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MARGIN NOTES
PAUL TOURNIER
"...the medicine of the person."

Paul Tournier was a general practitioner in Geneva for nearly fifty years. Although he had never had a specialist training and disclaimed the title of psychiatrist, his own experiences, and his discovery that many patients needed help going deeper than drugs or surgery, led him to develop and practise what he called the "medicine of the person", in which medical knowledge, understanding and religion are combined. Instead of lying on a psychiatric couch, his patients were often sitting in his living-room by the fire and talking to the doctor, sometimes in the presence of the doctor's wife. Few psychiatrists have helped so many patients to solve their problems as Tournier did.

Paul had already decided by the age of twelve that he wanted to be a doctor, and although his school carrier was not distinguished, he soon proved to be an outstanding medical student at the University of Geneva. He was also a popular leader among his contemporaries, and was elected President of a country-wide student body. During his time at university, he helped the International Red Cross after the First World War in their work of repatriating Russian and Austrian Prisoners of War.

After graduating from the uuniversity in 1923, he spent one year as a junior doctor in Paris, before returning to Geneva to spend a further four years at the Polytechnic. Then, in 1928, he entered private practice in Geneva, and remained in it until his retirement. For the whole of his career Paul Tournier was a General Practitioner.

His decision for christian devotion and change of his therapeutic was so radical, that he wrote in 1937 a letter to all his patients informing them that he changed his orientation and he would go beyond the physical dosorders of the patient to the deeper problems of the whole personality. Soon after that he wrote his first book, The Healing of Persons.


THE MEANING of PERSONS
by Dr. Paul Tournier


"I had begun corresponding with Dr. Tournier after reading his book, The Meaning of Persons. This led to my meeting Dr. Tournier, and later interviewing him for the French television. In reading The Meaning of Persons, I had been struck by Dr. Tournier's description of his studio, located in a quaint house outside the city of Geneva in Switzerland, and his habit of receiving patients in that particular room, having first illuminated a fire of peat in a low grate surrounded by glazed tile. To my joy, Dr. Tournier met me at the gate that led from the road to his country house, and then into the accurately described studio, there, a warm peat fire was already ablaze."

- L. CANTELON

see photo above, at right:
Dr. Tournier and I converse in the rose garden behind his Geneva house.


"It is not repentance which reconciles us to God, since this reconciliation comes to us from Jesus Christ by Grace; but repentance is the indispensable road that leads to it..."

Psychology and the Spirit
by Paul Tournier

The creative power is God, the divine Word which calls first the inorganic world into existence, and then the biological world to life: "The Lord God formed man of the dust of the ground, and breathed into his nostrils the breath of life; and man became a living soul." (Genesis 2:7) And St. Paul, on the Areopagus in Athens (see footnote at end of article), announces the "God that made the world and all things therein," who, he adds, is "not far from every one of us: for in him we live, and move, and have our being." (Acts of the Early Church 17:24, 27, and 28)

I should like to show the reader how this conception resolves, in medical thought, difficulties which without it seem absolutely insurmountable. Let us consider an example, the symphonic orchestra. There are in an orchestra two big principle groups of instruments, strings and wind. We may compare them to the two constituent elements of the living being, the body and the mind.

The invisible conductor of the orchestra controls both these groups of instruments at the same time, and co-ordinates them. He makes a sign first to the one and then to the other to take up the principal theme, in accordance with the plan laid down by the composer. Similarly in a sick person our attention is drawn now by the physical and now by the psychical symptoms, but the two kinds are always there.

Without the invisible conductor the astonishing correlation which exists between the organic facts and the psychical facts remains an impenetrable mystery. For example, I am sad - that is a psychical sign - and I weep - which is a physical sign. On what does the correlation between these two signs rest? I may think, with certain doctors, that I weep because I am sad. But that leaves the mechanism unexplained; why does my sadness provoke secretion in my lachrymal glands rather than the contraction of my big toe? I may think, with other doctors, that I experience the sensation of sadness because my lachrymal glands are secreting tears - and of course, because at the same time all sorts of other mechanisms are at work in my vegetative nervous system. But in this case there is no explanation of why these nervous phenomena are accompanied by a feeling of sadness rather than joy.

The same problem crops up throughout the whole field of medicine. From Hippocrates onwards, doctors have always been passionately interested in these psycho-physical concordances, without any satisfactory explanation to them, from the purely scientific point of view, having been found. Kretschmer (see note) has shown the concordance between certain types of physique and a predisposition to certain mental diseases. And I might add that even without having made a study of physiognomy, we all judge from a cursory glance at our neighbor's face whether he is an anxious type or a contented one, profound or superficial. Does the mind mold the body, or is it the body which determines the mind?

Our spiritual life itself also presents the double aspect I have described: it is made up of intermittent creative flashes and permanent automatisms. In art, too, we find the same mixture: a work of art springs from a creative inspiration, but it can be manifested only through a technique, that is to say through acquired automatisms.

The religious life itself is no different in this respect. Point by point we shall find in it all the features we have noted above with regard to life: the incessant fluctuations, regulations and sensitivity, the elusive and intermittent character of that which is specifically living and creative, and lastly the automatisms which prolong it, and which are at one and the same time its witnesses, its support and its womb.


Dr. Paul Tournier and Lee Cantelon, Geneva, Switzerland, 1978

A STABLE SPIRITUAL LIFE
Firstly, the fluctuations: many of the people I see yearn for a stable spiritual life. They blame themselves, after bursts of fervor, for falling back into lukewarmness, and after victories of obedience, for backsliding into sin. In this they are doubtless right - and I blame myself for the same thing; but I must at the same time bring them to see that it is our normal human condition. There is scarcely any such thing as a stable spiritual life. In any case it is rather a Hindu than a Christian ideal - the disappearance of the person, absorbed into the great Whole.

We do not posses God. We find him periodically, and that is precisely the authentic and living religious experience. It is an adventure, of which the return of the Prodigal is an illustration, whereas the elder son, to whom the Father says, "Thou are ever with me," (Luke 15:31) undergoes no religious experience.

God has allowed man a greater margin of liberty than the animals in his creation. It is not only the organic margin of deviation of which we have spoken, and which by its fluctuations maintains the life of the body: it is a margin of more moral disobedience which maintains, if I may put it so, his spiritual life. Viewed in this light, the moral conscience is seen to be exactly comparable with the organic sensitivity described in the works of Dr. Maurice Vernet. (see note)  It is when we stray from the direction ordained by God, for his purpose, that it comes into action in order to bring us back. This coming back, which is repentance, reconciles us to God, and rekindles our spiritual life. To be more precise, it is not repentance which reconciles us to God, since this reconciliation comes to us from Jesus Christ by Grace; but repentance is the indispensable road that leads to it, as Christ himself said at the beginning of his ministry, "Repent: for the kingdom of heaven is at hand." (Matthew 4:17)

Thus God's plan for our spiritual life is realized, as in the life of the body, in a succession of corrections of our deviations. We sense great uneasiness when we recognize that we are not what we thought we were or wanted to be - such moments are so many decisive stages of our spiritual life: we are forced to our knees, and there find once more, through God's grace and forgiveness, harmony with him and with ourselves. Even complete sincerity at such moments, is an unattainable ideal. But what is attainable is the periodic movement of sincerity, the movement, in fact, when we confess that we are not as we have sought to appear; and it is at those moments that we find contact with God once more.

The progress of our spiritual life is made up of these kinds of successive discoveries, in which we perceive that we have turned away from God instead of going towards him. That is what makes a great saint like St. Francis of Assisi declares himself chief among sinners. We hear Christ's command, "Be therefore perfect, even as your Father which is in heaven is perfect." (Matthew 5:48) We find this intuitive aspiration towards perfection in unbelievers as well as in believers. And it is precisely because we feel the impossibility of following this call that we recognize our need of God and his grace, of Jesus Christ and his atonement. If we thought we did not need God, should we still have a spiritual life?

This spiritual life, in its characteristic sudden creative welling up, is therefore entirely subjective, inexpressible, and also inter­mittent. It is not manifested in the order of objectively observable phenomena except by its fruits: 'By their fruits ye shall know them.' (Matt. 7.20). Now, these fruits are actually new automat­isms, substituted for the old ones. St Paul enumerates­ The fruit of the Spirit is love, joy, peace, longsuffering, gentleness, goodness, faith, meekness, temperance' (Gal. 5.22-3).

To be sure, a fruit is a living thing. At the moment when the breath of the Spirit blows, all these qualities enumerated by the apostle well up like a spring of fresh water. But, inevitably, they gradually crystallize into new automatisms, and form a new' personage. Thus piety is manifested in all the habits which go to make up this personage: regular prayer, confession, Bible reading, the Church with all its rites and ceremonies. (He who, on a plea of preserving spontaneity, refuses to submit to any religious discipline, will find his piety becoming extinguished, just as we were unable to grasp life apart from the automatic living phenomena of the body and the mind, so we cannot conceive of spiritual life detached from all concrete and regular expression.

Thus, in the spiritual life too, automatisms, the necessary servants of life, are at the same time its tomb. These habits of piety, indispensable as I have shown them to be, can very quickly become emptied of their truly creative substance, to become nothing more than the cloak of a devout personage. There are bigoted stick-in-the-muds in every church. In a pious family it is easy to mistake for a living faith what is in reality only a system of rigid principles which imprison life.

In adolescence a child brought up in this sort of formalist environment may very well revolt against his parents and regard all their religious and moral traditions as a hollow farce or a straitjacket. His indictment will have something in it of the accents of Christ himself when he inveighed against the Pharisees, those great religious personages of his day. They too were imprisoned within rigid principles whose distant source was in the revelation of the living God, though now there lingered only the automatisms; it had left behind. Jesus Christ took his stand against them, saying: 'I am ... the life' (John I I.25).

On the other hand, another child of that same family may possibly submit, and be stamped with the heavy imprint of its principles. He will be turned into a crushed and anguished being, with all his reactions determined for him. His parents, or perhaps his grandparents, have really had their lives shaken by the impact of the Spirit. But he himself has had no personal experience of it. The moral discipline which for the parents was quite spontaneous, is to him no more than an external constraint, a drill, a collection of automatisms.

Every psychotherapist has come across these tragic failures of moralism, a fact which has moved some theologians to join with certain psychotherapists in an attempt to restate the problem of asceticism in the light of the Bible and of modern psychology. It is the impulse of the heart that has spiritual value, the willing *

Life, the Spirit, the person, are not substantial realities which we can hold in our hands. They cannot be docketed, analyzed, or described. They are as fleeting as a lightning flash-by the time we have seen their light and heard the rumbling that follows them they have already gone. We cannot reach the person either by means of introspection or by objective scientific study. We must therefore, seek another way of approach. And that approach must by through the Spirit.

- PAUL TOURNIER



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