[The pendulum, the gap, and the clinic. Leendert Bouman (1869-1936) and the 'psychological turn' in Dutch psychiatry].

Abstract

In recent historical literature, the Dutch psychiatrist Leendert Bouman (1869-1936) is named 'the godfather of psychological psychiatry'. He is regarded as one of the exponents of a shift or 'pendulum' movement from a biological-materialistic to a psychological, phenomenological orientation in the Dutch psychiatry of the Interbellum. As a professor of the orthodox calvinist Vrije Universiteit of Amsterdam, he explicitly opposed a 'soul-less', biological-reductionist psychiatry. In addition, he played an important part in the introduction and spread of new'psychological' theories and especially Karl Jaspers' phenomenology in The Netherlands. It is one-sided and misleading, however, to refer to Bouman as a 'psychological' psychiatrist. Most of his scientific work was of a neurological and biological nature. He did not see biological (or nomothetic) and psychological (or idiographic) approaches as mutually exclusive, but as necessarily complementary. In this he followed Jaspers' distinction between and complementary use of the causal connections of psychic life (explanatory psychology) and meaningful psychic connections (psychology of meaning). Boumans pluralist orientation was rooted in his fundamentally clinical attitude toward psychiatry. In his view, a psychiatrist was in the first place a clinician. In the clinic, he stressed, a psychiatrist has to view and examine each individual patient in his bio-psycho-social totality. The case of Bouman illustrates that the history of psychiatry is by far richer and more complicated than is suggested by the standard account of that history being characterized by a pendulum movement and a one-dimensional struggle between 'somatic' and 'psychological' schools. It also suggests that the interaction between theory and clinical practice should be emphasized as an important dynamic factor in the history of psychiatry--next to or even above the dichotomy between 'biology' and 'psychology'.