Skip to 0 minutes and 7 secondsSo Jonathan, can you tell me a bit more about Craiglockhart? Yeah. So Craiglockhart, which is a big country house just outside Edinburgh-- In Victorian times, it was a place associated with hydrotherapy, where people went to take the waters. So during the First World War, it became a special hospital for traumatised soldiers, and there were a variety of different approaches to treatment used there. Some of our Learners may be familiar with Pat Barker's novel, Regeneration, or, indeed, the movie that was made out of it, and that explores rather well these different treatments. There was a Dr. Yealland who believed in electroshock therapy. Then there was Dr. Rivers, who believed in the talking cure, and there was Dr.

Skip to 0 minutes and 55 secondsBrock-- Arthur Brock-- who believed in what he called 'ergotherapy,' which was therapy through work-- what we might now call occupational therapy-- sort of physical activity. Rivers had read deeply in Sigmund Freud, and he believed in the curative power of talk-- what we would now call psychoanalysis-- but he wasn't a Freudian in the sense of thinking that sexual trauma was the key to things. With these soldiers, it was to do with reliving, and thus, in some senses, expiating the trauma of what they had seen and experienced in the trenches. And Brock, as I say, was a really important figure because he got the patients out there-- working on local farms, going into schools.

Skip to 1 minute and 47 secondsAnd he also encouraged them to write-- to produce-- a magazine, so there was a magazine called The Hydra. And the work on that he thought was a very important part of the therapy. And of course, one of the most famous 'inmates,' if you like, was Siegfried Sassoon. Yeah, that's right. So I mean, the story of how Sassoon got to Craiglockhart is an interesting one because Sassoon, who was a very brave officer-- but he reached a point at which he really felt he needed to speak out against the war. He just thought the carnage was too much-- the war could no longer be justified. But of course, for a serving officer to speak out against the war-- this was treason.

Skip to 2 minutes and 32 secondsThis was grounds for a court-martial. So he was in severe trouble. His friend, Robert Graves, had found out about the work of Rivers at Craiglockhart. I think in the discussion with Andrew, I incorrectly said Graves had been treated at Craiglockhart. That wasn't actually the case, but he knew about Rivers. And what Graves decided was that he would persuade the court-martial that Sassoon was suffering from shell shock so that he wouldn't be court-martialed and shot. And there's a famous passage in Robert Graves's great autobiographical memoir of his experience in the First World War, Good-Bye to All That, where he talks about this moment, and I've got it here. 'Sassoon,' says Graves, 'looked very ill.

Skip to 3 minutes and 21 secondsHe told me he had just been down to the Formby links'-- that's a golf course just near Liverpool where you come from-- 'and thrown his Military Cross into the sea. We discussed the political situation. I took the line that everyone was mad except ourselves and one or two others, and that no good could come of offering common sense to the insane. At last, unable to deny how ill he was, Siegfried consented to appear before the medical board. Much against my will, I had to appear in the role of a patriot, distressed by the mental collapse of a brother-in-arms-- a collapse directly due to his magnificent exploits in the trenches. I mentioned Siegfried's 'hallucinations' in the matter of corpses in Piccadilly.

Skip to 4 minutes and 6 secondsBeing in nearly as bad a state of nerves as Siegfried myself, I burst into tears three times during my statement. I prayed that when Siegfried came into the boardroom after me, he would not undo my work by appearing too sane.' Well, the trick worked, and Sassoon was duly sent to Craiglockhart. Graves accompanied him there, and he met Rivers. And so Sassoon found himself in this environment full of these soldiers suffering from shell shock. He was so brave-- he did win the Military Cross. And who did he meet when he was at Craiglockhart? Well he met Wilfred Owen, who seriously was suffering from shell shock.

Skip to 4 minutes and 45 secondsAnd it was there, of course, that Sassoon encouraged Owen to write more explicitly about the war. Owen had been writing poetry for a long time, but the idea of writing poems that were really up-front about the trauma of the war-- that was inspired by Sassoon. So many of Wilfred Owen's greatest poems, for example, 'Dulce et Decorum Est,' the poem that ends with the line about the old lie-- that it is a beautiful and sweet thing to die for your country. These were written at Craiglockhart. Some of both Owen's and Sassoon's poems were published in Hydra, the in-house magazine there. How closely did Sassoon edit Wilfred Owen? Yeah.

Skip to 5 minutes and 28 secondsThey did work extremely closely together, so there are-- you have surviving manuscripts-- they're in the British Library in London-- of some of Owen's most famous poems, where Sassoon has put markings on them, has contributed to that process. We've been looking at some old footage from one of the other hospitals for shell shock victims-- extraordinary footage of before and after. It has to be said-- scholars have questioned some of that footage. It has been suggested that the patients were actually sort of re-enacting their symptoms, rather like some of the famous footage of soldiers going over the top in the war, which was actually sort of filmed in retrospect.

Skip to 6 minutes and 8 secondsSo we need to be a little bit careful with that evidence, but, nevertheless, it does give an extraordinary sense of shell shock being a physical condition as well as a mental one. And they had never seen anything like it before on such a scale. The doctors were puzzled when they saw soldiers with these symptoms, hence why they had to do something about it. Of course, they had to get them back on to the front and get them well again, but it was a shock as much to the doctors as to anybody else because it hadn't been seen on that scale.

Skip to 6 minutes and 37 secondsAnd, of course, this was an age where ideas of bravery, of the stiff upper lip, of duty, of patriotism, was so important. So the sense of a soldier becoming like a child, being frightened, showing emotion, and of a body collapsing-- this was, by some of the military top brass, regarded as rank cowardice. And so for the doctors to show that this was something real, something that the men were not in control of, and something that demanded treatment, demanded sympathy, was of enormous importance. And really, the modern understanding of what we now call Post-Traumatic Stress Disorder began there.

Skip to 7 minutes and 23 secondsBut I want to sort of move away from, for a moment, that notion of PTSD being entirely to do with soldiers, with men in the First World War, because we have a better understanding now of trauma, and trauma can affect all sorts of people, as we know. It can affect women who've been raped or had miscarriages or stillbirths, and I think there are some very powerful poems about trauma. I mean, one of the poems we've been looking at dates-- it's a Katherine Philips poem from the 17th century, and she writes about miscarriage, and it seems to me as relevant, as fresh, as painful, about the trauma of losing yet another-- her 15th or 16th baby.

Skip to 8 minutes and 9 secondsAnd so that's something that we've been looking at, and indeed, I went to speak to two people who'd experienced PTSD to talk about their experiences with them, and how writing had helped them come to terms with their experience. Yeah, of course-- you're absolutely right. I mean, any kind of sudden shock can be a form of trauma. I mean, the people who are in involved in terrorist attacks, in accidents, but also, as you say, sort of less high profile, more private traumas-- this is something that people experience. And of course, the experience itself is not new-- that a language for it emerged in the First World War, and now there is a modern medical understanding of it.

Skip to 9 minutes and 3 secondsBut writers throughout history have been able to explore trauma. You give the example of Katherine Philips, a woman writing about the trauma of miscarriage, of stillbirth. Shakespeare, too, clearly is fascinated by trauma. The film of his tragedy of war, and indeed, lost children, Macbeth, is a really good example of interpreting extreme behaviour in Shakespearean characters by way of PTSD. This is the film with Michael Fassbender as Macbeth, Marion Cotillard as Lady Macbeth. It begins with an image of a dead child. We know that the Macbeths have had a child, but have lost it. And whereas other characters in the play do have children, the Macbeths don't. And we know, too, that Macbeth has had an extraordinary violent time in battle.

Skip to 10 minutes and 6 secondsSo the director of that film version sort of took the idea that Macbeth is suffering from battlefield stress and Lady Macbeth from trauma due to the loss of a child, and that this was a way of exploring the characters psychologically. But there's also-- I mentioned rape. One of the poems that we're looking at is a poem called 'For Lavinia,' which is a marvelous poem by Peter Robinson, which was about a real story-- the rape of his girlfriend. And he draws on Shakespeare's Titus Andronicus-- the character of Lavinia, who is raped and mutilated-- trauma of the most inconceivable kind. Can you talk a little bit about Titus?

Skip to 10 minutes and 53 secondsYeah, I mean, Titus was Shakespeare's first tragedy, his bloodiest play, and certainly, if you want trauma, it's there in abundance. This is the play that includes the stage direction, 'Enter a messenger with two heads and a hand.' Titus is a warrior, a soldier. He comes back from the wars, and then he's faced with appalling catastrophes, as his sons are beheaded. He cuts off his own hand to try and save their life, but then his hand is brought back to him. And at one point, he's so traumatised on seeing this absolute sort of catalogue of dismemberment, that all he can do is laugh.

Skip to 11 minutes and 32 secondsVery astute on Shakespeare's part-- the idea that in times of extremity, words can fail us and only some kind of hollow laugh is possible. But another moment in the play comes where Titus's brother, Marcus, witnesses Lavinia, his niece-- this daughter of Titus-- and she's been raped. And then, the rapists have cut off her hands and cut out her tongue so she cannot identify who's done it. And Marcus witnesses her, and he produces this rather beautiful, rather strange, speech describing her body, so that some people find this rather distasteful-- that he speaks beautiful poetry at a time of great trauma.

Skip to 12 minutes and 16 secondsBut what Shakespeare seems to be suggesting is that the-- it's almost like a sort of slow-motion effect-- that Marcus is trying to comprehend what he's seeing-- this beautiful young girl who has been so hideously violated and mutilated. He's slowly trying to come to terms with it, as if he's witnessing a bad dream and realising it's a reality. We've included the speech among the course materials for people to look at, and it's a very helpful way of understanding the context for this very brave poem by Peter Robinson that we'll also be reading and that you spoke to the poet, Peter Robinson, about.

Craiglockhart and the origins of PTSD

In this video, we find out some more about medical approaches to shell shock during the First World War, focusing on the pioneering work of doctors at Craiglockhart Hospital in Edinburgh.

We’ve been conducting some research into the different treatments for shell shock that were developed at Craiglockhart, including talking therapy and ‘ergotherapy’ - that is, occupational therapy. We’ve also been finding out more about some of the patients who were treated at Craiglockhart, in particular, the famous First World War poets Siegfried Sassoon and Wilfred Owen. As we’ll see in the video, it was at Craiglockhart that Owen and Sassoon met and began their great friendship. Sassoon encouraged Owen to write about his experiences of war, and there are manuscripts of Owen’s poems that still survive today, on which you can see edits and amendments made in Sassoon’s hand. You can explore some of the manuscripts of Wilfred Owen’s poems on the British Library website.

In our conversation, we mention a film adaptation of Shakespeare’s Macbeth, directed by Justin Kurzel and starring Michael Fassbender and Marion Cotillard. In this adaptation, it is suggested that Macbeth is suffering from PTSD, caused by his violent encounters on this battlefield. If you’d like to find out more about this interpretation, you can follow the link below to watch a press conference for the film on YouTube. You can watch as much of the Michael Fassbender interview as you’d like to, but the discussion of PTSD is mainly from 8:38. A PDF transcript of this section of the interview has been made available, please see the link under the ‘downloads’ title below.

Some learners have flagged up difficulties with watching the video above, so you can also try this link to another interview with Michael Fassbender, about playing Macbeth, and about how he imagined the character to be suffering from PTSD.

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Literature and Mental Health: Reading for Wellbeing

The University of Warwick

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