Psychiatrie in meervoud. De wetenschappelijke oriëntaties van de Nederlandse psychiatrie in het interbellum (1918-1940)

Vijselaar, Joost; Abma, Ruud

doi:10.18352/studium.1498

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“…16 De Nederlandse context: het wezen Ook in Nederland begonnen psychiaters zich af te zetten tegen de negentiende-eeuwse psychiatrie ohne Seele. 17 In deze ontwikkeling kan de Nederlandse psychiater Leendert Bouman (1869-1936) gezien worden als een overgangsfiguur. Hij speelde een belangrijke rol in de introductie van het werk van Jaspers in Nederland.…”

Section: Achtergrond Twee Vormen Van Kritiek: Hermeneutische Fenomenunclassified

Hoe 'tijd' psychiatrie opnieuw betoverde

Bloem¹

2018

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In his dissertation 'On time and time-forms', the Dutch Psychiatrist Paul Theodoor Hugenholtz (1903-1987) developed an anthropology and psychopathology based on time-experience. Hugenholtz' dissertation builds on the work on time of anthropological and phenomenological psychiatrists: Ludwig Binswanger (1881-1966), eugène minkowski (1885-1972), Viktor emil von Gebsattel (1883-1976) and erwin Straus (1891-1975). Their anthropological psychiatric work on time should be interpreted in the context of a 'new' psychiatry of the early twentieth century, the rise of holistic science and a broad cultural, philosophical and scientific reappraisal of time. The time debate shows a reconsideration of psychiatry in which methodology, epistemology, values and the understanding of time mutually influenced each other between 1910 and 1939. This type of psychiatry should be studied as a cultural phenomenon, without losing sight of the psychiatric aspirations of its practitioners. With the cultural historical perspective it can be understood as a psychiatric reflection on the relationship between timeexperience and the meaning of human existence in a modern world.

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Section: Achtergrond Twee Vormen Van Kritiek: Hermeneutische Fenomenunclassified

Hoe 'tijd' psychiatrie opnieuw betoverde

Bloem¹

2018

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“…Neurochirurgen kunnen deze zeer precies plaatsen en de kans op problemen na plaatsing, zoals infectie, is relatief klein. 3 Met dezelfde techniek worden de laatste dertig jaar ook sommige patiënten met ernstige psychiatrische klachten behandeld zoals in de bovenstaande casus. Het aantal psychiatrische patiënten wereldwijd met elektroden in de hersenen is met zo'n 600 klein vergeleken met het aantal neurologische patiënten.…”

Section: De Recente Geschiedenis Van Diepe Hersenstimulatieunclassified

“…W6-9 (p. W6). 3 Op dit moment is bijvoorbeeld de mortaliteit door complicaties bijna verwaarloosbaar: de kans voor mensen met de ziekte van Parkinson om te sterven na implantatie van diepte-elektroden is voor mannen en vrouwen respectievelijk 0,030 en 0,037 keer hoger dan de kans van vergelijkbare niet-geopereerde patiënten met Parkinson om in dezelfde periode te sterven aan andere oorzaken. Movement Disorders, 28.6 (2013), 763-71 (p. 764).…”

Section: De Recente Geschiedenis Van Diepe Hersenstimulatieunclassified

“…Anatomen die kritisch stonden tegenover Galls werk beschouwden zijn methode als correlationeel en anekdotisch. 3 Daarom moest classificatie ook niet verward worden met verklaring. Om tot gegronde uitspraken te kunnen komen over de functies van de hersenen was meer nodig, namelijk experimenteel onderzoek.…”

Section: Elektrische Lokalisatieunclassified

“…2 Ook begon het inzicht te dagen dat een natuurwetenschappelijke psychiatrie een vrij onpersoonlijke psychiatrie was. 3 De dagelijkse rondgang door grote ziekenzalen, het aflezen van laboratoriumuitslagen zonder de patiënten te spreken, het stond met name jonge artsen steeds meer tegen. 4 De biologische benadering binnen de psychiatrie in de negentiende eeuw was voor een belangrijk deel verbonden met de gestichtspsychiatrie.…”

Section: Psychiatrie In Meervoudunclassified

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This history of deep brain stimulation in psychiatric disorders describes how the idea, technology and scientific and clinical application of deep brain stimulation developed, from the first research with brain electrodes around 1860 to modern therapeutic deep brain stimulation. From 1860, brain researchers knew how to relate specific cortical brain areas to certain (sensory and motor) functions with increasing precision through ablation and electrical stimulation, and neurosurgeons explored the first diagnostic possibilities of cortical electrical stimulation. Between the 1920s and 1950s, backed by unprecedented philanthropic investment, particularly from the Rockefeller Foundation, a scientific psychiatric approach developed in which biological, psychological and social aspects were considered important. From this holistic perspective combined with psychoanalytic insights, doctors and researchers in the 1930s and 1940s tried to understand and improve two important new somatic treatments of the 1930s - electroconvulsive therapy and psychosurgery. From 1948, the first experiments with deep brain stimulation in psychiatric patients took place in the United States. Deep brain stimulation managed to develop into its own experimental field with the support of the American government, but the clinical experiments did not yield unambiguous results. The psychoanalytic interpretation of patients' experiences during stimulation also proved to be difficult. Despite these problems, all stakeholders and institutions believed that deep brain stimulation was a promising therapy. In the 1950s during the Cold War, deep brain stimulation in the United States contributed to the fear of (massive) mind control and behavioural manipulation of civilians. Doctors and researchers had found several brain regions in the midbrain in particular that they could use to influence behaviour of their laboratory animals through deep brain stimulation. In the 1970s, the anti-psychiatric movement strongly protested against electroconvulsive therapy and (plans for) experiments to influence unwanted and/or aggressive behaviour of psychiatric patients and prisoners through psychosurgery and deep brain stimulation. Doctors were, on the contrary, working hard at the time to optimise their psychosurgical procedures, both technologically through the stereotact and neuroanatomically through standardisation of some brain regions relevant to psychopathology. Discussions between proponents and opponents were conducted from strong utopian and dystopian perspectives with overly high expectations of the possibilities of deep brain stimulation. Investigations of the American government in the 1970s revealed a serious lack of national oversight of the above developments. This contributed to new medical-ethical guidelines on informed consent, among other things. However, controversy meant that by the end of the 1970s, psychosurgical procedures, including deep brain stimulation, hardly ever took place, despite new scientific understanding that they could be effective treatments for certain psychiatric patients and could not be used for mind control. During the reintroduction of deep brain stimulation for psychiatric disorders in the late 1990s expectations were again high. This was despite the fact that the treatment had remained virtually unchanged and it was not - and still is not - well understood how it works. The positive results of small-scale experiments were not replicated in better-controlled large-scale effect studies. Unlike in the 1970s, there was relatively little critical discussion.

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Psychiatrie in meervoud. De wetenschappelijke oriëntaties van de Nederlandse psychiatrie in het interbellum (1918-1940)

Abstract: * Prof. dr. Joost Vijselaar is als bijzonder hoogleraar geschiedenis van de psychiatrie werkzaam bij het Departement Geschiedenis en Kunstgeschiedenis van de Universiteit Utrecht en als senior wetenschappelijk medewerker bij het Trimbos Instituut in Utrecht.

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Hoe 'tijd' psychiatrie opnieuw betoverde

Hoe 'tijd' psychiatrie opnieuw betoverde

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