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EBP), Which Participates in the Netherlands School of Primary Care Research (Care), Acknowledged in 1995 by the Royal Dutch Academy of Science (KNAW) 1 The study of this thesis was performed in the Research Institute Evidence Based Practice (EBP), which participates in the Netherlands School of Primary Care Research (CaRe), acknowledged in 1995 by the Royal Dutch Academy of Science (KNAW). Financial support has been kindly provided by: AstraZeneca BV Janssen-Cilag BV Pfizer BV Glaxo SmithKline BV Wyeth BV This support is gratefully acknowledged. 2 VAN HULP EN HEIL DE PASTORALE PSYCHIATRIE VAN ALPHONSE MAEDER (1882-1971) Een onderzoek naar de betekenis van de helende functie van het christelijk pastoraat voor professionals in de psychiatrische praktijk HANS MEISSNER 3 Van hulp en heil de pastorale psychiatrie van Alphonse Maeder (1882-1971) Een onderzoek naar de de betekenis van de helende functie van het christelijk pastoraat voor professionals in de psychiatrische praktijk een wetenschappelijke proeve op het gebied van de Medische Wetenschappen Proefschrift ter verkrijging van de graad van doctor aan de Katholieke Universiteit Nijmegen op gezag van de Rector Magnificus prof. dr. C.W.P.M. Blom, volgens besluit van het College van Decanen in het openbaar te verdedigen op datum des namiddags om tijdstip uur door Johannes Wilhelm Georg Meissner geboren op 13 augustus 1959 te Ens, De Noordoostelijke Polder Kok: Kampen. 4 Promotor: prof. dr. H.A.M.J. ten Have Manuscriptcommissie: prof. dr. G. Glas, Universiteit te Leiden prof. dr. F.A.M. Kortmann (voorzitter) prof. dr. H.P.J. Stroeken, Universiteit te Leiden 5 INHOUDSOPGAVE Hoofdstuk 1 Inleiding 1. Aanleiding en motivatie 2. De helende functie van het pastoraat 3. Vraagstelling 4. Opzet Hoofdstuk 2 Leven van Alphonse Maeder 1. Biografische gegevens, kinder- en jeugdjaren 2. Positivistische levensfase 1.’Die Maschinentheorie des Lebens’ kan niet kloppen: Hans Driesch 2. De ingeving om psychiater te worden: Berlijn 3. Enkele geschiedkundige noties over de Zwitserse psychiatrie 4. De psychiatrische opleiding van Maeder: Zürich, Bleuler en Jung 1. “Die faszienierende Gestalt des Meisters S. Freud” 5. Biografische gegevens over echtgenote: Louise Maeder-Bosing 6. Het echtpaar Maeder gaat wonen in Zürich 7. De afscheidsbrief van S. Freud 3. Idealistische levensfase; Genève, 1917 tot omstreeks 1923 4. Religieuze levensfase, vanaf omstreeks 1923 tot 1971 1. Aanloopfase van 1923 tot omstreeks 1926 1. De eerste leergang te Amersfoort 2. De tweede leergang 3. De derde leergang 4. Een herinnering van Maeder te Amersfoort 5. Boekbespreking in het huisorgaan van de Internationale School voor de Wijsbegeerte te Amersfoort 6. Openingsrede tijdens een conferentie van artsen en theologen in Spandau 2. Religieuze tussenfase: 1928-1932 1. Emil Brunner 3. Christelijke levensfase 1. De Oxford- Groep 6 2. De bekering tot het christelijk geloof 5. Het Nederlands Koninklijk Huis en Alphonse Maeder 6. De tachtigste verjaardag van Maeder Hoofdstuk 3 Het werk van Alphonse Maeder 1. Inleiding 2. Positivistische fase 1. Eigen psychoanalytische inzichten 3. Idealistische fase 4. Religieuze fase Hoofdstuk 4 Perceptie, verwerking en invloed van het werk van Alphonse Maeder bij enkele psychiaters in Nederland 4.1 Tijdgenoten 1. J.H. van der Hoop 1. Inleiding 2. Nieuwe richtingen in de zielkunde 3. Zelfverwerkelijking in Mensch en Gemeenschap 4. Een geval van schizophrenie 5. Sexualiteit en zieleleven 6. Recensie van ‘Heilung und Entwicklung im Seelenleben’ 7. Bewusstseinstypen 8. Van der Hoop: een Maederiaanse Freudiaan 2. W.J. de Haan 1. Een dissertatie over ‘Psychoanalyse’ op basis van inzichten Maeder 2. Moderne zielkunde en evangelie 3. Evaluatie 3. H.C. Rümke 1. Maeder in ‘Ontwikkelingspsychologie en psychotherapie 2. Maeder en de opkomst van de klinische psychiatrie 3. Maeder in ‘Karakter en aanleg in verband met het ongeloof’ 4. Maeder in een artikel van Rümke over de betrekkelijkheid van de psy- chiatrische diagnose in het Nederlands Tijdschrift voor Geneeskunde 5. Rümke in zijn ‘Psychiatrie’ deel 1, deel 2 en deel 3 over Maeder 6. Studies en voordrachten over psychiatrie 7. J.A. van Belzen over Rümke en Maeder 7 4. Het tijdschrift ‘Predikant en Dokter’ en dr. Alphonse Maeder 4.2 Latere generatie 1. A.L. Janse de Jonge 1. Over de integratie, het geweten en het geslaagde in het psychisch functio- neren 2. Over de vraag naar de geest 2. E.A.D.A. Carp 1. De analytisch-psychologische behandelingsmethode volgens Jung 2. Psychosen op exogene grondslag en geestelijke defect-toestanden en Mae- der 3. G.A. Lindeboom 1. Psychosomatische geneeskunde en de pastorale psychiatrie van Maeder 4. J.H. Van den Berg 1. De betekenis van de phaenomenologische of existentiële anthropologie in de psychiatrie 2. Maeder in protest tegen de theorie van Freud over de liefde in de omgang met het kind 3. Maeder en de psychologische betekenis van de toekomst 4. Maeder en het venijn van Freud; de dromer beproeft al dromend zijn toe- komst 5. Maeder als oase in het landschap van de psychoanalyse 6. Maeder breekt in op een religie afwijzend cultureel klimaat, dat door Freud, Marx en Darwin gedomineerd wordt 5. H.R. Wijngaarden 1. Inaugurele oratie: positieve waardering voor de teleologische functie vol- gens Maeder 2. Bij Maeder mist een adequate onderscheiding tussen mens als beeld van God in materiële en in formele zin 4.3. De invloed van Maeder Hoofdstuk 5 Maeder en Tournier: pastorale geneeskunde 5.1. Wie is Paul Tournier? 8 5.2. De relatie tussen Maeder en Tournier 1. Techniek en geloof, met een bespiegelend voorwoord van Alphonse Maeder 1.1. De invloed van Emil Brunner 1.2. De pastorale geneeskunde als nieuwe geneeskunst 2. Médicine de la Personne 3. De sterken en de zwakken 5.3 Pastorale geneeskunde 5.4 Specifieke invloeden van Maeder op Tournier Hoofdstuk 6 Perceptie, verwerking en invloed van het werk van Alphonse Maeder bij enkele theologen in Nederland 1. Inleidende opmerkingen 2. H. Kraemer 1. Maeder steekt de Nederlandse dijk tussen psychotherapie en pastoraat door 3. J.C.A. Fetter 1. Maeder die langer hoe meer christen wordt “in den gewone zin” en zijn aanvan- kelijke overschatting van de prospectieve functie 4. J.G. Fernhout 5. G. Brillenburg Wurth 1. Christelijke zielszorg, in het licht van de moderne psychologie 2. Les van Maeder: geen ethische zelfstandigheid zonder opvoeding 6. E. van der Schoot 1. Hoofdstukken uit de Pastorale Psychologie 2. Het pastorale gesprek 7. J. Firet 1. Het agogische moment en Maeder’s opvatting over de complementariteit in de re- latie tussen psychotherapeut en cliënt 8. Ph. J. Huijser 1. Biecht en private zondebelijdenis 9. W. Zijlstra 9 1. Op zoek naar een nieuwe horizon met het Maederiaanse begrippenpaar ‘integratie’ en ‘regulatie’ 10. Concluderende paragraaf Hoofdstuk 7 Evaluatie van de thema’s in het werk van Alphonse Maeder 1. Inleidende opmerkingen 2. Medische filosofie in het algemeen 3. Reformatorische filosofie en geneeskunde 4. Reformatorische wijsbegeerte van de geneeskunde 5. Dooyeweerds anthropologische denkbeelden 1. Actualiteit van de wijsgerige anthropologische denkbeelden van Dooyeweerd 2. Ontsluiting in het kader van het onderscheid tussen structuur en richting 3. Pathologie, therapie en geloofsfunctie 6. Strijbos’ structuuranalyse van de geneeskunde 7. Evaluatie van het werk van Alphonse Maeder Hoofdstuk 8 Discussie en conclusies 1. Beantwoording van de centrale vraag van deze studie 2. Programmatische kanttekeningen bij een pastorale psychiatrie Hoofdstuk 9 1. Samenvatting 2. Zusammenfassung 3. Summary Bibliografie van Alphonse Maeder Literatuurreferenties Namenregister Zakenregister Curriculum Vitae 10 HOOFDSTUK I INLEIDING 1.1 Aanleiding en motivatie Deze studie onderzoekt de wijze waarop de pastorale psychiatrie van Alphonse Maeder (1882-1971) licht werpt op de betekenis van de helende functie van het christelijk pastoraat voor professionals in de psychiatrische praktijk.. Het onderzoek komt voort uit interesse naar de vraag wat psychische gezondheid is en is een vervolg op een drietal kleinere deelstudies. De eerste twee deelstudies mondden uit in een referaat in het kader van de opleiding tot psychiater. De laatste studie verscheen als artikel ingevolge een vrije studie over christelijk pastoraat aan de Theologische Universiteit van de (vrijgemaakte) Gereformeerde Kerken te Kampen (Meissner, 1996). Al vrij snel na de start van de specialisatie tot psychiater in 1988 kwam de vraag naar psychische gezondheid op. Over dit onderwerp zou het zogenaamd eindreferaat, bij de afronding van de eerste drie basisjaren van de opleiding tot psychiater, gaan. Bij het voorbereidend literatuuronderzoek bleek echter dat de vraag onbeantwoordbaar werd geacht of ook - minder of meer uitdrukkelijk - onbeantwoord gelaten werd (bijvoorbeeld De Ridder, 1990; Kaassenbrood, 1991). Het onderwerp van het referaat veranderde in de ònbeantwoord- baarheid van de vraag wat psychische gezondheid was. Sterke nadruk kwam te liggen op een verbinding tussen deze ònbeantwoordbaarheid en een gebrek aan ideeën over samenhang en richting in de psychiatrische hulpverlening. Bij de bespreking van het referaat werd opge- merkt dat sommige literatuur over psychische gezondheid niet alleen een oorspronkelijke verbinding legde met het godsdienstig leven, maar soms ook een vergelijking maakte tussen psychische hulpverlening en het pastoraat. Het woord gezondheid kon immers gemakkelijk herleid worden tot religieuze termen als heiligheid of heelheid, terwijl prikkelend opgemerkt werd dat de psychische hulpverlening een richtpunt miste waar het christelijk pastoraat tenminste nog een voorbeeld kende, namelijk Jezus Christus (bijvoorbeeld Van den Berg, 1969).
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