Clif's Book World

A case could be made that the misery and suffering endured by those serving in combatant roles by European soldiers of WWI were the most extreme of any war in history. (I explicitly limit this generalization to soldiers from European countries because they were in the trenches for four full years whereas American soldiers were engaged in active combat for less than a year.)

This novel is therefore particularly poignant because it provides a psychological study of the consequences of war by telling the story of a British anthropologist serving in the role of a psychiatrist in a mental hospital during WWI who has the duty of rehabilitating mental casualties so that they will be able to return to military service. This setting provides a setting for numerous conversations between doctor and patients during which horrendous memories are being extracted in an effort to facilitate recovery from various types of mental breaks.

Most of the book follows the methods of a Mr. Rivers who uses talk therapy methods we would feel comfortable with today. However, late in the book the book's story visits the practice of Dr. Yealland who's methods would be considered brutal and barbaric to today's standards.

I was surprised to learn from the Author's Notes at the end of the book that all the main characters in the book, both doctors and patients, were based on actual historical characters. Even one of the scenes in the book where a patient makes modifications to the poems of another patient is based on handwritten marks by that character in an actual early draft of poems later published. After learning how closely it follows actual historical records I changed my classification of the book to historical fiction.

Any human society that is mobilized for war by definition is sick; organizing for mass murder can't be good. Therefore this book utilizes a unique handle for exploring the consequences of war on the human mind. It is perhaps a more effective way of explaining the stresses of war than writing about action at the front.

This book is first in a trilogy that continues with The Eye in the Door and culminates in The Ghost Road (winner of the 1995 Booker Prize).

Some quotations that caught my attention:

'I don't know what I am. But I do know I wouldn't want a f-faith that couldn't face the facts.' (p83)

'. . . if I were going to call myself a Christian, I'd have to call myself a pacifist as well. I don't think it's possible to c-call youself a C-Christian and . . . and j-just leave out the awkward bits.' (p83)

British society was very class conscious so it is ironic that all classes were forced to share the same trenches.

"One of the paradoxes of the war -- one of the many -- was that this most brutal of conflicts should set up a relationship between officers and men that was . . . domestic. Caring. As Layard would undoubtedly have said, maternal. And that was the only trick the war had played. Mobilization. The Great Adventure. They'd been mobilized into holes in the ground so constricted they could hardly move. And the Great Adventure -- the real life equivalent of all the adventure stories they'd devoured as boys -- consisted of crouching in a dugout, waiting to be killed. (p107)

I found the following observation interesting because it relates war time mental breakdowns among men with those experiences by women during peace time:

"Pilots, though they did indeed break down, did so less frequently and usually less severely than the men who manned observation balloons. They, floating helplessly above the battlefields, unable either to avoid attack or to defend themselves effectively against it, showed the highest incidence of breakdown of any service. Even including infantry officers. This reinforced Rivers’s view that it was prolonged strain, immobility and helplessness that did the damage, and not the sudden shocks or bizarre horrors that the patients themselves were inclined to point to as the explanation for their condition. that would help to account for the greater prevalence of anxiety neuroses and hysterical disorders in women in peacetime, since their relatively more confined lives gave them fewer opportunities of reacting to stress in active and constructive ways. Any explanation of war neurosis must account for the fact that this apparently intensely masculine life of war and danger and hardship produced in men the same disorders that women suffered from in peace."(p222)

Some of the psychiatric treatment methods used a hundred years ago are more painful to read about than the battle experiences. It's pretty well summarized by the following quote where a doctor is summarizing his philosophy of treatment:

". . . The last thing these patients need is a sympathetic audience."(p228)

Thus treatment methods include electrical shock and cigarette burns applied to the tongue.