Development of psychoanalysis and psychotherapy in Croatia is closely connected with the work of the psychoanalyst Stjepan Betlheim (1898-1970). During his studies of medicine at Graz and Vienna, and when specializing in neuropsychiatry on various clinics and institutions in Vienna, Zurich, Paris and Berlin, he came across psychoanalysis and entered training in psychoanalysis. He became a member of the Vienna Psychoanalytic Society, and returned to his native city Zagreb in 1928.
He opened a private psychiatric practice in Zagreb, dealing mainly with neurosis. He has diffused the ideas of psychoanalysis in Zagreb intellectual circles. In the 1930s, he opened a mental hygiene facility modelled after Freud’s clinic in Vienna, where he treated free of charge external patients who could not afford therapy. In 1941, dr.Betlheim was withdrawn the right for public work. He joined the Partisans and spent World War II as their physician. Afterwards, jointly with the Belgrade psychoanalyst Dr. Hugo Klajn, he concerns himself with war neurosis (PTSD) which affected Yugoslav partisan soldiers. After demobilization in 1946, he was again appointed head of the Mental hygiene ambulatory facility, and as of 1948 moved to the neuropsychiatric clinic at the Faculty of Medicine in Zagreb.
In 1953, professor Betlheim founded the first ambulatory Psychotherapeutic ward in the former state, at the neuropsychiatric clinic of the Faculty of Medicine of the University of Zagreb. Since then he was also given the authority to work as a university teacher in the field of psychotherapy with students and young physicians. Just before the opening of psychotherapeutic ward, he published the article “Organisational problems in psychotherapy“ (after E.Klain, in: Stjepan Betlheim. Works, letters, documents. 1898-1970, editor Ruth Betlheim and Gordana Lerotić, in Antibarbarus edition, Zagreb, 2006), from which we single out just some of the features: psychotherapist’s education in psychiatric institutions, general hospitals, clinics, setting out of mental hygiene outpatient departments; importance of scientific work; training-analysis not only for psychoanalysts but also for other psychotherapists, opportunities for additional training abroad, and other.
At the Psychoanalytic Congress at Amsterdam in 1951, after a long isolation, he meets with the colleagues from Europe and the United States gradually renewing old acquaintances and friendships through correspondence and encounters with psychoanalysts and their visits to Zagreb during the following years (among his guests there were Edith Jacobson, G.Geroe, S.Lebovici, P. Parin, Lizzy Rosenberger). In 1952, he became a direct member of IPA.
Professor Betlheim also renewed his wider public activity making popular the themes of mental health and psychotherapy based on psychoanalysis (rostrums, lectures, Parent School, and similar). Such activity, on a narrower professional basis as also on a public level, made it possible, among other things, to reduce resistance towards psychoanalytic ideas and psychoanalytic psychotherapy in a society which with its ideological viewpoints and socialist practice came frequently in conflict with middle-class values and capitalist practice of the western societies. Fortunately, in the former Yugoslavia there had been no major censorship in respect of psychoanalysis and psychoanalytic psychotherapy, which enabled younger generations to join in the training in psychoanalytic psychotherapy initiated by Prof. Betlheim, together with his disciples Prof. Blaževic, Prof. Cividini-Stranić, Prof. Klain, Prof. Nikolić, who at the same time had all been the university professors at the Faculty of Medicine of the University of Zagreb. All that was said earlier makes possible to have better understanding of the presence of psychoanalytic ideas and of the possibility to enter training in psychotherapeutic and psychoanalytic techniques since early 1950s, as well as of the reason for major integration of psychiatrists and psychiatry registrars into psychoanalytic training in Croatia. This situation gradually evolved so that also the representatives of other humanistic professions joined in the training.
After Dr. Betlheim with his collaborators, and also within the framework of the Yugoslav psychiatry, had over the years prepared foundations for further and more independent development of psychotherapy, in 1963 was founded the first Section for Psychotherapy in Zagreb, at the Medical Association of Croatia.
At the beginning of the year 1969, the psychotherapeutic ward of the neuropsychiatric clinic moved into the newly constructed building. It also got the new name Mental Health Centre (CZMZ), and in 1989, it was renamed to the Clinic for Psychological Medicine. The first director of the Mental Health Centre was the first collaborator of Prof. Betlheim and his former student, Prof. Dr. Duška Blažević.
Before the year 1991, in Mental Health Centre (later the Clinic for Psychological Medicine) which was the national institution approved by the Ministry of Health, and the then Yugoslavia, as an psychotherapeutic institution providing services of psychotherapeutic treatment based on psychoanalytic foundations and the training in psychoanalytic psychotherapy. The training included seminars in theory, supervisions of three supervisors, supervision of preschool child therapy conducted over the period of one year, and of adolescent therapy over the period of one year, and the so-called didactic analytical individual and group psychotherapy.
Professor Blažević was the first editor and editor-in-chief of the journal Psychotherapy, which was first published in 1971. Although in difficulties during the war in Croatia in the 1990s, the journal continued to be published until 1999. At the end of 2016, it began to appear again under editorial leadership of Prof. Ljiljana Moro, group analyst and psychoanalytic psychotherapist. Participating in editorial committee are the analysts and psychoanalytic psychotherapists from abroad.
An exceptionally important impetus was given to the development of the psychoanalytic psychotherapy in our country by the organization of seminars, of which the first was held in 1966 at Mokrice, a historical venue not far from Zagreb (now it is in Slovenia), and later on at the Plitvice Lakes, with education in psychotherapy as a topic. Seminars, with themes in psychoanalytic theory and with clinical psychotherapeutic presentations, discussions in large and small groups, with minor alterations in their organization and structure, were held every other year over the next thirty years or so. These seminars gathered also psychotherapists from the majority of national capitals of the former Yugoslav state, and gradually introduced to active participation the growing number of younger psychiatrists, and also a minor number of psychologists. In addition to actual direct involvement during the seminar days, they have been a permanent source and stimulation to professional discourse in psychoanalytic psychotherapeutic community, wherein was also included the psychotherapeutic section.
In addition to these seminars, which were mainly organized by native professionals, there were also seminars with lectures held by visiting lecturers and supervisors of clinical case studies, psychoanalysts and/or psychoanalytic psychotherapists from abroad. The first and longest cooperation (since as early as the 1970s) was with the psychoanalyst Michel Vincent from Paris (Alfred Binet Centre), and later on with other French psychoanalysts (Marie Lise Roux, Thierry Bokanowski, Phillippe Jeammet, Bernard Penot, Henri Vermorel). For our development was decisive, however, the somewhat later established seminar-cooperation with the Italian psychoanalysts (Paolo Fonda, Paola Gollineli, Hectore Jogan, Rocco Pisani, Vlasta Polojaz, Maria Rosa de Sordo) during which the topics discussed were related to psychoanalysis and psychoanalytic psychotherapy.
In 1991, out of the Section for Psychotherapy at the Medical Association of Croatia developed the Croatian Association for Psychotherapy (also at the Medical Association of Croatia, HLZ), chaired by Prof. Dr.Muradif Kulenović, the then director of the Clinic for Psychological Medicine and longstanding editor-in-chief of the journal Psychotherapy. At a later point the Croatian Association for Psychoanalytic Psychotherapy was founded, whose first president was prof Kulenović. The Association developed intensive lecturing activity (topics from theory of psychoanalytic psychotherapy and psychoanalysis), round table discussions and workshops. The Association cooperated in that with the Institute for Group Aanlysis, the Croatian Association for Child and Adolescent Psychiatry, the Workshop for Family Therapy, which was all as yet within the framework of the Clinic for Psychological Medicine. The change was not only in the title, it involved also further development of the criteria for training in psychoanalytic psychotherapy, getting closer to the programme published by the European Federation for Psychoanalytic Psychotherapy in public sector.
The above text clearly shows that the Croatian Association for Psychoanalytic Psychotherapy, the Croatian Psychoanalytic Society, and the Institute for Group Analysis had a common or shared history since the end of the 1960s until mid 1990s when the split into two societies occurred: Croatian Association for Psychoanalytic Psychotherapy (HDPP) and Croatian Psychoanalytic Society. The cooperation between these two societies is very fertile and of good quality.
We would like to stress again that it was owing to great personal engagement and generous assistance of Italian analysts (mostly from the psychoanalytical society Centro Veneto), and under the guidance of the Italian training psychoanalyst and supervisor Dr. Paolo Fonda (later the director of the East European Institute for Psychoanalysis) that the IPA Croatian Psychoanalytic Study Group was founded, whose members were Prof. Klain, Prof. Eugenija Cividini Stranić, Prof. Nikolić, Dr Dragan Josić and Prof. Vlasta Rudan, who was also the first chairman of the Study Group. With time, the Study Group has grown into the Croatian Psychoanalytical Society (provisional) with the membership in IPA. The first supervisors to candidates for psychoanalysts from Croatia were the Italian training psychoanalysts from Trieste (Italy), and later on also the Amsterdam Psychoanalytical Institute which organized one part of the instruction for candidates from the former East European countries.
During the 1970s, the Summer School of Psychoanalysis and Psychotherapy was organized within the Interuniversity Centre in Dubrovniku. During the ten years of IPA and EPF, within the same Centre was held the East European School for Child and Adolescent Psychoanalysis, to be later moved to Rabac in Istria (Croatia), which was attended by potential candidates or by already confirmed candidates for training in psychoanalytic psychotherapy or psychoanalysis. In the school programme on two occasions participated also Mrs. Lidija Tischler, one of the founders and a member of EFPP. For many years in Dubrovnik is also active the Summer school for psychosomatics and psychotraumatology. Still active today is the Summer school for psychoanalytic psychotherapy under the guidance of Dr. D.Podrug who lives and works in the United States, and the Summer school for psychosis psychotherapy conducted by group analysts.
As we have attempted to show, the psychotherapy training in our country for many years was carried out in a matrix based on seminars, supervisory forms of study and didactic groups. In this matrix were involved all experts in our psychotherapeutic institution (Clinic for Psychological Medicine of the Clinical Hospital Centre (KBC) and the School of Medicine of the University of Zagreb), and on a broader scale (psychoanalytic psychotherapists from Split and Rijeka who carried out their training thorugh the Zagreb group of the Croatian Association for Psychoanalytic Psychotherapy). Abundant international cooperation helped to disseminate and extend knowledge of psychoanalytic theory and practice. We are quoting just a few names of this rich opus of individual, group and family psychotherapists and analysts: S.M. Abend, R. Battegay, W.Berger, S.Bolognini, E.Brainin, Janine Chasseguet-Smirgel, M.Cox, Fern Cramer Azima, R.Diatkine, A.Gibeault, A.Green, P. GrayPh.Jeammet, H.Jenkins, P.Lewis, D.Montgomery, M.Pines, V.D. Volkan
As of 1996, the qualification criteria for entrants in training in psychoanalytic psychotherapy have been changed. These criteria with minor alterations are still valid today: three initial interviews, own therapy 400 hours (currently 480), two supervisions covering a total of 240 hours, reading seminars in theory 340 hours, casuistic seminars, monitoring the progress of training entrants by elected committee.
Due to the change of the Law on Associations in 2001, a new founding assembly of the Croatian Association for Psychoanalytic Psychotherapy had to be held in 2002, and new Articles of Association passed. Thus, the public nature of our Association’s work was legally regulated, irrespective of the institution within which it had developed (Clinic for psychological medicine). Since 2014, the Association moved to a new location, in its independent premises.
