Notes on the development of a form of pscyhotherapy practised by priests at the Kneipp clinic at Worishofen in the late 19th Century and early years of the 20th Century
I’ve shared a few pieces from a dissertation I wrote some thirty years ago, but only recently I realised that I haven’t provided any of the material about the man who was central to my research; one Fr V Raymond, a Dominican priest from France who was chaplain to the Kneipp hydrotherapy clinic. Raymond wrote a book, published in English translation in 1914 by R and T Washbourne, called Spiritual Director and Physician.
It’s a fascinating and pretty much forgotten text that was widely reviewed at the time and suggests a path to a form of psychotherapy, soul therapy, that can usefully be compared to Sigmund Freud’s early practice and technique of pscyho-analysis although the theoretical framework is very different. Of course this chapter could do with some editing and correcting, and additional material that can easily be gleaned today through the magic of search engines – but I’m going to leave it as it is for now in the hope that it might be of interest to someone out there who might just happen upon this page as they search for material on the history of psychotherapy, pscyho-analysis, and Christian pastoral practice.
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A small group of devotees of the system developed at Worishofen by Monsignor Sebastian Kenipp was sufficiently organised by 1897 to merit the formal founding of the ‘Kneipp-Bund’[1]. It was with this group or institute that a Fr. V Raymond of the Dominican Order became associated.
He had moved from France to work at the Institute although it is likely that his first introduction to Kneipp’s work was as a patient for a nervous breakdown. Fr Raymond is not listed in the catalogue generalis of the Dominican Order for 1878 nor in that 1910 which suggests that if this was his real name then he may have become disconnected from his order in the turmoil following the expulsion of religious from France in 1903[2]. Many French Dominicans left the order during that period and it may simply be that he slipped across the border and found himself associated with Mgr Kneipp. The fact that he is not listed in the Dominican catalogue of members could also imply that V Raymond was a nom de plume but a passing reference in one of the Kneipp annuals mentions a Fr V Raymond as having travelled to France as chaplain to Mgr Kneipp around 1895[3].
There seem to be few third-party references to Fr Raymond and his work at Worishofen. A few reviews of his book were published in mainstream journals but I have found only one writer who cites Raymond, Robert Thouless, in his Introduction to the Psychology of Religion. Thouless considers the role of confession in striking a compromise between the models of religious life exemplified by Bunyan and Cellini:
Clearly, if the sense of sin is absent, immorality must be expected; but on the other hand, it is not a satisfactory solution of the problem so to intensify the sense of guilt that it becomes morbid. … This problem is to some extent solved by the Catholic practice of auricular confession (which exists also in some form or other in very many Protestant bodies). Simply on the psychological level, the value of confession appears to the lie in the fact that it maintains a predominantly healthy-minded attitude towards sin …[4]
This is a view echoed in H. L. Philip’s book Freud and Religious Belief in which he writes:
Freud missed the vital point about prayers such as the General Confession in the Anglican Church, namely that it is an open statement by the sinner that he is well aware of the fact that he is a sinner and a miserable one; … His act of confession is above everything else, a conscious one and everything is done by the religious community to make this as conscious as possible. Ordinarily there are preparatory sentences and a solemn calling upon the believer to examine himself before he makes his confession. … We have, in fact, on the one hand an unhealthy pathological guilt, and on the other a healthy self-knowledge, the result of self -analysis, possibly with the assistance of priest or minister.[5]
The soul-therapy employed by Raymond at the clinic was a radical departure from the water-cure and methods advocated by Kneipp. Yet Raymond’s practice was strikingly similar in many respects to the technique developed by Freud. This is hardly surprising as Raymond demonstrates a familiarity with the work undertaken by Janet and others linked to the Salpêtriere in Paris. As might be expected, however, these priests were also explicitly employing the techniques of the confessional.
What Maritain termed ‘pathological scruples’ which might arise in a penitent at confession who ‘tends to push his will into the sphere of the unconscious’[6] was very much the focus of the therapeutic work undertaken by Raymond at the Kneipp Institute. Raymond offered an account of the Institute’s work in his book, Spiritual Director and Physician. The introduction presents the author’s understanding of the genesis of mental illness and demonstrates that he shared the theological conviction of his time that the world was a ‘vale of tears’ and that humanity was inherently sinful. God, according to Raymond, had gifted some people in a way which allowed them to lead pleasant lives of dedicated service to his glory while others receive their ‘share’ of suffering. He believed that this latter group would be consoled by the knowledge that the biblical gospels indicate suffering as the ordinary and sure way to eternal life. Of more immediate consolation might be the words of Blanc de Saint-Bonnet that sorrow ‘is the source of all depth of character and of mind’.[7] This exalted view of distress and suffering did not, however, prevent Raymond from offering solace and relief to those who came to him with their troubles.
The subsequent chapters of Raymond’s book have titles illustrative of his sources and influences. The first, ‘On Neurosis’, considers the work of a number of medical researchers including Charcot, Janet, and Beard. Raymond suggests that ‘neurasthenic patients [who] are usually subject to feelings of fatigue, and are incapable of effort’ will benefit from his ‘spiritual treatment’. The treatment involved more than simple confession or catharsis; it also required an intervention on the part of the listener. Raymond believed that some of his patients, the geignards or whiners, availed of his spiritual treatment simply because it was so much cheaper than the medical alternatives: ‘such patients would certainly treat their doctor as they do the director of their conscience if the visits were charged at the same rate’[8]. The second chapter, ‘On Hysteria’, demonstrates an awareness of developments in psychology when he rejects the etymological understanding of hysteria and notes that it may effect men as well as women; men being ‘most liable between twenty-five and forty’ (and note again that this is written before the First World War had placed this on the agenda of mainstream psychiatry). Even around 1910 Raymond felt that the increasing pace of life would have a detrimental effect on mental well-being and that account must be taken of stress and trauma in any dealings with hysterics. He prescribes religious belief as having a calming influence in the healing of such cases.
The Kneipp Institute therefore began to employ a threefold approach to therapy. This involved psychotherapy (the healing of souls), physical therapy (exercise), and exercises of piety. The psychotherapy required the therapist to engage with the patient through active listening and constant availability. Raymond suggests that much can be done for those in distress if they can realise that someone is willing to listen to them in a non-judgmental manner and he would invite his patients to feel free to come to him when they wished and to spend as much time with him as they wanted. The psychotherapy, however, could only be successful if the patient was intelligent and educated, otherwise the therapist would have to adopt a more active approach using concrete examples that were intelligible to the patient and made his or her situation clearer. At the beginning of the treatment the therapist might have to inspire confidence in the patient through the assertion of authority but this could only be therapeutic if it took account of the patient’s current state and if he/she was willing to comply.
The work of the Kneipp Institute may not seem so very unique and creative when looked at eighty years later in the light of twentieth century psychology. Indeed, Raymond seems to think that the developments he had read about in the writings of researchers at the Salpêtrière were illuminating, an aid to understanding, but not yet superseded by the tradition of priestly confession. He clearly believed that his work was a development of spiritual direction rather than of psychology. His work was directed at restoring human beings to their relationship with God and this required enabling them to be functional persons in a world of strife, stress, and sin. In doing this he was following a line of theological thought that can be found summarised much later by the psychoanalyst John Klauber in 1974:
Christianity is a monotheistic religion in which man and God have become identified. In Christ, the logos, the principle of the universe was made flesh. God became perfect man, and a man could be God without shedding his human characteristics.[9]
The image of a perfect human being, coupled with the lifelong struggle towards that perfection, are central themes in Christian life. The restoration sought at the Kneipp Institute might merely have been to a state of ordinary human functioning but beyond that lay a greater vision in which immortal life and heavenly bliss would be the eventual reward for the faithful believer. Trouble and toil during an individual’s earthly life was understood as part of the general misfortune repeatedly chosen by humanity throughout biblical history. The quest for perfection was underscored by the belief that the essence of human life, the consummation of what it is to be a human person, would only be realised after death and even then would be dependent upon the established virtue of the individual. Christian practice had therefore developed a self-understanding in which the self that was being renounced was always the false-self; those attributes of individual persons that rendered them less than perfect in the eyes of the all-seeing all-judging God. The Christ had been crucified on a hill, set on high above the failure of humanity, and those who called themselves Christians, inspired by the Pauline motto, ‘to become more like Christ’, engaged with their selves and aspired to becoming ‘fully human’.
Raymond on the causes of mental illness
Father Raymond’s system of therapy involved a combination of religious and psychological techniques and his understanding of neurasthenia and mental illness was based on the very latest research from the French psychiatrists. Nonetheless his orientation was fundamentally theological and it was to a religious explanation that he turned when he defined the actual cause of mental suffering.
We all know that suffering has always existed, and will continue to exist. The madman and the infidel alone are so devoid of sense as to hope to escape from it, or to blame as the cause of it God, or their surroundings, or society, which makes too great demands upon its members. [10]
Raymond goes on to quote from Pere Lacordaire:
“As during the past six thousand years a certain amount of rain falls each year from heaven, just as surely has humanity produced its regular flow of tears.”[11]
The individual person cannot avoid their allotted share of suffering, they simply have to accept that their suffering has a place in the Divine plan for humankind. Those who have good health are charged with the obligation of using their good fortune to support the ongoing work of creation, while those who are ill have a special place in that work through sharing in the pain of Christ who burned with the desire to suffer[12].
Nothing more should be needed to make us bless the pains that are sent us, receive them with gladness, or at least with resignation, for by them we bear the character of our Saviour stamped upon us.[13]
So the cause of suffering lies within the person as they stand before a God who wills everything in life; suffering is unaffected by social or environmental factors. Christian writers have consistently noted the fact that suffering persists despite the constant attacks made upon it by humanity, and indeed despite our many successes in alleviating its effects to some extent. Pain, however, persists and for those who are afflicted may seem pointless and inexplicable. For these sufferers Raymond wishes to offer the consolation of acceptance, of offering to God, of knowing that their lives are just as valued by God as any other. If we ask why God might feel the need to afflict suffering then Raymond will answer in terms of the humanity’s continuing sinfulness; in a footnote he gives the example of the ‘shameless Press at the disposal of the enemies of the Church’. Such an affront to the reign of God distances the whole of humanity from the ideal of Christian perfection and Raymond’s God requires suffering and ‘martyrs’ in atonement.
God has often claimed pure and innocent victims to expiate the sins that are committed in secret or in our perverted modern Society[14].
Such an understanding of the role and cause of suffering must give rise to the question as to how Raymond understood healing and its purpose. Why, if it is the will of God for some to be afflicted, should a priest engage in trying to relieve that suffering? Raymond addresses this question by suggesting that he would be happy if his book, and by implication his work, could help to instil hope in those who are ill, the hope that their complete trust in God will bring them the ‘undying reward that will certainly follow’. In the meantime, as they await the comfort of death, Raymond hopes that:
… the advice here offered may be of real spiritual profit to those who are already afflicted, and make them feel that their suffering serves to make them understand and to sanctify the most sorely tried life.[15]
The God who inflicts suffering in order to gain some sort of compensation for human failure to obey that same God’s demands is far from being an appealing God and certainly not the kind of God that Raymond’s own tradition lays any emphasis on at the beginning of the twenty-first century. Other explanations seem to be demanded and yet for those people for whom life was constrained and unpleasant because of illnesses that medicine seemed unable to either cure or explain such an explanation may have made the possibility of continuing in life just that bit more bearable. This kind of theology may also have made it easier for people to feel that their illness was not immediately caused by their own behaviour but was part of sharing in the human condition. The desire to apportion blame, to discover what action and what person had caused dysfunction or illness did not end with the nineteenth or even twentieth century. By placing personal suffering within the context of Divine will Raymond may well have been opening up a psychological possibility for his patients arising from their no longer having to locate the cause of their illness in themselves, so that they could then concentrate on acceptance and living their lives as fully as possible.
Given such an understanding of suffering and its causes perhaps we can conclude that Raymond understood his role as a healer in terms of helping people out of their unbearable suffering so that they could achieve a state of ordinary human suffering.
Raymond’s Sources
Whatever Raymond’s theological understanding of suffering and his purpose in working as a minister of healing he was a careful reader of the latest research in psychiatry and neurology. Possibly the most fascinating and remarkable thing about his book is the range of his sources, the content of his footnotes. Many of the authors referred to, including Charcot and Janet, will be familiar to those who have read about the intellectual development of Sigmund Freud.
Raymond traces the history of the understanding of neurosis, hysteria, psychasthenia, and scruples, before he proceeds to reflecting on his own technique for treating people suffering from these maladies. The illness known as scruples may seem out of place in this list but it was of central importance in Raymond’s work and even today it retains a special distinction as an object of religious diagnosis and healing. A longer discussion of the psychology of scruples comes in the next chapter but some understanding of the concept will be useful at this stage.
Scruples, as one might expect, arise in people of firm religious conviction who for some reason or another become concerned that their practice of faith is less than perfect, and who are unable to accept the simple fact that perfection cannot be achieved. It may lead to an individual becoming concerned that they have failed to make a proper confession of all their sins, that they have been negligent in observing some minute detail of preparation before taking communion at the eucharist. These people may then return, time and time again, to their confessor, asking for absolution of some (unintended) sin. It is clearly a form of compulsive behaviour but it is not amenable to treatment by psychologists but would appear to be a special kind of illness that can only be treated by a psychologically sensitive priest. The psychologist cannot treat it for the simple reason that the sufferer cannot accept that the psychologist fully appreciates the eternal consequences of their illness, of the possibility of damnation. By asserting their pastoral authority over the sufferer, a priest may, however, be able to command their obedience to a regimen of treatment with the patient being secure in the knowledge that God will not condemn them for having obeyed the instructions of their pastor. Scruples formed a large part of Raymond’s caseload at Worishofen and are the basis of some of his most interesting accounts.
So Raymond was familiar with the main forms of mental illness that formed the basis of psychological work at the end of the nineteenth century and that, with the exception of scruples, are also described in Freud’s work. Beginning with neurosis Raymond notes the significant development in understanding such cases that followed the insight that:
All such disturbances … become more simple and are more easily grouped together when they are studied in their mental aspect rather than in the physical[16].
He then quotes Pierre Janet’s designation of these illnesses as ‘psychological maladies’ and the fact that in Germany they were called ‘psychoneurosis’, noting that there was a conflict in medical circles as to whether or not some expressions of psychoneuroses were true psychological illnesses. Fulgence Raymond, who had succeeded Charcot at the Salpetriere, had suggested that there was a difficulty with the common diagnostic term, neurasthenia, which was not so much an illness as a group of symptoms[17]. An American doctor, George Beard, had also tried to define neurasthenia more precisely, describing it as basically a form of exhaustion, both physical and mental. So immediately we find Raymond describing psychological development by referring to the very people who were much later identified as being central and important figures by Henri Ellenberger in his history of psychiatry, The Discovery of the Unconscious (1970). Charcot, Janet, (Fulgence) Raymond, Beard, and also Grasset, and Dubois; Raymond’s reading about neurosis is neither esoteric nor medically obscure but is systematic and scientifically aware.
Raymond’s chapter on hysteria begins with a quotation from Briquet, again a figure mentioned several times by Ellenberger. Raymond continues his account through Brodie, Charcot, Legrand du Saulle, Dubois, Janet, and Trelat, among others. So here too we find Raymond drawing upon many of the key figures in psychology of his time with a concentration on the members of what might be called the Salpetriere school; Jean-Martin Charcot, Fulgence Raymond, and Pierre Janet. This particular concentration is of interest not just because of the prominence of these figures in the field of psychiatric research but also because of the obvious intellectual link to Sigmund Freud who was also highly influenced by the work done at the Salpetriere and who had studied under Charcot for a short period of about three months covering the end of 1885 and the beginning of 1886.
There is little point in continuing this trawl through Raymond’s sources, the first two chapters are indicative of the rest and they suggest simply this: that Fr V Raymond, a Frenchman who found himself working in a clinic in the south of Germany, developed his own thinking about psychotherapy through careful and systematic study of the most respected scholars in the field. Where Freud and other medical practitioners might criticise Kneipp for his semblance of quackery, Raymond was less vulnerable, at least no more vulnerable than Freud himself. At the end of the nineteenth century, as Sigmund Freud was studying the developments in psychological medicine, developing his own clinical practice in Vienna and beginning the work that would lead to the birth of psychoanalysis, a Roman Catholic priest was reading the same material and applying it to his own clinical work in the south of Germany.
Reviews of Spiritual Director and Physician
Spiritual Director and Physician went through several editions in at least three languages. Statements in both the English and French editions suggest that the work originally appeared in German but I suspect that it is likely that Raymond himself prepared the German version from his own manuscript written in French, his native tongue and the language of most of his source material. The 1908 French edition has an introduction written at the end of 1907 but a letter by Professor Dubois of Berne, published in the book, is dated July 1907 and expresses the hope that the author will bring out a French edition clearly suggesting that Dubois had seen the text in another language which I take to be the German text referred to by a Lancet reviewer.
The English translation was published in England by Washbourne’s in 1914. The same translation was used for the American edition published by Benziger Brothers also in 1914. Reviews of the English edition appeared soon afterwards in several journals including the British Medical Journal.
A review of Le Guide des nerveux et des scrupuleux (1908) was published in the Revue Thomiste.[18]. The Revue was a French Dominican journal of some standing in Catholic theological circles. The reviewer notes that the wide range of subjects covered in the book may appear confusing and might prove difficult for readers, ‘especially French readers, particularly fond of logic’. The reviewer concludes, however, that the book would be useful for those who are ill, for doctors, and for confessors.
Another contemporary review, this time by a Docteur J Loiselet, can be found in a 1909 edition of Etudes [19]. This review, begins by suggesting that the book could equally be called The Guide of Guides to Neuroses; le Guide des guides des nervreux.. The reviewer concludes that, ‘It is a good book, a truly priestly work‘ and expresses the hope that it will prove useful to those for whom it was written although he points out that scientifically some of the statements are not quite ‘au point‘. In particular he suggests that the writer might have distinguished between the easily treatable minor scruples and the more entrenched major scruples. This may well have been a suggestion incorporated by Raymond in later editions as the distinction is quite clear in the English edition at page 22:
At times, even in cases that at first sight appear serious, one may trace the origin of the evil to ordinary simple, unimportant scruples … But there are false ideas of a more serious and tenacious nature – real scruples, in fact – fears that arise from an unhealthy state of mind …[20]
The American edition, published by Benziger Brothers of New York in 1914 was reviewed in the [American] Ecclesiastical Review [21]. This review opens with a statement about the relationships between disorders of the soul, mind, and body. The reviewer suggests that:
… the physician of the body should be as far as possible a pathologist of the mind, while the physician of the soul should be conversant with the abnormalities of the brain and its nerve extensions. It may safely be said that a priest cannot heal sick souls unless he be somewhat, at least, acquainted with sick nerves… This book is sufficient for the priest in this regard. [22]
The reviewer uses the term ‘borderland abnormalities’ to refer to a whole cluster of afflictions including neurosis, hysteria, psychasthenia, scruples and temptations of various kinds. The review ends:
In view of the ever-growing non-Catholic literature on psychotherapy, faith-healing, and so on – literature that contains with some truth much error and absurdity – a work like the present, based upon physical science, sound psychology, and moral and ascetical theology, is a real boon.[23]
As well as these reviews in theological, Dominican, and pastoral journals, the English edition was also the subject of short reviews in both the British Medical Journal and the Lancet. Both of these reviews compliment the author on his insight, tactfulness, and his sensitivity to the need for appropriate medical expertise with the Lancet’s reviewer writing that this was:
A book that in its German form has attracted much attention is Spiritual Director and Physician … The tact of the author is exemplified in the preface … The book is worthy of study by clergymen of all denominations and by medical men[24].
The review in the British Medical Journal was longer and served the double purpose of praising Raymond’s work while protecting the professional interests of the physician. As Freud had earlier criticised the ineffectiveness of Pastor Kneipp’s treatment so too this reviewer made clear his scepticism about hydrotherapy. The reviewer’s greatest praise for Father Raymond highlights Raymond’s respect for the role of the medical doctor.
In the English translation (1891) of My Water Cure, Father Kneipp of Worishofen, Bavaria, writes: ‘I have successfully cured many cases of cancer in early stages. All applications were chiefly directed towards purifying the blood and saps.’ Such remarks are calculated to raise suspicion in the minds of most medical practitioners. But whatever claims may be made at the present day on behalf of the Kneipp Institute, its chaplain, Father Raymond, has succeeded in writing a book of 330 pages with only one solitary reference to hydrotherapy. And in this reference to the use of the water cure in the treatment of nervous diseases no excessive claims are made, while the importance of the physician in prescribing and regulating its application is fully recognized.[25]
Raymond’s approach to spiritual healing is contrasted with the quackery and appeals to supernaturalism of other religious healers of the time. This reviewer had obviously encountered ministers of religion whose activities as healers had given cause for concern, even if only because they did not maintain what he considered to be an appropriately deferential attitude towards the medical profession. Nonetheless, while lauding Raymond’s willingness to work alongside medical doctors, the reviewer is also willing to concede that Raymond’s knowledge and reading is admirable.
Father Raymond is described as having been a ‘sufferer from neurosis’ himself, and his book is interesting as a practical treatise on what is called ‘spiritual healing.’ He writes with sympathy, and with surprising knowledge for a non-medical author, on the neuroses, hysteria, psychasthenia, and such symptoms as obsessions and scruples. And it is in these conditions alone that he claims to effect benefit by his ministrations. If such restraint were exercised by spiritual healers in this country, and if they were content, as Father Raymond appears to be, to insist upon the union of effort on the part of the priest and of the doctor, there would be far less reason for criticism of the methods of procedure adopted by certain irresponsible persons. For there can be little doubt in the mind of any medical man of reasonably broad views that the appeal to religious sentiment may be made useful in assisting recovery in suitable cases. …[26]
It seems noteworthy in itself that the British medical establishment at this time was open to considering Raymond’s book worthy of serious attention and on the whole positive about the contents and approach of his work. While this had much to do with the scholarship demonstrated by Raymond in his theoretical presentations it may also have arisen because of the priest’s willingness to expose the application of his methods through several case histories.
[1]Brockhaus
[2] Letter from Simon Tugwell OP dated 1 December 1998
[3] Kneipp Almanac 1896, Paris
[4]Thouless, p56
[5]Philip, p27
[6]Zilboorg, p61
[7]Raymond, p8
[8]ibid, p19
[9]Klauber, p250
[10]Raymond, pg 2
[11] ibid, pg 3
[12] ibid, pg6
[13] ibid, pg6
[14] ibid, pg9n
[15] ibid, pg10
[16] ibid, pg12
[17] ibid, pp12-13
[18]Revue Thomiste Volume XVI (1908) pp696-697
[19]Etudes Volume 118 part 1 (1909) pg 149
[20] Raymond, pg22
[21]Ecclesiastical Review, Volume 50 (1914) pp626-627.
[22]ibid pg 626?
[23]ibid pg 627
[24]The Lancet, London, Volume 1 for 1914, page 1119
[25]The British Medical Journal, March 28 1914 at page 715
[26]The British Medical Journal, March 28 1914 at page 715
Colin Brady 