Farewell interview Marrie Bekker

Farewell interview Marrie Bekker; pioneer in autonomy-focused approach to mental disorders

Published: 01st June 2022 Last updated: 03rd June 2022

For decades, Professor of Clinical Psychology Marrie Bekker was a pioneer in the field of psychological disorders, autonomy and gender sensitivity in psychological research. In June, she retires from Tilburg University. "It may seem inconceivable now, but even in psychological research there was sometimes a one-sided male perspective. In my work I have strived to find explanations for the remarkable gender differences in psychopathology."

At an early age, Marrie Bekker worked as a summer helper in psychiatric institutions, after she had not been selected to study medicine and began studying psychology. "I found this work fascinating, and I was still hesitating between psychiatry and psychology. At one point I met a female psychologist who had an incredibly good conversation technique. I was deeply impressed. I wanted to learn that too."

Antipsychiatry

"It was also the time of anti-psychiatry," Marrie continues. "The idea emerged to talk with people about their problems, instead of over their heads and based on preconceived ideas about what was wrong with them. For me, that was a very attractive angle from which to approach psychological problems. In any case, clinical psychology, the part of psychology that deals with mental health and mental disorders, is an incredibly interesting field."

"The idea came up to talk to people about their problems, rather than over their heads, based on preconceived ideas about what would be wrong with them"

Marrie Bekker

Waves of Emancipation

Currently, emancipation and gender are in the spotlight, but for long times they were not. "I started in the third feminist wave. Psychological research at that time was mainly done by men. As a student at the University of Amsterdam I became involved in a large research project on phobias. It struck me that these anxiety disorders were especially prevalent in women. To my surprise, this fact was not part of the otherwise very extensive research agenda. That seemed so strange to me. Eventually I did manage to make this the subject of my graduation research. During that period I did a lot of preliminary work for later research."

"To my surprise, the fact that anxiety disorders occurred almost exclusively in women was not part of the research agenda"

Jack-of-all-trades

Several times in history, feminist counseling was under fire and women's studies were discontinued. In collaboration with organizations such as the Dutch Foundation (and European Association) of Women and Health Research, WOMENInc and the Alliance Gender and Health, Marrie Bekker put a lot of effort into getting gender on the research and mental health agenda, and did so successfully. In addition to these efforts, jack-of-all-trades Marrie Bekker was a full-time professor of clinical psychology, department chair of the Department of Clinical, Developmental and Cross-Cultural Psychology, and program director of the Master's in Psychology and Mental Health. She served on the Psychology Chamber and is a practicing mental health psychologist. She also did a lot of university managerial work in the field of emancipation. She obtained many grants and was a regular columnist for the Tilburg University newspaper Univers. In recent years, Marrie Bekker has campaigned on a national level for a better connection between master's programs and the mental health program.

Autonomy

Self-directedness in connectedness with others. That's autonomy-attachment. A term that plays a central role in Marrie Bekker's work. "There has been an awful lot of research into the complaint-oriented approach in the form of cognitive behavioral therapy. But this doesn't work for everyone. For example, many people do not want to be exposed to anxiety-provoking situations, an important part of this therapy. Moreover, a good proportion relapses after initial recovery, or develops another disorder. I had a lot of evidence for possible improvement if you do more justice to the person behind the complaints and their attachment history. Our studies confirmed the idea that a lack of autonomy - the ability to manage oneself in connection with others - is at the heart of psychopathology. Strengthening autonomy-attachment, as in our autonomy strengthening therapy (AET), could therefore lead to recovery. Therapists were enthusiastic about this, and effect studies - including one by the recently promoted Laura Kunst - showed that it works. The protocol is very practical. Recently we also developed a blended treatment module for both clients and care workers. The next step is to open it up in book form for the English-speaking area."

"A lot of improvement in symptoms is possible if treatment does justice to the person behind the symptoms and their attachment history"

Grateful

"I am very grateful that we have been able to add empirical evidence to the autonomy-focused approach, in addition to the practice-based evidence that was already there. Clients recognize themselves in the view, and the autonomy-focused approach has a lot of resonance in practice such as in the treatment of anxiety disorders. In the near future, we will also apply the autonomy-enhancing therapy to, and investigate, eating disorders and conversion disorders, or psychosomatic problems, such as unexplained paralysis symptoms."

"Nice to see that the autonomy-focused approach resonates in practice"

Farewell to Tilburg University does not mean farewell to science for Marrie Bekker. "I will remain affiliated with the VU and RINO Amsterdam as a researcher and responsible for the post-master training as a health care psychologist. Together with WOMENInc and the IAWMH we will organize an international conference on gender and mental health in Maastricht in November, for scientists and practitioners. It's nice to be able to contribute in this way to the improvement of clients who have sometimes struggled for years, and to offer them an alternative in the form of a more sustainable recovery.”