12 Psychiatrists who Shaped Psychiatry in Turkey in the Republic’s First Century

ABSTRACT

Who are the influential figures that molded Turkish Psychiatry into what it is today? This review introduces 12 psychiatrists who shaped psychiatry in Turkey during the first century of the Republic. The article presents Rasit Tahsin, the first neuropsychiatrist who establish an academic psychiatry department in Turkey; Mazhar Osman, who had so much influence that his name became a phrase to describe the mentally ill, and still lives on with the institutions he built; Ihsan Sukru, the founder of neuropathology in Turkey, a historical figure in viral encephalitis research; Fahrettin Kerim Gokay, famous for his political career and his fight against alcohol and tobacco; Rasim Adasal, a Cretian who is a cornerstone in Ankara psychiatry and a well-known figure in Turkish society life; Abdulkadir Ozbek, who introduced psychodrama to Anatolia-his ‘earth’; Leyla Zileli, who disseminated psychoanalysis from Ankara to Turkey; Orhan Ozturk, a founding figure for the Journal, the Association, and Hacettepe; Ayhan Songar, a prominent figure in society and also in state bureaucracy; Ozcan Koknel, the amiable face of psychiatry in society and a respected voice; Oğuz Arkonaç, a vigorous advocate for the establishment of contemporary psychiatry with DSM III in Bakırköy and then in Turkey; and Gunsel Koptagel-Ilal, who progressed the work in the psychosomatics as one of Turkey’s first female psychiatry academics. As with any list, we acknowledge that absolute consensus is not possible; we are preparing a more extensive selection to be published as a book next year. We present our selection to your liking, hoping that one or more of our colleagues reading this article will be included in the selection for the next century, reflecting our collective conscious creation of psychiatry in Turkey.

INTRODUCTION

From the Editor

As the Turkish Journal of Psychiatry we are dedicated to producing content that contributes to the advancement of psychiatry and we strive for every article to be ‘high quality’. As the current editor-in-chief, I am personally anxious about this particular piece being ‘good’ with a secretly pride being a part of it: For the 100^th anniversary of the establishment of our Republic, the TJP Editorial Board has decided to write about 10 influential psychiatrists in Turkish psychiatry; Şahap Erkoç, Kazım Cihan Can, Latif Alpkan, and Tarık Tuna Gözütok graciously agreed to embark on this endeavor together. We aimed to focus on our colleagues whose previous work have left a mark in Turkish psychiatry. These psychiatrists were undoubtedly influential with their work, but we aimed for the reader to also see the human side of these people. We set out to choose 10 individuals, but in our very first meeting, ended up with a list of 20 people. The journal has certain rules though and we needed to limit the number. With the help of Kazım Cihan Can’s analogy of the century to one complete cycle of a clock, we found the middle ground with 12 psychiatrists, but we have also agreed to publish a book next year including a wider selection. Alongside our Editorial Board members Berna Uluğ and Cengiz Kılıç; Kâzım Yazıcı, Arşaluys Kayır, Başak Yücel, and Raşit Tükel have also contributed to the article by introducing their mentors. We are aware that our selection should have been broader, and there will surely be objections to certain names; however, we comfort ourselves with the recognition that ‘no list is perfect’. In this article, you will read about our colleagues in their chronological order of birth.

This cartoon was published in Akbaba Magazine at 1933. The upper panel explains the context ’According to the newspapers Mazhar Osman gets angry if he’s not mentioned in the news once in every couple days’. The lower panel is from the mouth of the person speaking over the phone: ’Who am I talking to? Akşam (the newspaper)? Send here a photographer and a reporter, take his pictures and interview him immediately! He is very angry!!’

RAŞIT TAHSIN TUĞSAVUL (1870-1936)

Kazım Cihan Can, Şahap Erkoç

Raşit Tahsin, the founder of academic psychiatry in Turkey, was the first physician with a specialized training in neuropsychiatry. Born in Beykoz in 1870, Raşit Tahsin graduated from the Military Medical School with honors and the rank of captain in 1892, after which he was sent to Germany. He pursued his residency training from 1893 to 1896 at Kraepelin’s clinic in Heidelberg. During his time in Germany, he visited neuropsychiatry clinics in Berlin, Munich, Vienna, and Leipzig and had the opportunity to work with significant figures such as Binswanger, Flechsig, and Nissl. Upon his return to Istanbul, he was appointed as a lecturer in neuropsychiatry at the Gülhane Military Academy, where, as one of his students described, he began working in a branch that did not yet have a chair in the country: Nervous and Mental Disorders. In a later article, he mentioned how, amidst all difficulties, for the first two years in the psychiatry department, he could only provide theoretical education. It took another two years for him to establish an outpatient unit and four more years to open an inpatient with 12-15 beds. At a time when even physicians were skeptical about psychiatry being a medical discipline, his efforts to promote the discipline were later summarized (Anonymous 1936):

“As the nervous and mental disorders was neglected and belittled by contemporaries, he felt frustrated. To emphasize the importance of the discipline, he didn’t confine himself to teaching at school but whenever possible, he wrote (articles) or gave lectures (to the public).”

He actively contributed to the structuring of medical education at Gülhane. With his excellent knowledge of German, he assisted Rieder Pasha, one of Gülhane’s founding professors, as an assistant and translator, undertaking the translation of medical educational material and resources into Turkish. In 1909, following the merger of military and civil medicine after the Second Constitutional Era, he was appointed as a lecturer at the Medical Faculty. He continued his career as a psychiatrist and physician until the university reform in 1933 when he contract was not renewed forcing him to retire. His son, Esat, from his first marriage to a German woman, was appointed as an associate professor at the Faculty of Medicine in 1933. Raşit Tahsin passed away on February 6, 1936, due to a heart attack.

It’s said that Raşit Tahsin, known for his cheerful and witty character, was also notably overweight. His obesity became a subject for magazines and caricatures. In an interview two years before his death, a journalist described his obesity as follows:

“(…) The great part of Raşit Tahsin’s fame was provided by his belly. As much as he was known for his intellectuality, perhaps he gained even more fame for his obesity. I can say without exaggeration that there is no fatter citizen within the borders of the Republic of Turkey.”

His life story suggests that Raşit Tahsin was both a psychiatrist and a patient of psychiatry. Kraepelin was not only his mentor and friend but also his personal doctor. From a letter Dr. Wieting Pasha wrote to Kraepelin, it’s understood that Raşit Tahsin, who likely suffered from bipolar disorder, had “periods of extravagance lasting 2-3 months (…) followed by frequent crying spells (…) depressive” periods, indicating that he was not always fit for work (Wieting 1909).

In 1910, at the 4th International Congress for the Care of Mental Patients held in Berlin (Internationaler Kongreβ zur Fürsorge für Geisteskranke), he presented an oral paper titled ‘Mental Diseases and Psychiatry in Turkey.’ Later published in both German and Ottoman, this presentation became the first international report from Turkey in the field of psychiatry. He was elected as a permanent member to the International Society for Mental and Nervous Medicine established at this congress, upon Kraepelin’s recommendation.

Domestically, along with his contemporaries like Avni Mahmud and Mazhar Osman, he actively participated in organizational activities. He was one of the founding members of the Society for Mental and Nervous Medicine founded in 1914. With the establishment of the Republic, this society eventually became the Turkish Society for Mental and Nervous Medicine and later evolved into the currently active Turkish Neuropsychiatric Association. Following a disagreement with Mazhar Osman after a meeting in 1918, he left the Association and founded the short-lived Society for Mental Medicine which was active between 1918 and 1926.

As described by Dr. Mustafa Hayrullah, “He didn’t quite enjoy writing as much as speaking and socializing.” (Diker 1936) Besides the published congress report, he also authored a textbook titled ‘Serîrîyât-ı Akliyye Dersleri’ in 1920. This book, primarily translated and adapted from his mentor Kraepelin’s textbook, consisted of the classification and clinical features of psychiatric disorders in its first part and case presentations in its second part.”

MAZHAR OSMAN UZMAN (1884-1951)

Şahap Erkoç, Tarık Tuna Gözütok, Kazım Cihan Can

Born in 1884 in Dedeağaç, Mazhar Osman graduated from the Mekteb-i Tıbbiye-i Şâhâne (Imperial School of Medicine) at the young age of twenty. He immediately began his residency training in neuropsychiatry under his mentor Raşit Tahsin. He became a faculty member as an assistant to Raşit Tahsin immediately after the completion of his training. There is no doubt that this young physician would later leave an indelible mark on the history of psychiatry in Turkey.

Following the declaration of the Second Constitutional Era (İkinci Meşrutiyet), Mazhar Osman received a government scholarship to continue his education in Germany. He spent six months working at Kraepelin’s clinic, where he had classmates such as Alzheimer, Cerletti, Jacob, and Spatz.

This cartoon was published in Akbaba Magazine at 1933. The upper panel explains the context ’According to the newspapers Mazhar Osman gets angry if he’s not mentioned in the news once in every couple days’. The lower panel is from the mouth of the person speaking over the phone: ’Who am I talking to? Akşam (the newspaper)? Send here a photographer and a reporter, take his pictures and interview him immediately! He is very angry!!’

Amidst the turbulent bureaucratic atmosphere of the Second Constitutional Era, he lost his position and scholarship at the faculty, compelling him to immediately return to Istanbul to work as a military physician at Gülhane Hospital.

During World War I, he was appointed as the Chief Physician at Haseki Psychiatry Hospital. In 1916, when the Istanbul L’hôpital La Paix was seized by the Ottomans due to the French being the enemy at the time, he became the Physician-in-Chief of La Paix. During the Armistice period, when the French took over the hospital again, they wanted Mazhar Osman to remain as the chief physician, a position he held until his death.

Between 1920 and 1922, based on the recommendation of Abdullah Cevdet, the Minister of Health, he was appointed as the chief physician of the Toptaşı Asylum. He later resigned sensing that the political atmosphere might lead to his dismissal. In the following years, he sent his trainees Fahreddin Kerim, İhsan Şükrü, Necati Kemal, and Ahmet Şükrü to Europe for further education.

Immediately after the establishment of the Republic, he was reappointed as the chief physician at Toptaşı. He pioneered the relocation of the old hospital to the new one, later named Bakırköy Mental and Nervous Diseases Hospital. He was actively involved in the hospital’s construction, organization, and the inclusion of transferred patients. Bakırköy Mental and Nervous Diseases Hospital became the largest mental facility and still has a great impact on Psychiatry in Turkey.

In 1933, after twenty-four years since his departure, he returned his university as a full professor. Bakırköy then became a university clinic.

In addition to teaching, medical practice, writing, and editing, he was founder and leader in many professional and civil organizations. Among his notable roles were the presidency of the Society for Mental and Nervous Medicine, the Turkish Medical Chamber, and later, the presidency of the Green Crescent Society. He notably led campaigns against alcohol and tobacco. Mazhar Osman also played a crucial role in establishing Turkey’s first neurosurgery clinic and initiating its specialization training.

Passing away in 1951 after a highly productive life, his legacy included the founding of the Bakırköy Mental and Nervous Diseases Hospital -which is named after him-; training many doctors who later pioneered Turkish psychiatry; writing numerous books such as ‘Akıl Hastalıkları’(Mental Disorders), ‘Tababet-i Ruhiye’(Psychiatric Medicine), ‘Keyf Veren Zehirler’(Indulging Toxins); publishing ‘Şişli Müessesesinde Emrâz-ı Akliye ve Asabiye Müsâmereleri’ the first neuropsychiatry journal in Turkey, ‘İstanbul Seririyatı’ for medical education and ‘Sıhhi Sahifeler’ for lay people. Mazhar Osman was a pioneering physician who reshaped concepts and perceptions related to mental illnesses. Throughout his work and efforts, he always aimed to establish the understanding that ‘insanity is illness, and the insane are patients.’ His actions and vibrant personality became synonymous with psychiatry in the eyes of the public, leading to the phrase ‘Mazhar Osmanlik’ (a case for Mazhar Osman) for psychiatry patients.

Before concluding, we’d like to correct one common misbelief. There is an inaccurate story on Mazhar Osman’s surname that it was initially ‘Usman’ and later was changed to ‘Uzman’ by Atatürk. This mistake was first encountered in the article under his name in the Istanbul Encyclopedia as follows (Yildirim 1994):

“When the Surname Law was passed, he adopted the surname ‘Usman’ as a symbol of his professional engagement with mental disorders, but this name later settled as ‘Uzman.’”

One of his students, Necati Kemal, described Mazhar Osman’s unique character after his passing with these words (Erkoc 2001):

“Our leader has passed away… For years and a lifetime, we were so accustomed to seeing him like a north star in the chief physician’s chair and over us, that I now feel ‘acephalic’.

He had anger… He had fury… He was dominating… Yet, he had taste… He had color… Now we became a tasteless, colorless crowd…”

İHSAN ŞÜKRÜ AKSEL (1899-1987)

Şahap Erkoç, Kazım Cihan Can

İhsan Şükrü was born in Istanbul in 1899. After completing the Ottoman Union School, he entered the Medical Faculty. He was attracted to psychiatry during the Şişli Conferences he attended as a student (Aksel 1979):

“Mazhar Osman Bey was giving public lectures, talking about mental illnesses, and sometimes inviting mentally ill patients to the stage. We went to that evening lecture. (…) He stepped up to the podium and began with ‘Gentlemen,’ which had a great impact on me. He moved on to the subject, explaining mental illnesses in a way that a lay person could understand. Then he talked about hysteria and said, ‘Now I will show you how hypnosis can cure hysteria.’ He brought in a patient experiencing hysteria (…) and put him to sleep with hypnosis, pricked him with a needle, but he didn’t feel it. Then the patient greeted us and left the room. Frankly, this had a great impact on me. The idea settled in me that Psychiatry is a positive (science) and a branch that I can select.”

Later, he attracted the attention of Mazhar Osman and started his residency in neuropsychiatry at Toptaşı Mental Hospital and Haydarpaşa Military Hospital while he was still a medical student. After being the chief resident there, he went to Germany in 1922 for further education. After working for a year at the Department of Pathological Anatomy in Munich and the Neuropathology Clinic Laboratory at Hamburg University, he returned to Istanbul. İhsan Şükrü, the founder of the neuropathology in Turkey, presented data from over nine hundred autopsies he conducted in his own laboratory at national and international congresses. He presented his data on alterations in brain caused by rabies virus at the First International Neurology Congress held in Bern in 1931. In the University Reform of 1933, he was appointed as an associate professor in pathology. After working with Schwartz for two years, he returned to Bakırköy. He became an associate professor of psychiatry in 1940 and a full professor in 1946. After Mazhar Osman passed away, he became a distinguished professor. He held the position of chief physician at La Paix Hospital and served as the President of the Turkish Neuropsychiatry Association until 1972.

In 1953, he was elected as the dean of the Faculty of Medicine at Istanbul University and during this period, he established a modern psychiatry clinic in Çapa. He also facilitated the establishment of the child psychiatry clinic by Rıdvan Cebiroğlu in 1958.

After the May 27 coup, he was among the faculty members dismissed by the military administration - known as the 147s -referring the number of the regulation leading the dismissals-. Following this incident, he had a dispute with Ayhan Songar, Recep Doksat, and Kazım Dağyolu, but eventually returned to his position three years later. He retired in 1973. After his passing in 1987, in accordance with his will, he was buried in a grave close to his beloved Yahya Kemal (Beyatlı) (Yazici 2006).

İhsan Şükrü, a highly recognized and productive scientist internationally during his time, was elected an honorary member of the World Psychiatric Association. He has published over three hundred works. Many anecdotes shared by those close to him acknowledge İhsan Şükrü›s compassion and humility towards his patients, students, and colleagues. According to his student Günsel Koptagel İlal, İhsan Şükrü was a person who “acted naturally, found immediate solutions without losing his composure in the face of critic events, was cheerful, and had superb organizational and managerial skills.”

FAHRETTIN KERIM GÖKAY (1900-1987)

Tarık Tuna Gözütok, Şahap Erkoç

Born in 1900 in Eskişehir, Fahrettin Kerim entered the Faculty of Medicine in 1916 and began working at Toptaşı Mental Hospital while he was still a student. Upon graduation from the Faculty of Medicine in 1922, he also received a certificate as a specialist in mental and nervous disorders. He received training at Kraepelin’s clinic in Munich between 1922 and 1923, engaging in experimental psychology. When he returned to Turkey in 1924, he served as the Chief of the Experimental Psychiatry Clinic. He played significant roles in the relocation of Toptaşı to Bakırköy between 1924 and 1927. In 1926, he was appointed as Raşit Tahsin’s assistant at the Darülfünun Faculty of Medicine and became a professor in the 1933 University Reform. Following Mustafa Hayrullah’s retirement and partly to evade the difficulties of working with Mazhar Osman, in 1942, he shifted to the neurology clinic and became a full professor.

Fahrettin Kerim: Even the animals acknowledge the harms of alcohol. You put a bucket of raki and water in front of a donkey and he wouldnt choose raki, he goes with water…Why?

A drunk from the audience: Because he’s a donkey!

Gökay was an industrious instructor with over two hundred books, articles, and monographs to his credit. Particularly, his books titled “Ruh Hastalıkları” (Mental Illnesses) and “Sinir Hastalıkları” (Nervous System Diseases) were used as neurology and psychiatry textbooks by students for many years. He was the founder and publisher of the magazine “Tıp Dünyası” (World of Medicine), which began in 1928 and continued until his death. During his tenure in the neurology clinic, he published neurological yearbooks annually. He also founded and served as the president of the Society for Mental Health.

Active in the Green Crescent Society (Yeşilay), he also wrote and managed the Yeşilay Newspaper for a period. His frequent mention of anti-alcoholism in his writings and speeches became strongly associated with Gökay and his image. In fact, the label image of the famous drink of that time, Kulüp Rakısı, was likened to Gökay, and in taverns, orders would be placed saying, “bring me a Fahrettin Kerim.” Some say this is also mockingly referencing the short stature of the governor.

Known more for his political career than his medical one, Gökay served as the Governor and Mayor of Istanbul between 1949 and 1957, and was the Ambassador to Bern from 1957 to 1960. Additionally, he served as an Member of Parliament from Istanbul between 1961 and 1965, holding the position of Minister of Urbanization and Resettlement in 1962-1963, and the Ministry of Health and Social Assistance for a brief period in 1963. He passed away in 1987.

During his governorship, considering it harmful to mental health, he imposed a ban on car horns. It is rumored that upon hearing about this ban, Adnan Menderes referred to Gökay as ‘insane’. Gökay did not hold back in his response: “If he calls me insane, nobody believes in that, but if I call him insane, he will never convince anyone of his sanity for the rest of his life.”(Şentürk 2008)

RASIM ADASAL (1902-1982)

Kazım Cihan Can

Ali Rasim Adasal was born in 1902 on the island of Girit (Crete) and received his early education in a Turkish school there. Due to escalating tensions between Turks and Greeks, his father sent him to Istanbul to live with his sister, who was married to a naval officer. Adasal encountered language difficulties because of his former education in both Turkish and Greek, forcing him to repeat the final year of primary school.

In 1920, he enrolled in the Faculty of Medicine and graduated in 1925 as a lieutenant physician. His specialization training took place at the Gülhane Military Medical Academy Neuropsychiatry Clinic under Nazım Şakir. Following his residency, Adasal worked as a continental physician or neuropsychiatrist in various cities such as Izmir, Erzurum, Erzincan, Istanbul, and Balıkesir.

After Nazım Şakir›s retirement, Adasal became a professor in 1945. He took over as the director of the Psychiatry Clinic at the newly established Ankara University Faculty of Medicine in April 1946. He remained at the helm of the psychiatry clinic at the same institution until his retirement in 1972 due to reaching the age limit. His health began to decline in the early 1980s, prompting him to move to Izmir, where he passed away in 1982.

Rasim Adasal

Adasal authored numerous medical and paramedical works, including influential pieces such as a three-volume ‘Psychiatry’ book, ‘Medical Psychology’, ‘Gender, Love, and Marriage’, and ‘Psychology of Earthly Gods, Leaders, Commanders, and Heroes’.

He founded the Ankara Neuro-Psychiatry Society, later renamed the Turkish Society of Nervous and Mental Health in 1945. This society eventually started publishing the Turkish Journal of Psychiatry under the leadership of Orhan Öztürk.

With a colorful and impactful personality, a speaking style with a prominent (Cretian) accent, energetic demeanor, and sometimes a fiery temper, Adasal was popular not just among the psychiatry community but also in wider spheres due to his broad interests and knowledge (Sayıl 2005). He had a keen interest in sports, having played football during his medical school years, and held positions like the President of the Ankaragücü Sports Club, Deputy Chairman of the Turkish Football Federation, and Editor-in-Chief of Kırmızı Beyaz Sports Magazine. Additionally, he taught Sports Physiology and Health at the Military School.

Adasal’s interests were not confined to sports. He completed degrees in psychology and philosophy alongside medicine. An avid reader and intellectual, he not only shared his knowledge with colleagues but also with the public through lectures at the Kızılay Conference Hall in Ankara, articles in newspapers and magazines, and notably, the radio and television program called “Esen and Adasal,” which he hosted with constitutional law professor Bülent Nuri Esen on Turkish Radio Television Corporation.

His lectures and discussions extended beyond working hours, often taking place in various restaurants and taverns in Ankara. To better grasp Adasal’s teaching and oratory skills, let’s hear from his student, Necati Kölan (Sayıl 1999):

“Instead of keeping a rigid style during the lectures, we found ourselves analyzing of a novel or a movie from the perspective of psychology and psychopathology which was mesmerizing to us. (…) We found the corridors of betrayal with Lady Macbeth who was obsessed with washing off the bloodstains from her hands; the turmoil of the jealous male soul through Desdemona’s drowning, and our youthful tears in young Werther’s sobs in the fields.”

ABDÜLKADIR ÖZBEK (1920-2000)

Arşaluys Kayır

My Anatolia, my Anatolia, Filled with work, bursting at the seams Where I seek in the sky, but find on earth To its bee, its flower, its bird, its forest, its stone The first stop where I was deeply struck, My anchor, My Earth

Abdülkadir Özbek - December 1999

He was Anatolia as he introduced the psychodrama group therapy method to Turkey. He had strong organizational skills, scientific intuition, and clinical knowledge.

Together with foreign directors, we always sang the lyrics ’Ha bu diyar, ha bu diyar’… Whenever the opportunity arose, we would sing his song, recalling him, but with a different ending. Instead of ‘Tell the truth, friends, can that lover exist without me?’ we’d say, ‘Can psychodrama exist without you?’…

Abdülkadir Özbek easily finds his place among the psychiatrists who left a mark on the first century of the Republic; he introduced group psychotherapy and psychodrama to Turkey; he formed a group that received education spreading the method nationwide and it has been expanded and sustained by individuals trained over forty years now. Many psychodrama trainers and psychodramatists were raised through his efforts. In a city as large as Istanbul, there were talks of psychotherapy in the 70s but no education came into play until behavior therapies arrived. I first watched Abdülkadir Hoca perform a psychodramatic enactment of a meeting between father and son on stage during the Group Psychotherapies Congress at the Ankara University Psychiatry Clinic in 1976. During those times, this clinic regularly held symposiums on group psychotherapies. The directors were Abdülkadir Özbek, Engin Geçtan, Leyla Zileli, Celal Odağ, Ülkü Gürışık, Haluk Özbay, Abdülkadir Çevik, and names like Grete Leutz. Once, the Hoca took Leutz on a trip to Asclepion. Leutz said, ‘Why don’t you hold your symposium here?’ and that was it. Starting in Bergama in 1983, these congresses still continue the 47th of which will be held in 2024. Psychodrama, sociometry, and group psychotherapy methods align perfectly with the need of our age for the improvement of society (sociatry) extending from the individual to the community.

Abdülkadir Özbek was born in 1920 in Doğubayazıt. He graduated from Istanbul University Faculty of Medicine. He specialized in psychiatry at Bakırköy Mental and Neurological Diseases Hospital in 1952. By 1967, he began working at the Ankara University Faculty of Medicine Psychiatry Clinic. In 1972, for educational purposes, he was sent to West Germany by the Faculty. He joined Grete Leutz’s psychodrama group in Lübeck, was influenced by his experience there, and started his training. He continued his psychodrama practice first at the Gütersloh Psychiatry Hospital in Germany and then in the mixed neurosis department at the Ankara University Faculty of Medicine Psychiatry Clinic. In collaboration with Grete Leutz, president of the Moreno Institute in Überlingen, Germany, he established a psychodrama training group in Ankara in 1982. In 1984, he founded the Turkish Group Psychotherapies Association and remained its president for a long time. The education groups continued in Istanbul in 1985, Izmir in 1986, and later in other cities.

Shortly after celebrating the 25th year of the Group Psychotherapies Congress held at Bergama Asclepion, Hoca migrated from this ‘Diyar’ to the other on June 13, 2000. Moreno, the founder of the psychodrama method, is referred to as ‘the person who brought laughter to psychiatry.’ For Abdülkadir Özbek, we say, ‘the person who opened the closed doors of psychotherapy, elevated psychodrama from within.’ Thanks to the collaboration between Leutz and Özbek, as psychodramatists in Turkey, we received extensive training from foreign experts, especially those coming from Germany, paying nominal fees.

In 1992, our school in Bergama was named the ‘Dr. Abdülkadir Özbek Psychodrama Institute.’ Recently, with the merging of psychodrama associations in Istanbul, Izmir, Ankara, Denizli, and Adana, we became the ‘Dr. Abdülkadir Özbek Psychodrama Associations Federation.’ We are a member of FEPTO (The Federation of European Psychodrama Training Organisations).

Books and Translations:

Brautigam W. and Christian P. (1978) Psychosomatic Medicine. Translated by A. Özbek and C. Odağ.

Özbek A. (1971) Introduction to Social Psychiatry.

Özbek A. and Leutz G. (1987) Psychodrama.

Blatner A. (1993) Steps into Our Communication World with Psychodrama. Translated by A. Özbek.

Schützenberger A.A. (1995) A Brief Presentation of Psychodrama Methods. Translated by A. Özbek.”

LEYLA ZILELI (1925-2008)

Berna D. Uluğ, M. Kâzım Yazıcı

Professor Dr. Leyla Zileli worked with relentless professional passion and determination at Hacettepe University between 1964-1998 and at Başkent University between 1998-2008. She played a significant role not only in establishing these departments but also in nurturing generations of medical students and psychiatrists. She left a deep impact on her students, colleagues, and patients, being an exceptional figure and educator. Alongside Doğan Karan and Orhan Öztürk, she established the Department of Psychiatry at the Hacettepe University, laying the foundation for an educational program and clinical practices that remains influential for generations.

Leyla Zileli was the daughter of Tevfik Kâmil Koperler, who was the general secretary at the Lausanne Peace Conference and later served as Turkey’s ambassador to Sofia, Madrid, and Belgrade. Growing up abroad and being exposed to multiple languages at her home, she was proficient in French and English. She was surprised and delighted when she was chosen for the editorial board of L’Encéphale near her retirement. We presume that she was also familiar with Slavic languages. She once expressed her desire to learn Russian post-retirement to revisit Russian classics in their original language, though we don’t know whether she accomplished this goal.

After completing her psychiatry residency in Istanbul, she pursued psychoanalytic psychotherapy training in the United States. Throughout the years, she generously made use of her knowledge for her students and patients. In her later years, she rediscovered her old diplomas for psychoanalytic training, corresponded with international organizations, and had her training analysis approved. Despite her worsening illness, she never lost her eagerness to learn and her passion for teaching until her final days.

Leyla Zileli had a deep and sincere affection for her students and patients, never withheld her effort, time, or energy. She was one of the most talked-about and beloved figures among the faculty members. As her students, we realized the reason why as we delved into our residency. Her office door was always open while she was not examining a patient. She examined, treated or provided guidance to anyone seeking help; from faculty members to students, residents, or hospital staff; for themselves or their relatives. She advised to us, “Instead of spending ten minutes explaining why you can’t see these people, spend five minutes seeing them.” She was personally calling in her patients from the waiting room. If she couldn’t be heard over the noise, sometimes she would stand by her door, arms crossed, waiting for her patient, jokingly saying, “One of the world’s two oldest professions.”

We were eagerly awaiting for her patient evaluations in the department. We witnessed that she spent nearly an hour discussing sexual obsessions with a severely obsessive patient who couldn’t speak due to their obsessions or sat for minutes chatting with a patient with catalepsy at their bedside. She was an extremely diligent person. Apart from visits, supervisions, and meetings, she regularly held book clubs. Together we read a lot from Freud, Kernberg, Kohut, Klein, Fairbairn, and Winnicott. She shared book chapters with us and took on more responsibility than anyone else in discussions.

Hacettepe University Faculty of Medicine Department of Psychiatry. Leyla Zileli on the front, sitting. Orhan Öztürk standing, second from the right.

The “supervision sessions” starting at five in the evening never ended until the patient’s audio recording finished. These education-supervision sessions were accompanied by delicious cakes Prof. Zileli offered to us. These sessions which made the psychiatry training a great privilege at Hacettepe, later became gatherings that brought all psychiatry residents and psychiatrists together in Ankara, fostering the dissemination of dynamic psychiatric education.

Leyla Zileli was a very polite person, addressing everyone by name, never forgetting names and was respectfully formal even to the twenty-year olds. None of us ever heard her speak unkindly, yet she didn’t shy away from gently cautioning those who went overboard. If she was upset or disappointed, she would start her speech with “My child” which we all recognized as a sign of what’s going to come. One of the first lessons her residents learned from her was not to judge their colleagues’ behaviors or words. Leyla Zileli stated, “If what you say is wrong, it’s wrong, nothing to discuss; if what you’re saying is correct, you’ve said something perhaps the other person didn’t want to hear or didn’t ask for your opinion and it is not your right to say that” Sometimes, she would tell us that she wrote a very stern letter to someone in authority and reading that to us. The letter would contain serious criticism yet expressed in a very cordial manner.

She had a tendency for subtle humor and wit. She was surprising as much as she taught to us. Inside her bag, one could find paper scraps, compasses, colored pencils, scissors, ribbons, and many other things we didn’t know of. Sometimes in the middle of a meeting, she’d take scissors and a piece of paper, spending minutes cutting fine strips or making origami. Despite doing all these, she would never miss a single word in presentations or discussions.

Apart from the education we had from her, Leyla Zileli left us with warm, delightful, and unique memories. She was both a wise master to us and a friend who made you smile. She remains ingrained in our hearts and minds, embodying diligence, passion to work, compassion, intelligence, and a sense of humor.

ORHAN ÖZTÜRK (1925-2023)

Cengiz Kılıç

My first memory of Orhan Öztürk dates back to the early days of 1986 when I arrived at the psychiatric clinic for the residency entrance exam. I recall finding Leyla Zileli warm and affectionate during the oral exam, while Orhan Öztürk appeared serious and distant. He asked me, “What would you like to change about yourself?” When I responded, “I would like to be more assertive, sir (I used the word assertive as it is pronounced in French)” he asked, “What do you mean by assertive?” I replied, “To be more proactive’’, now with a proper Turkish equivalent. He seemed pleased with my answer. In fact, the questions he posed during our initial encounter summarized two fundamental aspects important to Orhan Bey. The first was his meticulousness regarding the use of language. Throughout the years I worked with him, Orhan Bey tirelessly warned us to be conscious about the way we use language, urging us to use words in their - if they existed – proper Turkish form. He tried to make us understand that using foreign words wouldn’t make our article better; it wouldn’t elevate its value. During his tenure as the editor of Turkish Journal of Psychiatry, he strived to change the careless, incomprehensible style of expression he labeled as “translated Turkish”. He resisted to those who claimed that Turkish couldn’t be a language of science and if the Turkish Psychiatry Journal was to gain international recognition, the publication language should be English. He argued that the most significant obstacle to Turkish becoming the language of science was this erroneous belief. The second aspect he valued was applying a scientific, rational approach to every matter individuals face and encouraging others to do the same. During supervision hours, he showed us that what the patient said and what we understood might not always align, demonstrating how to employ interviewing and questioning techniques to obtain reliable information.

During our residency we used to meet at Orhan Öztürk’s office or sometimes at his apartment for Journal or Book clubs. These were fun experiences as much as they are educational. We were meticulously reading the papers submitted to the Turkish Journal of Psychiatry, actually word by word, editing them and correcting each other’s mistakes. These sessions are so deeply embedded in our minds that it earned us an”editor’s eye.” Due to this success in education on publishing, I believe his most emphasized contribution revolves around the publication of this Journal. However, I think the truth is more than that: Orhan Öztürk was such a dedicated, enthusiastic and a persistent individual that in every task he undertook, he would achieve success; and he actually did. Being enthusiastic was not enough; it’s also essential to inspire others to feel enthusiastic about the task. He knew how to make us, a group of junior trainees, feel important and valuable through this education.

Among previous generations, some found Orhan Öztürk stern and authoritative. I’d prefer the term “disciplined”; I never felt that he disregarded us. He was respectful not just to us but to patients, students, nurses, psychologists, to everyone he interacted with. We witnessed how seriously he took resident training and how much he valued it during the joint supervision hours he conducted with Leyla Zileli. Often, both of them would be there at the “small visit room” in Ward 44 (Inpatient Psychiatry Unit) even before the residents arrive. It’s not easy for such attitudes to be adopted; being a role model is crucial; the more repeated the more they are solidified and internalized. Orhan Öztürk didn’t like being addressed as “Hocam”; he was ‘Orhan Bey’ and Leyla Zileli was ‘Leyla Hanım’ for us. This mode of address is so internalized that it even shows in a poem written by one of our patients:

‘…

Even if we don’t find health in life, Even if we don’t reach our destination, The world keeps turning, even if we’re not there, O Leyla Hanım, my Orhan Bey!

…’

For Orhan Öztürk, one of the most essential clinical skills was to build up a proper doctor-patient relationship. I enjoy discussing this the most when I lecture the interns and residents. From his teachings, we learned to encourage residents to involve in teaching activities, the importance of having nurses as an essential part of the treatment team, the necessity of psychologists and psychiatrists working together, and to instill courage in students to query. I know that I just repeat Orhan Bey’s words during case presentations when I say, “Let the med student who follows up the patient speak first.” I’m certain that many of his expressions and principles continue to live on this way, and will continue to do so.

His Books:

Psychoanalysis and Psychotherapy

Servant Self vs. Autonomous Self: The Psychological Origins of Allegiant Society

Mental Health and Disorders (co-authored with Aylin Uluşahin)

AYHAN SONGAR (1927-1997)

Şahap Erkoç, Tarık Tuna Gözütok

Ayhan Songar was born in 1927 in Gönen. After graduating from Istanbul Faculty of Medicine in 1950, he began his training in psychiatry and became a psychiatrist in 1953. He continued his academic career in Istanbul University, becoming an associate professor in 1956 and a full professor in 1962, contributing to the establishment of the Psychiatry Clinic at Cerrahpaşa. He conducted extensive research on the effect of music in the treatment of psychiatric disorders for many years with the late ethnomusicologist Rahmi Oruç Güvenç and established a music therapy unit in the clinic.

Interested in photography and technology, Songar taught not only psychiatry but also Cybernetics and Biophysics within the Faculty of Medicine. At the clinic where he worked, he repaired and even manufactured electronic devices. In the 1950s, he personally undertook the electronic hardware manufacturing and trade of ECT devices that newly trained psychiatrists would take with them to rural areas.

Besides his psychiatric practice, he was occasionally appointed to bureaucratic positions. He served as the head of the Observation Specialization Department at the Forensic Medicine Institute. Additionally, he held positions as a faculty member at the Dental School and the Turkish Music State Conservatory. Songar assumed various responsibilities such as being a board member and general secretary of the Istanbul Medical Chamber between 1956-1960, a member of the State Planning Organization’s Youth Affairs Commission, and a board member of the Turkish Radio Television Corporation. He also briefly served as the President of the Turkish Green Crescent Society.

Among his written works are the three-volume Physiology of the Nervous System (1960), Our Brain and Nerves (1979), Energy and Life (1979), Cybernetics (1979), Basic Psychiatry - Psychophysiological Basic Information (1981), as well as articles published in various journals. He founded the Symposium journal in 1962, which is still published under the name “Yeni Symposium,” and served as the publisher for many years.

Songar, who passed away in 1997, was a popular psychiatrist. He was a recognized social figure, especially admired by conservative circles. He used to see patients from all over Turkey in his clinic until the early hours of the morning. His interviews and articles were frequently published in conservative media. His controversial views on political activists and his beliefs that these individuals need psychiatric rehabilitation has sparked considerable debate (Akyol 1998).

ÖZCAN KÖKNEL (1928-2022)

Raşit Tükel, Başak Yücel

Prof. Dr. Özcan Köknel was a scientist who played a significant role in the contemporary practice of psychiatry in Turkey, particularly in the fields of psychopharmacology, youth mental health, and alcohol-substance addiction. His work in these areas earned him international recognition as he actively served in various international organizations. Özcan Köknel was honored as a Royal Honorary Member by Belgium for his research and contributions to the field of psychiatry.

In 1954, Özcan Köknel started his honorary residency (without pay) at Istanbul Faculty of Medicine (IFM) under İhsan Şükrü Aksel. The Psychiatry Department’s clinical building was inaugurated in 1955, soon after his arrival. The meetings with residents initiated by Köknel in that building continue unchanged to this day. His contributions remain integral to IFM Psychiatry’s history.

He specialized with his thesis titled “Electrostimulation of the Olfactory Nerve in Psychosis and Psychoneurosis Cases” in 1958. Between ‘59-’60, he studied Electroencephalography in Zurich, and ‘62-’63, he conducted research in psychopharmacology at the University of Milan. In 1973, during his studies in London, he explored treatment options for alcohol and substance abuse on personal and societal dimensions. His work focused on alcohol and substance abuse after this period. He served on CENTO’s “Drug Sub-Commission” and was the WHO “Turkey Collaboration Representative” from 1971 to the 1980s.

Özcan Köknel was a humane, gentle, and perpetually open-minded intellectual. He was a writer who made psychiatry understandable and endearing to every stratum of society, fighting against stigmatization as a psychiatrist. He authored numerous books on youth issues, mental health, and substance addiction. His book “Today’s Youth in Turkish Society” won the Turkish Radio Television award in 1970 and “the Youth of the Republic and Its Problems” the Yunus Nadi award in 1979. He received the 1983 Sedat Simavi award for his research on “Cannabis Addiction.”

He was diligent and well-disciplined; he would wake-up very early every morning and start working, always arriving early at the clinic. He was always well-dressed, wearing a tie, with all buttons of his coat done up. He was always approachable and respectful; we often saw him welcoming us, including young residents, in a standing position.

He held the positions of Secretary-General and Board Chairman at the Turkish Neuropsychiatry Society. During the tenure of Professor Dr. İhsan Şükrü Aksel as President and himself as Secretary-General at the Turkish Neuropsychiatry Society, the foundations of Neuropsychiatry Archive, one of the leading journals in neurology and psychiatry in Turkey, were laid. Similarly, the groundwork for the National Psychiatry Congresses now organized by the Psychiatric Association of Turkey (PAT) was laid during that period. Actually, the first issue of the Neuropsychiatry Archive was published in 1964 as the proceedings of the first National Neuropsychiatry Congress.

He was one of the founding members of the Psychiatric Association of Turkey (PAT) which aimed to bring together all psychiatrists in Turkey under a common umbrella and was the first elected chairman of the PAT board.

As evident in his professional interests, Özcan Köknel was a person sensitive to societal issues. In 1989, he was among the founders of the Association for Supporting Contemporary Life (Çağdaş Yaşam Derneği), contributing to the establishment and formation of the association’s bylaws and regulations. He was also among the founders of the Turkish Spastic Children’s Foundation.

He was always there for the residents and young psychiatrists at Istanbul Faculty of Medicine’s Psychiatry Department; he was always an excellent teacher and guide to us. His support and leadership for young residents and specialists during the establishment of the PAT also remain unforgettable.

Özcan Köknel will be remembered not only by the medical community but by the entire society for his personality, contributions to the field of psychiatry, his teachings, and his writings.

OĞUZ ARKONAÇ (1932-2001)

Şahap Erkoç

Oğuz Arkonaç was born in 1932 in Istanbul. He commenced his academic career at Istanbul University Faculty of Medicine and completed his specialization in psychiatry between 1959 and 1962 at Renard Hospital affiliated with the Washington University’s School of Medicine. Among his colleagues at this hospital were Winokur and Guze. This training significantly shaped Arkonaç’s understanding of psychiatry and his practice. Upon returning to Turkey, he played a role in establishing the Cerrahpaşa Psychiatry Clinic alongside Ayhan Songar. Between 1965 and 1997, while working in Bakırköy, he held the titles of associate professor and the clinical chief.

In the early years at Bakırköy, he contributed to the publication of Bakırköy Mental and Nervous Diseases Hospital Medical Journal and Bakırköy Mental and Nervous Diseases Hospital Medical Bulletin. He was actively conducting clinical drug research at the time.

He undertook a scientific leadership role during Yıldırım Aktuna’s hospital reforms. He closely followed the psychiatric literature and pioneered the recognition and use of a significant mile stone in the DSM system, DSM-III in Turkey.

He played a prominent role in encouraging and supporting the physicians in Bakırköy to conduct research. In a time when reaching out to the scientific journals was not that easy, he generously shared his own copies of the international psychiatric journals such as The American Journal of Psychiatry, The British Journal of Psychiatry, Acta Psychiatrica Scandinavica, Schizophrenia Bulletin. Additionally, he developed a standardized method of forensic psychiatric reports, and promoted its widespread use.

Oğuz Arkonaç’s academic legacy was shaped by the works he contributed to psychiatry literature, including Depressive Diseases (1970), Schizophrenia (1976), Psychopharmacotherapy (1978), Psychiatric Symptoms and Syndromes (1983), Psychiatric Disorders and Treatments (1986), Emergency Psychiatry (1989), Psychotic Disorders and Treatments (1996), Annotated Psychiatry Dictionary (1999). Notably, the book Psychiatric Symptoms and Syndromes, published by the Bakırköy Mental Hospital Foundation, contributed to a new understanding of psychiatric disorders.

His contributions to the widespread use of psychiatric scales and interview schedules, leading the translation and adaptation of graded scales into Turkish had significant effects for the development of psychiatric practice in Turkey. He encouraged physicians around him to be academically productive, promoting publishing in scientific journals and presenting in conferences.

A staunch advocate of the descriptive organic psychiatry, Oğuz Arkonaç urged his colleagues to embrace this stance, with frequent emphasis on the organic basis of disorders. Reflecting this psychiatric approach, it is said that in a conference, whenever he has the microphone, he was repeatedly mentioning the Schizophrenia as a brain disease which generated a response from Ayhan Songar “Come on, Oğuz, we don’t say schizophrenia is a kidney disease, we also accept it as a brain disease!”

GÜNSEL KOPTAGEL-İLAL (1933-2023)

Şahap Erkoç, Kazım Cihan Can

Günsel Koptagel-İlal was born in Istanbul in 1933. She learned to speak French with French governesses in her pre-school years. She completed her middle school education at the English High School for Girls on Istiklal Avenue and finished high school at Robert College. After entering Istanbul Faculty of Medicine, she also learned to speak German through private lessons. Due to psychiatric issues within her family, she decided to become a psychiatrist at a younger age while still a medical student. She shared her desire to become a psychiatrist with her mentor, İhsan Şükrü, during her internship. Learning that the last year student Koptagel spoke three languages, İhsan Şükrü became excited and expressed his desire to immediately include her in the residency application process they were about to open. Koptagel mentioned she couldn’t apply for that since she hadn’t finished her obstetrics and gynecology internship yet. İhsan Şükrü then contacted the Obstetrics and Gynecology chair, Tevfik Kazancıgil, and she was allowed to take the exam before the completion of her clerkship and began her psychiatry residency.

After the first year of her residency, she went to Germany and completed her psychiatry education there. Throughout her education and subsequent career, she focused on psychoanalysis, psychoneurosis, and psychosomatic diseases. After obtaining her specialization, she participated in therapy-oriented work at Çapa (Istanbul Faculty of Medicine). During this period, she had a brief marriage with Rıfat Ilgaz, a prominent Turkish author. In 1968, she became an associate professor, one of Turkey’s first female psychiatrists. She conducted studies and published works on ‘psychopathological art’. She presented papers in conferences she organized or attended in this field. As Ayhan Songar insisted on to include her as a faculty member at Cerrahpaşa, she moved to Cerrahpaşa Faculty of Medicine at 1972. Even though she was not politically active before the 1980 coup, in 1982 under military command when she was the head of the psychiatry department, she was dismissed under martial law1402 like many other faculty members at the time. Some say this decision was influenced by internal conflicts within the faculty. Koptagel eventually returned to her position in 1992.

After retiring in 2000, Koptagel, an intellectual and versatile woman of the Turkish Republic, continued her scientific and cultural activities. She authored numerous books, articles, delivered lectures, and translated works. Some of her original works include “Medical Psychology,” “Sense of Incompleteness in Women,” “German-Turkish Psychiatry Dictionary.” Additionally, she translated the books “Psychiatry Psychosomatic-Psychotherapy,” “The Patient Family,” “Introduction to Psychoanalysis” into Turkish.

Once, she says, when she visited Anna Freud in England, Koptagel presented Anna Freud the translation of Sigmund Freud’s work. Anna Freud’s first reaction upon taking the book was to inquire whether the book’s copyright had been deposited with the Freud Foundation. Koptagel says she couldn’t hide her surprise at this question (Erkoc 2002).

Throughout her transition from being a student to a faculty member, Günsel Koptagel-İlal worked with many people from different backgrounds and worldviews. She was very careful about her autonomy yet she maintained a respectful attitude towards others’ lifestyles. In her own words, ‘what others believed in didn’t concern’ her.