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War and the Practice of Psychotherapy: The UK Experience 1939–1960

Published online by Cambridge University Press:  26 July 2012

Edgar Jones
Edgar Jones
Affiliation:
Institute of Psychiatry & Guy's King's and St Thomas' School of Medicine, Department of Psychological Medicine, 103 Denmark Hill, London SE5 8AZ
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During the Second World War, it is argued, “the neuroses of battle” not only deepened an understanding of “psychopathological mechanisms”, but also created opportunities for the practice of psychotherapy, while its perceived efficacy led to a broader acceptance within medicine and society once peace had returned. This recognition is contrasted with the aftermath of the First World War when a network of outpatient clinics, set up by the Ministry of Pensions to treat veterans with shell shock, were closed within a few years in response to financial pressures and doubts about their therapeutic value. In the private sector, psychoanalysis under the leadership of Ernest Jones remained an idiosyncratic activity confined largely to the affluent middle classes of London. According to Gregorio Kohon, “it was strongly opposed by the general public, the Church, the medical and psychiatric establishment, and the press”. The Medico-Psychological Clinic of London, originally set up in 1913, offered psychotherapy on three afternoons a week in premises at 30 Brunswick Square under the direction of Dr James Glover. However, it closed in 1923 after Glover and his brother Edward had both become psychoanalysts. As the First World War drew to a close, Maurice Craig helped to persuade Sir Ernest Cassel to fund a hospital for ‘Functional and Nervous Disorders’ at Penshurst, Kent, to treat neuroses in the civilian population. Although moved to permanent premises near Richmond, it remained small-scale and at the time no attempt was made to establish a network of similar institutions throughout the UK. The Tavistock Clinic, opened in Bloomsbury in 1920, struggled to secure funding throughout the interwar period and its efforts to win official recognition from the University of London were consistently rebutted. Thus, despite the epidemic of shell shock and other so-called war neuroses, psychotherapy remained a marginal activity during the 1920s and 1930s.

Type
Articles
Information
Medical History , Volume 48 , Issue 4 , 01 October 2004 , pp. 493 - 510
Copyright
Copyright © Cambridge University Press 2004

References

1 J R Rees, The shaping of psychiatry by war, New York, W W Norton, 1945, p. 116.

2 Eric Rayner, The independent mind in British psychoanalysis, London, Free Association Books, 1990, p. 268.

3 Ben Shephard, A war of nerves, soldiers and psychiatrists 1914–1994, London, Jonathan Cape, 2000, p. 164.

4 Gregorio Kohon, ‘Notes on the history of the psychoanalytic movement in Great Britain’, in G Kohon (ed.), The British school of psychoanalysis: the independent tradition, London, Free Association Books, 1986, pp. 24–50, on p. 28.

5 L S Hearnshaw, A short history of British psychology, 1840–1940, London, Methuen, 1964, p. 165.

6 H C Cameron, ‘Sir Maurice Craig’, Guy's Hospital Reports, 1935, 85: 251–7, p. 254.

7 H V Dicks, Fifty years of the Tavistock Clinic, London, Routledge & Kegan Paul, 1970, pp. 61–3, 101.

8 Joanna Bourke, ‘Psychology at war’, in G C Bunn, A D Lovie and G D Richards (eds), Psychology in Britain: historical essays and personal reflections, Leicester, BPS Books, 2001, pp. 133–49, on pp. 134, 138.

9 R H Ahrenfeldt, Psychiatry in the British army in the Second World War, London, Routledge & Kegan Paul, 1958, pp. 147–62.

10 R H Ahrenfeldt, ‘The army psychiatric service’, in Arthur Salusbury MacNalty and W Franklin Mellor (eds), Medical services in war: the principal medical lessons of the Second World War, London, HMSO, 1968, pp. 175–216, on pp. 200–3.

11 Malcolm Pines, ‘The development of the psychodynamic movement’, in German Berrios and Hugh Freeman (eds), 150 years of British psychiatry 1841–1991, London, Gaskell, 1991, pp. 206–31, p. 229.

12 David H Malan, Individual psychotherapy and the science of psychodynamics, London, Butterworth, 1979, p. 74.

13 Pearl King and Ricardo Steiner (eds), The Freud–Klein controversies 1941–1945, London, Tavistock/Routledge, 1991.

14 Sonu Shamdasani, ‘The psychoanalytic body’, in Roger Cooter and John Pickstone (eds), Companion to medicine in the twentieth century, London, Routledge, 2003, pp. 307–22, on p. 308.

15 The National Archives (hereafter TNA), WO32/13462, J R Rees, Untitled typescript of a speech (n.d.), p. 2.

16 TNA, WO32/11550, Report of a conference on psychiatry in forward areas held in Calcutta, 8 to 10 August 1944.

17 Shephard, op. cit., note 3 above, p. 171.

18 TNA, WO222/759, Medical Quarterly Reports of No. 41 General Hospital, April 1941 to December 1944.

19 Robert Drew, Commissioned officers in the medical services of the British army 1660–1960, Volume II, London, Wellcome Historical Medical Library, 1968, p. 224.

20 TNA, WO222/759, Medical Quarterly Reports of No. 41 General Hospital, 15 Jan. 1941, p. 3.

21 Ibid., Quarterly Report to 30 September 1943; Quarterly Report to 31 March 1944.

22 Tom Harrison, Bion, Rickman, Foulkes and the Northfield experiments: advancing on a different front, London, Jessica Kingsley, 2000, p. 155.

23 W R Bion and John Rickman, ‘Intra-group tensions in therapy: their study as the task of the group’, Lancet, 1943, ii: 678–81, p. 678.

24 Wilfrid R Bion, The long week-end 1897–1919, London, Free Association Books, 1986, p. 278; Oliver Lyth, ‘Wilfrid Ruprecht Bion’, Int. J. Psycho-Anal., 1980, 61: 269–73.

25 Basil Beaumont, The technique of group work, London, Favil Press, 1935, p. 5.

26 J Bierer, ‘Group psychotherapy’, Br. med. J., 1942, i: 214–16.

27 T M Harrison and D Clarke, ‘The Northfield experiments’, Br. J. Psychiatry, 1992, 160: 698–708.

28 Patrick B de Maré, ‘Major Bion’, in Malcolm Pines (ed.), Bion and group psychotherapy, London, Routledge & Kegan Paul, 1985, pp. 108–10.

29 Pat de Maré, ‘Michael Foulkes and the Northfield experiment’, in Malcolm Pines (ed.), The evolution of group analysis, London, Routledge & Kegan Paul, 1983, p. 223; see also Harold Bridger, ‘The Northfield experiment’, Bull. Menninger Clinic, 1946, 10: 71–7; T F Main, ‘The hospital as a therapeutic institution’, Bull. Menninger Clinic, 1946, 10: 66–70.

30 Wellcome Library for the History and Understanding of Medicine (hereafter WL), PP/SHF/C3.6 Letter to S H Foulkes from J Rickman, 17 August 1945.

31 WL, PP/SHF/C3.8 Notes of staff meetings led by Major Foulkes, 24 May 1945, p. 2.

32 S H Foulkes, ‘Group analysis in a military neurosis centre’, Lancet, 1946, i: 303–5, p. 303.

33 Roger Cooter and Steve Sturdy, ‘Of war, medicine and modernity: introduction’, in Roger Cooter, Mark Harrison and Steve Sturdy (eds), War, medicine and modernity, Thrupp, Sutton Publishing, 1998, pp. 1–21.

34 Joanna Bourke, ‘Disciplining the emotions: fear, psychiatry and the Second World War’, in Cooter, Harrison and Sturdy (eds), op. cit., note 33 above, pp. 225–38, p. 232.

35 S H Foulkes and Eve Lewis, ‘Group analysis: a study in the treatment of groups on psycho-analytic lines’, Br. J. Med. Psychol., 1944–46, 20: 179–80.

36 Foulkes, op. cit., note 32 above, p. 303.

37 Ibid., p. 305.

38 TNA, WO222/846, Report on the Work of the Medical Division, Military (P) Hospital, Northfield, 25 December 1944, p. 1.

39 Ibid.

40 Mathew Thomson, ‘Constituting citizenship: mental deficiency, mental health and human rights in inter-war Britain’, in Christopher Lawrence and Anna-K Mayer (eds), Regenerating England: science, medicine and culture in inter-war Britain, Amsterdam, Rodopi, 2000, pp. 231–50, p. 241.

41 Shephard, op. cit., note 3 above, pp. 265–7; Harrison, op. cit., note 22 above, , pp. 205–13.

42 ‘Obituary Thomas Forrest Main’, Int. J. Psycho-Anal., 1991, 72: 719–22.

43 Main, op. cit., note 29 above, p. 66.

44 Ibid., p. 67.

45 Bridger, op. cit., note 29 above, p. 75.

46 S H Foulkes, ‘Principles and practice of group therapy’, Bull. Menninger Clinic, 1946, 10: 85–9, p. 86.

47 Bethlem Royal Hospital Archives, The Medical Superintendent's Report on the Organization and Work of Mill Hill Emergency Hospital to December 31 1940, p. 2.

48 D W Millard, ‘Maxwell Jones and the therapeutic community’, Freeman and Berrios (eds), op. cit., note 11 above, pp. 581–604, on pp. 583–5.

49 Maxwell Jones, A Baker, Thomas Freeman, Social psychiatry: a study of therapeutic communities, London, Tavistock Publications, 1952, pp. 2–3.

50 Ibid., p. 4.

51 Ibid., p. 14.

52 Millard, op. cit., note 48 above, p. 589.

53 Edgar Jones, ‘Aubrey Lewis, Edward Mapother and the Maudsley’, in K Angel, E Jones and M Neve (eds), European Psychiatry on the Eve of War: Aubrey Lewis, the Maudsley Hospital and the Rockefeller Foundation in the 1930s, Medical History, Supplement No. 22, London, Wellcome Trust Centre for the History of Medicine at UCL, 2003, pp. 3–38, on pp. 30–1.

54 Edgar Jones and Simon Wessely, ‘Psychiatric battle casualties: an intra- and inter-war comparison’, Br. J. Psychiatry, 2001, 178: 242–47, p. 243.

55 William Brown, ‘The treatment of cases of shell shock in an advanced neurological centre’, Lancet, 1918, ii: 197–200.

56 W Johnson and R G Rows, ‘Neurasthenia and the war neuroses’, in W G Macpherson, W P Herringham, T R Elliott and A Balfour (eds), History of the great war based on official documents, medical services, diseases of the war, Volume 2, London, HMSO, 1923, pp. 2–61; see also TNA, PIN15/2402, Conference on Entitlement in Neurasthenia, 10 November 1939, Dr Gordon Holmes, who had been consultant neurologist to the BEF in World War One claimed that “86% of the men were back to the line within a fortnight or three weeks”, p. 13.

57 Thomas W Salmon, ‘The care and treatment of mental diseases and war neuroses (“shell shock”) in the British army’, Mental Hygiene, 1917, 1: 509–47.

58 K L Artiss, ‘Human behaviour under stress: from combat to social psychiatry’, Mil. Med., 1963, 128: 1011–15.

59 TNA, WO222/1735, Medical Quarterly Report, No. 1 Canadian Exhaustion Unit, July 1944 to March 1945.

60 Captain P B de Maré, ‘Exhaustion Centre’ (typescript, August 1944), p. 2.

61 TNA, WO222/1735, Medical Quarterly Report, 31 December 1944, pp. 1, 4.

62 TNA, WO32/11550, ‘Psychiatric service in operational theatres, report on visit to 21 Army Group’, p. 1.

63 S A MacKeith, ‘Lasting lessons of overseas military psychiatry’, J. Ment. Sci., 1946, 92: 546–7.

64 TNA, WO32/11550, No. 7 Base Psychiatric Centre, 30 September 1944.

65 ‘Ways and means in psychiatry’, Lancet, 1945, i: 614.

66 R D Gillespie, Psychological effects of war on citizen and soldier, New York, W W Norton, 1942, pp. 76–7.

67 R D Gillespie, The York Clinic for Psychological Medicine, Guy's Hospital, London SE1, London, 1944, p. 3.

68 ‘York Clinical Annual Report for 1944’ (typescript, n.d.), p. 5; see also, Felix W Brown, ‘Report of the York Clinic’, Guy's Hospital Gazette, 1945, 59: 129–33.

69 Thomas A Munro, ‘Report on the York Clinic for Psychological Medicine’ (typescript, 9 July 1948), p. 2.

70 M Woodside, ‘York Clinic 1956, calculations and comments’ (typescript October 1958), p. 3.

71 J J Fleminger, ‘Psychiatry at Guy's’, Guy's Hospital Gazette, 1983, 97: 296–302, p. 301.

72 C P Blacker, Neurosis and the mental health services, London, Oxford University Press, 1946.

73 Ibid., p. 47.

74 P Roazen, Oedipus in Britain: Edward Glover and the struggle over Klein, New York, Other Press, 2000, pp. 144–5.

75 Rayner, op. cit., note 2 above, p. 263.

76 ‘Obituary’, Lancet, 1952, i: 1073.

77 Pines, op. cit., note 11 above, p. 226.

78 ‘Obituary’, Lancet, 1965, i: 1077.

79Medical Directory for 1949, Part 2, London, J & A Churchill, 1949, pp. 398–405.

80Int. J. Psycho-Anal., 1939, 20: 504–6; Int. J. Psycho-Anal., 1950, 31: 311–13; Int. J. Psycho-Anal., 1954, 35: 471–3.

81 Mathew Thomson, ‘The psychological body’, in Cooter and Pickstone (eds), op. cit., note 14 above, pp. 291–306, p. 300.

82 Malan, op. cit., note 12 above, p. 229.

83 Millard, op. cit., note 48 above, p. 590.

84 Nick Manning, The therapeutic community movement: charisma and routinization, London, Routledge, 1989, p. 26.

85 Ibid.; Kathleen Jones, Mental health and social policy 1845–1959, London, Routledge & Kegan Paul, 1960, p. 168.

86 Pines, op. cit., note 11 above, p. 229.