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Abstract

The totality of man. The anthropological approach to psychiatry in the work of Lammert van der Horst (1893-1978)

The anthropological approach was one of the new approaches to psychiatry that emerged in the interbellum. In the Netherlands professor Van der Horst (VU-university Amsterdam and the municipal University of Amsterdam) was its most prominent proponent. The general idea of the anthropological approach was to integrate the various ways of knowing then available. A psychiatric disease was seen as the result of a failure in the self-realisation of the individual person. This required to consider all relevant aspects relating to the patient’s existence. How to tailor these ideas to concrete forms of diagnosis and methods of treatment was no easy matter and Van der Horst devoted himself all his life to this task. He first sought to classify man in three or four types of character inspired by the works of Heymans and Kretschmer. Then he tried to give the specific human aspect its place in psychiatry by introducing a ‘pneumatic’ dimension in his analysis of persons. He also connected this dimension to Calvinism, the church he belonged to. In the 1940’s he made a turn towards existentialism and tried to connect this philosophy to anthropological psychiatry. In spite of its fragmentary appearance I believe it is possible to discern a degree of continuity in the work of Van der Horst. The concern with the specifically human was always central to him. Moreover Van der Horst saw no strict divide between addressing questions in psychiatry and thinking about the greater questions of life which provides an explanation for his meandering thoughts. The dissertation of J.H. van den Berg which appeared in 1946 offers an interesting contrast to Van der Horst. To Van den Berg the anthropological approach was no more than a method best developed by Binswanger. Van den Berg tested this method and concluded that the approach could offer hermeneutic insights at points where methods of the natural sciences fell short. These restrictions had the sake of clarity. In stark contrast, and in spite of all his efforts, many aspects in the work of Van der Horst remained obscure. However his search for an overarching anthropological approach to psychiatry is still interesting to us because it questions what the borders of the field actually are. Since the various approaches to psychiatry are still at best loosely integrated this question is of continuing relevance.

Keywords: Psychiatry,  Netherlands,  Van der Horst,  Anthropological approach