Craiglockhart War Hospital*, or ‘Slateford’ as Sassoon called it in his memoirs series, had been established in 1916, largely because of the growth in number of officer casualties to shell-shock due to their experiences in the horrific Battle of the Somme (‘Dottyville’—Craiglockhart War Hospital and shell-shock treatment in the First World War, T Webb). It lay in spacious and pleasant grounds on the outskirts of Edinburgh and was housed in a former a hydropathic facility,  a form of therapy popular with the Victorian and Edwardian higher classes.

The Doctor was pleased to discover that, here, he might have chance to utilise his methods more fully, since these patients were more used to being listened to, having their opinions asked, and voicing their thoughts. They were even wiling to discuss their dreams and nightmares. It was in relation to this that Rivers made a remark that probably haunted him ever afterward – that it was simpler to studying officers’ dreams because they were “more intelligent”. This has brought criticism accusing the doctor, a man who diligently tried to explain how every one, even the so-called primitive cultures, should be seen as equal, of being Elitist. Indeed, at first glance, from a modern point of view, the comment does sound insulting to the working man; however, we must consider several points. Rivers was a man who liked words to be used in their original contexts (Instinct and the Unconscious; Chapter II, Rivers, 1920) and thus used them so himself. The early meaning of intelligence is closer to the military sense – gathering of information, NOT the ability to use information, or the speed at which one processes it. Regarded that way, his statement is sadly true; a man of officer class would have had a longer and more varied education, more likelihood of travel to a wider range of places and therefore much more chance to gain broader knowledge. If dreams largely rely on our imagination for content, it is not elitist to suggest that the officers’ dreams would be more complex at this time– A man who left school at 16 or 18, and had the privileges of the higher classes would have more for his mind/imagination to feed on, to produce imagery from, than a chap of the same age , with equal brain capacity, who left basic education at fourteen and worked in a mine, factory or on a farm with the chance to travel nowhere more than a dozen miles away.

At Craiglockhart, the doctors, under direction of Major William Bryce, had other problems: this time it was the authorities who did not fully approve of their methods. As at Maghull, the medical staff viewed shell-shock humanely in comparison  to the government to whom these men were still soldiers and should be under military discipline at all times.

One inspector was horrified to discover patients wearing slippers and dressing gowns, and that the men had been allowed to remove their tunics when scything some grass.
He complained vociferously and it became a running battle for the doctors, to keep the authorities from closing the hospital as a disgrace whilst steadfastly using the techniques they were dedicated to and believed to be right. It is a credit to them that none of the medical staff, appear to have wavered despite this pressure. Siegfried Sassoon, there in 1917, recalled ‘After the War, Rivers told me that the local Director of Medical Services nourished a deep-rooted prejudice against [Craiglockhart], and actually asserted that he “never had and never would recognize the existence of such a thing as shell-shock”.’ (Sassoon, Sherston’s Progress, 1936)

Several techniques were used in the effort to return the patients to something like their former selves. Most of these would now be called therapies but at this time the methods were just being developed. Bryce and a second colleague, Brock, preferred keeping the men active and creating opportunities for them to exercise skills unrelated to the war where achievement might help build their confidence. All joined in a version of group therapy where they were given the chance to discuss their symptoms, reactions and solutions with other patients in an attempt to both pool resources and prove to them they were not alone in their plight.

Rivers’ patients joined in these activities but he was also perfecting his ‘Talking Cure’. This consisted of finding out, through discussion, what precisely had happened to the soldier, how his condition built up, what finally broke his resistance to it, then helping him regain his health and self-respect by refocusing his attention and re-educating him about his condition. Understanding what had occurred and why, Rivers asserted, was a major tool in helping the man not breakdown so badly again, and in proving to him that his illness was not the result of any kind of weakness.

As  many had been brought up to believe men did not react in that way, most were at least a little baffled when it turned out they did – and most doctors ( if they really understood the condition) didn’t bother to explain what had led to it. Once the soldier gained an idea of the mechanisms at work however, the doctor noted, they found the whole thing rather less frightening and were able to put it into context more easily.

Attempting to encourage the adoption of this approach elsewhere and promote the fact that shell-shock WAS a real illness, Rivers presented a paper to Section of Psychiatry, Royal Society of Medicine, in 1917 (The Repression of War experience), detailing the reasons he concluded many cases of war neurosis happened, how his technique addressed it and offering examples as to its success. The overall reaction to this is not recorded, but perhaps satisfied that his training and knowledge were finally coming to fruition, Rivers continued his work at what was affectionately known as ‘The Hydro’. Despite the long tiring hours, the feud with authority and being on call twenty-four hours per day, his only real concern was a niggling awareness that several the men he was helping would be returned to the Frontline as soon as they were passed fit by his superiors. Convinced by government propaganda like almost everyone else who remained in England, he had believed that the war must be fought to a decisive end by whichever side won it, in order to discourage European leaders from entering into such conflict again for the mere gain of land.

• The building and grounds which formed the hospital are now part of Edinburgh Napier University ( Napier University, Edinburgh until 2009) Craiglockhart Campus,  and houses the library which maintains a small museum and the War Poets Collection exhibition which is open for the public to view. http://www2.napier.ac.uk/warpoets/