The Standard for Insanity

"The Standard for Insanity"

Since Pat Barker's Regeneration is set in a mental hospital, it seems fitting that questions about mental disease and the definition of sanity should be raised. At the very start of the book, Rivers and Bryce are discussing the case of Siegfreid Sassoon, a dissenting officer of the British army. As they discuss his diagnosis of "neurasthenia," Barker is laying the groundwork for one of Regeneration's many themes: no one is completely qualified to judge the sane from the insane, for insanity finds its way into us all. The ambiguity surrounding the definition and treatment of neurasthenia offers just a glimpse into the ever-changing and highly subjective world of mental evaluation.

The history of neurasthenia traces back before World War I to a scientist by the name of George A. Beard. Beard coined the actual term "neurasthenia" which means nerve weakness (Marlowe). Neurasthenia was attributed rather vaguely to the stress of everyday life, or, for soldiers, the stress of the trenches. Many also felt it was a disease primarily of the upper class, which means it would apply more often to officers in the army than regular men. Andrew Scott Myrtle, who wrote on the validity of neurasthenia, believed like many medical professionals of the era that "it is not the machine workers, the factory workers, who suffer but 'the inventors of the machines'" (Gijswijt-Hofstra 145). Not only did neurasthenia come from the many stresses of daily life, but it also had a myriad of symptoms. Every article on neurasthenia offered a different set of acceptable symptoms, the most common being sleeplessness, headaches, and fatigue (Marlowe). Cures for neurasthenia were as varied as its symptoms. When working with one patient, Beard "promptly zapped the young doctor with a 'faradic current' from 'head to toe'" (Martensen 1243). Electric shock was still being used during World War I, as evidenced by doctors like Lewis Yealland, but other cures such as bed rest, sea-salts, and expensive cruises were also circulating (Gijswijt-Hofstra 145).

The sense of ambiguity that surrounded neurasthenia had a large effect on society's views of neurasthenic patients. Although World War I was one of the first instances where people recognized that mental disorder or disease might be responsible for actions that were otherwise characterized as cowardly, there remained a strong sense that diseases like neurasthenia were ultimately the result of a weak will. Robert Martensen describes neurasthenia as giving people a "socially legitimate explanation of their inability to perform their expected roles" (1243).