Reflections on “Emil Kraepelin: Icon and Reality”

To the Editor: Engstrom and Kendler’s Review and Overview Article (1), published in the December 2015 issue of the Journal, argues persuasively that the historical or real Kraepelin is not the icon created by the neo-Kraepelinians. While it is important to know about Kraepelin’s work in experimental psychology, we question why there is no mention of Kraepelin’s work promoting eugenics, racism, and anti-Semitism. Kraepelin died in 1926, before the rise to power of the Third Reich, but he mentored three prominent Nazi psychiatrists: Robert Gaupp (1870–1953), Paul Nitsche (1876−1948), and Ernst Rüdin (1874–1952). Gaupp echoed the thoughts of Kraepelin when he wrote that he felt wrong caring for “his patients, when people of ‘full value’ were starving to death in the world outside” (2). Nitsche was the director of the Sonnenstein hospital where tens of thousands of mentally ill were killed under the guise of mercy killing (euthanasia), and he later headed the entire T4 euthanasia program. Rüdin, president of the Society of German Neurologists and Psychiatrists, was author of the 1933 “Law for the Prevention of Hereditarily Diseased Offspring” and was referred to as the “Reichsführer for Sterilization.” Rüdin, who acknowledged the “eminent” Kraepelin as his teacher and collaborator, wrote that “thanks to Hitler has our 30-year-long dream of translating racial hygiene into action finally become a reality” (3).

Kraepelin was an ardent proponent of eugenics and of “degeneration theory,” which propagated that the Aryan race was degenerating into higher rates of mental illness and other conditions due to various undesirables in its midst. In a 1919 paper titled “Psychiatric Observations on Contemporary Issues,” Kraepelin proclaimed that “dreamers, poets, swindlers and Jews” possess “distinctly hysterical traits” and fall outside the bounds of normality, adding that Jews exhibit “frequent psychopathic disposition.” These tendencies, he noted, are most importantly accompanied by “their harping criticism, their rhetorical and theatrical abilities, and their doggedness and determination” (4). Kraepelin also stated that “the preponderant influence of the Jewish spirit on German science, as is unfortunately wielded ever more intensely, appeared to me to be a serious danger” (5). Kraepelin was clearly guilty of profound boundary violations, allowing his clinical work and academic pursuits to be influenced by a right-wing socio-political agenda—an agenda that led psychiatrists, for the first time, to exterminate their patients during the Nazi era. This thinking began early on with his writings on “crime as a social disease”; with his attribution of criminal acts to “congenital inferior predisposition”; and with his membership in the nationalistic, extreme-right “Committee for the Rapid Subjugation of England” (4). His views later progressed to a multitude of statements regarding his dreams for a more authoritarian rule in his German fatherland, with Shepherd referring to his writings and lectures as displaying “disturbing overtones of proto-fascism” (4). Kraepelin was considered to be one of the foremost campaigners against homosexuality, stating that “homosexuality had to be fought prophylactically,” and he suggested the age of consent be raised to protect young people from homosexuals (6), viewing homosexuality as a disturbance based on degeneration (7). Hence, he openly promulgated views of another psychiatrist, Alfred Hoche, who coauthored The Permission to Destroy Life Unworthy of Life. Kraepelin believed that “reasonable policies of racial hygiene” (verstandige rassenhygiene) should serve as the solution to Germany’s problems of “degeneration” (8), suggesting that cultural influences add to the decline and weakening of the “race.”

Kraepelin contributed fundamentally to the ideological basis of racial hygiene in Germany. Gaupp proclaimed that Kraepelin’s work “comprised nothing less than the foundation of all Nazi racial hygiene laws” (9). Kraepelin is neither a generative forefather nor a great icon, as history looks at his views. Kraepelin may be the father of psychiatric eugenics; however, we dispute declaring him the forefather of a field dedicated to the ethical caring and management of long-suffering individuals striving to recover and reclaim meaningful roles and functions.