Marina Larsson, Shattered Anzacs: Living with the Scars of War, Kensington, NSW, UNSW Press, 2009.

In what way, I wonder, will the psychoanalytic fraternity in Australia acknowledge the  the Great War a century ago, the emergence of psychoanalytic treatment amongst the medical profession? For Australians next year marks the centenary of the landing at Gallipoli on 25th January 1915. Although psychoanalysis in Australia had its origins in these wartime hospitals and in the treatment of shell-shocked soldiers as historian, Joy Damousi also points out, I am slightly surprised to find this has been somewhat overlooked by the professional community – and others. I could be wrong here and am certainly open to correction.In 1919 three psychiatrists – or were they called ‘neurologists’ in those days?- returned to Australia from the Military Hospitals  where they had worked alongside British colleagues, including, perhaps, W.H.R. Rivers whose work with shell-shock victims is recorded in Pat Barker’s Regeneration Trilogy published from 1991.  They had discovered Freud’s ideas of the ‘talking cure’ in the treatment of shell shock- Paul Dane, John Springthorpe and Roy Coupland Winn among them. On the other side of the fence at the fifth Psychoanalytic Congress at Budapest in 1918  Hungarian psychoanalyst Sandor Ferenczi had presented his findings on War Neurosis. Ferenczi was subsequently elected President of the International Psychoanalytical Association – before the war turned and the Austrian-Hungarian Empire was defeated.

During the 1920s Both Dane and Winn returned to England for further psychoanalytic training. Melbourne based Dane was analysed by Joan Riviere and, in 1939, sent his daughter to England for treatment with Anna Freud. Winn who lived in Sydney was was a patient of Dr Noble. In 1931 he set up the first private practice as a psychoanalyst in Australia. On the eve of the Second World War both liaised with the Australian Government and with Ernest Jones for the resettlement of European psychoanalysts displaced by war in Australia.

In the immediate post war period, when it was becoming clearer that soldiers were returning suffering from shell shock as well as other severe medical conditions, a third doctor, Melbourne based John Springthorpe, set about trying to ameliorate the situation – or at the very least establish a method of treatment for them. Before the war Springthorpe was one of the most senior medical practitioners in the neurological field with considerable experience in treatment of the insane. In February 1919 Springthorpe was appointed as the Commonwealth Medical Referee for Neurological cases. By mid 1920 his services were terminated.

On 14 July 1920 he wrote to the Commonwealth Repatriation Commission to express his views about the way ‘neurological cases’ in the cohort of returned soldiers were being managed. His letter, discovered in the National Archives of Australia is sharply critical of the attitude of local medical practitioners who had no experience of war conditions. People who suffered from war trauma were far more numerous and complex than his other concern, the cardiac cases but, as Springthorpe wrote, ‘ the local Medical Boards ( without any experience at the front) had discharged many as malingerers and without any pension. They have been coming back ever since. Later on they were quite wrongly treated with isolation and restraint’. At ‘Mcleod’, a Repatriation Hospital in Melbourne to which he was placed in charge  in February 1919, Springthorpe  discovered that ‘cases were then all over the hospital and elsewhere, without any differential diagnosis and with but very little treatment’. He continued:

‘I separated, classified, and treated them…By August I had treated 111 shell-shock and hysteroid and 132 neurasthenic,  with 51 complicated by gas poisoning, a number also cardiac and 26 confusional or mental. The treatment occupational, Home or other Leave, physical and psychotherapy drugs etc is summarized in a report to the DGMS ( Director General Medical Services) in November’ 1919.

Springthorpe was relieved of his duties in August 1919, even though, he noted,  he was ‘well on the way to the establishment of a satisfactory scheme’ but there was no provision for follow up after discharge from hospital’. Why this was so is not clear from the records I have looked at so far… perhaps he was a thorn in the side of the Commissioners. Springthorpe wrote:

Feeling that not all was being done for neurological cases (many were under no treatment and wandering about dissatisfied) I brought the matter under the notice of the Repatriation Department and also before the DGMS who, at my suggestion gave me an outpatient clinic one afternoon a week at the Base Hospital. I found, however, that another clinic was in prior operation, practising simply by hypnotism ( the use of which is now limited by experts to cases of amnesia and terrifying dreams and so out of place at this stage for outpatient treatment) and that there was no publicity whereby cases requiring treatment could learn of our existence and no official attempt to extend our influence’.

Despite his efforts the Repatriation Commission had decided not to ‘utilise my services’ despite support for him from the Minister and from the Returned Soldiers League. Be that as it may Springthorpe continued, ‘the obligation to action remains and all concerned to look to it to restore these most distressing of cases’.

In its response to Springthorpe’s letter the Repatriation Commission was having none of it. It rejected Springthorpe’s views on treatment and defended its authority and the knowledge if the doctors it had appointed – all senior, experienced, and recognised leaders in their fields.

‘All neurological cases were treated by physicians who are experienced and well qualified to do so’, an officer, Dr J F Agnew, opined in Minute Paper to the Commission’s Chairman.   None had been treated with restraint and isolation other than ‘definite mentals who have been certified insane by Lt Col Jones Inspector General of Mental Hospitals* and Major Hollow, Mental Specialist and Superintendent at Mont Park Asylum’, he continued.  Indeed the whole matter had been discussed by senior officials at the Medical Advisory Board. Agnew named these distinguished personages:  Sir Henry Maudsley, Lt Col. R R Stawell, Col Geoff. Syme and Lt Col. James Ramsay Webb – ‘all of whom are specialists with war service and experience’.

The Commission’s position is summed up in para 12 of the Minute:

Expert opinion is definite as to the best method to be adopted in the treatment of neurological cases as to the best method to be adopted in the treatment of neurological cases, and it is clearly laid down that the concentration of these men in a clinic is productive of more evil than good and in the best interests of the men they should be placed in suitable employment as the best and readiest means of their final rehabilitation… When these men are kept for unlimited periods in Hospital  in such clinics as Dr Springthorpe suggests they suffer from “Hospitalitis” and very often in the course of such treatment develop new symptoms owning to their proclivities to imitate the symptoms of their fellow patients.

It appears that  Springthorpe, drawing on his experience in the field hospitals,  recognized the degree of suffering caused by shell shock as something little known until the Great War and which affected all classes. The Commissioners on the other hand appear to have maintained a belief in a class distinction between themselves and, apparently, the  ‘lower classes’ that were the patients.

In August and September this year the Australian Broadcasting Corporation finished televising a 4 part series, ‘The War That Made Us’, tracing through the diaries of those who were there – a nurse, Kit McNaughton, an Officer, ‘Pompey Elliott’ and a trooper, Archie Barwick, their impressions and the psychological changes occurring within them as a result of their experiences at the Front. Elliott, we were told, did not recover from the war: he suicided in 1931. Kit McNaughton had her own suffering, too. Although she returned to her home at Little River south of Melbourne and married her long time beau, she remained torn between the life she had left behind on the fields of war and the conventions to which she returned. I have reviewed Janet Butler’s elegant biography of Mc Naughton ‘Kitty’s War’ here.

One of the historians featured on the program, albeit briefly, was Marina Larsson whose book, Shattered Anzacs: Living With the Scars of War published in 2009, takes up the problem of post war suffering.

Death did not occur only on the battlefields, she points out, but often many years later as a result of wounds and illness. Death also occurred through suicide as a result of mental distress and trauma – Post Traumatic Stress Disorder.  Larsson also points to the cost to families when a loved one returns home and slowly reveals their depth of scarring. The insidious onset of alcoholism, heavy smoking and domestic violence are all responses to unbearable pain and terror. The casualties of war are far reaching across time. They may be held for generations within the family’s unconscious.

What became of Springthorpe and of the men who returned from war with such shocking psychological injuries is something to look at further. Marina Larsson has made a very good start.

References:

Australian Broadcasting Corporation ( 2014) ‘The War That Changed Us’ Television Series, televised August-September 2014.

Pat Barker,(1991) Regeneration, Sydney, Penguin Books.

Janet Butler (2013), Kitty’s War:The Remarkable Wartime Experiences of Kit McNaughton, St Lucia, University of Queensland Press.

Joy Damousi (2005), Freud in the Antipodes: A Cultural History of Psychoanalysis in Australia, Kensington, UNSW Press.

Marina Larsson ( 2009), Shattered Anzacs: Living With The Scars of War, Kensington, NSW, UNSW Press.

Dr John Springthorpe’s Memo on treatment of Cardiac and War Neurosis, 14 July 1920. Series No A2489, Control Symbol 1920/ 4166, Barcode, 4794937, Canberra, National Archives of Australia.http://recordsearch.naa.gov.au/scripts/Imagine.asp?B=4794937, accessed 25 September 2014

Commonwealth of Australia, Department of Repatriation, Minute Paper, re Dr Springthorpe’s memo. on Treatment of Cardiac and war Neurosis, dated 23 July 1920, Series No A2489, Control Symbol 1920/ 4166, Barcode, 4794937, Canberra, National Archives of Australia.http://recordsearch.naa.gov.au/scripts/Imagine.asp?B=4794937, accessed 25 September 2014.

* W. Ernest Jones, Inspector General of the Insane was given an honorary post in the Army.