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‘Psychotherapy in Practice’: Dr John Springthorpe – Melbourne Physician – Australasian Medical Congress -1924.

29 Tuesday Nov 2022

Posted by Christine in 1920s, John Springthorpe, Medical Pracitioners

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Attitudes towards psychoanalysis by senior medical practitioners in Australia, Foundational ideas about psychoanalysis in Australia, John Springthorpe

FROM SPRINGTHORPE’S PAPER TO THE AUSTRALASIAN MEDICAL CONGRESS 1924.

What did the Australian medical profession actually say about Freud and psychoanalysis during the 1920s? Why was there so much antipathy towards it? In an attempt to understand this, I have been reading the Australasian Medical Journals from the early twentieth century. John Springthorpe was a former lecturer in Medicine at the University of Melbourne, recognised for his interest in psychotherapy, and the relationship between mind and body, had some thoughts which he delivered at the Australasian Medical Congress in 1924. Springthorpe was one of the most senior practitioners of medicine in Melbourne Australia from 1883 until his death in 1933. In this paper, Springthorpe is most scathing about Freud’s thought as he asserts the superiority of his own methods, derived, in part from the practice of hypnosis. These are the trio: analysis, suggestion and re-education. Here are some of the statements Springthorpe made about his theory of mind, the practice of psychotherapy and psychoanalysis and Freud.

*****************************************************************************

‘Psychotherapy is very complex…. the present position is very complex. It involves heredity, psychical as well as physical, comparative physiology and anthropology, the relations of mind to matter, of instinct to intelligence, of the conscious to the unconscious, of the place of the emotions, the intelligence and the will, of the endocrine glands and the sympathetic nervous system; upon each and all of which each must satisfy himself’.

‘ There is advantage, also, in co ordinating, if possible, all under one guiding principle – just as matter and life have been brought under their unities of origin. To state my own opinion upon this even more open question without dogmatism, I may say that I find myself a psychical monist and regard it probable that our mind, though at present confined in limited material setting, informed as to realities by a few imperfect scouts and reacting through material expressions, but possibly destined after trial and testing ultimately and always to use their little freedom of will in accord with the supreme’.

‘In psychotherapy two intellects are concerned, the operator’s and the patient’s, and, of course, the ingenuity of the former should be used purely for the needs of the latter. Psychoanalysis is thus doubly personal. It is interesting to note that whilst Freud basis his analysis on a fundamental emotion, Coue, ends his suggestion with “Know thyself”‘.

‘In my experience each patient should suggest his own analysis and any set plan is inadvisable’.

‘Each case is a case to itself and there are no watertight classifications… For pushing analysis into the subconscious. the main methods are the “relaxation and mild hypnotism” of Haydn Brown, the “auto-Hypnosis” of Coue, the deep hypnosis of Bramwell,and the “psychoanalysis” of Freud…. In my experience, however, the need thus analytically “tapping the unconscious” is rare; therapeutically the subconscious requires rather to be influenced by indirect than to be controlled by direct suggestion’.

‘Freud’s psychoanalysis calls for special attention. It mus suffice here to say that his view of causation is now abandoned, save by a few extremists, in favour of the wider and more applicable post-Freudian, that his his methods of procedure ( free association, word association, symbolic interpretation, dream analysis and so forth) are now held to be rarely necessary, often misleading, at times dangerous and almost always cumbersome and tedious, whilst his views on repression and mental conflicts seem largely overstatements and in some cases contrary to definite laws. The value of his contribution to the position is, thus, that of an investigator not of an interpreter and at bottom his methods tend to an intellectual misdirection of fundamental suggestions. His ‘Symbols’ again can prove anything that is in the mind of the operator. And as regards the actual results, it would be amusing if it were not pathetic to see psycho-analysts laboriously seeking and proudly proclaiming results that are often producible to even greater advantage and in a fraction of the time by simpler forms of suggestion. After all treatment by analysis is pre-eminently the province of an educated profession not of the academician or theologian’.

John Springthorpe, ( 1924), Psychotherapy in Practice, in Transactions of Congress, Supplement to the Medical Journal of Australia, 21 June 1924, pp, 448-451.

Shell Shock in the Great War: Letters From ‘The Front’.

24 Tuesday Nov 2015

Posted by Christine in Great War, John Springthorpe, War Neurosis

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controversy about shell shock, Great War, medical views of shell shock, Soldiers letters, War shock

The psychological impact of the Great War upon soldiers occupied the thoughts of the leading members of the Australasian Medical Congress in Brisbane held in August 1920. Papers on the use of psychoanalysis in the treatment of neurasthenia was  also noted by London’s Ernest Jones  in the first edition of the International Journal of Psychoanalysis.  The keynote speaker was  John Springthorpe whose paper addressed the lack of psychological components in the syllabus at medical school. the resulting professional ignorance was catastrophic for Australian soldiers at the Front. The final statistics are not in as to how many returned home suffering from shell shock, or endured it for many years afterwards. Nor do we have information about the suicides that resulted although a search through the newspaper archives reveals reportage in 1916, of the suicide of a Mr Peter Hogan, a returned soldier and an inmate of Broughton Military Hospital, who threw himself under a train at Petersham railway station in Sydney.

Springthorpe told the Congress:

We sent men physically unfit to enter upon the strains for which they were temperamentally unsuited, and then back again when their prompt, even immediate breakdown was inevitable. Our medical officers at the front from their ignorance and inexperience, were unable to differentially diagnose the different psychical disabilities incurred, and even more unfit to teat them. Men were punished and even shot ( though not by us), for such disabilities as if they were crimes. After a time the cases got so bad – and dealt with in special hospitals, miles behind the lines but still under shell fire.

No stranger to controversy Springthorpe was among friends and supporters on this occasion. Introducing the Congress, its President, Dr William Taylor, noted that in past wars “old time diseases” had usually killed more than were wounded in the field. In the Great War disease  had been replaced by hellish devices of gas and flame throwing which, coupled with the issue of high explosives, renders ti difficult to conceive how anything had escaped destruction. The resulting inferno along with the misery of the trenches caused the nervous system to be worked up to the highest pitch of tension... Is it to be wondered at that a large number iof soldiers should suffer from neuroses of different kinds to a greater or lesser extent, purely functional in many cases and in others [adding] to the effects of injury. ( Taylor, Proceedings, p. 22).

To learn more about the way people thought about shell shock in war time Australia I typed the  words ‘shell shock’ into the search engine of the Australian National Library’s digitized newspaper collection : TROVE along with the dates: 1 January 1914 to 31 December 1916. I discovered not just  accounts of shell shock and its treatment by medical practitioners, but a seam  letters from soldiers in the field. These had  passed, somehow,  through the censor’s hands to reach their destination.  These were from Australian soldiers. In civilian life they were among the legions of  labourers, clerks and bankers who had enlisted to serve the Empire.  These letters were written to family and friends who forwarded them to the local newspaper editor editors for publication.  Most towns throughout New South Wales where I found most of these letters, had their own newspaper. Editors were well known to the community and, moreover, the folk who forwarded these letters to the paper knew that their townsfolk would be interested in the  progress of their men at war.

In these letters  home the men related their experiences at the battle for Pozieres from 23rd July 1916 until the 4th August, 1916. Often a way of assembling one’s mind after terrible events, the letters are vivid descriptions of thier battle experiences.  By the end of 1916 the term ‘shell shock’ was familiar to the soldiers and, increasingly, to the folk at home. ‘Shell Shock’ had emerged early and surprisingly. By December 1914, shortly after the war’s beginning, reports were reaching London that large numbers of soldiers had been evacuated from the British Expeditionary Force  with nervous and mental shock. (Shepherd, 2002: 21). Charles Myers, a psychologist who investigated the condition likened the condition – with its symptoms of paralysis, the loss of senses, loss of speech and/or  hearing – to hysteria ( Myers 1915).  Initially explained as a sign of weakness and fearfulness, if not degeneracy, shell shock was increasingly understood as a condition which observed neither rank or class. It was as difficult to treat as to understand  although generally, views evolved from an emphasis on physical interpretations at the commencement of the war to acceptance of psychological understandings at its end.

The Letters

Corporal Harold Glover was buried when a shell exploded close to him. He was dug out, unconscious for some hours As recorded by his doctor, John Springthorpe, a Melbourne Psychiatrist who was serving in Military hospitals,  Glover reached England suffering from ‘headaches, tremors, bad dreams, fainting attacks, cardiac pain and general nervous excitability’ (NAA B2455, GLOVER H A). His letter written to his brother was published in the Singleton Argus on 12 October 1916.

Words cannot describe what the situation was like… It was not warfare at all but simply murder. One need not be in the front line of the trenches to get wounded or killed: you get it in your dugoput or simply miles behind the lines…. The sight of the dead and wounded soldiers is nearly enough to make one go mad and thes tench from the dead horses and human bodies is absoletly unbearable at times. Big men cry and are absolutely broken- spirited with the scenes of bombardment… Gallipoli was never like this…

Fred Brown, a former clerk, wrote to his sister:

The dead, both British and German, were in many places piled waist high and when gaps were made in the parapet the biodies were thrown in to fill the gap along with empty rifle equipment and bomb boxes. A man who a few minutes previously was your mate was now a barricade for you. Amongst all the dreadful things of war, the most pitiful is a man who has lost his mental balance. You see dozens upon dozens of them without a scratch, yet ruined for life. ( Gloucester Advocate 1916)

Joseph Jackson, born in 1863, lowered his age to enlist in 1915. After the battle at Pozieres he was admitted to hospital in England and subsequently elected to return to Australia. His letter was published in the Maitland Mercury on 17th January 1917.

We had three go luny ( loony) from sehh shock… It was painful to realize how many good fellows had gone whilst the memory of the agonizing sights of the wounded linger with you… Talk about Hell. wll, if it’s any worse than Pozieres then I don’t want to assist old Nick.

According to Harry Bedford,  some men could not stand the strain. They went off their heads. Holding on until the end of their turn at the front was worst: it is then a man sees a chance of getting out safely and he begtins top think, “Onlu a few more hours to go: I wonder if I will get knocked”.

Springthorpe’s Intervention

At the Congress Springthorpe who had been  embattled with the Repatriation Department since June 1920 asserted that in the field hospitals  psychological treatment for these men was a poor relation to physical treatment.  The hospitals were not especially staffed, he explained. Many men were sent to places not equipped to treat these men. Many remained ‘for months, misunderstood and uncared for until finally disharged, often without any pension, because an uninformed board could find no disabilities’. When they returned to Australia the first arrivals were dismissed, without pension, as malingerers; the next batch dealt with as requiring isolation and restraint. And ever since until the last few weeks, all have been under the triple control of the Defence, Pensions and Repatriation ( Government Offices) without any nexus or comprehensive scheme. 

Legacies of war, apart from names engraved upon country town memorials throughout Australia, were the ongoing trauma of disability, the shattered minds of the traumatized soldiers which in turn tore apart the lives of many families over many years anf generations ( Larsson 2009).
Returned soldiers found they could not simply slip back into their old lives, nor could families make room for them as they had expected.

References:

Charles Myers ( 1915) ‘A Contribution to the study of shell shock: being an account of three cases os loss of memory, vision, smell and taste, admitted into the Duchess of Westminster’s War Hospital, Le Touquet’, The Lancet, 2  February 1915, pp. 316-319.

1916 ‘OUR BOYS AT THE FRONT.’, Singleton Argus (NSW : 1880 – 1954) , 12 October, p. 2, viewed 24 November, 2015, http://nla.gov.au/nla.news-article80448930

Gloucester Advocate 4 November 1916, p. 3.

Ben Shepherd ( 2002) A War of Nerves: Soldiers and Psychiatrists in the Twentieth Century, London, Pimlico ( Random House).

John Springthorpe: Australasian Medical Congress, 1920, Section VIII: Neurology and Psychological Medicine, pp. 402-404.

‘John Springthorpe’s Memo on Cardiac and War Neurosis’,National Archives of Australia http://recordsearch.naa.gov.au/SearchNRetrieve/Interface/ViewImage.aspx?B=4794937

Dr W Taylor,  Presidential Address, Australasian Medical Congress, 1920, p 22.

1916 ‘Returned Heroe’s Death.’, National Advocate (Bathurst, NSW : 1889 – 1954), 26 August, p. 2, viewed 24 November, 2015, http://nla.gov.au/nla.news-article158525008

 

Mental Hospitals for Returned Soldiers -WW1

28 Sunday Sep 2014

Posted by Christine in John Springthorpe, Shell Shock, War Neurosis

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Institutional care, Melbourne, Shell Shock

Further to my previous post about psychiatric treatment of shell-shocked soldiers in  Australia after the end of the Great War I notice that an exhibition about this has been opened in Melbourne.The AGE announced it today under the heading: “Family Tells of WW1 War Hero’s 35 Years as a Mental Patient in Bundoora Hospital”. A life wasted….You can read about it here….

On the 100th Anniversary of the ANZAC landing at Gallipoli – 25 April 2015

25 Thursday Sep 2014

Posted by Christine in John Springthorpe, War Neurosis

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Kitty's War, Pioneers in Australian Psychoanalsyis, psychoanalysis and war, PTSD, Repatration Commission post WW1, war neurosis, Wartime experiences

 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.

Front Cover

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.

 

 

 

 

 

 

 

 

 

 

The Springthorpe Memorial – death and mourning in nineteenth century Melbourne

03 Thursday Jan 2013

Posted by Christine in John Springthorpe, Medical circles, Melbourne, pioneers

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death and mourning, John Springthorpe, monuments, ninetheenth century

I am reblogging this post by Janine, a fellow historian, about the Springthorpe Memorial which is found in a Melbourne Suburb – Kew. Springthorpe as I noted in my comments, was a leading medical practitioner in the Melbourne mental health field from the 1880s and among the ‘psychoanalytic pioneers’ identified by historian Joy Damousi in her 2005 book, Freud in the Antipodes. As Janine says, the memorial tells us much about the Victorian way of death and mourning – so sentimental to our twentyfirst century eyes and ears but perhaps this derogation of past attitudes is a product of current fantasies of invincibility, where science rules and death so often sooshed away.

The Resident Judge of Port Phillip

On a beautiful 24-degree summer afternoon, where more perversely pleasant to visit than a cemetery?  So off we went to Boroondara Cemetery in High Street Kew, primarily to see the Springthorpe Memorial which I’d seen many times in photographs but never actually visited.

Boroondara Cemetery was established in 1858 as a garden cemetery and, with imagination, you can just sense the Victorian conceptions of death and mourning that underpinned its design.  The original plan, since abandoned, was for curved paths and winding roads, but it nevertheless maintains its rather forbidding red brick perimeter wall, caretaker’s lodge with slate roof and a clocktower, and rotunda.  Its most famous monument is the Springthorpe Memorial, completed in 1907 after ten years’ construction and described in 1933 in The Age as “one of the most beautiful and most costly in the commonwealth”.

It was erected by Dr. John Springthorpe to commemorate his wife…

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