Dr. W.H.R. Rivers, a military psychologist at the Craiglockhart mental facility in Scotland, reads a letter published by Siegfried Sassoon, a British second lieutenant. In his missive, Sassoon decries the meaningless violence of the interminable Great War (later known as World War I). Rivers then discusses the letter and Sassoon, a potential patient, with his supervisor, Bryce. Evidently, the normally skeptical military board has declared Sassoon mentally ill in order to undercut the effectiveness of his critique. Rivers wearily agrees to treat the outspoken soldier.
Some time before, Robert Graves, Sassoon’s good friend and fellow soldier, convinces Sassoon to agree with a diagnosis of mental illness and comply with orders to undergo treatment at Craiglockhart, a progressive center for the treatment of officers. Sassoon, however, is hoping that his letter will force the military authorities to court-martial him, which will make him a much-needed martyr before the apathetic British public. Graves lies and tells his friend that he is unlikely to be court-martialed. Graves further argues that Sassoon’s hallucinations—of decomposing corpses in London streets and faces of long dead soldiers—suggest he is actually mentally ill. Graves claims that if Sassoon does not cooperate and appear before a mental health board, he will be thrown into a common lunatic asylum. Sassoon, trusting Graves, relinquishes.
Once committed, Sassoon arranges to travel by train to Craiglockhart with Graves, but his friend does not arrive at the station on time. Sassoon therefore arrives at the hospital alone. He pauses briefly outside of the intimidating façade but eventually forces himself to enter.
Dr. Rivers quietly watches Sassoon arrive at Craiglockhart and mulls over his newest patient, whose writing and behavior seem coherent and logical. He reflects that it is convenient for the military authorities to assume that Sassoon is mentally ill because his words are most dangerous to them. Rivers observes the lieutenant pause before entering the building, noting Sassoon's “small private victory over fear” (9).
Sassoon and Dr. Rivers meet for tea and discuss Sassoon’s beliefs about war. Sassoon explains that he no longer dislikes the Germans, but rather, his anger is focused on British citizens and non-combatants who remain apathetic to the great suffering of soldiers in combat. He admits to exposing himself to excessive danger on the battlefield, understanding that this may signify a death wish, but insists that he took his most unnecessary risks while under orders from his superiors. Sassoon insists that he is not a pacifist, but rather, he is a critic of the cruelty involved in this particular war. Dr. Rivers enquires about Sassoon's dreams and hallucinations, learning that his new patient often sees apparitions of crawling corpses as he is waking up or falling asleep.
Sassoon keeps pulling at the threads on his shirt that used to hold his ribbon for bravery in combat. Dr. Rivers learns that Sassoon regrets throwing his ribbon in a river; the lieutenant describes how the light ribbon didn’t sink but “bobbed around in the current, looking depressingly insignificant against a looming ship in the background" (15). The two part on good terms and Dr. Rivers warns Sassoon he is not neutral: as a military psychologist, it is his job to convince the lieutenant to return to war.
At dinner in the cafeteria, Dr. Rivers tells Bryce he finds Sassoon surprisingly “impressive” (16). Meanwhile, Sassoon imagines another scene from the war but manages to eat in peace. A patient named Anderson introduces himself to Sassoon and they chat about golf. Suddenly, a man across the room vomits and has to be dragged out; Dr. Rivers abandons his dinner to follow his heaving patient.
After gently attending to the vomiting man, the psychologist reflects that his patient's suffering is “without purpose or dignity” (19). The man, known as Burns, was thrown through the air by an exploding shell and landed with his face in the decomposing stomach of a German corpse. Now, every time he attempts to eat, Burns can only taste and smell rotting flesh. Dr. Rivers agrees with Burns that his plight is like a sick joke, with none of the honor or respect that a more orthodox wound might garner.
Outside, Captain Graves finally arrives at Craiglockhart.
Sassoon meets Graves and directs him to Dr. Rivers. Graves, who has recently undergone treatment for shell-shock, explains to Dr. Rivers why he convinced Sassoon to accept placement in the hospital: He believes that Sassoon’s long-term health depends on maintaining his bond with his soldiers. Being court-martialed would have separated Sassoon from his men permanently; at least this way, the lieutenant can be cured and then return to the front. Graves tells Rivers that Sassoon sent him a copy of the anti-war letter before it was published. As soon as he received it, Graves left the Isle of Wight (where he was being treated) and made it his mission to save Sassoon by convincing their superiors of his mental instability.
Graves admits to Dr. Rivers that he lied to Sassoon to get him to acquiesce to the plan, but the psychologist condones it, saying it was the best way to preserve the lieutenant’s mental health. Graves describes his own performance in front of the mental health board; he spoke the whole time and ordered Sassoon to remain silent, lest he make too much sense. In response to Dr. Rivers' questions, Graves explains that he agrees with his friend’s anti-war sentiment but believes that soldiers still have a duty to serve above all, whether or not they support a particular war or action. Graves dismisses famous pacifists like Bertrand Russell and Ottoline Morrell, claiming they are simply manipulating Sassoon for their own political gain. After hearing Graves's account, Dr. Rivers suggests that Graves stay with Sassoon, who will need support during his first night at Craiglockhart.
Dr. Rivers sits down to analyze the poems that Sassoon wrote while recovering from a shoulder wound. The poems describe a soldier discovering a sleeping figure that is really a rotting corpse, a general surveying his troops before bloody combat, and the pain of watching fellow troops die on the battlefield. Rivers reflects that Sassoon has achieved a seemingly stable mental state by processing his trauma through poetry. Many soldiers attempt to forget the unforgettable, which is why they are tormented by cruel nightmares. In the corridor, Dr. Rivers meets Sassoon’s new roommate, who anxiously asks if the lieutenant is a German spy. Dr. Rivers assures him that Sassoon is neither German nor a spy.
Anderson, a combat medic, describes a dream in which he is pinned down naked and bound with corsets while his father-in-law jabs at him with a staff that has a serpent curled around it. Anderson then becomes defensive, mocking Freudian theories and daring Dr. Rivers to interpret his dream. The psychologist connects the snake and staff to the caduceus badge that medics wear on their uniforms. Anderson admits that he is afraid to practice medicine again, specifically because of the blood he will have to see. He describes mistakenly letting a mud-covered soldier bleed to death. However, even though Anderson dreads having to return to his civilian practice, he treats it as an inevitability. As a result, his screaming nightmares keep the entire floor awake every night.
Sassoon and Graves go swimming in the pool, appraising each other’s scars and playing in the water. Sassoon remembers an injured young soldier who “had a neat little hole” between his legs (33) after having his genitals shot off. Afterwards, the lieutenant goes to Dr. Rivers' office for their meeting.
Sassoon explains to Dr. Rivers that it suits Graves to attribute Sassoon's actions to a mental breakdown because it allows Graves to avoid confronting his own inaction. Dr. Rivers asks about Sassoon’s brother and father, both of whom have been dead for years. The lieutenant describes his life before joining the military, when he struggled to integrate his vastly different desires and interests. He identifies the army as the “only place [he has] ever really belonged” (36). Dr. Rivers asks Sassoon if he feels guilty for being safe in the hospital while troops continue to die on the front, provoking outrage from the lieutenant.
Elsewhere in Craiglockhart, Burns decides to go for a walk in the English countryside. It is crisscrossed with barbed wire fences and full of thick mud , making it disturbingly reminiscent of the trenches. In the fog, the soldier stumbles upon a tree filled with dead, hanging animals. Burns starts to run but then returns to confront the grisly, surreal scene. He takes the animals down and arranges them in a circle on the earth, which is where he feels they are “meant” to be (39). He then takes off his clothes and lies naked in the center of the ring, feeling peaceful. Eventually, Burns returns to the hospital, where everyone has been looking for him. He realizes that he has only returned because he wants to continue his treatment with Dr. Rivers.
The first chapters of Regeneration feature several characters who dismiss the new psychological diagnoses and treatments that emerged during World War I. The officers on the medical review board view shell-shock as a performance put on by cowards trying to escape combat. Likewise, Anderson, the medic, views Freudian theories with suspicion. These attitudes are largely reflective of the time period, when psychology was not yet an established field.
Dr. Rivers, however, champions a cutting-edge psychological approach to treating patients. Barker portrays Rivers as kind, compassionate and effective, thus validating the methodology. Perhaps most important aspect of Dr. Rivers’ psychoanalytic treatments is his emphasis on remembering and processing trauma, which contemporary society encouraged soldiers to forget. Thus, from the outset of the novel, Barker favorably distinguishes Dr. Rivers from the other military authorities and from society at large.
Barker shrouds Sassoon’s actual mental health beneath a veil of ambiguity. Though he is articulate and logical when he speaks, Sassoon experiences troubling hallucinations of agonized, crawling corpses; he is haunted by scenes and images of the war. Meanwhile, the authorities who declare Sassoon mentally ill do so out of political convenience. A sane, critical war hero is much more difficult to dismiss than one who has been committed for shell-shock. Graves also has personal reasons for classifying Sassoon’s actions as the result of exhaustion or imbalance. According to Sassoon, Graves agrees with his anti-war beliefs, but has chosen to support Sassoon's diagnosis of mental illness because it allows Graves to ignore his own inaction in the face of injustice. Despite these various personal agendas, Barker does not explicitly specify whether Sassoon's actions are a sane man's response to an insane conflict or the seeds of psychological unraveling.
Nevertheless, Barker depicts the ways in which war impacts a soldier's psyche by writing from the perspective of Rivers' patients'. This allows the reader to fully understand both the affliction and the diagnosis. For example, Sassoon’s hallucinations blur the lines between his nightmares and reality, appearing primarily as he is rising from or slipping into sleep. His dreams are intruding into the waking world; past events are trampling on the present. Burns also experiences similar confusion during his hike through the English landscape, which increasingly resembles the muddy trenches of war - this is representative of how the war has impinged on the home-front. At one point during his short voyage, Burns makes a grisly and surreal discovery whose sudden violent appearance is emblematic of the trauma of war. Burns arranges the dead animals to rest on the earth and dreams of joining them, longing for a peaceful death to release him from his demons. This entire sequence is dream-like, even though it occurs in real life (or so Burns, and therefore the reader, are led to think). Eventually, Burns chooses to return to the living world, but only because he trusts that Dr. Rivers will be able to cure him.
Sassoon, meanwhile, continues to defy classification. He is against the war, but he is not a pacifist, condemning only the continuation of the current conflict. When self-identified pacifists appear in the novel, Graves strongly condemns them as self-involved political actors. Sassoon is different from these individuals because although he claims to despise subjecting men to combat, he holds combat experience in high regard. He believes that only those who have fought can understand the real horrors of war: anti- war civilians and non-combatants are despicable because they can never repay or even truly understand the sacrifices that soldiers make on their behalf. This irony—Sassoon respects the combat experience while fighting to end it—is creates recurring tension throughout the novel.
Barker repeatedly underlines the fact that men who have fought together on the battlefield share an extremely strong bond unlike any other. Graves even credits Sassoon's commitment to his men with keeping the lieutenant alive. However, Sassoon's connection to the soldiers who are still risking their lives also contributes to his guilt for being tucked away safely at Craiglockhart. When he wrote his letter, he assumed he would either end up back in battle or locked in jail. Now, Sassoon seems mortified about being relatively comfortable while his men are dying. Dr. Rivers is able to uncover Sassoon's feelings of guilt and uses them to push Sassoon towards returning to battle, which is the military’s ultimate goal for soldiers who go to Craiglockhart for treatment.
These first chapters highlight several characters' internal conflicts that will continue throughout the novel. Sassoon believes that he has a duty to his fellow soldiers, which is why he attempts to bring the troops safely home by speaking out about ending the war. However, Sassoon's letter ultimately leads him to be separated from his soldiers and from active duty, which leaves him feeling guilty and agonized. Graves, despite agreeing with Sassoon’s assessment of the war, holds that a soldier’s highest loyalty should be not to his comrades, but to his commitment to fight. This initial commitment should not ever be compromised, Graves insists, regardless of a soldier’s evolving views. Meanwhile, it seems as though Graves, who has been treated for shell-shock, is focusing on Sassoon's case so he can avoid facing his own conflicting feelings about his relative inaction. Like Sassoon, Dr. Rivers struggles with figuring out how to act in both in the best interest of the military and of his patients. Often the two are in direct tension: he is a man tasked with healing the ill so they can be sent back to the battlefield to die.
Barker depicts World War I as a conflict without glory. Sassoon’s poem “To the Warmongers” shows that fighting in a war is only respectable to those that have not had to watch men die in the mud. Burns’ neurosis is particularly stripped of Hollywood sheen: he describes his wound as a disgusting joke, not a hero’s injury. The focus on rotting corpses, dismembered body parts, and horrific images of gore in the soldier’s dreams and flashbacks reinforces Barker's brutal and realistic depiction of war. Barker's depiction of combat is not glamorous or heroic, but tedious, numbing, horrifying, and visceral.
Furthermore, Barker subverts the popular image of the soldier as the epitome of masculinity. Instead, war and its shattering consequences prove to be emasculating for many of the soldiers. During the World War I era, mental illness was often seen as a sign of cowardice or, worse, as a lie that soldiers relied on as a way to avoid battle. Being removed from action and cared for in a hospital left many men feeling like they had failed some crucial test of masculinity. Anderson’s dream of being bound with corsets reflects this; he admits that being in Craiglockhart is emasculating. In another scene, Sassoon recalls a young soldier who was physically and very literally emasculated by the war. Barker will continue to develop this theme of undermined masculinity throughout the novel.