Shame and Medicine Exeter
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Hiding in shame: the history of the early Dutch family movement in psychiatry

Once upon a time, a young Dutchman emigrated across the Atlantic in hopes of making his American dream come true. Some decades later, he was indeed a successful businessman, a millionaire, and respected in the highest circles. Grateful to his country of origin for providing him with an education, he wanted to give back by doing something for some of the least privileged of its inhabitants: psychiatric patients. And so, in 1964, Arnold van Ameringen started the Pandora Foundation to combat stigma about mental illness. His story was all over the newspapers.

What Van Ameringen did not disclose, was that he had a very personal reason for his remarkable choice of charity. He had witnessed how his wife, and later their daughter, had become mentally ill – and had been particularly hurt by how his loved ones had been treated in society after returning from a psychiatric hospital. It was this personal experience more than anything that made him set up Pandora, inspiring decades of thought-provoking campaigns confronting the Dutch public with mental illness stigma. But the fact that he was actually a husband-of, and a father-of, individuals with mental illness, would not come out until years after his passing in 1966.

Van Ameringen is one of the main historical characters in my PhD research into the origins of what I am calling the Dutch family movement in psychiatry, where family members of people with psychiatric problems advocated for their relatives and/or for themselves.  Van Ameringen’s story is symbolic of one of the main things this movement fought against (and of course still does): the stigma of mental illness and the shame resulting from this stigma, not only in those who suffer from mental illness themselves, but also in those closest to them. Van Ameringen did not hesitate to spend lots of money and energy to fight against the stigma. However, disclosure of his personal experience was not an option, apparently – the shame was too strong.

My historical research has shown that the roots of the Dutch family movement in psychiatry go back to anonymous activism by family members like Van Ameringen since the 1950s. The very first ones organising in The Netherlands, I have found, were spouses of people with an alcohol addiction, forming self-help groups in 1956. From 1961 onwards they did so under the name Al-Anon, just like the American organisation that was their example. They guarded their anonymity so well that it is impossible for me as a researcher to name anyone who was involved back then, but even to the extent that Dutch Al-Anon today places their origins in the 1970s rather than in 1961.

The shame that came with the addiction of a loved one was key in Al-Anon insisting on anonymity. In a speech at the national AA convention in 1968, “Olga” explained how shame of a husband’s behaviour made the wife of an alcoholic stop inviting anyone to her home. Her loneliness was added to by her having to take on all responsibilities – for the household, the children and the income – leading to permanent physical and psychological overload and her feeling powerless, deceived and abandoned. Olga’s story was one of shame leading to isolation, leading to more shame, leading to more isolation.

Reading through the advice columns in the popular women’s magazine Margriet in the 1960s, anonymous letters to the editor confirms that the shame that relatives felt was not exclusive to spouses of alcoholics. A man is hesitant to visit his cousin who has been admitted, a mother of a “mentally deficient child” describes how it hurts her when people say rude things about “crazy people”, and a young woman finds that no man will date her because of her mentally ill mother. It was no wonder that family members in those days shied away from disclosure when the consequences were so painful.

It was those same consequences that in 1972 worried Corrie van Eijk-Osterholt, just before she took the step that would make her a prominent activist in the Dutch anti-psychiatry movement. Van Eijk-Osterholt’s twin sister Mies had been admitted to a psychiatric hospital in 1947, and had lived there in poor and abusive circumstances ever since – circumstances that were still quite common in Dutch institutions at the time. In the early 1970s, Van Eijk-Osterholt turned the notes that she had kept about the experiences of her sister, as well as her own as her sister’s advocate, into a book. Publishers were very interested: critical books on psychiatry were bestsellers in those anti-psychiatry years. There was one condition, though: that she publish under her own name.

In a video interview ten years later, she spoke about how shame had always kept her from being open: “I had a job, and I would not think of telling them I have a sister in an institution. […] I thought that I would be fired. If I make even one mistake, they will say: see, she has it too. How else could it be, with a twin sister? So I kept silent.” But when facing the choice either to give up her anonymity to get her book published, or else remain silent, she decided to take the plunge: “I thought: one-two-three-for-God’s-sake-let’s-do-it, but I was very nervous. And the day [the book] was in the newspaper, a neighbour came to my door with the page and said: is that you? I thought I would die. And then I thought: this must be over. I have to be brave now and no longer beat around the bush. So I started talking about it…”


Irene Geerts

Medical historian and PhD candidate at the Open University of the Netherlands

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