[In the following essay, Showalter examines the psychological effect of shell shock on male sexual identity and Sassoon's hospitalization under the care of psychiatrist William H. R. Rivers.]

On July 23, 1917, 2d Lt. Siegfried Sassoon arrived at Craiglockhart War Hospital near Edinburgh to be treated for war neurosis by Royal Army Military Corps psychiatrist Capt. William H. R. Rivers. Their three-month-long therapeutic relationship, intensified by the urgency of the war, exerted a powerful influence on each man's life and ideas. The record of this encounter is one of the best sources we have for studying the inscription of male gender anxieties during the war, anxieties that manifested themselves in the body language of neurotic symptoms and in the structures of writing, both memoir and psychiatric text.

“Dottyville,” as the hospital was called by Sassoon and his friends Robert Graves and Lt. Wilfred Owen, also a patient, was a former hydropathic hotel for the nervous or alcoholic rich, which boasted extensive facilities for gardening, tennis, swimming, and other games. Yet Sassoon—who had been ordered by a military review board to undergo medical treatment after he published his famous pacifist denunciation of the war, “A Soldier's Declaration,” in May 1917—was apprehensive. “After all,” he wrote, “a mad-house would be only a few degrees less grim than a prison, and I was still inclined to regard myself in the role of a ‘ripe man of martyrdom.’” But he had heard that there was something unusual about Rivers, a professor at Cambridge who had made a distinguished reputation for himself as an anthropologist and clinical psychologist. One of the first in England to support Freud's work, after the war he became a pioneer member of the British Psychoanalytic Society. “Rivers was evidently some kind of great man,” Sassoon wrote in his war memoir, Sherston's Progress. He looked forward to meeting him, and from the first five minutes of their conversation, he felt reassured: “There was never any doubt about my liking him. He made me feel safe at once and seemed to know all about me.”

In order to understand the transactions between Rivers and Sassoon, we must first look at the phenomenon of war neurosis or, to use the term invented by military physicians, shell shock. Although he did not seem to have any unusual physical or behavioral symptoms, the stresses and concerns that motivated Sassoon to publish his open letter of protest against the war could easily be seen as part of the larger syndrome of shell shock to which army doctors and administrators had gradually become accustomed. The Great War was the first large-scale military operation in which mental breakdown played a significant role. This was so, historians have suggested, because of the high degree of impersonality, tension, passivity, and uncertainty trench warfare produced. As Eric Leed explains, “neurosis was a psychic effect not of war in general but of industrialized war in particular … the neuroses of war were the direct product of the increasingly alienated relationship of the combatant to the means of destruction.” In a study of neurosis in the air corps, Rivers had discovered that the “quantity of neurotic symptoms correlated not with the intensity of battle, the length of an individual's service, or his emotional predisposition, but with the degree of his immobility.” Rivers concluded that a man's most rational response to anxiety is some kind of manipulative activity, through which he acquires a sense of himself “as an autonomous actor in a world of instrumentalities.” When technological warfare deprived men of their sense of agency, they lost their natural defenses against fear and regressed toward neurosis, magic, or superstition.

The diagnosis of shell shock encompassed a wide range of physical and emotional symptoms, strikingly differentiated by class and rank. In soldiers, symptoms tended overwhelmingly to be physical: paralyses, limps, blindness, deafness, mutism （the most common symptom）, contractures of a limb, or vomiting; in officers, symptoms tended toward the emotional: nightmares, insomnia, fatigue, dizziness, disorientation, and anxiety attacks. Sexual impotence was widespread in all ranks, so that the sexual wounds that Sandra Gilbert has noted as a major trope of postwar writing had their source in symbolic disorders of powerlessness.

Shell shock has also developed a unique mythology in the literature of the war. The historian Martin Stone, for example, sees it as the “tragic motif of the death of the Victorian Spirit” and suggests that “the shell-shocked soldier has taken on something of a Romantic guise, like his 19th century counterpart, the tubercular artist.” In a psychiatric context, however, shell shock can be seen as the first large-scale epidemic of male hysteria. Doctors had long been aware that hysteria could appear in men, but they were not prepared for the enormous numbers of men who developed hysterical symptoms during the war. By 1916 shell-shock cases accounted for as many as 40 percent of the casualties in the combat zones. By 1918, there were over twenty army hospitals for shell-shock patients in the United Kingdom. And, by the end of the war, eighty thousand cases had passed through army medical facilities. One-seventh of all discharges for disability were for nervous disorders.

This parade of emotionally incapacitated men was in itself a shocking contrast to the heroic visions and masculinist fantasies that had preceded it in the British Victorian imagination. The poetic image of the Great War was one of strong, unreflective masculinity, embodied in the square, solid figure of General Haig, prepared by the poems of Kipling and the male adventure stories of G. R. Henty and Rider Haggard. For officers in particular, the cultural pressures to conform to these British ideals of stoic and plucky masculinity were extreme. As Paul Fussell notes in his glossary of the romantic vocabulary of war literature in which this generation was steeped, “not to complain” is to be “manly.” A brochure of Instructions for the Training of Platoons for Offensive Action （1917） describes how the platoon commander should gain the confidence of his men. He must be “well turned out, punctual, and cheery, even in adverse circumstances,” look “after his men's comfort before his own and never spare himself,” “enforce strict discipline,” and be “blood-thirsty and forever thinking how to kill the enemy.” Legends circulated of officers who went over the top kicking a football as they charged the enemy trenches. In fact, the rate of war neurosis was four times higher among officers than among enlisted men. Initially, army personnel tried to assimilate the evidence of shell shock into the moral, military, and medical categories they had established before the war. Some tried to excuse it as a physical injury to the central nervous system caused by proximity to an exploding shell. When faced with a hysterical soldier displaying unmanly emotions—such as a private who cried so continuously that he could not handle his rifle—they diagnosed his case as “excessive action of the lachrymal glands” and blamed it on organic causes. Many senior army officers, on the other hand, believed that shell-shock cases were either madmen who should be committed or cowards and malingerers who should be shot.

But gradually most military psychologists and medical personnel came to agree that the real cause of shell shock was the emotional disturbance produced by warfare itself, by chronic conditions of fear, tension, horror, disgust, and grief; and war neurosis was “an escape from an intolerable situation,” a compromise negotiated by the psyche between the instinct of self-preservation and the inhibition against deception or flight, which were “rendered impossible by ideals of duty, patriotism, and honor.” Placed in intolerable and unprecedented circumstances of fear and stress, deprived of their sense of control, and expected to react with outmoded and unnatural “courage,” thousands of men reacted instead with the symptoms of hysteria; soldiers lost their voices and spoke through their bodies. For some, the experience of combat and loss may have brought to the surface powerful and disturbing feelings of love for other men. For most, however, the anguish of shell shock included more general but intense anxieties about masculinity, fears of acting effeminate, even a refusal to continue the bluff of male behavior. If it was the essence of manliness not to complain, then shell shock was the body language of masculine complaint, a disguised male protest, not only against the war, but against the concept of manliness itself. Epidemic female hysteria in late Victorian England had been a form of protest against a patriarchal society that enforced confinement to a narrowly defined femininity; epidemic male hysteria in World War I was a protest against the politicians, generals, and psychiatrists.

“The real source of wonder,” wrote Thomas Salmon, was not that neurosis “should play such an important part in military life, but that so many men should find a satisfactory adjustment without its intervention.” In Shell-Shock and Its Lessons an important book by military doctors G. Elliot Smith and T. H. Pear published toward the end of the war, the authors explained that the long-term repression of feeling that led to shell-shock symptoms in combat was only an exaggeration of male sex-role expectations in civilian life. “The suppression of fear and other strong emotions is not demanded only of men in the trenches,” they wrote, “it is constantly expected in ordinary society.”

There were two major ways of treating shell shock during the war, both intended to get men back to the trenches as fast as possible. The treatments were differentiated according to rank. Shell-shocked soldiers, on the one hand, were treated with the hostility and contempt that had been accorded hysterical women before the war. Not only in England, but in all European countries, they were subjected to forms of disciplinary treatment, quick cures, shaming, and physical retraining, frequently involving painful electrical shocks to the afflicted parts of their bodies. These were in fact semi-tortures designed to make the hysterical symptom more unpleasant to maintain than the threat of death at the front. Officers, however, were regarded as harder to treat and usually given various kinds of psychotherapy.

Sassoon's therapy raises some interesting specific problems, because he did not think he was suffering from shell shock at all. His assignment to a war hospital rather than a court-martial had been engineered by the desperate efforts of Robert Graves and others to save him from the consequences of his pacifist outburst. Yet there were reasons why Sassoon's late-blooming pacifism could be officially understood and categorized as a form of war neurosis. His letter declaring the war a “deliberately prolonged … war of aggression and conquest” seemed like a bizarre aberration from one whose daredevil valor in combat had earned him the nickname Mad Jack and won him the Military Cross. In London, recovering from a war wound in the spring of 1917, he had had hallucinations of corpses on the pavement and fantasies of assassinating General Haig. And some shell-shock experts would have regarded Sassoon as a likely candidate for mental breakdown according to a theory that “strange first names” were symptomatic of latent family degeneracy.

Rivers diagnosed Sassoon's case as a “very strong anti-war complex” and set about curing it through psychoanalytic techniques. In his therapeutic practice, Rivers relied on what he called autognosis, or self-understanding, which involved discussion of traumatic experiences; and reeducation, in which the “patient is led to understand how his newly acquired knowledge of himself may be utilized … and how to turn energy, morbidly directed, into more healthy channels.” In Sassoon's case, this meant Rivers embarked on a delicate and subtle intensification of his fears that pacifism was unmanly and cowardly, a process heightened by Sassoon's strong admiration, respect, and affection for Rivers and by the Craiglockhart regime. In contrast to the passive rest cures favored in this period for hysterical or neurasthenic women of Sassoon's class （such as Virginia Woolf）, military doctors felt that intense activity was essential for the restoration of male self-esteem. Sassoon was urged to resume a life of energetic masculine endeavor at Craiglockhart. Unlike the nervous women of the generation, who were forbidden by male psychiatrists to write or work, Sassoon was encouraged to take up a vigorous program of sports, was provided with a room of his own so that he could write undisturbed, and even had a hospital newspaper, The Hydra, edited by Wilfred Owen, in which to publish his poems.

In lengthy conversations three times a week, Rivers and Sassoon talked not only about Sassoon's life and war experiences but also about European politics, German military history, and the dangers of a premature peace. This talking cure was intended to make Sassoon feel uneasy about the gaps in his information and to emphasize the contrast between his emotional, and thus feminine, attitude toward the war and Rivers' rational, masculine, Cambridge don's view of it. At the same time, Sassoon found himself in the company of “nurses and nervous wrecks” and men who had “done their bit in France” crying like children. He was anxious to assert his superiority to his fellow officers: “Sometimes I had an uncomfortable notion that none of them respected one another; it was as though there were a tacit understanding that we were all failures, and this made me want to reassure myself that I wasn't the same as the others.”

By October, Sassoon was overwhelmed with guilt about his exile from the troops, about betraying the men who had fought with him, and about making a convenient separate peace that served to shorten the war for him. These anxieties were expressed in nightmares about the war, described in such poems of the period as “Sick Leave”:

When I'm asleep, dreaming and lulled and warm—
They come, the homeless ones, the noiseless dead
.....................
Out of the gloom they gather about my bed.
They whisper to my heart; their thoughts are mine.
“Why are you here with all your watches ended?
.....................
In bitter safety I awake unfriended;
And while the dawn begins with slashing rain
I think of the Battalion in the mud.
“When are you going out to them again?
Are they not still your brothers through our blood?”

In November, acceding to Rivers' diagnosis that he had been sick and giving up his antiwar complex, Sassoon was cleared by a medical board, became once more, as he says, an “officer and a gentleman,” and went back to the front. Some historians have argued that there was really something neurotic in Sassoon that craved death, loved the war, and derived a drug-like satisfaction from facing danger. But this view seems mistaken to me. Without psychiatric intervention, Sassoon might have stuck to his pacifist principles. Rivers was the agent of a military establishment which had to frame his rebellion as a nervous breakdown and which found it more practical to isolate him in a mental hospital then to let him reach a political and public audience that might have supported his resistance.

Ironically, Rivers was as changed by their discussions as Sassoon was. He began to have antiwar dreams brought on by what Sassoon had told him. In his posthumous book, Conflict and Dream （1922）, Rivers explored the psychoanalytic issues of fear, anxiety, and sexual repression which had come out of his work with Sassoon and other patients at Craiglockhart. In a series of brilliant hypotheses, he also began to apply to female hysteria some of the ideas about gender anxiety that he had developed in his study of male hysteria.

Yet the covert intention of Rivers' therapeutic practice had been the reinscription of male gender anxieties in someone who had spoken against the war, and we can see his enormous and lasting success in Sassoon's postwar literary career. As Paul Fussell has pointed out, Sassoon devoted virtually all of his life after the war to an obsessive “re-visiting of the war” and his life before the war, “plowing and re-plowing” his experiences in a series of six memoirs. He was one for whom, as Fussell says, “remembering the war became something like a life work.” Sassoon described himself as motivated by a “queer craving to revisit the past and give the modern world the slip.” He seemed to be continuing the process of autognosis in which he had been trained by Rivers, conducting a kind of self-psychoanalysis the object of which was to justify his life as a man. George Sherston, the autobiographical hero of the war trilogy that comprises Memoirs of a Fox-Hunting Man, Memoirs of an Infantry Officer, and Sherston's Progress, is a simplified and macho version of what Sassoon called his “outdoor self” not a poet, but rather the manly participant in hunting and combat.

Rivers is installed in the memoirs, in Sassoon's diaries, and in his autobiography Siegfried's Journey as a father figure, conscience, or, we might also say, superego. He appears for the first time in Sherston's Progress. The first section of the book is named for him, and he is the only character given his real name. As Sassoon declares, “[my] definite approach to mental maturity began with my contact with the mind of Rivers,” and in his writings Sassoon continues to use Rivers as the measure of mature masculine wisdom. When, at the end of Sherston's Progress, he describes his convalescence from yet another war wound, it is Rivers who comes to see him and to set him straight: “His presence was a refutation of wrongheadedness. I knew then that I had been very lonely while I was at the War; I knew that I had a lot to learn, and that he was the only man who could help me.”

The note struck here, of loneliness and dependence, is one of many which hint at the homoerotic element in Sassoon's feeling for Rivers. Fussell suggests that Rivers was the embodiment of the male “dream friend” who had been the companion of Sassoon's boyhood fantasies. Rivers, who was fifty-three when he met Sassoon, was unmarried; he derived his greatest emotional satisfaction from his role as the teacher, mentor, and therapist of troubled young men. His colleague and student Charles Myers was one of many acquaintances who observed that through his psychiatric work in the war Rivers was able to release many of his long-repressed nurturant feelings, and thus “became … a far happier man.” When Rivers died suddenly in 1922, Sassoon was emotionally devastated. In a poem called “Revisitation,” he imagined himself haunted by Rivers' ghost, “selfless and ardent … whom I am powerless to repay.”

In his diary for March 26, 1921, Sassoon recorded his ambition to write the great English novel about homosexuality, “another Madame Bovary dealing with sexual inversion” which would be “free from any propagandistic feeling … as natural as life itself.” Although he never wrote such a novel, one might argue that the trilogy of war memoirs is Sassoon's disguised epic of homosexual feeling. The romantic homosexual subtext of his memoirs, the chronicle of “a wholly masculine way of life,” is one of the indirect forms through which he addresses questions of masculinity, which paradoxically can only be indirectly expressed since “to think about masculinity,” as Peter Schwenger notes, “is to become less masculine oneself.”

However indirectly, the psychiatric discourse of shell shock and the literary discourse of war memoirs opened up a significant discussion of masculinity that had been avoided by previous generations. Feminist interpretations of hysteria in women have helped us decode physical symptoms, psychotherapeutic exchanges, and literary texts as the representations of feminine conflict, conflict over the meaning of femininity within a particular historical context. Yet the meaning and representation of masculinity have been accepted as unproblematic. By applying feminist methods and insights to the symptoms, therapies, and texts of male hysteria, we may begin to understand that issues of gender and sexual difference are as crucial to understanding the history of masculine experience as they have been in shaping the history of women.