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CHAPTER TEN Shell Shock Pat Barker, Regeneration (1991) On horror’s head horrors accumulate. —Shakespeare, Othello Pat Barker’s novel Regeneration fuses fact and fiction. It takes place in 1917, mainly at Craiglockhart hospital in Scotland, where the poet Siegfried Sassoon becomes the patient of the neurologist-psychiatrist Dr. W. H. R. Rivers. These two historical figures are surrounded by a group of fictional characters. What links them all is that they exhibit various forms of what was then known as shell shock. “Shell shock is the war’s emblematic psychiatric disorder,”1 that is of World War I, the time of Barker’s Regeneration. The term was applied to soldiers who suffered a breakdown as a consequence of their experiences under fire in modern warfare. Theories about its etiology shifted. At first it was taken literally as resulting from exposure to forces generated by high explosives with the vibrations or shock waves causing neurological disturbances . This view follows the precedent of hypotheses about what befell the victims of nineteenth-century railroad accidents.2 Later this so-called “commotional shock” was thought to be accompanied by “emotional shock.” Alternative descriptions of the same syndrome were “combat fatigue” and “war neurosis,” the one more suggestive of a physical, the other more of a psychological condition. Shell shock was actually an amalgam of the physical and the psychological insofar as the fighting that the soldiers had undergone and the carnage they had witnessed led them to produce symptoms such as mutism, stammering, twitching, paralysis, nightmares, and hallucinations. So shell shock is a mode of speaking through the body, of converting fear and mental trauma into palpable manifestations. Shell shock, Elaine Showalter argues in The Female Malady, was the male equivalent to the illness called hysteria in women. In a chapter titled 169 “Male Hysteria” (167–94), Showalter traces the great reluctance to acknowledge the possibility of the occurrence of hysteria in men, although Pierre Briquet (1796–1881) and subsequently both the great French neurologist Charcot and Freud had recognized it in males, admittedly far more rarely than in females.3 The very phrase “shell shock,” Showalter asserts, was a tolerated euphemism whose efficacy lay precisely in its capacity “to provide a masculine-sounding substitute for the effeminate associations of hysteria” (172). Shell shock amounted to “a recategorization of behavior” from “cowardice ” or “indiscipline” to “the belief that a particularly close hit by a heavy shell or a prolonged barrage prompted a mysterious transformation in the soldier’s nervous system, which damaged his self-control.”4 While traditional -minded officers, who wished to enforce the military virtues of courage, honor, and duty, regarded the shell-shocked as “moral invalids,” victims of war neurosis, as it also came to be known, were increasingly accorded the regard and sympathy that used to be reserved for the physically injured.5 Still, in Regeneration patients allowed to go into town for a few hours’ leave from the hospital are reluctant and ashamed to wear the yellow badge signifying their status. Their presumption that they are in disgrace contrasts with the automatic pity for the amputees that the character Madge glimpses on her visit to the hospital to see to her physically wounded fiancé. Shell shock became an ever more serious problem as the war continued . Eric Leed cites an estimate in the Official History of the War, Medical Services : Casualties and Medical Statistics6 that between 1916 and 1920 4 percent of the 1,043,653 British casualties were psychiatric cases.7 The appearance of new cases after the end of hostilities is due to the amnesia and consequently delayed onset of the disorder now posited as one of its possible characteristic features.8 After the war, around 65,000 British ex-soldiers were drawing disability because of “neurasthenia,” 6 percent of the total, and 9,000 were hospitalized long-term.9 The nature of the combat in World War I was especially conducive to the development of shell shock. In the extended, inconclusive fighting in northern France and Flanders, the Allied and German armies went over the same ground again and again. Throughout October and November 1914 three battles raged in the mud at Ypres (Paschendaele) where the British casualties rose from 55,000 in the first encounter to 300,000 in the third. Even more protracted fighting took place on the Somme from July to November 1916, taking an equally heavy toll. By September 1916 tank warfare subsided into trench warfare, which put quite new strains...

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