Science in Christian Perspective



Modern Techniques, Centuries Old 
In Geel, Belgium
Stanley E. Lindquist, Ph.D '

From: JASA 14 (September 1962):

Centuries ago, a young princess fled from Ireland because of the incestious advances of her father who was king. She finally ended her trip in Geel, Belgium, where with her retinue she set up housekeeping.

Her father continued searching for her and she finally was found. His solution to the problem was to behead her and the priest who had helped her escape. Many legends were created about things that happened where the beheading took place. The legends were unimportant, but the results of the notoriety in a sense caused the creation of one of the most unusual mental hospitals in the world.

Mentally ill people came to the place of her beheading and were purportedly cured, during the 6th century. As the stories of the healing spread, the numbers of people visiting increased. Gradually funds were accumulated from grateful people to build a church. The people came, some were "cured" and some stayed, being called "pilgrims," the first time this term was used.

The exact time community treatment was started is unknown. It is presumed that some families came with one who was not well, and stayed for a time, visiting the shrine, praying for a cure. However, the cure being delayed in some cases, the family would arrange for the one who was ill to stay in the home of a family near, for a fee, while the patient continued visiting the shrine. This became the basis for the present day treatment of the mentally ill.

As the influx of people grew, the church was expanded to include some rooms where the more violently ill could be kept until they would become well enough to go into a home. These facilities were soon outgrown and a general hospital near by opened a section for this purpose. Eventually a separate hospital was built, which has about 400 beds at the present time.

Occupational therapy, wherein the patients worked on the small farms, sewed, or performed small manufacturing operations; group therapy, in which the one or two patients, members of the family, and a visiting supervisor took part; family group therapy, in which the whole "family" talks over the problems of adjustment; social therapy, the change of the environment and surroundings; all of these "new" methods have been used through the centuries at Geel!

Geel is a town of 25,000 people, spread over a considerable area. Most of the land is taken up by small farms. It is beginning to be urbanized with more and more people working in factories in neighboring towns. This is having the effect of possibly causing a deterioration of the climate necessary for the unusual treatment procedures.

There are 2,500 patients in the community. One out of 10 are mentally ill or retarded. At one time the concentration was as high as one patient to six normals. The usual procedure followed is for the patient to be admitted to the central hospital for physical examination and diagnosis. After an orientation period, the patient would be placed in a home usually on a farm in the community. Here he w o u I d meet his foster "mother" who would be his primary "therapist." Sometimes the patients would be much older than their mother."

Usually there are two patients in a home, housed with an average family, often with young children. Typically the mother and father would have been reared to maturity where two mental patients have lived. When these grown children set up their own home, they also take mentally ill people into their family. Sometimes in long term treatment, the patient may be "inherited" from their parents who have died or who can no longer care for them. The kind and loving treatment that is so effective in calming the patients is passed on from generation to generation.

The basic premise of this procedure is that association with a healthy personality will have a healing effect on the mentally ill person. The main burden of this is carried by the foster "mother," as the husband is out working during the day. This woman is typically a relatively uneducated person who has learned techniques of caring for any aberrations that might occur. The family has especially the quality of sharing deep and inclusive love of the individual, for their financial remuneration is not equivalent to the cost and trouble that is involved. This is one of the finest demonstrations that I have seen of Christian love.

The cost of this operation is phenomenal according to American standards. The government pays the hospital 56 francs ($1.02) a day for the total care of the patients. This includes everything; clothes, bedclothes, food and lodging. The hospital administration then pays the families that care for the patient from 40c to $1.20 per day, depending on the degree of illness nd amount of care required. The patients that require little care and are helpful on the farm, are in the 40c category. Most patients would be in the middle bracket. Imagine a per patient day cost of this figure in America.

The town is divided into sections. Each section has a central bath house. A psychiatrist is in charge of a section, and visits the home about once a month. A male nurse visits every two weeks with two nurses assigned per section. Emergencies and special treatment are handled in the central hospital. This is the extent of the "formal" therapy. The secret of the treatment is related to the density of the patient population, according to Dr. Radamaekers, the Medical Director. If it gets much lower than the 1 to 10 ratio of the present, the patients may be lost in the crowd of the town. As of now, the townspeople are aware of the patients, and know what to do if there is bizarre behavior. However if the concentration becomes less, Dr. Radamaekers is afraid that the unique features of the treatment will be lost.

A visit to this hospital is heart-warming. Dr. Radamaekers seems to fit in the pattern of most European psychotherapists in that he has little use for the mechanistic viewpoints of Freudian psychoanalysis. He is a sincere and dedicated man who is especially concerned with the personality and interest of the patient, explained and understood in a parsimonious manner.

He keeps firm control of his widespread hospital primarily through a meeting of all the staff every morning. Each nurse reports on what he has discovered the previous day to the whole group. Any new developments or interesting experiences are discussed freely. Thus each member of the staff is constantly being educated and trained in treatment procedures.

Once a week changes in placement are discussed. If a patient is involved he comes to the meeting himself, and gives his own viewpoint, and states his desires which are carefully considered. No moves are made without this procedure. Each patient is treated with respect and consideration.

Dr. Radamaekers spent the morning talking and taking me to visit several of the homes where patients were staying. It was possible to converse with them, ask questions as to their treatment and to speak to the members of the families. When finished, Dr. Radamaekers invited me to his home for a fine lunch, where I discovered that he too, had a patient living with him.

Dr. Radamaekers received some of his training in Cleveland, Ohio. When I expressed my appreciation to him for his kindness and consideration, he spoke warmly of the Americans. He said he was happy to have Americans visit him, and that he felt he owed so much to America for his training. As he spoke his eyes filled with tears.

The good Doctor retires next year. I wonder if his successor will have the same vision and capacity. Truly, the future of this centuries-old treatment will depend on this.