Journey’s End is a film adaptation of R C Sheriff’s play and novel of the same name. The film follows a group of soldiers in the trenches during March 1918, and stars Sam Claflin, Asa Butterfield, Stephen Graham, and Paul Bettany.
We sat down with Professor Edgar Jones from Kings College London, psychodynamic psychotherapist who has seen the film and is was kind enough to speak about his research on PTSD, treatment of war syndromes and psychological effects of war on civilians which are all prevalent themes throughout the film.
What is a psychodynamic psychotherapist and what made you want to train in this area?
Psychodynamic psychotherapy is based on the idea that part of a person’s problems or distress is caused by memories or conflicts that are unconscious, that is not readily explored in daily life. The therapist will seek to discover these issues by allowing the person to talk freely without a prepared script, to explore their dreams, fantasies and fears. It is also important to build up a picture of the person’s life, their upbringing and core beliefs so that fears and anxieties can be set in their cultural context. The therapist is there to act as a guide, to suggest possible explanations and enable the person to think of new ways of doing things or viewing old problems in a different way.
How was PTSD dealt with (if at all) in 1918 when the film was set?
PTSD is a relatively modern diagnosis, formally acknowledged by the American Psychiatric Association in 1980. However, army doctors on all sides in the First World War knew that conflict was a powerful trigger for psychological breakdown. In Britain the term ‘shell shock’ was adopted in February 1915 and a range of treatments were devised. These included immediate respite in forward psychiatric units and specialist hospitals and wards in the UK for those soldiers suffering from more severe and lasting illnesses. The Maudsley Hospital, for example, opened in January 1916 to research and treat shell shock. The problem, however, was that there were large numbers of soldiers suffering from psychological wounds and very limited treatment facilities so many soldiers with shell shock never received specialist care.
Nowadays PTSD is quite widely talked about within mental health; does this help sufferers with dealing with their disorder?
There are a number of treatments for PTSD which have been studied rigorously and shown to be effective. In the UK trauma-focused, cognitive behaviour therapy is widely practiced and has high success rates. Such treatments are the result of growing understanding of mental illness and research into neurobiology (the way that the brain processes traumatic thoughts and memories), so talking about traumatic experiences with a trained therapist is recommended.
We often hear about soldiers with PTSD but how can it affect people in other ways?
Soldiers sometimes suffer from PTSD because they are exposed to danger or have to risk their lives on the battlefield. A key risk factor for PTSD is being involved in a life-threatening situation. As a result, civilians who have suffered a violent assault or been in a terrifying road traffic accident or who are repeatedly exposed to traumatic events are at risk of PTSD. However, it is not an automatic connection and most people in these circumstances will come through the stressful experience without a formal mental illness.
Given the current political climate, we are potentially faced with another world war. How do you think the effect on civilians would be different this time?
Studies of civilians during the Blitz and indeed of office workers evacuating the Twin Towers show that most people behave appropriately in moments of crisis. They help each other and make sensible decisions. Panic is in fact rare in these situations and is often misinterpreted by commentators. It means doing something that is irrational and not likely to benefit the person at threat. So running down a road away from a bomb and shouting is not necessarily an example of panic. It could be an appropriate life-saving action particularly if the person is calling out warnings to others. Studies of past conflicts have shown that people are often more resourceful and resilient than the authorities believe they will be. Nevertheless, it is also important that accurate information is given about threats and informed advice is given about how to respond to particular events.
Professor Edgar Jones as Professor Edgar Jones, Programme Leader for MSc in War & Psychiatry, King’s College London