François Ferrero: Inquiry of the Geneva 1980s’ Psychiatry Crisis:
François Ferrero’s Reply to David S. Janowsky’s Comment


          David Janowsky’s exceptional experience sounds very familiar to me.

          I confirm that it was not an easy task during the ‘70s and ‘80s to defend such a position as a “Centrist.”

          His remark about psychiatrists who practice psychotherapy, or even psychoanalysis, and give psychiatric drugs with some “trepidation,”  evokes a lot of memories. During my post graduate training in Geneva and Paris I received much better training in psychotherapy, with a lot of individual and group supervision, than I did in psychopharmacology which was, including in Bel-Air Hospital in Geneva, definitely poor. At that time, there was no drug monitoring and our knowledge of adverse events and drug interactions was also extremely limited.

          For a majority of my colleagues in training, it was a true problem to combine psychiatric and a psychotherapeutic treatment. This question was discussed openly with Daniel Widlöcher during my postgraduate training in Paris. Daniel Widlöcher was a famous, very respected and open-minded French psychoanalyst, child psychiatrist and professor at La Salpêtrière in Paris.

          He proposed working jointly with a colleague and sharing the responsibility of treatment, assuming alternatively for one Patient the role of the Psychotherapist and for another Patient the role of the Psychiatrist.

          It was a pretty complex organization which required very good collaboration and strong confidence between the two colleagues.

          Back to Geneva: I decided not to follow Widlöcher’s suggestion and began to combine both responsibilities.

          I was convinced that Switzerland had some good assets for organizing combined treatments, thanks to a double title of MD, specializing in psychiatry and psychotherapy.

          This interesting page of the history of Swiss psychiatry goes back to 1931, with the adoption of the first regulation of the medical specialties by the Federation of the Swiss Medical Doctors (FMH) which introduced a separation between psychiatry and neurology.

          (I will not discuss here the implications and consequences of such a decision which was also made in France in 1969 under the pressure of the “Young Psychiatrists.”)

          In 1935 a meeting of Swiss psychotherapists was held in Zurich with 33 participants. This meeting introduced the first split in the community of psychotherapists with the creation of two societies: the Swiss Society of Medical Psychotherapy, headed by Walter Morgenthaler and supported by a majority of MDs; and the Swiss Society of Practical Psychology, led by Carl Gustav Jung. Jung was of the opinion that the interests of psychotherapists and psychiatrists were too different (divergent) for developing a fruitful collaboration. His Society attracted mainly non-MDs.

          Going back to Janowsky’s comment: I fully agree with his description of the cultural revolution.

          As mentioned in my answer to Barry Blackwell, the main question at that time, at least from my point of view, was that of the relationship to authority in every domain of society.

          Janowsky’s last paragraph is fascinating to me: How is it possible to have such a clear understanding of what was going on in the small city of Geneva?  


February 21, 2019