A short history of the University Hospital for Psychiatry and Psychotherapy Tübingen

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After antecedents going back to the beginning of the 19th century the University Hospital for Psychiatry Tübingen was opened in November 1894. Of crucial influence among all the initiatives finally leading to its construction was Wilhelm GRIESINGER (1817-1868), who started to give lectures on psychiatry in 1845 as director of the Medical Hospital Tübingen after a long-standing break. The first director, in charge of the newly founded hospital from 1893 till 1901, was Ernst SIEMERLING (1857-1931), who himself devoted especially to the pathologic-anatomical examination of nervous diseases as well as to the description of symptoms of diseases and forensic-psychiatric problems. After he had accepted a professorship in Kiel, Robert WOLLENBERG (1862-1942), like Siemerling a former disciple of K.F.O. WESTPHAL, became director of the hospital for psychiatry. Wollenberg became famous by his clinical descriptions especially of melancholy and hypochondria. In 1906 he accepted an appointment as lecturer at the university of Strasbourg.
His successor in Tübingen was Robert GAUPP (1870-1953), who directed the hospital from 1906 to 1936 and was one of the most influential personalities shaping German psychiatry. Gaupp and Karl BONHOEFFER had worked with Carl WERNICKE at Breslau, Gaupp later joined Emil KRAEPELIN in Heidelberg and Munich. In a speech in 1902 he tried to outline the limits of psychiatric knowledge and expressed his belief in the following sentence: Not one cause, but several do create mental diseases. Due to his work in sick bays his interest focused on problems of traumatic neuroses, which he declined to be consequences of commotio cerebri, as postulated by OPPENHEIM and other psychiatrists, but rather considered them to be sheer psychogenic disturbances. GAUPP became famous by his observation performed over decades and subsequent description of the disease in the highschool teacher Wagner which gave birth to the dynamic way of looking psychiatric phenomena by describing personality, experience and the point of falling ill in the development of delusion. During GAUPP's professorship the childrens' department of the hospital for psychiatry was opened in 1920 after some time of a makeshift preliminary stage and subsequently burst into blossom under its first director Werner VILLINGER.
From 1936 till 1944 one of Gaupp's disciples, Hermann F. HOFFMANN (1891-1944), was director of the hospital for psychiatry. His progeny examinations for the first time systematically dealt with the descent of endogenous psychoses. Furthermore he devoted his attention to the relationships between environment and personality, predisposition and life cycle, character and environment. He continued GAUPP's dynamic way and searched for the possibility of an understanding psychiatry on biological basics. In 1933 Hoffmann joined the NSDAP and was appointed vice-chancellor of the University of Tübingen in 1937. As "Vice-chancellor in SA uniform" he was one of the most exposed national socialists of the university. Contrary to the national socialists' sterilisation law Hoffmann did not consider affective psychoses to be an indication for sterilisation whereas he firmly pleaded for even exceeding the legal limits as the so-called antisocial psychopaths were concerned. As far as we know the hospital did not take part in any of the so-called "euthanasia actions" of the Third Reich.
After Hoffmann's death Wilhelm EDERLE directed the hospital and its sick bay department till 1945. Ederle had brought SAKEL's insulin therapy to Tübingen in 1936. Electroconvulsive therapy was introduced into the hospital, a serological laboratory was established and neurological activities were further expanded. The X-ray department set up prior to World War II now established encephalographic and angiographic neurodiagnostics too.
In late February 1945 Werner VILLINGER (1887-1961) took over the preliminary direction of the hospital. In 1946 he went to Marburg in exchange with Ernst KRETSCHMER (1888-1964) who had already been working with Gaupp in Tübingen. From 1946 till 1960 Kretschmer was director of the hospital for psychiatry. After having already adopted Gaupp's dynamical approach to psychiatry he extended it in his paper on delusions and manic-depressive syndrome and especially in his crystallizing the sensitive delusion. He was the first to introduce the term of multidimensional diagnostics into psychiatry. His systematic synthesis of the theory of physical constitution and characterology made him well-known throughout large parts of society and opened new aspects in medicine, psychology and anthropology. In 1921 "Physique and character" ("Körperbau und Charakter") was published (26th edition 1977), in 1922 "Medical psychology" ("Die medizinische Psychologie"), in 1923 "Hysteria", in 1929 "Ingenious men" ("Geniale Menschen") and in 1949 "Psychotherapeutical studies" ("Psychotherapeutische Studien").
From 1960 till 1972 Walter SCHULTE (1910-1972), a disciple of Hans BERGER in Jena, the inventor of the EEG, was director of the hospital for psychiatry. He had worked in Bethel and as director of the "Landesheil- und Krankenanstalt" in Gütersloh. The experiences he had gained there found their expression in his book "Klinik der Anstaltspsychiatrie" (1962). Schulte was the first to discover the antidepressive effect of sleep withdrawal and to introduce it systematically into the treatment of depressions. He was an advocate of a close relationship between neurology and psychiatry and consequently attached much importance to the establishment of two neurological wards within the hospital. Besides publications on neuropsychiatric borderline subjects (among them on syncopal fits and the foundation of the "Almanac for Neurology and Psychiatry") he concentrated on the personal relationship between doctors and patients and its effects and moreover on problems of endogenous psychoses - especially of melancholy - and Geriatric Psychiatry. Rainer TÖLLE and Schulte published their textbook "Psychiatry" in 1971 - it has now reached its 10th edition. Meanwhile the differentiation of clinical structures continued: In January 1972 Germany's first day clinic was opened.
The Clinical Home for Young People , until 1966 part of the psychiatric department, became autonomous and is called Department of Psychiatry for Children and Young People. First director has been Reinhard LEMPP, who had worked with KRETSCHMER before. Lempp devoted his attention to the significance of cerebral lesions in early childhood as factors of vulnerability with regard to the development of psychic disorders. Moreover he focused on psychoses in early childhood and in young people including their psychotherapy and on questions of forensic psychiatry. Gunter KLOSINSKI, senior physician of the Clinical Home for Young People till 1986 and lecturer for psychiatry of children and adolescents in Bern till 1990 followed. His work revolves around the significance of sects and youth religions with regard to their impact onto the psychiatry of children and adolescents, moreover on dynamic family problems and questions of an age-group-related psychotherapeutical access to children and young people.
The Department of Psychoanalysis and Psychosomatics established in 1967 under the direction of Wolfgang LOCH (1915-1995) was the first German lectureship of this kind. LOCH had previously worked with Alexander MITSCHERLICH in Heidelberg and Frankfurt and was influenced by Michael BALINT. He put his main emphasis on the field of psychoanalytic theory and the science of diseases ("Die Krankheitslehre der Psychoanalyse", 5th edition 1989). LOCH was one of the outstanding personalities of psychoanalysis in Germany after World War II. Afterwards Heinz HENSELER took over his chair. He came from Ulm and, besides methodological questions, focused above all on the problem of suicide from a psychoanalytic point of view ("Narzistische Krisen", 2nd edition 1984).
After SCHULTE's sudden death LEMPP temporarily directed the hospital from 1972 till 1974, then directorship was handed on to Hans HEIMANN, who had worked under Jakob KLAESI and Max MÜLLER at the University Hospital for Psychiatry Bern (Waldau) and qualified as a university lecturer by his research on the effect of scopolamine by comparative psychopathological- electroencephalographical examinations in 1953. Between 1964 and 1974 he had been director of the Research Department for Psychopathology at the University Hospital for Psychiatry in Lausanne. Apart from psychopathological and psychophysiological research his work extended to fields of psychopharmacology, border areas between psychiatry and philosophy, psychiatry and religion, respectively, and methodological questions regarding research in psychiatry. Influenced by Ludwig BINSWANGER he attached special importance to an existential analytical attitude to counterbalance the objectivity of natural sciences in neurobiological research. Heimann essentially continued the tradition of a multidimensional attitude already established at this hospital. In 1979 a Section for Neurophysiology was founded, directed by Mathias BARTELS. Since 1975 a specialized ward enables patients addictive to alcohol to receive a six weeks' inpatient treatment with subsequent out-door after-care. Since 1990 another ward performs qualified detoxification (accompanied by motivation therapy) for addictive patients. To fulfill the need of therapeutic facilities for chronically ill patients or patients on the verge of chronification in the long run an after-care clinic for 16 persons was founded in 1975. This after-care clinic is supported by an independent charity but is closely interconnected with the hospital for psychiatry by a cooperation contract as far as staff is concerned. It is a medical rehabilitation facility in which predominantly younger, sometimes seriously disturbed patients are treated within the scope of a multidimensional therapy program.
In 1988 the Section for Forensic Psychiatry , directed by Klaus FOERSTER, was established in the hospital. Foerster scientifically focuses on problems arising with expert assessments of patients neurotically desiring to retire with a pension, on diagnosis and quantification of personality disturbances as well as on affective acts and the psychotherapy of criminals.
After Heimann was given the emeritus status Gerhard BUCHKREMER took over direction of the hospital on October 1, 1990. BUCHKREMER was assistant doctor and senior physician with Tölle in Münster and qualified as a university lecturer by his research on prophylaxis of recrudescence in schizophrenic patients in 1984. Apart from this his scientific emphasis lies on studies of the communication style in families with schizophrenic patients and on therapeutic possibilities for addicted smokers.

In 1995, taking account of recent developments, the hospital was renamed into University Hospital for Psychiatry and Psychotherapy now including the following departments:
  1. General Psychiatry and Psychotherapy with Outpatients' Department, Section for Neurophysiology and Section for Forensic Psychiatry and Psychotherapy
  2. Psychiatry and Psychotherapy in Children and Young People with Outpatients' Department
  3. Psychosomatics, Psychoanalysis and Psychotherapy
The general psychiatry department comprises 10 psychiatric wards, including a special ward for gerontopsychiatric patients, a detoxification ward, a specialized psychotherapy ward for patients with alcohol problems, with altogether 141 beds as well as the outpatients' department and two day clinics (one of them a special gerontopsychiatric day clinic) with additional 20 therapy places each. In 1996 the partial renovation of the hospital was completed. Crucial for diagnostic and scientific ends are the sections neurophysiology with EEG, EMG and brain mapping, Doppler sonography, clinical psychology and a clinical-chemical laboratory. The psychopharmacological and psychophysiological laboratory (with sleeping lab) predominantly serves scientific purposes. Therapeutical facilities include besides pharmacotherapy and psychotherapy motion therapy, occupation therapy and physical therapy. The social service with four people at present plays an important part in regulating social questions and in sociotherapy. Several workshops (mechanical, gardening, carpeting) and a sports field also belong to the hospital, which are used for therapeutical purposes.

1996 revised and amplified by M. Leonhardt and M. Bartels
Remarks and requests(kppinfo@uni-tuebingen.de)

Copyright: Dr.Anil Batra(anil.batra@uni-tuebingen.de) , Dr. TiloKircher(tilo.kircher@uni-tuebingen.de) , Prof. Dr. Mathias Bartels
(mathias.bartels@uni-tuebingen.de) Last revised on 28/07/1997 by Dr. A. Batra