How two wars shaped the Tavistock

27 October 2020

Sebastian Kraemer, Sarah Helps and Glenn Gossling gave a whirlwind tour of the history of our ideas as part of our online festival ‘100 years of the Tavistock and Portman’ last week.  In case you missed it, you can watch the talk again on our YouTube channel.

Sebastian reflects on the early days of the Tavistock Clinic which was founded after Hugh Crichton-Miller observed the effects of shell shock during the First World War. From its early days, the Tavistock and Portman has demanded doing things differently explains Sebastian. 

The Tavistock is usually assumed to be a place where you can get psychotherapy, but this does not give any hint of a remarkable story of innovation and humanitarian responses to major crises throughout the 20th century. Both world wars demanded doing things differently, and that has been the Tavistock and Portman story throughout the decades. Following founder Hugh Crichton-Miller’s vision, it was army psychiatrists and psychologists that had to change their ways.

The Tavistock and Portman: A history of ideas

The first world war

When the phrase ‘shell shock’ was first used it implied some kind of assault on the body, which of course is true. When faced with a sudden catastrophic event our bodies react, for example with a rapid fall in blood pressure. But the odd symptoms that some soldiers presented to doctors confused them, because they could find no sign of damage. These men had not been injured but they were most certainly profoundly affected. They could not balance themselves, nor hear or see properly and were afflicted with shaking of part or the whole body. 

In those days, a good soldier was someone could take anything ‘on the chin’ and not be troubled by it, so the army assumed that these were not good soldiers. Some men were simply terrified and ran away from the front line, for which their punishment was execution by firing squad, authorised by Field Marshall Sir Douglas Haig.

By the middle of the war there was dawning recognition that breaking down in combat was not so much evidence of cowardice, as of psychological trauma. If you have seen your comrade standing next to you blown to pieces, or have been yourself buried alive in the earth lifted by an exploding shell, this is not something you can comprehend; it is too much to take in. Yet soldiers were advised to forget what had happened and just carry on. The most distinguished army physician of the day was William Rivers who in 1918 wrote in the leading medical journal the Lancet  ‘I deprecate the ostrich-like policy of attempting to banish painful memories from the mind’.

Two of the founding doctors of the Tavistock Clinic, Hugh Crichton-Miller and his colleague James Hadfield had worked with post-traumatic patients in army hospitals during the war. They had devised forms of psychotherapy there and wanted to provide similar help to civilians who could not afford the high fees charged by Harley Street specialists (of whom Crichton-Miller was one). The Tavistock was regarded by the medical establishment as rather eccentric. Just as in the army, prevailing attitudes to mental problems were highly moralistic, so this was a courageous thing to do. But they persevered and gathered support from the wealthy and influential upper classes, including, as a Vice President of the clinic in 1927, Field Marshall Haig.  

The second world war

The British Army approached the second world war with apprehension. They did not want to have soldiers who would break down, then to be pensioned off for the rest of their lives. They appointed an enthusiastic former soldier, Dr John Rawlings Rees, who himself had seen action in the first war, as their chief army psychiatrist. Rees had been at the Tavistock since its foundation and became its director in 1933. Younger and more progressive, he was interested in how the clinic itself was organised and had introduced an element of democracy so that the next generation of clinicians, such as Wilfred Bion, would be encouraged to stay. The army now wanted Rees to use psychological expertise to select candidates for officer training. Before that they simply took young men from the upper class public schools, but now – wanting to keep up with what they had heard about German initiatives in military recruitment – needed a more democratic approach. 

The result was the War Office Selection Board (WOSB), which devised a test of potential leadership, in groups without designated leaders. Candidates would spend a few days together and the observers, who included future Tavistock luminaries – such as Wilfred Bion, Jock Sutherland, Isabel Menzies, Elliott Jaques, Ronald Hargreaves, John Bowlby and Eric Trist – could see that real leadership was not a matter of social class but of attentiveness to others. This profound insight upended the traditional concept of ‘authority’ as something you are born with, and replaced it with a capacity for human relatedness.  

This was revolutionary and became the basis of the post war Tavistock’s methods of work, using groups for learning in place of classrooms for teaching, but also understanding that an awareness of how we manage ourselves with our colleagues is part of the work itself. 

In the space of three decades, reverence for blind heroism at the front line had given way to respect for the courage to know – and to speak – your mind in a complex modern world.

Sebastian Kraemer, Honorary consultant, Tavistock and Portman

For 100 years, the Tavistock and Portman has proudly been at the forefront of exploring mental health and wellbeing. From attachment theory and infant observation, to applying psychoanalytic and systemic approaches in varied settings, our ideas have led to changes in care, education, how organisations work and beyond. 

Our centenary festival is celebrating our history and exploring contemporary issues in relation to identity, relationships and society. It is considering how we continue to draw on our heritage to provide valuable responses to contemporary and future problems from the perspective of equality and inclusion.

Visit 100 years of the Tavistock and Portman to find out more about our history. 

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