier, which allows for the reader to sympathize with the effected soldier.
Further, Sassoon depicts the soldier as a normal man who then falls into delineated a madness that the reader can follow and understand.
Sassoon and Owen’s portrayal of shellshock show different understandings and approaches to shellshock, which seems to mirror the perspectives of their psychologists. Brock
97 Stallworthy, 157 98 Stallworthy, 146 99 Stallworthy, 146 31 did not heavily implement talk therapy, but rather focused on ergotherapy and ones function to society, which overall had a tangible nature. Brock’s therapy did not focus on the internal processing, and therefor did not have a deep theoretical psychological component. Owen’s poetry mirrors this by having a lot of physical descriptions rather then psychological ones. This is not to say Brock presented Owen with the idea that shellshock had a physical nature, but rather that the focus on the physical was prevalent throughout British thinking and Brock did not offer an alternative point of view. Rivers, in his talk therapy with Sassoon, did offer alternative explanations that were specifically psychological. Rivers exposed Sassoon to Freudian interpretations and theories on repression. In turn, Sassoon describes shellshock in his poetry in a much more psychological way. In many ways the correlation between a psychologists’ perception of the disorder and the patient’s perception was to be expected. The psychologist’s duty was to reframe the patient’s mental state, which included reframing their perception of the disorder.
Owen and Sassoon’s poetry show the important role that psychologists and scientific knowledge had on a soldier’s perception of shellshock. Soldiers at the front were exposed to
Realist psychologist who attempted to treat patients as quick as possible. Those soldiers mirrored that approach in their informal, reverse-shock treatment of fellow soldiers. They understood shellshock as an issue that did not need to be dwelled upon and could be resolved quickly. Both
Owen and initially Sassoon described the horrors of war in a particularly physical manner, which aligned with the general British population’s perception of shellshock. Owen was not exposed to deeper psychological interpretations, and therefor continued with that approach. Sassoon, on the other hand, was exposed to such interpretations and reflected on them in his poetry. Therefor, it appears that the scientific understanding available to the soldiers by their psychologists greatly 32 influenced the soldiers’ concepts of shellshock.
Shellshock is no longer diagnosed today. Its specific symptoms were only found during
World War I. Today soldiers with combat stress are diagnosed with PTSD, which has its own scientific interpretations and treatment methods. The DSM-III, which describes all known mental disorders today, helped standardized the scientific understanding and treatment of PTSD. In other words, PTSD patients today are unified under a common treatment process and understanding. This shows through in war-poems today. Poets use the direct phrase “PTSD” to indicate the larger experience. Websites like MyPTSD act as a forum for soldiers to communicate, but also suggests a sense of identity not only as part of a larger common group, but also as a person with a clearly defined problem.100 It appears that today’s psychology shapes ones understanding of the combat stress much like it did in World War I.
100 "MyPSTD Forum." MyPTSD. (N.p., n.d. Web. 13 Apr. 2016)
33
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