This is the story of the very beginning of recognition of the condition suffered by so many veterans of war, now known as ‘post traumatic stress disorder’ or PTSD. During and after World War I, it was often colloquially called ‘shell-shock’ – but that was when it was recognised as a medical condition. Too often, it was seen as malingering or cowardice and sufferers ridiculed, abused or even executed for desertion.

The author describes the particular conditions of this war that led to the high numbers of both officers and enlisted soldiers suffering from this ‘nervous and mental shock’: high explosive artillery, rapid-fire machine guns, modern mortar shells, aerial bombardment, poison gas and flamethrowers, and trench warfare in which soldiers were often forced into a helpless, passive position for hours, days or weeks at a time. In other words, warfare of an industrial nature on an industrial scale.

Something had to be done to restore soldiers to some semblance of health, when physical wounds had been healed but the mutism, shaking, nightmares, paralysis, or blindness remained with no apparent physical cause. Craiglockhart was a specialist military hospital established in Scotland specifically for the care of shell-shocked British officers. By the end of its first year of operation, it had admitted 556 patients. By the war’s end, it had treated over 1,800.

Unfortunately, enlisted men received no special care and were either expected to return to active service or invalided out of the army with no treatment available to them.

The book describes the care provided at Craiglockhart under the direction of the two principal psychiatrists: Dr William Halse Rivers and Dr Arthur Brock; two men whose treatment approaches and general philosophies differed widely but when matched with the ‘right’ patients, they were able to effect great change for the officers involved.

And this is where the poetry part of the equation comes in.

Two officers who were perfectly aligned with their therapists’ approaches were the (later to become famous) war poets Wilfred Owen (treated by Dr Brock) and Siegfried Sassoon (treated by Dr Rivers). Poetry was at this time a revered literary form and each of these men found solace and expression of their wartime experiences in writing.

When Wilfred Owen first came to the hospital he was young, inexperienced and at the very beginning of his literary career. He was thrilled to meet the older, published Sassoon, who became something of a mentor, and Owen’s writing developed as the two men exchanged ideas and discussed their work. All the time they were also engaged with the various therapeutic programs set out for them by their respective doctors.

Sassoon is an interesting character, because he came to despise what he began to see as the deliberate continuation of the war by the Allied governments: rather than seeking peace he believed they were prolonging the war in order to crush Germany completely. He was so appalled by this that he initially risked court-martial rather than obey orders to return to the front. Again, an example of the difference in treatment of officers (usually from upper and middle class ranks) and enlisted soldiers (usually working class men). Sassoon had also won a Military Cross for bravery early in the war so his stance proved very embarrassing for the War Office at the time.

When the Armistice was finally declared in November 1918, he described it as: ‘a loathsome ending to the loathsome tragedy of the last four years’ and ‘They mean to skin Germany alive. A peace to end peace.’ Looking at what happened just two decades later, who could argue he was wrong?

What took Sassoon back to the front was not support for the war but for the soldiers who served under him and concern for their welfare. He felt guilty (as many at Craiglockhart did) for living in relative comfort while his men suffered.

Owen, too, was discharged and returned to active duty. Unlike Sassoon, he did not see the Armistice declaration. He was killed in northern France at the age of twenty-six, just two weeks before the cease-fire. As Charles Glass notes in this book:
‘Owen was a success for Craiglockhart and for ergotherapy [the therapeutic approach of Dr Brock], but for him the outcome was death.’ (p279)

There are many interesting characters in this book: military people, early figures in the field of psychotherapy, well-known literary and artistic people of the era. For me, the stand-out ‘character’, if you will, is the poetry, snippets of which are quoted throughout, illustrating the state of mind of the two main poets discussed. It is especially enlightening to see the nature of their poetry change as they discarded the patriotic ‘heroic’ themes of the era for more gritty realism as their own war experience began to bite, and in Sassoon’s case at least, his growing pacifist beliefs were reflected in his verse.

So, here are two samples of poems by these men because they and their work should not be forgotten. Especially now as the world seems to be once again moving towards darkness.

Anthem for Doomed Youth
What passing-bells for these who die as cattle?
Only the monstrous anger of the guns.
Only the stuttering rifles' rapid rattle
Can patter out their hasty orisons.
No mockeries now for them; no prayers nor bells;
Nor any voice of mourning save the choirs,
The shrill, demented choirs of wailing shells;
And bugles calling for them from sad shires.
What candles may be held to speed them all?
Not in the hands of boys, but in their eyes
Shall shine the holy glimmers of good-byes.
The pallor of girls' brows shall be their pall;
Their flowers the tenderness of patient minds,
And each slow dusk a drawing-down of blinds.

Wilfred Owen  (written 1917, published posthumously 1920)  

Aftermath
Have you forgotten yet?...
For the world's events have rumbled on since those gagged days,
Like traffic checked while at the crossing of city-ways:
And the haunted gap in your mind has filled with thoughts that flow
Like clouds in the lit heaven of life; and you're a man reprieved to go,
Taking your peaceful share of Time, with joy to spare.
But the past is just the same--and War's a bloody game...
Have you forgotten yet?...
Look down, and swear by the slain of the War that you'll never forget.

Do you remember the dark months you held the sector at Mametz--
The nights you watched and wired and dug and piled sandbags on parapets?
Do you remember the rats; and the stench
Of corpses rotting in front of the front-line trench--
And dawn coming, dirty-white, and chill with a hopeless rain?
Do you ever stop and ask, 'Is it all going to happen again?'

Do you remember that hour of din before the attack--
And the anger, the blind compassion that seized and shook you then
As you peered at the doomed and haggard faces of your men?
Do you remember the stretcher-cases lurching back
With dying eyes and lolling heads--those ashen-grey
Masks of the lads who once were keen and kind and gay?

Have you forgotten yet?...
Look up, and swear by the green of the spring that you'll never forget.

Siegfried Sassoon  (written 1919)

Soldiers Don’t Go Mad is published by Bedford Square Publishers in March 2025.
My thanks to the publishers for a review copy.