Preface - My third experience in psychiatry

The Third Experience

After that followed an experience of a totally different nature at the university clinic in the city of Groningen. This was an interesting and exciting period, marked first of all by growing skepticism towards somatic therapies such as insulin coma and carbon dioxide inhalation. I just barely experienced the last of such treatments. Psychoactive drugs formed the basis and support of every treatment. Treatment itself stretched across a variety of methods, the most important of which was psychotherapy, in particular psychoanalysis. In addition, there were non-verbal therapies such as creative therapy and psychomotor therapy. Social-psychiatric interventions were considered an approach in its own right, to be practiced by specially trained social workers under the guidance of a psychiatrist.

The clinic was open to new developments. Client-directed therapy was received enthusiastically after several of Carl Rogers’s staff had informed us about it. We welcomed behavior therapy, although not without some reservations. It was a period of optimism about what was possible in psychiatry and what would become possible in the future.

In this climate of optimism, inspiration, and innovation, the first books by authors who would later be associated with antipsychiatry began appearing on the market. Those authors comprised a rather heterogeneous group: Goffman and Szasz in the US, Laing and Cooper in Great Britain, Mannoni in France, and later also Basaglia in Italy. Thomas Szasz actually does not belong in this list, although he is often included by others. It is more correct to consider him a critical psychiatrist.

The Netherlands had its own antipsychiatrist, in the personage of Jan Foudraine. In addition to psychoanalysis he promoted the therapeutic community, and acrimoniously criticized the view that psychiatric disorders have somatic causes like other diseases. In those days Professor Kees Trimbos* also had a certain reputation of being a critical psychiatrist. He maintained that many of the causes of psychiatric disorders should be sought in the social context in which the affected people lived. He was a devoted educator regarding sexual problems in the Roman Catholic population. Prevention was to him a highly underrated and promising area of psychiatry. Trimbos was inclined toward antipsychiatry but did not identify with it.
Objections to the practices in institutional psychiatry as well as alternative views on the “true” nature of psychiatric disorders were passionately argued, in particular by us residents. We expected much to change and improve in psychiatry.

In short, academic psychiatry was marked by integrated views on psychiatric disorders, a wide palette of treatments emphasizing social and psychological approaches, and hermeneutical influences. Coercion was much less in the foreground of the academic milieu, although it certainly was not absent.

*The Netherlands Institute of Mental Health and Addiction is named after him. – translator

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