John Bowlby at war and the psychoanalytic controversial discussions
By the end of the First World War it was becoming clear that its devastating eﬀects were contributing to psychological distress and mental illness. This was particularly so for the soldiers who had survived but suﬀered major physical and emotional wounds. What nowadays is clearly documented as post-traumatic stress disorder had not yet been recognised, let alone conceptualised. However, some doctors were beginning to categorise the war’s psychiatric casualties in terms of suﬀering from shell shock or war neurosis. In this post-war context, a small group of psychiatrists under the leadership of
Hugh Crichton-Miller opened the Tavistock Clinic in 1920. It was originally known as the Tavistock Institute of Medical Psychology. The founder members worked hard to create informed public opinion and concern, which could drive reforms in the direction of mental health provision and training. In the early days, the Tavistock developed psychological treatments for shell-
shocked soldiers. From the outset, clinical services were for both adults and children. The Clinic’s ﬁrst patient was in fact a child, although a proper Children’s Department did not open until 1926. From the beginning, it was clear that oﬀering free treatment meant that the training of a new generation of professionals would have to be essential, in order to maximise resources. At the time, among the roughly 80 Tavistock physicians who contributed around six hours a week, many had little or no psychiatric training. The impact of bereavement was enormous: roughly three-quarters of a million
Britons died in the war, leaving around a quarter of a million widows and nearly four hundred thousand fatherless children. It was in the other foremost psychiatric institution in Britain, the Maudsley Hospital, where mental health professionals became aware of the fact that complex bereavement was a risk factor in the development of psychosis. It was during his psychiatric training at the Maudsley Hospital, from 1933 to 1936, that Bowlby became conversant with the link between bereavement and psychotic illness.