W H R Rivers: portrait of a great physician in Pat Barker's Regeneration trilogy

1The term shell shock was first used during World War I to describe the physical and mental breakdown of men in the incomparable brutality of trench warfare; standard therapies for their nightmares, sleeplessness, panic attacks, mutism, paralysis, and other symptoms, included electric shocks to affected body parts, hypnosis, and electroconvulsive therapy. 2 Rivers took a more psychological approach, and his insights form the basis for a wider understanding of what we now call posttraumatic stress disorders. Well-versed in Freudian theory, Rivers maintained that war neuroses did not result from the war experiences themselves but were “due to the attempt to banish from the mind distressing memories”. 1 He attributed his own clinical successes mainly to encouraging patients to remember, but he also described more subtle aspects of therapy, which he termed “re-education” and “faith and suggestion”, by which he meant the role of the therapist in reframing painful memories and the power of the therapeutic relationship itself. The Lancet article is one of Pat Barker’s sources for her own three-volume meta-novel about Rivers: Regeneration, 3