“As soon as he started work at the hospital he became…fascinated by the differences in severity of break down between the different branches of the RFC. Pilots, though they did indeed break down, did so less frequently and usually less severely than the men who manned observation balloons. They, floating helplessly above the battlefields, unable to either avoid attack or to defend themselves effectively against it, showed the highest incidence of breakdown of any service. Even including infantry officers. This reinforced Rivers’s view that it was prolonged strain, immobility and helplessness that did the damage, and not the sudden shocks or bizarre horrors that the patients themselves were inclined to point to as the explanation for their condition. That would help to account for the greater prevalence of anxiety neuroses and hysterical disorders in women in peacetime, since their relatively more confined lives gave them fewer opportunities of reacting to stress in active and constructive ways. Any explanation of war neurosis must account for the fact that this apparently intensely masculine life of war and danger and hardship produced in men the same disorders that women suffered from in peace”.
The thoughts of army psychiatrist W.H.R. Rivers from the novel Regeneration by Pat Barker. In Regeneration, the first of a trilogy, Barker blends fact with fiction in her depiction of the relationship between Rivers and the celebrated poet Siegfried Sassoon, at Craiglockhart during the First World War.