In Memoriam: Professor Yrjö Alanen (1927-2022)
It is with great sadness that we inform WPA members that Emeritus Professor Yrjö Alanen passed away in Finland on the 26th of December 2022.
The mainstay of his professional life was the development of humane holistic care of people experiencing problems within the schizophrenia group of psychoses. In recognition of his exceptional career the World Psychiatric Association granted him the Philippe Pinel Prize for Psychiatry for the person in 2008.
Alanen was awarded Honorary Life Membership of the International Society for Psychological and Social Approaches to Psychosis, (ISPS), a society in which he had been very active.
In 1979 Alanen received the seventeenth annual Stanley R. Dean Research Award, given by The American College of Psychiatrists and The Fund for the Behavioral Sciences in recognition of basic research accomplishment in the behavioral sciences contributing to our understanding of schizophrenia.
His academic dissertation book The mothers of schizophrenic patients (1958) was and still is a great classic in the history of schizophrenia studies. It is a study of the personality and mother-child relationship of 100 mothers and their significance in the pathogenesis of schizophrenia. Another classic study is The Family in the Pathogenesis of Schizophrenia and Neurotic Disorders (1966). His magnum opus is his book Schizophrenia, Its Origins and Need-adapted Treatment, (1997), Karnac Books. It has been translated into several languages and has had several reprints.
Alanen’s dissertation received international interest. This led him, in 1959, to continue his research at Yale university in the USA, in collaboration with, amongst others, Theodore Lidz. From early on in his clinical years his work was on developing the psychotherapy of psychoses in Finland. Yrjö finished his psychoanalytic training in 1966. From 1968-1990 he was the professor of psychiatry at Turku University and was the director of Turku University Clinic of Psychiatry.
During his first years at Turku University, he started the internationally famous Turku Schizophrenia Project. The main aim was to develop and study the care of those patients within the schizophrenia group of psychoses who were in the public mental health sector. This systematic work led to the development of the well-known Need Adapted Treatment approach.
The term ”need-adapted treatment of the schizophrenia group of psychoses” refers to integration of psychotherapeutically oriented treatments into a continuous process, broadly based on the changing needs of the patient, as well as those of the patient's network with whom they interacted.
Yrjö was always interested in families, family therapy and family work. In the early years it was seen as a support for individual therapy. At the same time family therapy, family therapy training and other family-centered activities were actively developed in Turku. In 1979, while Yrjö was chairing the Finnish Mental Health Association, the association started a national family therapy training program. This introduced systemic ideas and they were incorporated in the Need Adapted Approach. It started to develop in the directions that still prevail.
Alanen was influential in promoting national mental health policies. He led several national committees and the Need Adapted Approach was spread around Finland through the National Schizophrenia Project 1981-1987. Especially important were multi-professional psychosis teams and therapy meetings, where staff members regularly met the patient, his or her relatives and others close to the patient. In the beginning of the 1990s, there were 50 psychosis teams in different parts of Finland. Unfortunately, this development vanished with the severe financial depression that struck Finland and with organizational changes within health care.
During the years that followed Alanen’s activity, Finnish psychiatry has faced severe financial cuts and a return to a more traditional orientation, in keeping with the international trend of medication and diagnosis centered treatment. The humanistic Need Adapted Approach, however, survives in some centers.
Yrjö and his team published very many scientific papers in national and international journals. A glimpse of Yrjö’s extensive knowledge in the field can also be found in the book - Psychotherapeutic Approaches to Schizophrenic Psychoses (2009) - published in the ISPS book series. The leading chapter that he authored should be basic reading to all working with psychosis. But it is also important to mention his deep interest in classic authors e.g. Dostojevsky, Strindberg, Shakespeare, Simenon. He even published two books in Finnish connected with these authors.
Yrjö was married to Hanni for fifty years and Yrjö died only some months after Hanni.
Author: Jukka Aaltonen and Klaus Lehtinen