Shortly before dawn he woke. Still dazed from sleep, he put his hand to his left arm, expecting to feel blood. The dry cloth of his pyjama sleeve told him he’d been dreaming. He switched on the lamp and lay for a while, recollecting the details of the dream, then picked up a notepad and pencil from his bedside table and began to write.
I was in my room at St John’s, sitting at the table in front of the book case. Head was beside me, his left sleeve rolled up, and his eyes closed. The sleeve was rolled up well above his elbow, so that the full length of the incision was revealed. The scar was purple. The tablecloth was spread with various items of equipment: jugs of water, wisps of cotton wool, bristle brushes, compasses, ice cubes, pins.
My task was to map the area of hypersensitivity to pain on Head’s forearm. He sat with his eyes closed and his face turned slightly away. Every time I pricked him he cried out and tried to pull his arm away. I was distressed by this and didn’t want to go on, but I knew I had to. Head kept on crying out.
The dream changed and I was drawing a map of the protopathic area directly on to his skin. The pen was as painful as the needle had been. Head opened his eyes and said something I didn’t catch. It sounded like, ‘Why don’t
you
try it?’ He was holding an object out towards me. I looked down to see what it was, and saw that my own left arm was bare, though I couldn’t recall rolling up my sleeve.
The object in Head’s hand was a scalpel. I began to ask him to repeat what he’d said, but before I could get the words out, he’d leant forward and brought the scalpel down my arm, in the region of the elbow. The incision, although about six inches long, was so fine that at first there was no blood. After a second, small beads of blood began to appear, and at that point I woke up.
Rivers started to analyse the dream. The manifest content didn’t take long. Except for the cutting of his arm, the dream was an unusually accurate reproduction of events that had actually occurred.
Henry Head had been working for some time on the regeneration of nerves after accidental injury, using as his subjects patients in the public wards of London hospitals, before concluding that, if any further progress was to be made, more rigorously controlled tests would have to be done. Rivers had pointed out that these would have to be carried out on a subject who was himself a trained observer, since an extremely high degree of critical awareness would be needed to exclude preconceptions. Head had volunteered himself as the subject of the proposed experiment, and Rivers had assisted at the operation in which Head’s radial nerve had been severed and sutured. Then, together, over a period of five years, they had charted the progress of regeneration.
During the early stage of recovery, when the primitive, protopathic sensibility had been restored, but not yet the finely discriminating epicritic sensibility, many of the experiments had been extremely painful. Protopathic sensibility seemed to have an ‘all or nothing’ quality. The threshold of sensation was high, but, once crossed, the sensations were both abnormally widely diffused and — to use Head’s own word — ‘extreme’. At times a pinprick would cause severe and prolonged pain. Rivers had often felt distress at the amount of pain he was causing, but it would not, in life, have occurred to him to stop the experiment for that reason, any more than it would have occurred to Head. In the dream, however, the wish to stop the experiment had been prominent.
The latent content was more difficult. Superficially, the dream seemed to support Freud’s contention that all dreams were wish fulfilment. Rivers had wished himself back in Cambridge, doing research, and the dream had fulfilled the wish. But that was to ignore the fact that the dream had not been pleasant. The emphasis in the dream had been on the distress he felt at causing pain, and, on waking, the affect had been one of fear and dread. He didn’t believe such a dream could be convincingly explained as wish fulfilment, unless, of course, he wished to torture one of his closest friends. No doubt some of Freud’s more doctrinaire supporters would have little difficulty with that idea, particularly since the torture took the form of pricking him, but Rivers couldn’t accept it. He was more inclined to seek the meaning of the dream in the conflict his dream self had experienced between the duty to continue the experiment and the reluctance to cause further pain.
Rivers was aware, as a constant background to his work, of a conflict between his belief that the war must be fought to a finish, for the sake of the succeeding generations, and his horror that such events as those which had led to Burns’s breakdown should be allowed to continue. This conflict, though a constant feature of his life, would certainly have been strengthened by his conversations with Sassoon. He’d been thinking about Sassoon immediately before he went to sleep. But, on thinking it over, Rivers couldn’t see that the dream was a likely dramatization of that conflict. The war was hardly an experiment, and it certainly didn’t rest with him to decide whether it continued or not.
Recently almost all his dreams had centred on conflicts arising from his treatment of particular patients. In advising them to remember the traumatic events that had led to their being sent here, he was, in effect, inflicting pain, and doing so in pursuit of a treatment that he knew to be still largely experimental. Only in Burns’s case had he found it impossible to go on giving this advice, because the suffering involved in Burns’s attempts to remember was so extreme. ‘Extreme’. The word Head had used to describe the pain he’d experienced during the protopathic stage of regeneration. Certainly in Burns’s case, there was a clear conflict between Rivers’s desire to continue using a method of treatment he believed in, but knew to be experimental, and his sense that in this particular instance the pain involved in insisting on the method would be too great.
The dream had not merely posed a problem, it had suggested a solution. ‘Why don’t you try it?’ Henry had said. Rivers felt he’d got there first, that the dream lagged behind his waking practice: he was already experimenting on himself. In leading his patients to understand that breakdown was nothing to be ashamed of, that horror and fear were inevitable responses to the trauma of war and were better acknowledged than suppressed, that feelings of tenderness for other men were natural and right, that tears were an acceptable and helpful part of grieving, he was setting himself against the whole tenor of their upbringing. They’d been trained to identify emotional repression. as the essence of manliness. Men who broke down, or cried, or admitted to feeling fear, were sissies, weaklings, failures. Not men. And yet he himself was a product of the same system, even perhaps a rather extreme product. Certainly the rigorous repression of emotion and desire had been the constant theme of his adult life. In advising his young patients to abandon the attempt at repression and to let themselves feel the pity and terror their war experience inevitably evoked, he was excavating the ground he stood on.
The change he demanded of them — and by implication of himself — was not trivial. Fear, tenderness — these emotions were so despised that they could be admitted into consciousness only at the cost of redefining what it meant to be a man. Not that Rivers’s treatment involved any encouragement of weakness or effeminacy. His patients might be encouraged to acknowledge their fears, their horror of the war — but they were still expected to do their duty and return to France. It was Rivers’s conviction that those who had learned to know themselves, and to accept their emotions, were less likely to break down again.