On 1 September 1939 Hitler’s tanks rolled into Poland[1].

War had been coming for some time. Maybe since the signing of the Treaty of Versailles at the end of World War 1.

Fascism, however, was a relatively new phenomenon, it had been founded by Mussolini in 1919 and he had become the prime minister of Italy in 1925[2]. In 1920 Hitler had become the leader of the Nazionalsozialistiche Deutsche Arbeitpartei, or Nazi Party for short. After a failed coup in 1923 he was imprisoned and wrote Mein Kampf, where he outlined an ideology based on anti-Semitism and the belief in an Aryan master race[3].

Hitler became Chancellor of Germany in 1933 and following the Night of the Long Knives, where he had his rivals murdered, he established a one party state. The German President died in 1934 and Hitler appointed himself Fuhrer[4]. Then in 1936 he made an alliance with Mussolini and reoccupied the Rhinelands[5]. In March of 1938 Hitler annexed Austria.

With Hitler’s ascent to power persecution of the Jews began in earnest and in November 1938, during Kristallnacht, Synagogues were burnt down, Jewish hospitals and schools were ransacked, Jewish shops looted and hundreds killed[6].

With the annexation of Austria Ernest Jones and Anna Freud put their differences aside and began working together to help Jewish analysts, including Freud himself, escape from the Nazi regime, saving hundreds of lives[7]. Some came to Britain and some were helped to move on to the US. The influx of a large number of European analysts to England led to rising tensions between the Freudians and Kleinians, which would culminate in the ‘Controversial Discussions’ of the 1940s[8].

Then in September 1939 Hitler invaded Poland, initiating a new form of war called Blitzkrieg, where fast moving columns of tanks followed by infantry moved in under powerful air cover[9]. Within two days Hitler had taken the country. Britain and France were forced to abandon their policies of appeasement. At 11.15am on Sunday 3 September 1939, Prime Minister Neville Chamberlain announced that Britain was at war with Germany[10] and World War 2 had begun.

Preparing for war

In England, although a policy of appeasement was followed, preparations for war had been made.

In political circles there was wide-scale fear of what would happen if civilian centres were bombed[11]. Since the mid-1920s it was accepted almost as a matter of course that widespread panic and neurosis among civilians would be a consequence of air war and during the 1920s and 1930s; planning committees prepared themselves for the tasks of controlling mass exodus from the cities and mass panic among the population[12].

Psychiatrists and psychologists compared the position of the civilian in war unfavourably with that of the soldier, whose training acted as a check on the desire for self-preservation[13]. As Hugh Crichton Miller put it, ‘there is real danger that [the civilian] will seek, not security, but infantile security’[14].

From as early as 1934 Churchill had been bringing the prospect of air-war to the attention of Parliament[15]. Secret plans were drawn up for mass burials, many vulnerable civilians were evacuated from the cities and large psychiatric hospitals were set up to deal with the expected cases of civilians driven mad by the bombing[16].

One such hospital was Stanboroughs Hydro in Watford. At the start of World War 2, former Medical Director of the Tavistock Clinic, Hugh Crichton-Miller volunteered for the Emergency Medical Service of the Ministry of Health and became the Medical Director[17] of this former residential spa that had been taken over to operate as a war neurosis centre for air raid casualties[18]. In the event, the anticipated breakdown of the civilian population did not happen and at one point there were three patients to three doctors and 35 nurses[19]. It was quietly closed down. Hugh Crichton-Miller volunteered to go to Libya, but was told by the Director General of the Royal Army Medical Corps that 64 was too old for service abroad[20].

Similarly, although many people were initially evacuated from the cities, when no bombs fell, they returned to their homes. Then in 1940, when the bombs did finally come to London in the form of the Blitz, the expected panic and death toll still did not materialise. More than half the population of London stayed in their homes. The truth of the Blitz was that ‘the British were bombed and endured it’[21].

Although it was done with the best of intentions the evacuation of children proved to be one of the most damaging acts of public policy ever conceived[22]. In 1938 ‘The Cambridge Evacuation Survey’ was established by Susan Isaacs, Margery Fry, Sybil Clement Brown, John Bowlby, Melanie Klein and Lucy Fildes[23] and it was published in 1941 becoming the most famous of the evacuation surveys carried out during the war. Many children were miserably unhappy, evacuation was recognised as a mistake and John Bowlby developed some key insights into the importance of keeping parents and children together[24].

During World War 2 morale became a key issue for the government, linking together notions of public opinion, control of the news and propaganda[25]. In Britain, government measured ‘public opinion’ using a combination of Gallup Polls (which had been developed in America by George Gallup in 1936[26]), monitoring press reports, using information gathered by the regional staff of the Ministry of Information from shops, cinemas and Citizens Advice Bureaux, interpreting the data supplied by the intelligence services, and Postal and Telegraph Censorship, which monitored up to 200,000 letters a week[27].

Never before had government involved itself so intimately with the lives of its subjects[28].

Public attitudes were turned into numbers and charts that were used to formulate arguments and strategies and develop a new science of government and the management of public opinion[29].

Another preparation that was undertaken before the war started was to ensure that there would be support for troops who broke down. The Royal Air Force and Royal Navy quietly appointed neurologists from Guy’s Hospital and St George’s Hospital respectively[30].In April of 1939 JR Rees, the then Medical Director of the Tavistock Clinic, was approached to have his name put forward as consultant psychiatrist to the Army at Home[31], much to his surprise he was appointed and made responsible for the mental health of approximately three million people[32].

JR Rees enlisted the help of colleagues from the Tavi to research the Army psychiatry, with Emanuel Miller producing a survey of what had been done in World War 1[33]. Emmanuel Miller’s report identified a number of issues. The two overriding issues thrown up from the experience of World War 1 were the need for proper selection processes and how to deal with shell-shock[34].

People who were likely to break down under the pressures of war needed to be kept away from the actual fighting[35]. Collective factors were important – it was known that shell-shock was contagious and one case precipitated others, destroying morale[36].

Although the Army had learned many painful lessons about shell-shock in World War 1, much had been forgotten in the intervening years and the relationship between the military and psychiatrists had lapsed. Many lessons had to be learned again, but also medicine had moved on and there were new methods to try out.

During the war other issues would emerge, such as the training of troops, the management of morale and psychological warfare. Then towards the end of the war there were questions about how to change the nature of German society and promote democratic values.

Recruitment

Early in 1939 JR Rees recommended that the Army introduce recruitment procedures that included an element of psychological testing, but the idea was rejected[37].Once appointed, JR Rees took the rank of Brigadier[38] and was based at the Royal Army Medical College[39]. On the day that war broke out he found that he was the only Army psychiatrist available at Home. JR Rees realised that he would need more help. In the spring of 1940 JR Rees had a team ready to start work[40]: Ronald Hargreaves, ATM Wilson, Edward Bennet, Wilfred Bion, Leonard Browne, Henry Dicks, Robert Barbour, Ferguson Rodger and Emanuel Miller[41]. More than half of them had medals from World War 1, with two of them having being decorated for gallantry[42]. This experience gave them high standing and credibility in the Army.

This core group would later be joined by: Jack Pearce, Eric Wittkower, John Rickman, Mary Luff, Alex Kennedy and John Bowlby among others[43]. Later in the war the psychiatrists under JR Rees would privately call themselves the ‘invisible college’[44]. One of the first measures that Rees introduced was to get his own men to understand the military, how the Army lived and worked[45]. To this end, any psychiatrist coming from civilian life was attached to a combat unit for six weeks, with no medical duties, to learn about the culture and conditions of Army life[46].

JR Rees impact on Army psychiatry has been called ‘a story of brilliant innovation’[47]. He was motivated by his own experience in World War 1, to prevent the mistakes he saw there happen again, but he was also rooted in the belief that what the Tavi had to offer was important and could make a vital difference. He set out with the huge ambition to build the Army into an effective group of men who could win the war and to do this his immediate concerns were: morale, the best possible placement of men and prophylactic measures for mental health in the field[48].

World War 2 did not initially go very well for the British Army. By the end of May in 1940 they were once again fighting for their lives in Flanders. They were driven back to the coast and an emergency evacuation was organised at Dunkirk[49]. Thanks to nine days of calm weather almost 338,000 British and French troops made it across the Channel[50].

By the time JR Rees had his team in place it was already late to be working on the selection of men. Following Dunkirk the Army was forced to consider not only the impact of having had unsuitable men at the front, but also what it could do to rectify this. The job of selection fell to Ronald Hargreaves[51], who became Rees’s Assistant Director[52].

On his own initiative and at his own expense Hargreaves introduced basic intelligence testing to eliminate ‘unsuitable and inadequate men’ who were likely to be more inclined to discipline problems and desertion[53]. The first thing that he did was to remove ‘backward men’ from active duty and to move them to the Pioneer Corps where they did manual work[54]. Then, from the Canadian Army, he introduced the Pulhems system for grading men[55],[56]. This looked at: physique (upper limbs, lower limbs, hearing and eyesight), mentality and stability, then matched them to particular jobs[57]. Later in the war this was added to by looking at childhood background to identify people who would be likely to break down[58].

While the Army was reeling from the shock of Dunkirk and desperate to show that it was not an incompetent class ridden organisation, Ronald Hargreaves had the opportunity set in motion changes to produce a more modern and meritocratic approach. This came about largely through key relationships he formed in Leeds with Thomas Main and General Sir Ronald Adam, who had commanded a Corps at Dunkirk[59].

Tom Main had trained as a psychoanalyst under Michael Balint, and had been supervised by Anna Freud, Melanie Klein and Paula Heimann. In 1939 at the outbreak of war he had been called up, but then discharged as belonging to a reserved occupation[60]. However, Tom Main was determined to contribute to the war effort, so with the help and influence of JR Rees he had himself called up again[61] and started working on recruitment procedures with Ronald Hargreaves in Leeds[62].

Tom Main was found to have the great gift of being able to explain psychology with great clarity in everyday language[63]. Because of this he would become an important member of the Officer Selection Boards, which were formed to develop more efficient ways of selecting officers[64].

In 1940 Hargreaves began working with Progressive Matrices[65]. The Penrose-Raven Progressive Matrices test had been published just before the war. It was a test for ‘defective children’, but, at the Royal Army Medical Corps Depot in Leeds, Hargreaves adapted it and standardised it for the ordinary population group[66]. The important thing about it was that it didn’t test ‘education’, what had been learned or not at school, so much as ‘a man’s ability to learn by experience and to argue by analogy’[67]. By early 1941 pressure from Rees and Hargreaves led to an Advisory Committee on Mental Testing and by June they established a Directorate for Selection of Personnel[68].

Hearing of Hargreaves work General Adam demanded to be shown the intelligence tests that he was working on and then confounded Hargreaves by doing the 40-miute version of the test in 12 minutes and getting every question right[69]. Adams and Hargreaves shared a vision of using personnel selection that went beyond weeding out the unsuitable; they wanted to create a new kind of Army: one that was mechanised, technocratic and specialised[70]. In 1941, when General Adams became the Adjutant General, responsible for all questions of medicine and morale, JR Rees’s men effectively became consultants to the Army[71].

Officer selection

By 1941 the Army were having trouble finding officers. Until then officer selection was done by small interview boards of older officers, who knew the ‘right type’ from public schools and university[72]. Unfortunately, there were not enough of this ‘type’ and the Army found itself hopelessly at sea when faced with recruits from other backgrounds. However, the senior officers of the Army had a profound hostility to psychiatrists[73], and nicknamed them ‘trick cyclists’[74],[75]. General Adams commissioned a small group of officers to work with Rees’s men to come up with a solution[76].

HV Dicks through his connections with Military Intelligence obtained a document on the methods that the Nazis had introduced for officer selection[77],[78]. Rees and Hargreaves initiated their own experiments, which eventually resulted in War Office Selection Boards, which chose men based on personality and character[79]. The most celebrated innovation was the ‘leaderless group’ developed by Wilfred Bion[80].

The leaderless group involved candidates being given a task such as building a bridge over a river or escaping a POW camp. The task had to be done as a group, while under observation. No leader was appointed by the testing officer nor was any help given, The important thing was not how well any of the tasks were done, but how well, or not, personal relationships were maintained during the test. Through it the candidates’ spontaneous attitudes towards co-operation were revealed[81].

The leaderless group was one of a battery of nine tests conducted over three days. These included: three intelligence tests, three personality tests and three military tests[82]. The personality tests included Carl Jung’s word association test and a ‘thematic apperception test’, where candidates had to invent three minute stories based on pictures that they were shown[83].

The effectiveness of the War Office Selection Boards was evaluated by John Bowlby, who demonstrated the superiority of this method, showing that  it reduced the failure rate of officers from 45% to 15%[84].

Training

The British emphasis on drill and discipline designed to make men work together had been designed for the days of close rank formations. Modern battlefields were loose, amorphous affairs and what was required was troops who were motivated and intelligent enough to take the initiative on their own.

One initiative that the Army introduced came to be known as ‘hate training’[85]. This was a four day course that began with a lecture on hate, delivered in the ‘hate room’, which was hung with photographs of occupied Europe and followed by realistic battle training with live ammunition and a trip to the abattoir to watch animals being killed[86]. This kind of training was stopped in 1942 after Tom Main found that it was counter-productive, as when people thought of themselves as killers it produced depression and guilt rather than effective units of fighting men[87].

Following their success improving selection methods the Tavistocks ‘invisible college’ set to work on improving training. Their methods became known as ‘battle inoculation’[88]. This involved gradually introducing new soldiers to the sights and sounds of battle, showing them that they would not be hurt by the noise of explosions and that they could safely lie in a slit trench and have a tank go over them[89]. The purpose of battle inoculation and training with live ammunition was to minimize the morale-destroying effect of enemy weapons encountered in battle, to ‘debunk’ the noise and frightfulness of these weapons[90].

Research by HV Dicks gradually showed that what really counted a fighting unit was not hardening the men to the realities of war, but the psychological bonds and relations between its members – the solidarity of the group[91]. This insight was also central to the work of Wilfred Bion, first in officer selection and then in the rehabilitation of soldiers[92].

Providing clinical support

After Dunkirk, Britain started to see the affects of war on the mind. Men who had had no sleep for sixty hours began to behave oddly[93]. Many returning soldiers were in hysterical states and were sent to hospital[94].

The first medical account of war neurosis in World War 2 came from Belmont hospital near London, from William Sargant a doctor from the Maudsley. He received shell-shocked patients from Dunkirk and tried giving them sodium amytal. It had an immediate and dramatic effect restoring speech, halting trembling, restoring memory, at least until the drug wore off. He found that when the soldiers were able to talk about their memories of the events that had caused their trauma their condition improved[95]. A month after Dunkirk[96] he and Elliot Slater hastily published their findings in the Lancet[97] and ushered in a new pharmacological era of military psychology[98].

In the time between the wars a whole range of medical techniques had been developed, which doctors could apply to war neurosis. At one end of the scale this included the use of new drugs, particularly barbiturates[99], and at the other ECT (electro-convulsive therapy) and lobotomy. Although Sargant stood at the psychoanalytic end of these approaches, his model of war neurosis was quite physical and mechanistic[100].

Sargant advocated immediate first-aid, using barbiturates to knock out the patient so that the shock would not become ingrained in the patient’s personality, and if that did not work a drug induced deep sleep therapy for up to three weeks[101]. Other doctors experimented with a combination of drugs and analysis, but ultimately the military rejected these methods because they didn’t get anyone back to the front-line[102].

As the war progressed the military developed the basic medical procedure of triage. This involved dividing the wounded into three categories and giving most attention to those who could be returned to the war, while ignoring those who were dying[103]. Similarly psychiatric casualties were divided into three categories: those that could be returned to battlefield duties, those that could be retained in auxiliary or support functions and those who were finished as soldiers[104].

This lent itself to a three tier system with forward treatment near the front-line for soldiers capable of fighting after two to five day’s rest, further back was a hospital where 10-14 days of more sophisticated treatment could be given, and finally for more serious cases a Base Psychiatric Centre was established[105]. Spike Milligan perfectly captured these arrangements in his books on the war[106].

In terms of front-line psychiatry, the initial enthusiasm for the new pharmacological solutions gradually diminished with the realisation that in terms of keeping men fighting a good night’s sleep near the battlefield was more useful than anything else[107]. The main lesson, however, for psychiatrists was that they worked for the Army and not their patients, and what was required was a wholesale conveyor belt system of output[108].

When it came to planning for D-Day JR Rees put forward the argument that the Army had to accept that there would be psychiatric casualties, just as there would be medical ones and that it needed to put in place psychiatric support alongside the medical support to deal with casualties and reduce wastage[109]. In January 1944 JR Rees was given permission to appoint a psychiatric adviser to the 21 Army Group and the man he chose for the job was Tom Main[110].

Tom Main had been part of the team with Ronald Hargreaves who developed Officer Selection Boards. He had become an acknowledged expert on leadership and morale[111]. When working with the Parachute Regiment, he had even got his parachutist’s ‘wings’[112], as he felt that in order to understand the anxieties of the men, he should share their experience[113].

In the run up to D-Day he tried to put screening into practice to avoid predictable casualties and to ensure proper training, but in practice large scale changes were impractical, because they knew that they would soon be facing a shortage of manpower[114].

That being said, the exhaustion rate of ten per cent was only about half of what had been expected[115]. Main’s deputy Donald Watterson had taken steps to reduce wastage by getting the Army to organise more forward treatment centres in France and reversing the policy of evacuation[116]. This practice of treating casualties as near to their unit as possible became known as ‘forward psychiatry’[117].

Then in June of 1944 General Montgomery launched a series of offensives that fully engaged with the German Army. For the psychologists, patterns began to emerge. There would be a sudden influx of cases after the death or wounding of a commanding officer[118]. The number of men coming from a particular unit was an index of that unit’s morale. Bad leadership led to poor morale. By this stage in the war the Army had begun to accept that whenever there was serious fighting around ten per cent of the casualties would be psychiatric[119].

Impromptu front-line treatment centres were set up and Donald Watterson initiated psychiatry without psychiatrists. Medical Officers were instructed to treat men as if they were simply exhausted. They would be given a light dose of barbiturates and allowed to sleep for a couple of days. They would then be given a day to recover from the sedative before being returned to military duties with PT, drilling and a little R&R. This five to six day system at Field Dressing Stations dramatically improved return rates from 10 per cent to 65 per cent[120].Tom Main gradually faded from the picture, marginalised by the quiet competence of Donald Watterson who took over as psychiatrist to the 21 Army Group on 17 October 1944[121].

Throughout World War 2 the most serious cases of psychological problems were evacuated back to hospitals in England[122]. Northfield became the most famous of these.It contained soldiers from active duty in France, escaped prisoners of war, patients from the RAF and men who had ‘disciplinary problems’, but also an above average number of men who had been decorated for valour, and many who were intelligent and articulate[123]. Northfield, however, was a depressing place and few recovered as a result of being there. The military sent John Rickman and Wilfred Bion to deal with this [124]. John Rickman was one of the most important psychoanalysts in Britain. He had studied at Cambridge under the famous World War 1 psychologist WHR Rivers[125]. He had been analysed by Freud, Ferenczi and Klein[126]. He was a Quaker and conscientious objector[127], who had served in the ambulance service during World War 1[128]. He was also Wilfred Bion’s training analyst.

Wilfred Bion had been a tank commander in the World War 1 and would have been given a Victoria Cross if he had not sworn at officials in the War Office[129]. After being demobbed, he read history at Oxford University[130] and between the wars trained as a doctor and a psychoanalyst[131], starting at the Tavistock Clinic in 1932 and studying under JA Hadfield, before switching to John Rickman in 1938[132].

At Northfield John Rickman was put in charge of the Hospital Wing and started experimenting with group therapy[133]. When Wilfred Bion arrived he was put in charge of the Training Wing and found that the main form of treatment was sedatives, for patients and doctors alike[134].

Bion wanted to recruit his patients into the ‘battle’ against neurosis[135]. He took a bold step. Instead of trying to take control and stop the indiscipline, he let things spiral out of control, allowing things to get so bad that the collective neurosis would be displayed, to the point where the men themselves would be driven by their own self-respect to find ways of controlling it themselves[136].

The main group to emerge, almost as a test to Bion’s sincerity, was one that wanted to set up a dancing class[137]. Bion took the suggestion seriously and allowed the men to organise dancing lessons. After a month their daily meetings became business-like and Bion began to notice ‘an unmistakable esprit de corps[138]’.

Unfortunately, neither Rickman nor Bion included the military establishment in their project, and the Northfield experiment was summarily closed down after only six weeks[139], with Rickman and Bion hastily posted elsewhere[140]..

Although JR Rees had closed the experiment down, it had been a political move and at the end of 1944 a second Northfield experiment began[141].

This time JR Rees and Ronald Hargreaves gradually expanded the small-scale group therapy that Michael Foulkes was conducting at Northfield. Meanwhile Hargreaves recruited Major Harold Bridger to take Bion’s place running the training wing[142].

Michael Foulkes, originally Siegfried Heinrich Fuchs, was one of the first German psychoanalysts to emigrate to Britain[143]. He had trained in medicine in Vienna and was influenced by Herbert Marcuse and the Frankfurt School of Marxist sociologists[144] as well as by Freud[145].

Before the war Harold Bridger had been a maths teacher in Coventry[146]. In the Army he was initially put in charge of an anti-aircraft battery, but in 1943 transferred to the War Office Selection Boards, where Ronald Hargreaves was particularly impressed by how he handled group discussions[147].

With Hargreaves support Harold Bridger abolished the Training Wing, turning it into ‘the Hospital Club’ and then left it empty until the patients decided to do something with it[148]. What happened after some weeks was that the men summoned Bridger and the hospital’s commanding officer, demanding to know why public money was being wasted during wartime[149]. The commander was horrified, but Bridger was delighted and helped them start organising recreational activities themselves[150]. According to Foulkes, letting the patients organise things themselves changed the atmosphere of the whole hospital and made the patients much more engaged[151].

In spite of the seeming success of what was going on ‘tremendous tensions’ developed between Bridger and Foulkes[152]. It was into this mix that the third component – Tom Main – was introduced[153].

When Tom Main arrived to take command of Northfield in early 1945 he inherited a situation where there was ‘much indiscipline’, the military hierarchy was very unhappy, and non-psychiatric staff at the hospital felt excluded[154].

Tom Main considered the aim of the hospital was to be ‘the resocialisation of the neurotic individual for life in ordinary society’[155] and rather than closing down the experiment, as the military might have liked, he chose to expand it to create a ‘therapeutic community’[156] in which a ‘total culture of enquiry’ involved everyone at the hospital[157].

In terms of thought, Main was closer to Bion and Bridger than Foulkes, but Main also believed that there was still a need for individual therapy, particularly in cases of mourning[158]. Tom Main contributed to the success of the second experiment through the greater attention paid to the wider community, by involving a larger staff group involved, and running it at a slower pace[159].

By the end of 1945 most of the analysts were keen to get back to civilian life. Bion, Bridger, Foulkes and Rickman all joined the Tavistock Clinic and initiated a new phase in its history. Tom Main briefly joined the ‘Tavistock Group’[160], then worked with the Civil Resettlement Units, before becoming Medical Director of the Cassel Hospital for Functional Nervous Disorders in 1946, where he worked for the next 30 years[161].

The Northfield experiments are considered a key moment in the history of psychiatry, group therapy, and organisational studies[162]. Bion had turned the notion of authority on its head[163][164].

Morale

From the very outset of World War 2 morale was a key issue for the government[165]. Never before had government so involved itself in the minutiae of the lives of its citizens[166] or coordinated the use of this information in support of the government and military, anywhere where individuals needed to be governed by consent[167].

Edward Glover believed that winning the war was dependent on the authorities discovering and regulating the mental states and subjective capacities and orientations of the population – both in and out of uniform, both that of the allies and that of the enemy… in a word morale[168].

Government felt that the public needed a positive reason to get behind the war. To this end a new political contract opened up between the government and its subjects with positive implications for post-war social and economic reform[169].

William Beveridge had left a wealthy upper class circle to become a social worker in the East End of London, later becoming a journalist and academic. Beveridge had an incredible work ethic, starting each day at six with a cold bath. When the war came he was given the onerous task of reviewing the confusing array of sickness and disability schemes for workers. He quickly decided that there could be no coherent system of work benefits without looking at the plight of women, the old and children. Workers after all were not alone – they had families and they got old. Beveridge decided he needed to devise a system for everyone. There would need to be family allowances and a National Health Service. More than this though, the government would need to manage the economy to keep people in work to pay for all of this.

Beveridge’s stroke of genius was to make the complexity of his idea is easy to understand. He told anyone who would listen that he intended to slay five giants: want (poverty), disease, ignorance, squalor and idleness. He published his report after the bleakest of the war years, just as Britain’s luck was on the turn. Although there were plenty who opposed the report there was also a groundswell of popular opinion that after the war Britain could not go back to the mass unemployment and poverty of the thirties.

When he published his report in 1942 it sold better than any government report before or since. In London there were queues of people waiting to buy it on publication day and it eventually sold more than half a million copies (apparently a detailed analysis of the report was even found in Hitler’s bunker which described it as superior to the German system of social insurance in almost all points).

In spite of being cautious about the report Churchill acknowledged that it had helped boost morale.

Just as the government had to consider the morale of civilians, so JR Rees and his team had to consider the morale of soldiers. During the war JR Rees and the group around him came to see the problems of Army psychiatry as largely problems of social psychology and interpersonal relations[170]. There was a focus on morale building as exemplified by the problems between officers and the ranks[171]. This led to an interest in recruitment and selection methods for leadership, and the proper allocation of skills for the various roles of soldiers in the military[172].

Research quickly showed that high sickness rates were almost invariably associated with poor morale[173]. A range of materials was developed to combat this, ranging from films shown during basic training to set expectations[174], through to current affairs material that officers could use to initiate discussions[175].

By World War 2 it was recognised that organisational policy could improve the performance of large organisations by taking account of personality and motivation[176]. Research conducted by Edward Shills and HV Dicks found that what was crucial for the maintenance of morale was the group, the strength of bond between the soldiers themselves and their immediate leadership and not unreal and distant causes[177].

Work was also done studying and influencing the morale of the enemy[178]. Psychological warfare was a new role for psychoanalysis that developed during World War 2. It required a knowledge of the subjectivity of the enemy population and a mechanism of acting upon it[179]. Psychological warfare was waged through a number of loosely co-ordinated agencies[180]: the Psychological Warfare Division of the Supreme Allied Expeditionary Forces, the Political Warfare Executive (which co-ordinated the activities of the BBC, Ministry of Information, Office of War Information and the Political Intelligence Department of the Foreign Office).[181]

Led by HV Dicks psychiatrists interrogated prisoners of war and used statistical analysis to build up a picture of political attitudes and personality types[182]. This research was then used to create more effective propaganda. Between D-day and the German surrender almost 1,000 tons of leaflets were dropped on Germany each month[183].

By the end of the war even Eisenhower was willing to admit that ‘psychological warfare has proved its right to a place of dignity in our military arsenal’[184].

Building a new world

As the war came to an end a new problem emerged for psychoanalysts to deal with – the returning soldiers, and particularly returning prisoners of war. There had been a number of terrible battles for the British during World War 2, for example 20,000 men were captured at Dunkirk, 12,000 in Crete, and more than 130,000 in Singapore[185].

Dr ATM Wilson who was one of the Tavistock group, who won the Rockefeller research grant before the war[186], was particularly concerned about what was called ‘Prisoner of War mentality’[187]. He was responsible for setting up Civil Resettlement Units[188] to deal with the guilt, shame and collapse of morale experienced by prisoners of war[189]. These were by voluntary admission and gave returning soldiers a few weeks of secure accommodation while they ‘depressurised’, found work and found a sense of their own worth[190].

By the spring of 1945 prisoners from Japan and Burma began to return. The situation was dealt with by silence. There was no public discussion of the Far Eastern prisoner of war mentality[191]. Leaflets warned the returning men to ‘guard their tongues’[192], not talk to the press or relatives about their experience[193]. Next of kin were instructed by official pamphlets not to ask[194].The problems experienced by these men were contained in their family homes. Wives spent a life as unpaid caregivers to men emotionally crippled by their experiences[195], children lived in constant fear of rage and depression[196].

Belatedly, in the late 1970s, Far Eastern prisoners of war were offered medical examinations[197]. These found that many still had tropical diseases and around a third still had significant psychological problems[198].

During the war JR Rees[199] and HV Dicks also had the secret duty of looking after Rudolf Hess[200] and in the aftermath of the war Rees also saw other members of the Nazi hierarchy before the Nuremburg trials[201]. This study of Nazism fed into their work to promote democratic values in the occupied countries during post-war reconstruction[202].

The contribution of the Tavistock group to World War 2 was significant. JR Rees had little doubt that they had enabled the Army to make more efficient use of its manpower[203]. There was not the epidemic of mental disorders that there had been seen in World War 1[204]. They initiated a culture where fear was accepted, and psychoneuroses were recognised[205]. At the end of the war, with the therapeutic value of work established, the returning men were helped to find employment, to rebuild their lives.

The Tavistock Clinic during World War 2

As with many organisations, the war years were a test of survival for the Tavistock Clinic. The story for those who did not join up was very different to that of those who did.

In the immediate run up to World War 2 the Tavistock Clinic had been preparing to expand. It had developed plans to become a more academic Institute of Medical Psychology[206], buying a site at the junction of Store Street[207] and Ridgmount Gardens in Bloomsbury[208], but these plans were set aside by the start of the war. The Clinic itself was evacuated to Westfield Women’s College in Hampstead[209],[210] on 3 September 1939[211] and most of its records were sent to Store Street[212].

As well as staff many refugees were also moved to Westfield College. Since the annexation of Austria many prominent analysts had escaped persecution by moving to Britain. The Tavistock Clinic took its share of refugees throughout the war. Prominent names who were at Westfield at one time or another during the war include: Erwin Popper, Felix Boenheim, and possibly Walter Schindler[213].

Westfield College was part of the University of London, a small college situated on Kidderpore Avenue, Hampstead[214]. Staff not required by either the army or the Emergency Medical Service went to Westfield and lived as a small community, where consulting rooms by day would be staff bedrooms by night[215]. This arrangement brought together Clinic staff in way that had never happened before. Owing to the financial state of the clinic, with the drastic fall in numbers of patients (by around 50 per cent[216]) and donations, salaries could not be paid and staff worked on a voluntary basis[217]. This meant that to make ends meet staff pooled their resources[218] putting the incomes of their private practices into a common fund[219]. This not only allowed the less-well off to live, but also funded a significant portion of the Clinic’s overheads[220]. Although work in the adult and children’s departments continued, most educational courses were abandoned by the end of 1939[221],[222].

Forty four members of staff[223], including 20 senior staff[224], were called up into active duty. This included the director and both assistant directors[225]. Fortunately Mary Luff was quite quickly released from the Emergency Medical Services and towards the end of 1939[226] returned to the Tavistock Clinic to resume part-time duties and become the Acting Director[227] – becoming the first woman to be in charge of the Tavistock Clinic.

In 1940 the Germans began an intense bombing campaign against industrial targets in Britain. On 7 September they changed their strategy and the Blitz came to London. 51 Tavistock Square was reduced to pavement level[228] and in the spring of 1941 Malet Place[229] and Store Street[230] were destroyed[231].

By the end of 1940 patient numbers at the Tavi had halved again[232].

During 1940 Mary Luff gave up her work as Acting Director to take her children to the safety of the United States[233]. ATM Wilson took on the role of Acting Director, but was shortly called up, joining JR Rees in the Royal Army Medical Corps[234]. Jane Isabel Suttie then became the second woman Director[235]. Again this position was short lived and in 1941 she was obliged, for family reasons, to retire[236] to Ireland[237]. Margherita Lilley then took over.

1941 also saw the final retirement of Hugh Crichton Miller[238].

On 27 September 1941 the Tavistock Clinic turned 21 and the event was celebrated by a reunion and an address on the BBC[239].

Throughout the war close relations were maintained between the civilian and military staff, with many of the Army psychiatrists either staying at Westfield when on leave or coming back for staff meetings.

By 1943 the air raids in Britain had practically ceased and patient numbers, particularly children, began to rise again[240]. In 1944 Rosalind Vacher became the Acting Director[241] and the Tavi also started to get referrals of ex-servicemen from the Ministry of Pensions. Academic activities were resumed and eight students enrolled for the Diploma in Psychology[242]. The Council of the Clinic sold the Store Street site and this raised just about enough money to cover the Clinic’s debts. Once again the need for premises became a pressing problem. Westfield College wished to resume use of its building[243]. The lease of 2/4 Beaumont Street was bought and the Clinic moved there in August 1945[244]. It was a derelict former nursing home that had been used as a hostel for temporary civil servants during the war[245]. It was, however, bigger than any of the previous buildings and gave scope for growth[246]. This became the third home of the Tavistock Clinic.


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[131] T Harrison and D Clarke, ‘The Northfield Experiments’, p701, British Journal of Psychiatry, 160. 1992

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[133] B Shephard, War of Nerves, p258, Jonathan Cape, 2000

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[142] B Shephard, War of Nerves, p265, Jonathan Cape, 2000

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[159] T Harrison and D Clarke, ‘The Northfield Experiments’, p698, British Journal of Psychiatry, 160. 1992

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[170] HV Dicks, 50 Years of the Tavistock Clinic, p5, Routledge, 1970

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[173] JR Rees, Reflections, p58, The United States Committee of the World Mental health Federation, 1966

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[176] N Rose, Governing the Soul, p43, Routledge, 1991 [1989]

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[178] Royal College of Physicians, ‘Lives of the fellows, John Rawlings Rees’, http://munksroll.rcplondon.ac.uk/Biography/Details/3726, 1 April 2019

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[185] B Shephard, War of Nerves, p313, Jonathan Cape, 2000

[186] HV Dicks, 50 Years of the Tavistock Clinic, p105, Routledge, 1970

[187] B Shephard, War of Nerves, p314, Jonathan Cape, 2000

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[201] JR Rees, Reflections, p53, The United States Committee of the World Mental health Federation, 1966

[202] M Shapira, The War Inside, p171, Cambridge University Press, 2013

[203] B Shephard, War of Nerves, p325, Jonathan Cape, 2000

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[206] Royal College of Physicians, ‘Lives of the fellows, John Rawlings Rees’, http://munksroll.rcplondon.ac.uk/Biography/Details/3726, 1 April 2019

[207] HV Dicks, 50 Years of the Tavistock Clinic, p90, Routledge, 1970

[208] ‘Obituary, J.R. Rees’, British Medical Journal, p253, volume 2, 26 June 1969

[209] JR Rees, Reflections, p40, The United States Committee of the World Mental health Federation, 1966

[210] HV Dicks, 50 Years of the Tavistock Clinic, p94, Routledge, 1970

[211] The Tavistock Clinic Annual Report 1943, p6

[212] HV Dicks, 50 Years of the Tavistock Clinic, p94, Routledge, 1970

[213] HV Dicks, ‘Discussions with JR Rees on the History of the Tavistock Clinic’, unpublished interview, p7, 17 Dec 1964

[214] The Tavistock Clinic, Report for the period 1st January to 31st December 1939, p1

[215] HV Dicks, 50 Years of the Tavistock Clinic, p94, Routledge, 1970

[215] HV Dicks, 50 Years of the Tavistock Clinic, p94, Routledge, 1970

[216] The Tavistock Clinic, Report for the period 1st January to 31st December 1939, p4

[217] HV Dicks, 50 Years of the Tavistock Clinic, p94, Routledge, 1970

[217] HV Dicks, 50 Years of the Tavistock Clinic, p96, Routledge, 1970

[218] The Tavistock Clinic, Report for the period 1st January to 31st December 1939, p3

[219] HV Dicks, 50 Years of the Tavistock Clinic, p96, Routledge, 1970

[220] The Tavistock Clinic, Report for the period 1st January to 31st December 1939, p4

[221] The Tavistock Clinic, Report for the period 1st January to 31st December 1939, p5

[222] AV White, From the Science of Selection to Psychologising Civvy Street: The Tavistock Group, 1939-1948, p214, Kent Academic Repository, 2016

[223] The Tavistock Clinic Annual Report 1943, p6

[224] HV Dicks, 50 Years of the Tavistock Clinic, p98, Routledge, 1970

[225] HV Dicks, 50 Years of the Tavistock Clinic, p95, Routledge, 1970

[226] The Tavistock Clinic, Report for the period 1st January to 31st December 1939, p6

[227] HV Dicks, 50 Years of the Tavistock Clinic, p101, Routledge, 1970

[228] The Tavistock Clinic Report for the year 1940, p3

[229] The Tavistock Clinic Report for the year 1940, p3

[230] HV Dicks, 50 Years of the Tavistock Clinic, p94, Routledge, 1970

[231] The Tavistock Clinic Report for the year 1941, p3

[232] The Tavistock Clinic Report for the year 1940, p4

[233] HV Dicks, 50 Years of the Tavistock Clinic, p101, Routledge, 1970

[234] The Tavistock Clinic Report for the year 1940, p5

[235] The Tavistock Clinic Report for the year 1940, p5

[236] The Tavistock Clinic Report for the year 1941, p5

[237] HV Dicks, 50 Years of the Tavistock Clinic, p101, Routledge, 1970

[238] The Tavistock Clinic Report for the year 1941, p5

[239] Tavistock Clinic Report for the year 1941, p3

[240] HV Dicks, 50 Years of the Tavistock Clinic, p112, Routledge, 1970

[241] HV Dicks, 50 Years of the Tavistock Clinic, p112, Routledge, 1970

[242] HV Dicks, 50 Years of the Tavistock Clinic, p114, Routledge, 1970

[243] The Tavistock Clinic Annual Report 1943, p7

[244] The Tavistock Clinic Annual Report 1943, p7

[245] HV Dicks, 50 Years of the Tavistock Clinic, p117, Routledge, 1970

[246] The Tavistock Clinic Annual Report 1943, p7