“An oedipal conflict on an epileptic basis”: the diagnosing and treatment of behavioural problems in a Dutch child psychiatric clinic (1952–1962)

Abstract

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From talking cure to play- and group-therapy: outpatient mental health care for children in the Netherlandsc. 1945–70

“…The approach of these institutes was similar to that of the children’s departments of the four non-denominational universities’ psychiatric hospitals, established in the 1950s and headed by the newly appointed professors of child psychiatry. These could also either hospitalize a child for observation and treatment or provide outpatient care ( Bakker and Smit, 2020 ; De Goei, 1992 : 79–114). Unlike Child Guidance Clinics, these university clinics and Paedological Institutes focused on academic research and development of new kinds of treatment, and both focused on the child itself and his/her problems.…”

“…They were similar to the problems that brought parents and children to American Child Guidance Clinics (‘the everyday problems of the everyday child’; Jones, 1999 : 91–5). On average, these learning and behavioural problems were similar but less serious than those for which the outpatient departments of the university child-psychiatric clinics catered ( Bakker and Smit, 2020 ), whereas the Youth Psychiatric Services and the Paedological Institutes took care of the more serious cases of learning disabilities and autism ( Chorus, 2019 : 54–89; Rietveld-Van Wingerden, 2006 : 45–118; Van Drenth, 2018 ).…”

“…Although academic child psychiatry was equally dominated by psychodynamic theory, these clinics more often saw organic, particularly neurological, causes as well as neuroticism. This openness to other causes of children’s problems relates to the medical environment where the intake proceeded: a university hospital with opportunities for more sophisticated physiological and neurological examinations, such as an electroencephalogram ( Bakker and Smit, 2020 ).…”

“…This combined admission procedure was one of the suggestions to reduce waiting lists made by Theo Hart de Ruyter at a conference on the future of the Child Guidance Clinics in 1965. He was the first Dutch full professor of child psychiatry, a psychoanalyst, a former leader of each of the two kinds of institution involved, a highly respected authority in the field ( Bakker and Smit, 2020 ) and himself an early practitioner of this combined method. He also subscribed to the idea that not all cases needed an extensive, ‘classic’ examination; in many cases a shorter, ‘modern’ one could suffice ( Hart de Ruyter, 1965a ).…”

“…The latter allowed for an analysis of their emotions and social skills and could promote Ego reinforcement, Hart de Ruyter claimed (1955: 175–8; 1956; see also Mik, 1969 ). Moreover, in his Groningen clinic he used medication not only in cases of epilepsy but also as a means to support psychotherapy’s effectiveness ( Bakker and Smit, 2020 ).…”