Nelleke Bakker

Child Guidance and Mental Health in the Netherlands

In the Netherlands, as in the United States, the introduction of the concept of ‘mental health’ in education is closely related to the development of a network of child guidance clinics. The first of these was established in Amsterdam in 1928. However, a substantial movement to actively promote mental health did not come into existence until after the Second World War. Unlike in the USA, at the time in the Netherlands the school was considered of only little importance in the crusade for the prevention of mental illness. Teachers and school physicians alike were at the same time recognized as helping forces in the promotion of mental strength and conceived of as inadequately equipped to diagnose problem children. The tradition of labelling the school as a sick‐making institution appears to have been an important asset for the child guidance clinics’ lobby to successfully discredit the institution. Parents’ educational competence was likewise undermined by the infiltration of child‐psychiatric theory, concepts and categories of discourse. The mental health movement promoted an attitude towards the family that was even more disturbingly ambiguous. On the one hand the family was considered a most powerful medicine against what was consistently diagnosed as the moral crisis of society. On the other hand contemporary child‐psychiatric theory pointed at parenting as the prime seedbed of neurosis. Inspired by Sol Cohen’s new cultural history of education the author traces the origins and the initial success of the child guidance approach as part of a larger process of ‘medicalization’, accompanied by ‘neurotization’ as an effect of the growing influence of psychoanalysis. She argues that these processes created the conditions for the Dutch child guidance clinics to monopolize the care, treatment and knowledge of problem children. After discussing the growing ambiguity as to parents’ and the school’s competence in preventing mental illness, the establishment and early development of the Dutch child guidance clinics are described. Finally, an analysis is given of the clinics’ diagnoses and treatment of ‘difficult’ children at the height of the mental health movement’s success, immediately after the war. The child guidance clinics’ work was presented as a blessing for individuals, for society and for the public purse. The self‐image of the institution emphasized its role in the prevention of adult crime and psychiatric treatment. Moreover, the clinics were supposed to prevent much more expensive hospitalization of children in reformatories and children’s homes. In reality, however, they selected for treatment primarily those cases that fitted their approach. In doing so, they could further promote the belief in the mental health movement’s central idea of mental illness as a widespread disease. The child guidance clinics’ lobby succeeded in providing itself with a key role in the theatre of children’s mental health, the expert answer to what was conceived of as a serious crisis in society. Moreover, the lobby claimed to be the solution to the existing ambiguities as to the family and the school as child‐rearing milieux. Therefore, the way the child guidance clinics succeeded in promoting their own approach at the expense of the status and competence of other educational professions and institutions was both enabled by medicalization and neurotization and was itself another step in these processes.

Fresh air and good food: children and the anti‐tuberculosis campaign in the Netherlands c.1900–1940

As elsewhere in the Western world, between 1900 and 1940 the anti‐tuberculosis campaign in the Netherlands produced a wide range of initiatives to promote child health. In each of these the social and the medical were linked, as the hygienic ‘mood’ was encouraged by a child‐saving ethos that focused upon the poor. In this article the author discusses the choices that were made between anti‐tuberculosis interventions for children, the benefits projected on each of these and the categories of children for whom they were meant. Private and voluntary initiatives dominated the field, whereas the state turned out to be very reluctant to take responsibility. Medically controlled health camps for ‘weak’ children were a more important instrument than open‐air schools and mass medical examination. Medical surveillance produced new categories and data which in turn justified the continued growth of child hygiene after tuberculosis had become less of a threat during the 1930s.

Before Ritalin: children and neurasthenia in the Netherlands

This article is concerned with the history of the neurological disorder that preceded ADHD: ‘neurasthenia’ or nervousness, conceived of as a functional disease of the nervous system. Around 1900 it appeared on the scene of children’s disorders and it disappeared at the time of the pharmacological turn in psychiatry by the late 1960s. In spite of a series of adversary conditions neurasthenia survived. To explain this the author traces the history of neurasthenia and its more popular equivalents through a discursive analysis of Dutch child‐rearing literature. The focus is directed at the shifting content of the diagnosis, its symptoms and aetiology and on the advantages for people using this label. Neurasthenia is followed from the early twentieth century when ‘weak’ or ‘oversensitive’ nerves were discovered and discussed by experts, through the interwar years when schools were accused of producing ‘nervous’ children and the disease had to compete with psychoanalytical ‘neurosis’ and, finally, the immediate post Second World War period when concern for children’s mental health increased rapidly and ‘nervositas’ was one of its major expressions. The conclusion is drawn that childhood neurasthenia as a hereditary disease has been functional for experts, teachers, parents, and children in a variety of ways.

The dangers of schooling : The introduction of school medical inspection in the Netherlands (c.1900)

In this article the authors address the question of why school medical inspection in the Netherlands developed not only considerably slower than the British service but did so also on a more modest scale in terms of the impact on children’s lives. In the Netherlands school doctors were not allowed to treat children’s illnesses and therefore never opened clinics of their own. Likewise, they did not become part of the school system or even join forces in a national school medical service. To explain this the authors discuss the history of school hygienic concern since the mid‐nineteenth century, the respective roles played and arguments provided by the medical and teaching professions in the process of claiming the necessity for school medical inspection, and the conditions that have determined the appointment and instructions of school doctors since 1904. They draw the conclusion that the rapidly growing power of religious groups has limited the expansion of the medical regime. In the Netherlands schoolchildren did not become part of the ‘social body’ because of national fitness, but because society no longer accepted the inadequacy of the protection of pupils’ health against the dangers of schooling, especially after compulsory education was introduced.

The lamp in the living room. Dutch family educationalists on adolescence, 1915-1950

Until now Dutch historical youth studies have not focussed on the family as an educational environment. However, since World War I pedagogues have had high hopes of parents as educators of their teenage sons and daughters. On the basis of research into advice literature the author shows how family educationalists contributed to curtailing the ‘dangers’ of adolescence. Parents were recommended to loosen the reins on their adolescent children. This advice was based on different psychological theories. At first a physiological interpretation dominated educational thinking. During the twenties Adlers Individual‐psychology shifted attention to the relational aspect of the parent‐child interaction as well as to continuity in the educational relationship. In the thirties new psychological development theories gave birth to the concept of a ‘negative phase’ at the start of adolescence, followed by a neutral and even a positive phase concerning individual mental growth. This brought about a less negative apprecia...

Identifying the ‘subnormal’ child in an age of expansion of special education and child science in the Netherlands (c.1945–1965)

Between c.1945 and 1965 across the West special education has grown and differentiated substantially. In the Netherlands this expansion ran parallel to the academic recognition and rapid development of the study of learning disabilities. How are these two processes related? This article argues that in this country child science and special education have mutually stimulated each other’s growth and development. The creation of new categories of special-needs children brought about a climate in which the study of learning disabilities and their treatment could flourish. This, in turn, produced further differentiation between children with learning difficulties. Soon problems of identification and categorisation of mentally ‘subnormal’ children proved too complicated to rely on intelligence testing and medical-psychological diagnosis alone. Educational prognosis, based on long-term observation and all kinds of testing, became the key to a child’s future at school and educationists instead of psychologists became the foremost keyholders.

Comprehensive education: lost in the mi(d)st of a debate. Dutch politicians on equal opportunity in secondary schooling (1965–1979)

This paper addresses the question of whether the political debate concerning comprehensive schooling in the Netherlands between 1965 and 1979 was obscured by incompatible meanings of the concept of ‘equal opportunity’. On the basis of an analysis of ministerial plans and parliamentary debates the conclusion is drawn that Dutch politicians were using different but not incompatible meanings of this concept. The debate shows a remarkable continuity, with the meritocratic meaning of ‘equal opportunity’ unceasingly dominating the debate, while an egalitarian meaning remained unused. The analysis, moreover, shows that in the polarised political climate of the 1970s right-wing liberal opponents of comprehensive schooling created a mist by accusing their social-democratic adversaries of relying on an egalitarian meaning of the concept. This strategy appealed to the denominational parties, and may therefore have influenced the outcome of the debate with the consequence of comprehensive schooling being removed from the political agenda.

Cylinders and seances: Elise van Calcar and the spirit of Froebel

This essay discusses the life and work of Elise van Calcar (1822–1904), a writer and maternal feminist who introduced Froebel’s kindergarten in the Netherlands. Van Calcar also was the leader of a Christian branch of spiritualism. The focus is pointed at parallels between her reading of Froebel and of ‘messages’ from spirits in the ‘other world’ with whom she claimed to be in touch during spiritualist séances. Both Froebel’s Romantic pedagogy and spiritualism put emphasis on harmony and synthesis. Each of her projects was an attempt to transcend the dichotomy between the public and the private. Spiritual motherhood ruled the kindergarten and non-conformist religion, alternative medicine and Froebel training were practised at home. Both the kindergarten movement and spiritualism made her promote a ‘natural’ approach. Yet, she never stopped warning of the danger of leaving a child’s moral development to nature. Like a garden a child had to be worked upon.

Discovering social inequality : Dutch educational research in the post-war era

Between the 1940s and 1960s across Western Europe a spirit of reform along comprehensive lines manifested itself in secondary education, aiming at a reduction of the existing social inequality of educational chances. These reforms are said to be rooted in new policies and in new approaches in educational studies. This article explores the relationship between educational reform and educational science in a country, the Netherlands, which did not “go comprehensive”. Though, by the late 1950s, social inequality of educational chances, the waste of working-class talent, and the impossibility of a fair selection at the age of 12 had been discovered by Dutch educationists, equal chances were not mentioned as a target in the new Secondary Education Act (1963). Its focus was directed at the development of individual talent, regardless of class, and selection continued to be applied at a very early age. This policy was even approved of by the social democrats, who elsewhere acted as protagonists of comprehensive schooling. They held on to the deeply rooted idea of two different, class-bound kinds of pupils with different educational needs, the “intellectuals” and the “manuals”, a message that had been spread for a long time by educational researchers themselves.

Sunshine as Medicine: Health Colonies and the Medicalization of Childhood in the Netherlands c.1900-1960.

As in other Western countries in the Netherlands during the first half of the twentieth century, large numbers of school children were sent to holiday camps or ‘health colonies’ to gain weight and recover strength. At first this large‐scale hygienic enterprise was led by teachers, who wanted to ‘save’ poor, undernourished children by providing a ‘healthy refuge’ from the city. A few weeks of sunshine and fresh air at the seaside or in the woods was supposed to promote health and happiness and to improve morals. However, from 1920, stimulated by government subsidies, the colonies came under the authority and control of the medical profession. Consequently, criteria for admission were narrowed to purely medical reasons, particularly the prevention of tuberculosis, and the aims of the ‘treatment’ to physical improvement. In the process of medicalization of ordinary childrens lives the intermediate category of ‘weakness’ (between healthy and ill) seems to have played an important role, justifying a massive philanthropic effort long after tuberculosis had stopped being a serious threat. Paediatricians created a somatic culture around the childs body, which was replaced by a psychiatric culture around childrens emotions. This shift was stimulated by a second wave of medicalization focusing on mental health. Finally, a critical counter‐discourse, nourished by psychoanalysis and the improved health condition of children, dispelled the illusion that sunshine and fresh air were medicine.