The forgotten healer

WHR Rivers, who was born 150 years ago on March 12th, made major contributions to the development of neurology, psychology, psychiatry and anthropology, yet one of his biographies has the subtitle "the forgotten healer". Probably largely thanks to Pat Barker's Regeneration trilogy of novels, published 1991-95, he is best known now for his treatment of army officers suffering from shell shock in the first World War.

Given his background, it is no surprise that he should have gone into medicine or had links with the army. Uncles on both sides pioneered the development of speech therapy; Lewis Carroll was one of their patients. And Rivers was named after another uncle who served on Nelson's ship Victory at the Battle of Trafalgar.

He was academically gifted from an early age but a bout of typhoid fever prevented him from taking up a scholarship to Cambridge, where he would probably have studied classics. However, during his convalescence, a friendship with an army surgeon led to his studying medicine at the University of London with a view to joining the army medical corps.

His plans to join the army were frustrated when he was considered medically unfit (a legacy of the typhoid fever) and he became a ship’s surgeon and inveterate traveller. A few years later he became house surgeon at St Bartholomew’s in London, where he developed an interest in the psychological aspects of medicine (then relative virgin territory).

His research in neurology led to an interest in mental diseases and work at the Bethlehem Royal and Guy's Hospitals. His growing reputation led to lecturing posts at University College London and Cambridge University. He carried out pioneering work on sensory physiology and the effects of tea, coffee, alcohol, tobacco and other drugs. He founded and edited the British Journal of Psychology .

He developed an interest in anthropology and ethnology and scientific expeditions to the Torres Straits, the Solomon Islands and other parts of Melanesia and Polynesia followed. In 1914, he published the two-volume History of Melanesian Society .

During the war, he worked as a captain for the Royal Army Medical Corps at Craiglockhart War Hospital in Edinburgh, treating officers for various forms of war neuroses, especially shell shock. His humane treatment was based on the belief that even the bravest could succumb to overwhelming fear and that the best motivation to overcome it was the love and loyalty soldiers felt for each other rather than patriotism or hatred of the enemy.

His “talking cure” to help overcome the fear relating to war experiences was pioneering because shell shock was not considered a real illness at the time and was often treated with electric shock. Rivers encouraged patients to express their emotions, which also went against the “stiff upper lip” approach of the time.

The poet Siegfried Sassoon was sent to Craiglockhart in 1917, having gone public in his opposition to the war and his refusal to return to his regiment. Rivers treated him sympathetically. It must have been a huge dilemma for him that he was helping men to recover so that they could return to the front and possible death. His book, Conflict and Dream , reveals the difficulty he felt.

Pat Barker wrote: “He was a very humane, a very compassionate person who was tormented really by the suffering he saw and very sceptical about the war, but at the same time he did not feel he could go the whole way and say, no, stop.”

Sassoon and he developed a friendship (Sassoon referred to him as his “father confessor“). Sassoon returned to the war, was wounded, and as he lay recovering, he wrote in a letter to Robert Graves: “But yesterday my reasoning Rivers ran solemnly in, / With peace in the pools of his bespectacled eyes and a wisely omnipotent grin; / And I fished in that steady grey stream and decided that I / After all am no longer the Worm that refuses to die.”

When Rivers died of a strangulated hernia in 1922, Robert Graves, another patient of his, recorded in The Red Ribbon Dream the sense of well-being he felt in Rivers's rooms: "For that was the place where I longed to be / And past all hope where the kind lamp shone."

Sassoon credited him with saving him physically and spiritually and wrote in his autobiography: “I would very much like to meet Rivers in the next life. It is difficult to believe that such a man as he could be extinguished.”