While doing his night rounds, Dr. Rivers is introduced to a new patient, Billy Prior, who suffers from selective mutism but also has horrific nightmares that leave him screaming. Prior is an officer from a blue-collar background, which was rare during the early 20th century. When Rivers first questions Prior, the patient answers by writing in block letters on a notepad, claiming that he doesn’t remember his dreams or the incident that caused him to lose his voice. After a brief examination, Prior becomes difficult and refuses to communicate any longer.
Sassoon meets Graves for dinner, enjoying the opportunity to venture out of the confines of Craiglockhart. However, their conversation is awkward: the lieutenant admits to being afraid of the hospital and of his own mental health. While walking back to Craiglockhart, Sassoon seethes internally at the ignorant civilians around him, sparing his only positive feelings for a drunken soldier exiting a bar. As Sassoon begins to relax, he experiences a flashback of “Armageddon” (45). He thinks to himself that despite what Dr. Rivers may say, he is thoroughly happy to go to bed each night knowing that he is safe.
As Rivers prepares for bed, he becomes frustrated while contemplating Sassoon's anti-war opinions. Britain cannot leave German militarism to terrorize the next generation, Rivers thinks to himself. That night, Rivers dreams that he is testing sensitivity to pain by pricking the arm of his friend, Henry Head. As Rivers becomes increasingly uncomfortable with his role, Head becomes aggressive. He eventually picks up a scalpel and cleanly slices Dr. Rivers's arm open. At this moment, the psychologist wakes up. He reflects that this dream mimics the actual research he once performed with Head at Cambridge. Head was studying nerve regeneration and severed the nerve in his own hand in order to chart the return of physical sensation. Dr. Rivers was tasked with pricking Head with needles to test for sensitivity, which caused Head “extreme” pain (47). Rivers concludes that the dream is a result of his conflicted feelings about causing mental torment to his patients by forcing them to relive horrifying war experiences. The only patient he does not have to force is Burns, whose memories already haunt him plenty.
Dr. Rivers believes that his method of therapy, which encourages men to express their feelings and render themselves vulnerable, can be emasculating for men who grew up in an environment where masculinity is synonymous with repression. The psychologist even admits to bottling up his own emotions about his private life. However, Dr. Rivers believes that processing traumatic memories is the only way to treat shell-shock and therefore, remains committed to his methodology.
After his first night at Craiglockhart, Prior regains his voice. When Dr. Rivers visits him, though, Prior still refuses to cooperate. Prior senses the inherent power imbalance between a psychologist and patient, demanding to know why he must share personal information when the doctor doesn’t reciprocate. Prior suggests hypnosis, but Dr. Rivers explains that he would prefer to try other methods first. When the psychologist threatens to leave the room, Prior finally shares his memories about his breakdown. He was forced to stand in a flooded No Man’s Land for 50 hours while German shells whizzed all around him, killing his fellow soldiers. Prior also reveals that he saw the officer who relieved him from his post walking down a hallway at Craiglockhart.
Dr. Rivers next meets with Sassoon, who explains that despite Graves’ insistence, he has not been manipulated by Bertrand Russell or other pacifists. He says he was initially introduced to pacifism by Edward Carpenter, who also wrote The Intermediate Sex, a book which “saved” Sassoon by making him feel less freakish (54). Dr. Rivers, who is familiar with the book, warns Sassoon that if the details of his intimate life become public, people will use them to discredit his cause.
Dr. Rivers schedules two free hours so that he can finish some work. However, Billy Prior’s father interrupts him. Mr. Prior is a blue-collar worker with a thick accent who expresses nothing but contempt for his son. He believes that Billy's mother gave the young man upper-class pretensions by encouraging his improper ambition. Mr. Prior proclaims that would have had more pity for his son had he been shot. He also reveals that during his visit with Billy, the young officer was mute (despite the fact that Prior was speaking to Rivers earlier that day) and suffering from asthma.
Soon thereafter, Mrs. Prior comes to visit Dr. Rivers, embarrassed at what she imagines her husband has said. Unlike her husband, Mrs. Prior is soft, compassionate, and desperately proud of Billy. She explains that Mr. Prior has had a difficult life. He was sent to work when he was ten, and he is jealous of his son’s talents and aspirations. Mrs. Prior admits to preventing Billy from connecting with his father’s working-class background, for which Billy is resentful at times. Mrs. Prior muses that “the less you do” for men, “the more highly you’re thought of” (58).
Soon after Mrs. Prior’s departure, another patient, Broadbent, interrupts Dr. Rivers for a third time. Broadbent, who fabricates elaborate stories about honorary degrees and military awards, informs the psychologist that his mother is very ill. He requests time off from Craiglockhart to go visit her. Dr. Rivers, who is very suspicious about Broadbent's claims, instructs Broadbent to ask Bryce for permission to go. Broadbent becomes angry that Dr. Rivers won’t advocate for him and leaves the psychologist's office in search of Bryce.
After dinner, Dr. Rivers finds Prior sitting alone in the common room. The young officer is having trouble breathing. Prior reveals that his father physically abused his mother when he was a child. Dr. Rivers leads Prior to his room and physically inspects him, surprised that someone with intense asthma would be allowed to serve in the military. Prior explains that his asthma was much worse at home than it was on the front.
Prior wakes up screaming again and Dr. Rivers comes to calm him. Billy admits that he wants to impress the doctor before taunting him with some sharp psychological insights, saying that Rivers's patients must all look at him as a “Daddy” figure. Dr. Rivers realizes that Prior has been reading one of his books and learning about the practice and methodology of psychology, which unnerves him, although he cannot articulate why. Prior finds a section in Rivers's book about homosexuality and teases the doctor about it.
Prior then describes the class divisions on the front, claiming that only those with the "correct" clothing and background are truly welcomed by the other officers. He mocks the upper-class officers’ dreams of glory in war, but then states that the only thing that truly angers him is when civilians claim there are no class divisions in the army. Prior still refuses to share the content of his nightmares and again requests hypnosis. After the session is over, Dr. Rivers admits that he feels a sense of dread when he thinks about Billy Prior.
Sassoon shows Dr. Rivers a piece in the Times that discredits his letter by describing Sassoon as an otherwise patriotic soldier suffering from shell-shock. Depressed by this recent development, Sassoon points out another front page story: a boy who was not yet 18 has died in the war. The lieutenant is angry that a man not yet old enough to serve has been slaughtered and yet, people will read this news calmly over breakfast. Somewhat upset, Dr. Rivers stutters in his reply.
The psychologist brings the conversation back to Sassoon’s treatment, agreeing to meet with him three times a week and encouraging him to build relationships with the other patients. When he writes Sassoon’s admission report, Dr. Rivers omits any “intimate details” in order to protect him (70). The report outlines the lieutenant’s history and notes that he has “no physical signs of any disorder of the Nervous Systems” (71). Rivers also explains that Sassoon would no longer oppose the war if the end was in sight.
Later, when meeting with the other staff psychologists, Dr. Rivers discusses Sassoon. One of his colleagues questions the need to meet with Sassoon at all since he is not mentally ill. Dr. Rivers claims that it is his duty to convince Sassoon to return to the front, which he can only accomplish if he meets the lieutenant regularly. He believes since the lieutenant’s reasons for objecting to the war are emotional, he will be able to convince him to go back with superior logical arguments.
The final chapters of Part I explain the novel’s title: Regeneration. The phrase refers to an experiment in which Dr. Rivers participated; he charted the regrowth of a damaged nerve by testing his friend’s response to pain. This parallels his experience as a psychologist at Craiglockhart, where he also inflicts pain in the hopes of regenerating his patients' sanity. In both instances, however, Rivers is deeply disturbed when he sees that his methods cause pain, which reveals his sensitivity and compassion. The doctor is conflicted, unsure if his experimental methodologies justify the amount of psychological anguish his patients feel while processing their most traumatic experiences.
Dr. Rivers understands that reliving trauma and expressing emotions is not only painful, but potentially embarrassing. At this time, English society had fairly strict gender norms. Men were commonly expected to repress emotions and any other signs of supposed weakness; emotional reactions were generally associated with women. Rivers is highly aware of these conventions and realizes that his style of therapy can be an emasculating experience. It can also be deeply infantilizing: patients depend desperately on a doctor, who remains detached and independent, for care and comfort. Billy Prior senses this fundamental imbalance between psychologist and patient and attempts to rectify it by trying to induce Dr. Rivers to reveal personal information. Prior also studies psychology to close their knowledge gap and verbally takes the doctor down a peg whenever he can.
Regeneration explores the gender norms of early 20th-century British society not only through the doctor - patient relationship, but also through Sassoon’s homosexuality. Sassoon admits that he had difficulty accepting himself until he read The Intermediate Sex, which helped him to normalize his experience. Meanwhile, Rivers’ warnings to Sassoon about revealing his sexual orientation underline the conservative nature of English society at this time. The psychologist purposefully excludes Sassoon’s homosexuality from his official report to protect him from being judged and dismissed. Though some critics have asserted that the character of Rivers is also gay, Barker leaves Rivers' sexuality ambiguous. It is clear that Rivers has written about homosexuality, at least in the book Prior reads, and that he is familiar with the literature Sassoon cites on the topic. Yet Barker reveals very little about Rivers's personal life in general.
In the same report where he avoids mentioning Sassoon's sexuality, Dr. Rivers also writes that Sassoon shows no physical signs of mental illness - but in the context of the war, the line between sanity and insanity has become uncomfortably blurry. Sassoon confides to Graves over dinner that he is worried about his own mental health, particularly in an environment like Craiglockhart. Moreover, the lieutenant experiences a jarring flashback while walking home from that same meal. Unlike his colleagues, Dr. Rivers is convinced that Sassoon will benefit from therapy, even though he isn't showing any physical symptoms of illness.
Furthermore, Barker depicts the psychologically damaging aspects of war as universal. Graves, who is instrumental in Sassoon's institutionalization, has been diagnosed with shell-shock himself. Billy Prior is forced to endure fifty hours of life-threatening duty before another officer comes to take over his post; both Prior and his replacement end up at Craiglockhart. There is not a single character in Regeneration who experiences combat and emerges unscathed. Many of the soldiers' psyches are so shattered that they have no hope of ever leading normal lives. This reinforces the central question of whether insanity is a sane response to a cruel war. If war damages everyone it touches, is the damage a sign of mental illness or of a greater, all-encompassing force?
Pat Barker also presents war as deeply absurd, further stripping away the vestiges of glory from the act of battle. Billy’s suffering is not connected to a decisive or logical moment, but to a vain desire by the British army to maintain its pride by guarding a strip of No Man’s Land. This action does not lead to any military gains or victories, but rather, it endangers the lives of countless men for an altogether useless cause. Sassoon articulates this sentiment repeatedly in his arguments about how the war is perpetuating unnecessary slaughter.
The final chapters of Part I introduce the theme of class in the character of Billy Prior, an officer from a working-class background. Despite the propaganda that is circulating at this time about egalitarian brothers in arms, Prior explains that men on the front remain deeply divided by their economic positions in society. He feels the effects of these divisions, remaining isolated from his fellow officers, who, unlike Prior, come from upper-class backgrounds. Because of his mother's encouragement, Prior is also alienated from the blue-collar community that his father comes from, which only adds to his feelings of isolation.
Through Prior, Barker demonstrates the ways in which physical responses can be tied to psychological stress. On the morning of his parents’ visit, Prior is speaking articulately and feeling relatively well. However, he regresses once Mr. Prior arrives. The stress of facing his demeaning, abusive, and violent father leaves Billy mute and struggling to breathe. Many of the other patients suffer from physical reactions to psychological anguish: Burns's traumatic experience on the battlefield causes him to vomits whenever he tries to eat, and Willard, who appears later in the novel, cannot walk despite having no physical handicaps.
Voice and speech play a large role in defining several characters in Regeneration. Prior’s lack of speech communicates his anguish, while his subtle accent speaks to his both working-class roots and his upwardly mobile upbringing. Mr. Prior’s rough accent is a reflection of his working-class pride, and Mrs. Prior’s more genteel tone reveals her desire to transcend her socioeconomic class. Both Sassoon and Dr. Rivers have slight speech impediments. The psychologist notices Sassoon’s slurring speech when he first meets him, which he interprets as an indication of a “disguised… life-long stammer.” The disguised nature of the stammer could parallel the Sassoon’s hidden sexuality, while the stammer itself could be an indication of someone torn between different ideals. In fact, Dr. River’s stammer re-appears after Sassoon confronts him with evidence of the war’s cruelty, bringing into relief the tension between the doctor’s own morals. That both men suffer from the same speech impediment points to a shared experience or compatibility.