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02/17/09

"The Blameless Physician": Narrative and Pain, Sassoon and Rivers Robert Hemmings
Literature and Medicine, Volume 24, Number 1, Spring 2005, pp. 109-126 (Article) Published by The Johns Hopkins University Press DOI: 10.1353/lm.2005.0026

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The Blameless Physician: Narrative and Pain, Sassoon and Rivers

Robert Hemmings

Psychoanalysis meets psychological pain with narrative. As a discourse, psychoanalysis was itself founded upon narrativeits earliest therapeutic methods for the treatment of hysterical suffering based on the catharsis of the talking cure, its earliest articulations presented in the form of case histories about patients written by physicians.1 In On the Psychical Mechanism of Hysterical Phenomena: Preliminary Communication, Sigmund Freud and Joseph Breuer famously state that their hysterical patients suffer mainly from reminiscences, very often the repressed reminiscence of a traumatic event in the past.2 Pierre Janet claims that traumatic memories are dissociative in nature, cut off, whereas healthy memory is rooted in narrative: [M]emory is an action: essentially, it is the action of telling a story.3 The narratives exchanged between patient and physician in the therapeutic models that prevailed in early twentieth-century psychoanalysis were typically mediated by the physician through the case study, over which he had absolute narrative and interpretive control in spite of the patients resistance. The patients narrative, according to Freud, no matter how complete and self-contained it seems, is not so.4 The physician following Freuds relational model must examine the patients narrative with a critical eye, discover its inevitable gaps and imperfections, and follow these lacunas deep into the dissociated memory, the realm of the repressed traumatic experience.5 Primarily a blank or missing portion of a narrative, lacuna comes from the Latin word meaning hole or pit, etymological associations which inect the narrative gap with a spatialized dimension consistent with the archaeological metaphors that characterize Freuds conceptualizing of the psyche.6 Having discovered the patients lacunas, the physician is obliged, in composing his corresponding case historyhis narrative constructed
Literature and Medicine 24, no. 1 (Spring 2005) 109126 2005 by The Johns Hopkins University Press

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from above and temporally beyond the physician-patient encounter: what I will call in this paper a sur-narrativeto ll in these gaps with carefully considered supporting interpretations that draw up the dissociated memory from the murky depths of the unconscious to consciousness, and to the surface of the narrative. However, there are also cases in twentieth-century modernist literature of patients writing retrospectively of their psychoanalytic encounters to create their own sur-narratives. The sur-narratives of writer-patients often take the form not of case studies per se, but of homages. Lacking the generic interpretive imperative of the case study, patient sur-narratives do not so much ll in the gaps or seek to retrieve repressed dissociated memories as cover them over with layers of idealized memories of the physician-therapist, layers replete with their own imperfections and lacunas. Perhaps the best known example is H. D.s Tribute to Freud, the poets account of the treatment she sought to explore the traumatic effects of her personal experiences with death during the First World War.7 While some critics identify in Tribute a celebration of the collaborative nature of H. D.s interactions with Freud, which reinvigorated her creativity and imbued her with a sense of wholeness and perfection, others position Tribute as a feminist corrective to Freudian psychoanalysis in which the patient seems almost to cure herself of suffering, in spite of Freud, by symbolically replacing him.8 But more recently, some less altruistic features in the relationship between the poet-patient and what H. D. calls her blameless physician (after Homers designation of Aesculapius, god of medicine) have been pointed out, including H. D.s alignment of herself with spirituality and Freud with materialismshe with the gods, he with the goods.9 In any event, Tribute to Freud is the patients sur-narrative in which the traumatic pain that initiated the physician-patient encounter is assuaged through the patients construction of her own sense of order. A lesser known example of a poet-patient writing in retrospect is also rooted in the First World War, though more explicitly so, and involves the exploration of repressed traumatic experiences, encounters with death, and conceptions of spiritual and material being. In the case of Siegfried Sassoon and W. H. R. Rivers there are no detailed records of the narratives exchanged during their therapeutic sessions, nor did Rivers publish a case history.10 Sassoons poems and prose narratives represent the primary textual legacy of his work with Rivers. Sherstons Progress (1936) is the third volume of the autobiographical trilogy narrated by George Sherston, a thinly veiled stand-in for Sassoon; the only historical gure whose name is not altered in The Complete Memoirs of George

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Sherston is Rivers.11 Sassoons sur-narrative about their relationship is, like H. D.s, a tribute, but rather than seeking to replace Rivers, or explicitly counter his ideas, Sassoon seeks to transform Rivers from a mere physician into a guiding spiritual presence. Previous critical studies of Rivers and Sassoon have focussed on each mans inuence on the others ideas about war, pacism, and masculinity, with conicting views about the degree to which Sassoon was actually suffering from war neuroses.12 Pat Barkers novel Regeneration (1991) ctionalizes and expands their relationship, in effect providing Riverss perspective on the narrative of their work together that Sassoon creates in Sherstons Progress, while reviving interest in both historical gures. In her discussion of Barkers ction, Anne Whitehead focuses on Riverss theorizing about dreams that concerned his treatment of Sassoon.13 In this paper, however, my goals are more specic. By attending to the gaps, imperfections, and lacunas within Sassoons sur-narratives concerning Rivers, I explore the cultural tensions they seek, without complete success, to contain. The sur-narratives elide the suffering of the poet-patients war trauma and conceal the ensuing gaps with spiritual mirages he can neither fully accept nor wholly deny. By elevating the physician to quasi-spiritual mentor, Sassoon covers over his own complicity in the harsh materiality of war experience that initiated the therapeutic encounter in the rst place. Thus Sassoons hagiographic portrayal of Rivers is at once a compensatory and diversionary gesture: it compensates for the untimely loss of his physician-cum-mentor and friend by creating an homage, and it diverts, in the grandness of the transformation, both Sassoon and his reader from his traumatizing experience. Accordingly, I argue that his sur-narratives allow Sassoon to focus on the transcendent potential of human experience, which surmounts the trauma and the therapeutic procedures of material existence. But ssures of pain disrupt these sur-narratives and reveal the poet-patient unable to escape his past and unable to accept the spiritual future into which he projects his physician, safely beyond the harsh material conditions of the war-torn modern world. Like H. D., Sassoon demonstrates in his sur-narratives a preference for the order of the spiritual realm. But rather than usurping the physicians place to attain transcendence, Sassoon replaces himself with Rivers and seeks consolation in an order he cannot yet accept as his own.

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A Live Museum of War Neuroses In July 1917, already decorated with a Military Cross, Sassoon was sent by the military authorities to Craiglockhart War Hospital outside Edinburgh. Their motives were political. Eventually published in twelve newspapers, including the Times, and read out in the House of Commons, A Soldiers Declaration (1917), Sassoons statement against the war, was a potentially damaging document. The War Ofce sought to limit the damage by declaring that the author of A Soldiers Declaration was suffering from shell shock and therefore not of sound mind.14 Sassoon referred dismissively to Craiglockhart as Dottyville and insisted publicly that there was no psychological basis for his connement in the truly awful atmosphere of this place of wash-outs and shattered heroes.15 Entrusted to the care of the eminent ethnographer and psychologist W. H. R. Rivers, Sassoon would recall in the mid1930s how both of them had joked about the anti-war complex from which he was reputedly suffering.16 He asked Rivers outright if he was a shell-shock case and reports that Rivers replied, Certainly not (SP, 12). Compared to some of his dramatically incapacitated fellow inmates in that live museum of war neuroses (SP, 12), Sassoon thought his mental health was relatively untroubled and, consequently, accounts of his own suffering have no explicit place in his sur-narratives. This view seems to accord with Riverss initial assessment in the medical case sheetthe only record of Riverss response to this physician-patient encounter, hardly a case studytaken after their initial meeting on July 23, 1917. Leaving the space following the heading Disease blank, he noted: The patient is a healthy-looking man of good physique. There are no physical signs of any disorder of the Nervous System. He discusses his recent actions and their motives in a perfectly intelligent and rational way, and there is no evidence of any excitement or depression. . . . His views differ from that of the ordinary pacist in that he would no longer object to the continuance of the War if he saw any reasonable prospect of a rapid decision.17 The fact that Sassoon was free from any physical signs of nervous disease set him apart from many of Riverss other patients. Rivers knew that a rational, nondepressive demeanour and the lack of physical symptoms were not conclusive proof of an undamaged psyche,

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but this case sheet was completed before the commencement of more than three months of treatment, and therefore by no means amounts to a clean bill of mental health.18 Privately, Sassoon was very anxious about the impact of traumatic war experience, as shown by his diaries of the time, which reveal a preoccupation with the fragile state of his nerves, a preoccupation later swallowed up by lacunas in Sherstons Progress. While Riverss theoretical background is also largely elided from his sur-narratives, this background is nevertheless an important context for Sassoons quest to understand his suffering and cope, however indirectly, with the traumatic pain of his past experiences. Since his training in Germany in the early 1890s, Rivers had been interested in Continental approaches to neuroses and once back in England had become an early advocate of Freudian ideas.19 Rivers noted that before the war, due in large part to their foundation upon the theory of infantile sexuality, Freuds ideas were, in Britain, the subject of hostility exceptional even in the history of medicine.20 So it required considerable political acumen to expose the British medical community as gently as possible to the utility of Freudian ideas, ideas that were crucial to his own understanding and treatment of war neuroses. In Freuds Psychology of the Unconscious, Rivers emphasizes the naturalness of unconscious experience in human existence and the role of instinctual impulses in the unconscious, foregrounding what he found to be the most striking aspect of Freudian thought: the active nature of forgetting, especially forgetting unpleasant experience and suppressing it in the unconscious (IU, 160). But unlike the typical case studies of Freud, who sought to trace his patients illnesses back to childhood traumas or sexual development, Rivers focussed on the more immediate emotional conicts of front-line experience that produced the ight into illness.21

Repression of War Experience In December 1917, at the Royal Society of Medicine, Rivers presented a paper called Repression of War Experience in which he cautioned against the harmful effects of the standard medical advice for psychologically disturbed soldiers: avoid all thoughts of the war and you will be right as rain. The attempt to banish or repress the effects of painful experience from the mind not only did not work but actually exacerbated the neurosis. The mental discomfort and depression resulting from the conict that produced the neurosis tended

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to crystallise (IU, 123) around some incident of trauma the patient had experienced. The haunting memory of this experience often displaced the original affect of fear by producing its own affect of horror, guilt, or shame of survival. During waking hours the conscious mind worked fervently to banish these powerful affective memories. But during sleep the repressed images returned with a vengeance in dreams or nightmares when the painful affect, together with the experience round which it has crystallised, dominates the mind (IU, 123). Such distress often drove the sufferer to increased efforts of conscious repression until nally a comparatively trivial shock, illness or wound (IU, 123) caused a breakdown and the loss of ability to deal with the original conict. From these observations, Rivers developed a therapeutic treatment based upon the principle of catharsis whereby the patient was encouraged to eschew repressive tendencies and give voice to the traumatic memorieslatent narratives themselves, in Janets termswithout dwelling excessively upon them. Patient and physician would work together to construct from these painful memories a narrative that found some tolerable, or redeeming, even pleasant association for the trauma (IU, 189). In early July 1917, during the frantic days of putting the nishing touches to his public protest against the war, Sassoon began the poem he later, once under Riverss inuence, retitled Repression of War Experience.22 In this poem, Sassoon depicts a wounded and embittered soldier unfamiliar with the benets of Riverss narrative-based therapy. The speaker, who seems to be rehearsing repressive techniques favored by the nonpsychoanalytically inclined medico-military authorities Rivers describes in his essay, attempts to gure a moth as a talisman to keep his mind from wandering to darker subjects, but the scorching of its wings by a candle returns him to that from which he yearns to escape: No, no, not that, its bad to think of war, / When thoughts youve gagged all day come back to scare you.23 As the moth bumps and utters (line 5) against the reection of candlelight upon the ceiling, and is trapped there beating against the illumination and not passing through it, it symbolizes the surviving soldiers plight. It is not his experience exactly that traps him; rather, the reection of that experience through unbidden memories entraps him in a painful cycle of repression and repetition. The poem, itself a narrative fragmented by ellipses and dashes and abrupt shifts in resolve, recounts a struggle to repress memories of war experience, a struggle lost as painful affect eventually bursts through the silent gaps and oods the speaker with thoughts of madness:

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Hark! Thud, thud, thud, quite soft . . . they never cease Those whispering guns O Christ, I want to go out And screech at them to stopIm going crazy. (CP, 90, lines 368) A more central lacuna dominates Repression of War Experience. The absence of an explicit physician-patient relationship and of the insights into the harmful consequences of repression serve to distance Sassoon from the pain the soldier-patient depicts in his poem. After all, in 1917 Sassoon did not admit to being plagued by war neuroses; his public protest against the war was based, he liked to think, on rational, moral grounds. Moreover, in his personal demeanour he was able to maintain the aplomb of the fox-hunting man and the soldier-poet. But privately, in his diaries and letters, he provides ample evidence of the traumatic impact of his front-line experience. His terminology is of course different from Riverss technical discourse, but the psychological suffering he describes seems to be the same, as he invokes feeling nervous and rattled (D1, 132), being over-strained (D1, 161), wary of my nerves (D1, 171), and after the war being in a state of nerves and experiencing nervous exhaustion.24 This vocabulary of nerves seems to have protected him, even as he describes the symptoms of war neuroses, from feeling the full incapacitating pain they could bring on; the euphemistic description may also have sufciently concealed the condition so that he never felt bound to acknowledge it as his own. He certainly never admitted publicly to suffering from war neuroses. A diary entry from 1917 reveals the depth of the painful affect: [W]hile I lie awake staring at the darkness of the tent my own terrors get hold of me and I long only for life and comfort (D1, 133). He felt scarred and tortured by the nerve-strain of his front-line experience, [and yet] I suppose all this emotional experience (futile phrase) is of value, even if it leads nowhere now (but to madness) (D1, 133). Recovering from a head wound in Fourth London Hospital at Denmark Hill, Sassoon recorded his mental distress: And when the lights are out, . . . and the white beds are quiet with drowsy gures, huddled out-stretched, then the horrors come creeping across the oor: the oor is littered with parcels of dead esh and bones, faces glaring at the ceiling, faces turned to the oor, hands clutching neck or belly; a livid grinning face with bristly moustache peers at me over the edge of my bed, the hands

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clutching my sheets. Yet I found no bloodstains there this morning. . . . I dont think they mean any harm to me. They are not here to scare me; they look at me reproachfully, because I am so lucky, with my safe wound, and the warm kindly immunity of the hospital is what they longed for when they shivered and waited for the attack to begin, or the brutal bombardment to cease. . . . I wish I could sleep. (D1, 1612) Such a hallucinatory experience, a common symptom of war neuroses, affected Sassoon only intermittently, however, and several weeks after recording these nocturnal visitations, he wrote in his diary, For a while I am shaking off the furies that pursued me (D1, 167), but clearly he was not sure how long he could keep up his resistance.25 It is hard to conceive that such psychological horrors played no part in his public protest against the war in 1917, in his fears of an actual breakdown, or in his treatment with his physician. In Sassoons sur-narratives of the encounter between physician and patient, the extent of the psychological damage he suffered in the war, not to mention the subject of his sexuality and the possibility of an erotic attachment to Rivers (a prospect seized upon in unconvincing fashion by Wilson), all constitute signicant and conspicuous gaps.26 While Sassoon preferred to emphasize the political motivations behind the War Ofces decision to send him to Craiglockhart and to dismiss his experience of mental anguish as merely part of his anti-war complexthe light-hearted diagnosis offered by Rivers with a smile (SP, 12)after his release from the hospital, he made a note in his diary that undermines such jocularity. He writes that after the strain and unhappiness of the last seven months [at Craiglockhart] he would stop brooding about the wars futility and instead indulge in lighthearted stupidity and even feel peaceful-minded (D1, 197). It was, he said, the only way by which I can hope to face the horrors of the front without breaking down completely (D1, 198). And yet, despite his resolve, the obstinate concern about complete breakdown persisted; contemplating his return to the Western Front, he determines: I will not go mad (D1, 238, Sassoons italics). Like many veterans, including his friends Edmund Blunden, Robert Graves, and T. E. Lawrence, Sassoon feared the onset of madness, which Rivers recognizes as itself a sign of war neuroses.27 Five months later, in May 1918, Sassoon seems actually to acknowledge that what he had experienced was indeed a breakdown: I must never forget Rivers. He is the only man who can save me if I break down again (D1, 246).

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Rivers provided Sassoon with a strategy to keep madness at bay, which Sassoon adapted to suit his latent mysticism just as he converted Riverss inuence from a psychological to a spiritual mentor. In his paper Repression of War Experience, Rivers warns of the pitfalls of obsessive self-absorption and expresses the limitations of the talking cure: [I]n my opinion it is just as harmful to dwell persistently upon painful memories or anticipations, and brood upon feelings of regret and shame, as to attempt to banish them wholly [through repression] from the mind (IU, 203). For a reticent patient, this observation is tantamount to the physicians permission to conceal. Rivers approached the treatment of neuroses, including war neuroses, through what he called autognosis and reeducation. By autognosis he meant [t]he process by which the patient learns to understand the real state of his mind and the conditions by which this state has been produced.28 This search for self-understanding had to be combined with reeducation, a process . . . in which the patient is led to understand how his newly acquired knowledge of himself can be utilized.29 It is clear from his diaries and letters that Sassoon understood that his real state of mind had been badly shaken by his war experience and by the harsh materiality of the modern world. But rather than brood upon painful feelings of shame and survivor guilt, Sassoon chose ight. Burdened by his moribund material existence, he utilizes in his sur-narratives a hagiographic portrayal of Rivers and endows that great and good man who gave me his friendship and guidance with spiritual potential as yet unavailable to himself (SP, 15).

Faith and the Religiosity of Psychoanalysis Sassoons prose narrative of his work with Rivers at Craiglockhart, Rivers, part one of Sherstons Progress, has at its core a gap, a conspicuous lack of detail about therapeutic procedures. Sassoon raises the possibility of disclosing psychoanalytic insights into hallucinations and dreams, yet he invariably steps back from the edge. Riverss psychoanalytic treatment of Sassoon, regardless of its inuence on his later writing (which is profound), is impossible to ignore but is neither the focus of this sur-narrative nor the basis of a tribute that constructs for Rivers a role of transcendence. Midway through the narrative, Sherston, Sassoons stand-in, remarks on his desire for a few gramophone records of my interchanges of ideas with Rivers (SP, 28). The absence of such record-

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ings provides a convenient pretext to avoid the details of treatment, lest he report their confabulations incorrectly (SP, 28), and as a result lacunas appear where one might expect an elaboration of the interchanges between physician and patient. For example, the lingering pain of Sassoons front-line encounter with death seems to lie behind a haunting vision he records early in his narrative. Gusting late-night autumnal winds cast Sassoons mind back to the trenches and compel him to acknowledge that the reality of the War had still got its grip on me (SP, 21). He stirs from sleep after the storm subsides and sees the gure of a dead comrade standing nonchalantly in his doorway. His roommate awakens as well, but does not see a visitor, and when Sassoon looks again the gure of his comrade has vanished. Clearly such an experience in a patient is fodder for discussion with his physician, especially as Sassoon and Rivers met for sessions three times per week. Indeed, this haunting encounter probably did enter into their interchanges of ideas. The point is that it is dismissed in the surnarrative as an odd experience, dropped without further comment or analysis, and the very next section begins with Sassoons admission of suffer[ing] from a shortage of anything to say about his experience at Craiglockhart (SP, 22). The sur-narrative is not designed to conduct the reader back into the quagmire of trauma and pain but forward toward the possibility of spirituality, following Riverss lead. A more conspicuous gap opens up around the role of dream interpretation in this particular physician-patient relationship. Sassoons narrative is virtually complete, but he feels duty bound to add a few nal impressions: The analysis and interpretation of dreams was an important part of the work which Rivers did; and, as everyone ought to know, his contributions to that insubstantial eld of investigation were extremely valuable (SP, 48). The lightness of tone that puns on insubstantial, characterizing dream work as simultaneously ephemeral and weak or imsy, belies the heavy burden of the two recurring dreams Sassoon is subject to, a burden he prefers not to acknowledge fully, and certainly not to submit to depth analysis or interpretation. When he does raise the matter of his war neuroses he does so in a similar lightly ironic and intriguingly equivocal way: About my own dreams he hadnt bothered much, but as there may be someone who needs to be convinced that I wasnt suffering from shell-shock, I am offering a scrap of dream evidence, which for all I know may prove that I was! (SP, 48). The exclamation point almost invites the preemptive assertion of the nal clause to be read at face value. Whether or not physician and patient bothered much about dreams in the course

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of treatment, Sassoon offers his two pieces of dream evidence more to cover a gap he perceives in the narrative than to explore the depths of his unconscious. In the rst instance Sassoon recounts a battle-dream, as Rivers would have called it, in which he and his battalion are adrift in the mud of the Ypres Salient, a sector where he never actually served, the same sector he imagined himself in the night he saw the vision of a dead comrade in the doorway of his Craiglockhart billet.30 Now he is surrounded by the unmitigated horror (SP, 49) of the battleeld, and he feels sure of imminent death. Yet even in the depth of dream-despair, he notices a queer thing: the distressing dream allowed him to add a very complete piece of war experience to my collection (SP, 49). Here he seems to be drawing on Riverss view of the unconscious as a storehouse of experience associated with instinctive reactions (IU, 38), with memories drawn from unconscious as well as conscious sources, avidly collected, almost cherished, perhaps even fetishized, each new addition increasing the overall worth of the collection. Dream-despair offers him a glimpse of the ongoing vitality of his memory collection, which animated even as it disturbed his postwar life, especially as the portents of a new war began to gather. The second dream recurred, with subtle variations, every two or three months and amounts to this: The War is still going on and I have got to return to the front (SP, 49). Sassoon is upset because he is ill equipped for this return: he is anxious because he cannot nd his service kit, and he worries that he has forgotten how to perform his duties. Sometimes in this dream the anxiety is so intense that he bursts into tears as he frantically searches for his equipment. In spite of his fears and doubts, in the dream he often returns to the front, though it is a strangely altered front, always in Englandthe Germans have usually invaded half [of] Kent, and he is tak[ing] out a patrol, feeling quite keen about it (SP, 49). It bears remembering that Rivers argues in Conict and Dream that a dream is an attempt by the unconscious to solve an underlying conict that has been preoccupying the dreamer (CD, 17). He observes that the affective symptoms of a recurring dream or nightmare prevail until the conict underlying the dream is satisfactorily resolved (CD, 39). Through his work with hundreds of soldiers during the war, Rivers learned that encouraging a patient to talk through his trauma, to revisit it consciously, produced in accordance with Freudian theory abreactive, or cathartic, benets that lessened the affective intensity of the nightmare. As a patient slackened his repression, his battle-dreams

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would often evolve into recurring nightmares whose manifest content was transformed by the dream work into a setting less directly representational of the scene of trauma. The greater the transformation, the weaker was the affective intensity (CD, 67). For Rivers, a nightmare that jolts the sleeper awake bathed in sweat represented an unsuccessful solution to the conict, for where a conict is solved in a dream in a symbolic manner there is no affect remaining in that dream (CD, 71). The process of transformation sets the patient on the road to recovery. Even though Sassoon refers in the passage from Sherstons Progress cited above to Conict and Dream in all but name as an extremely valuable work, he resists an active engagement with the ideas it advances. His dream interpretations are intriguing as much for what he does not say as for what he does. Even in the diaries he describes his dreams rarely and briey, with perfunctory interpretations, if any at all.31 But in Sherstons Progress, a ssure opens beneath the lightness of tone and resolutely nonanalytic tenor of the narrative. From this ssure of pain he gestures toward Riverss ideas by claiming that the recurrent battledream at Ypres ended once he had written his account of military service (SP, 49), thereby demonstrating implicitly the psychoanalytic principle of abreaction endorsed by Rivers. The physician might have suggested that in creating the narrative Sassoon drew the repressed memories from the unconscious, where their affective energies had disturbed his sleep, into the conscious mind that was then enabled to face and to some extent resolve the underlying conict, dispelling the recurring dream, or at least transforming it. But such psychoanalytic insights, steeped in the materiality of modern warfare, have no place in Sassoons sur-narrative of potential transcendence. Instead, Sassoon offers perfunctory dream interpretations that gesture toward without fully engaging in the ideas Rivers developed from his own experience with modern war. The recurring anxiety dream of the war still going on, Sassoon explains, obviously dates from the autumn of 1917 (SP, 49), when he decided to leave Craiglockhart and return to active servicea decision he describes as a potential death-sentence (SP, 50). Not very startlingly, the dream proves to him the underlying conict between honor and patriotic duty, on the one hand, and [t]he instinct of self-preservation, on the other (SP, 50). That the dream situates the front in Kent, the land of his childhood, is the kind of detail that Rivers would surely have seized upon, but Sassoon does not remark on it. His reluctance to tap deeply into psychoanalytically informed dream interpretation in the sur-narrative of his physician-patient encounter suggests not a turning away from

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Riverss inuence, but a desire to locate its spiritual register. Rivers is for Sassoon the solution to Sherstons Progress, as he insists in a letter, because of the adaptability of his teachings, which stress the common ground between the talking cure and confession, between the healing powers of faith in psychological principles and faith in religious truths.32 Thus Sassoon was able to view dreams as windows into not only psychological but also spiritual truth, which he increasingly sought as he aged, and still maintain his emotional allegiance to his blameless physician. Some scholars have found Sherstons Progress disingenuous because of the religious overtones of its title and the concluding scene in which Rivers exorcises Sassoons demons with a smile.33 However, it is not religion as such, I believe, that underlies the allusion to John Bunyans Pilgrims Progress in the books title and epigraphI told him that I was a Pilgrim going to the Celestial City (SP, 9)but the almost spiritual nature of Sassoons devotion to Rivers and the spiritual inection by which he records his psychological insights in his sur-narrative. Rivers saw a relationship between medicine and religious beliefs, between the psychiatrist and the priest, between the cathartic benets of the talking cure and confession: [C]atharsis is the most important psycho-therapeutic agent in the process of confession, whether this form part of a religious rite or of a manifestly medical procedure.34 For Rivers, both approaches to human pain and distress were underwritten by the crucial element of faith focussed on the personality of the physician or priest.35 Early in Sherstons Progress, Sherston is told that Rivers was evidently some sort of great man (SP, 13), and soon after meeting him, he says, All I knew was that he was my father-confessor, as I called him (SP, 35). At the end, recovering from a head wound in the hospital, he is troubled by self-destructive thoughts, but when Rivers enters the ward, my futile demons ed himfor his presence was a refutation of wrong-headedness (SP, 149).36 Rivers exorcis[ed] Sassoons demons without saying anythinghis smile was benediction enough (SP, 149). The goal of Sassoons progress in this sur-narrative is to translate Riverss therapeutics of autognosis and reeducation into quasi-spiritual terms: to know the world for what it is, and ourselves for what the world has made us (SP, 150). In effect, Rivers provides an epistemology for Sassoon that not so much conates psychoanalysis with religion as draws out spirituality from psychoanalysis, affording a framework that signals the possibility of complete knowledge beyond traumatic experience. As such, the religiosity of psychoanalysis covers over the

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gaps, imperfections, and lacunas of Sassoons own sur-narratives, and offers him the comforting fantasy of transcendence.

The Return of War Sassoons association with Rivers continued after the period of his clinical treatment in 1917 until the physicians premature death in 1922, and indeed his devotion continued throughout the remainder of Sassoons long life (he died in 1967). Rivers became what Sassoon needed him to be. As he wrote in 1936, Rivers is the solution . . . [to] my own life up to 1922and since then too, for his spirit . . . has been my guide in many dark places.37 His use of spirit and dark places marks his movement toward a conception of existence that transcends the disturbing vagaries of material and psychological existence, and which seems to embrace a spiritual vision of life that probably served as a precursor to his Catholic conversion. Revisitation (W. H. R. R.), a poem from the early 1930s, is both another tribute and another sur-narrative of his relationship with Rivers. Unlike Repression of War Experience, Sassoon sheds the device of persona in this poem, as indicated by the parenthetical dedication to Rivers. He describes the strange survival (CP, 221, line 15) of Riverss ghost (line 16) who revisits (line 1) him at night: . . . What face To my hearts room return? From that perpetual silence where the grace Of human sainthood burns Hastes he once more to harmonize and heal? (CP, 221, lines 15) Sassoon feels [h]is inuence undiminished (line 7). Indeed, it seems strengthened and expanded here with Christian overtones. The warmth of this encounter with Riverss spirit contrasts sharply with the chilling ghostly intruders who haunted him at Denmark Hill hospital in 1917, or the ghost who darkened his doorway at Craiglockhart. Increasingly, he saw Rivers in the light of spiritual guide rather than therapist. The consecrated memory of Rivers served as an ally in Sassoons postwar struggles. As with other veterans, the war did not end for Sassoon with the withdrawal from the front line or with the armistice. In his celebrated autobiography, Robert Graves recalls how he and Edmund Blunden suffered from war shock in autumn 1919 at Oxford

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when they talk[ed] each other into an almost hysterical state about the trenches. . . . The war was not yet over for us.38 Two years later Blunden was on the point of breakdown and his employers at the Nation and Athenaeum booked him on a journey to Argentina, ostensibly to write a travel book but actually to provide him with the relief a change of scene might bring.39 In language similar to Sassoons, Blunden reports being troubled by his own futile demons even at sea: Still the dreams came; the war continued.40 Even during the day, the memory of traumatic war experiences is as sombre and as frightening as they were themselves in their aspect and their annals. They come unbidden, and when they will come, the mind is led by them as birds are said to be lured by the serpents eye. A tune, a breath of sighing air, an odourand there goes the foolish ghost back to Flanders.41 Sassoons experience echoes Blundens. In his diaries Sassoon frequentlyand tellinglyresolves not to think about the war. On June 30, 1921, for example, he writes, Ive given up thinking about the War. I am clear of it all, steadily settling down into a new state of mind, but in the very next sentence admits that the War comes back on me occasionally (D2, 73). Before long he complains of living in an [a]tmosphere of nerve-twitching exhaustion (D2, 75). Increasingly, Rivers, in memory as physician and in memoriam as spiritual mentor, serves his former patient in the struggle to regain equilibrium after the disasters of wartime. War veterans were not alone in suffering the painful memories of the First World War and seeking, or being compelled to seek, psychoanalytic intervention. The sur-narratives that emerge from these interventions, whether the case studies of the physicians or the personal narratives of the patients, are testimonies to both the varieties of misery and unhappiness and of the compensatory strategies produced by modern culture. In her Tribute to Freud, H. D. endows herself with spiritual capacities that challenge and transcend the transformation of traumatic pain into common unhappiness offered by Freud, and by attending to her sur-narrative carefully, mindful of its gaps and imperfections, readers can see that she seeks to replace him, thereby privileging a spiritual realm of existence she represents in contrast to Freuds materiality.42 In Sassoons sur-narrative tributes to Rivers, the smooth transmogrifying surface belies the lurking presence of underlying gaps, sinkholes of repressed experience. Readers attentive to the inevitable lacunas can see the patients desire to privilege the spiritual implications of his physician-patient encounter as a drastic veering away from the material reality of a modern world that had produced

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so much suffering and pain during the First World War, and which was gearing up for an unthinkable recurrence in the 1930s.

NOTES
1. I use physician throughout this paper to refer to Freud or Rivers, even while I am dealing largely with psychoanalytic encounters, because it captures better than psychoanalyst the reverence and authority bestowed upon them by their patients generally and by Sassoon in particular. While many psychoanalysts are not physicians, both Freud and Rivers were, and in the early period of the psychoanalytic movement, Freud gathered around him at the Wednesday Psychological Society keen practitioners who were exclusively physicians (see Gay, Freud, 173ff.). 2. Breuer and Freud, On the Psychical Mechanism of Hysterical Phenomena, 58. 3. Pierre Janet, Les Medications Psychologies, 3 vols. (Paris: Socit Pierre Janet, 191925), 2:272. Quoted in van der Kolk and van der Hart, The Intrusive Past, 175. 4. Freud, The Psychotherapy of Hysteria, 379. 5. Ibid., 379, 380. 6. Oxford English Dictionary, 2nd ed., s.v. lacuna. 7. See Freedman, Gifts, Goods and Gods, 185. 8. See, for example, Jaffe, She Herself is the Writing; Buck, H. D. and Freud; and Chisholm, H. D.s Freudian Poetics. 9. From H. D.s dedication To Sigmund Freud, in Tribute to Freud, v; Freedman, 187. 10. Sassoon does gure as Patient B in a case study of dreams in Riverss posthumous text, Conict and Dream, 16580, but Rivers discusses his own dream life, not his patients. 11. In Siegfrieds Journey, the third volume of his nonctive autobiography, Sassoon acknowledges the extent to which George Sherstons experiences, memories, and accounts represent his own: My experiences during the next three weeks [of 1917], which ended in my being sent to a shell-shock hospital, have already been related in Memoirs of an Infantry Ofcer [the volume preceding Sherstons Progress]. I am thankful not to be obliged to drag my mind through the details again (55). 12. See Showalter, Male Hysteria and Rivers and Sassoon; Caesar, Taking It Like a Man; and Wilson, Siegfried Sassoon: The Making of a War Poet and Siegfried Sassoon: The Journey From the Trenches. Showalter and Caesar argue that Sassoon did suffer from war neuroses; Wilson disagrees. 13. See Whitehead, Open to Suggestion. 14. See Wilson, War Poet, 384. 15. Sassoon, letter to Robert Graves, 4 October 1917, in Diaries 19151918, 189; hereafter referred to as D1 and cited parenthetically in the text. 16. Sassoon, Sherstons Progress, 12; hereafter referred to as SP and cited parenthetically in the text. 17. Medical Case Sheet, 23 July 1917, Document Archive: Siegfried Sassoon, Imperial War Museum, London, 2. 18. See Rivers, Psycho-therapeutics, 434. 19. See Slobodin, W. H. R. Rivers, 134. 20. Rivers, Instinct and the Unconscious, 3; hereafter referred to as IU and cited parenthetically in the text. 21. This point is made by Stone, Shellshock and the Psychologists, 255.

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22. See Wilson, War Poet, 378. 23. Sassoon, Collected Poems 19081956, 89, lines 45; hereafter referred to as CP, with page and line numbers cited parenthetically in the text. 24. Sassoon, Diaries 19201922, 150, 168; hereafter referred to as D2 and cited parenthetically in the text. 25. See, for example, Babington, Shell-Shock, 168; Kardiner and Spiegel, War Stress and Neurotic Illness, 20110; and Rivers, Instinct and the Unconscious, 69, 803. 26. See Wilson, War Poet, 393. 27. Rivers notes that the hallucinatory symptoms of neuroses often give rise to the patients anxiety over approaching insanity. Psycho-therapeutics, 437. 28. Rivers, Psycho-therapeutics, 437. 29. Ibid., 440. 30. Rivers, Conict and Dream, 68; hereafter referred to as CD and cited parenthetically in the text. 31. Examples of his dream descriptions appear in Sassoons published diaries: Diaries 19201922, 200, 222, 2278, 230, 232, and Diaries 19231925, 23, 147, 271. 32. Sassoon, letter to Ellis Roberts, 9 September 1936, Sassoon Collection, Harry Ransom Centre, University of Texas, Austin. 33. See, for example, Moeyes, Siegfried Sassoon, 18697. 34. Rivers, Psycho-therapeutics, 437. 35. Ibid., 436. 36. And now that angry feeling of wanting to be killed came over meas though I were looking at my living self and longing to bash its silly face in. . . . I suppose my nerves really are a bit rotten . . . . [O]nes mind was in a muddle and ones nerves were all on edge (SP, 1489). 37. Sassoon, letter to Ellis Roberts, 9 September 1936. 38. Graves, Good-bye to All That, 35860. 39. See Webb, Edmund Blunden, 131. 40. Blunden, The Bonadventure, 42. 41. Ibid., 65. 42. See Freedman, 186.

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Gay, Peter. Freud: A Life for our Time. New York: W. W. Norton, 1998. Graves, Robert. Good-bye to All That. London: Cape, 1929. H. D. Tribute to Freud. New York: Pantheon, 1956. Jaffe, Nora Crow. She Herself is the Writing: Language and Sexual Identity in H. D. Literature and Medicine 4 (1985): 86111. Kardiner, Abram and Herbert Spiegel. War Stress and Neurotic Illness. New York: Paul B. Hoeber, 1947. Moeyes, Paul. Siegfried Sassoon: Scorched Glory: A Critical Study. New York: St. Martins, 1997. Rivers, William Halse. Conict and Dream. London: Kegan Paul, 1923. . Instinct and the Unconscious. 2nd ed. Cambridge: Cambridge University Press, 1924. . Psycho-therapeutics. In Encyclopedia of Religion and Ethics, edited by James Hastings. Vol. 10, 43340. New York: Scribners, n.d. Sassoon Archives. Imperial War Museum, London. Sassoon Collection. Harry Ransom Centre. University of Texas, Austin. Sassoon, Siegfried. Collected Poems 19081956. London: Faber, 1961. . Diaries 19151918. Edited by Rupert Hart-Davis. London: Faber, 1983. . Diaries 19201922. Edited by Rupert Hart-Davis. London: Faber, 1981. . Diaries 19231925. Edited by Rupert Hart-Davis. London: Faber, 1985. . Sherstons Progress. London: Faber, 1983. . Siegfrieds Journey 19161920. London: Faber, 1945. Showalter, Elaine. Male Hysteria: W. H. R. Rivers and the Lessons of Shell Shock. In The Female Malady: Women, Madness, and English Culture, 18301980, 16794. New York: Pantheon, 1985. . Rivers and Sassoon: The Inscription of Male Gender Anxieties. In Behind the Lines: Gender and the Two World Wars, edited by Margaret R. Higonnet et al., 619. New Haven: Yale University Press, 1987. Slobodin, Richard. W. H. R. Rivers. New York: Columbia University Press, 1978. Stone, Martin. Shellshock and the Psychologists. In The Anatomy of Madness: Essays in the History of Psychiatry, edited by W. F. Bynum, Roy Porter, and Michael Shepherd. Vol. 2, 24271. London: Tavistock, 1985. Van der Kolk, Bessel A. and Onno van der Hart. The Intrusive Past: The Flexibility of Memory and the Engraving of Trauma. In Trauma: Explorations in Memory, edited by Cathy Caruth, 15882. Baltimore: Johns Hopkins University Press, 1995. Webb, Barry. Edmund Blunden: A Biography. New Haven: Yale University Press, 1990. Whitehead, Anne. Open to Suggestion: Hypnosis and History in Pat Barkers Regeneration. Modern Fiction Studies 44, no. 3 (1998): 67494. Wilson, Jean Moorcroft. Siegfried Sassoon: The Making of a War Poet: A Biography (18861918). London: Duckworth, 1998. . Siegfried Sassoon: The Journey From the Trenches: A Biography (19181967). New York: Routledge, 2003.