Help me Help Myself: Dutch Approaches to Mental Self-Help for Nervous Sufferers in the Modern Age (1870-1925)

Abstract

This thesis explores the historical role of mental self-help in the psychiatrisation of society in the Netherlands between 1870 and 1925. Rather than defining self-help merely as an oppositional practice to psychiatry, I argue for a more integrated understanding of it. Self-help was often a central, and at times even institutionalised, part of psychiatric care. Nervous suffering, a prevalent and elusive condition in this period of psychiatric professionalisation and the expansion of the “nervous industry,” offers a fertile field through which to analyse this dynamic. By examining patient files from the Rhijngeest sanatorium, Dutch self-help literature, and articles from the Nederlands Tijdschrift voor Geneeskunde, this study analyses the complex web of medical authority, individual responsibility, and dependency from multiple perspectives: those of physicians, help-seekers, and relatives. My research is informed by scholars such as Beeker, Roy, Dorothy Porter, Groys, and Scheer, and responds to calls for both the historicisation of psychiatrisation and greater attention to the psychiatric patients’ search for care and support. This focus on the experience of help-seekers is essential to shed new light on strong-held assumptions that patients were passive actors in their healing process. Methodologically, it combines hermeneutics with close reading of archival sources, including reading against the grain and attending to silences. These approaches are guided by a conceptual framework that redefines mental self-help as a historically fluid and integrated practice.

The central argument is that mental self-help in the context of nervous suffering was from the outset actively encouraged by physicians, provided it remained within medically approved boundaries or could generally be assessed as harmless. Quick fixes, “deviant” spiritualist practices, and alternative healers were frequently condemned, even as their ability to provide emotional support was at times acknowledged. Approved forms of self-help, such as dietary regimens, walking, and bathing, were promoted in both medical journals and popular self-help literature, reflecting middle-class values of self-reliance and willpower. However, this was not always experienced as positive on the receiving end. Helpseekers’ voices reveal how the responsibility for self-help can also take the shape of a burden: while advice and structure can offer reassurance, they can also feel overwhelming. Thus, self-help might carry the weight of a moral obligation, with failure internalised as personal insufficiency. In tandem with this, psychiatric discourse spread beyond the walls of the strictly professional institutions. Alternative treatments increasingly mirrored medical routines, forming a kind of shadow psychiatry. Help- seekers also supported one another and occasionally resisted medical authority. While professionals generally tended to encourage basic forms of self-help, this development was regarded by most doctors as detrimental: a form of quackery which, at worst, could sabotage an accepted and regulated therapy. Physicians began pulling back the strings. However, the momentum of the increasing shadow-psychiatric practice proved difficult, if not impossible, to contain. The dynamic between professional and popular strategies to combat mental problems proved a flywheel that ultimately led to what is currently called the psychiatrisation of society.