Obituary: Prof. Dr. med. Dr. phil. Horst Kächele, Ulm, a messenger of empirical research in psychoanalysis (born 18 February1944, died 28 June 2020)

A young man storms up the wide hotel stairs, almost running over his friend and his girlfriend – “Are you from Zurich? Are there analysts there who are willing to tape-record their psychoanalytic sessions?”; it gushes right out of him. “Why don't you ask Horst Kächele from Ulm, he has thousands of tapes … ,” I replied, just as spontaneously. “This Kächele is me myself … ,” Horst said laughing.

In this way began decades of friendship and of productive, for me always challenging, cooperations between Horst and myself (M.L.B.) at the Congress of the German Psychoanalytic Association (DPV) in Cologne in 1977. I have never forgotten the initial scene of our meeting, because – in retrospect – it immediately revealed so much of Horst's personality to me. Horst stormed through life, passionately, unconventionally and sometimes a bit overpoweringly. With an incredible energy, always full of fire and flame for psychoanalytic research, he overcame all the hurdles that stood in his way. Hurdles against tape-recordings of psychoanalytic sessions, which for him were part of a serious process and outcome research in psychoanalysis, are only a tiny example of this (Kächele et al. 1988). He had a great desire to move, to be in motion and to make psychoanalysis move. Therefore the death of this lively friend, researcher and psychoanalyst is particularly difficult to imagine, and particularly painful.

After a long and grave illness Prof. Dr. med. Dr. phil. Horst Kächele died on 28 June 2020 surrounded by his family. With his passing, international psychoanalysis loses a pioneer of research in psychoanalysis, a dedicated, pugnacious psychoanalyst and a warm-hearted personality.

After studying medicine in Marburg, Leeds and Munich (1963–1969), Horst Kächele accepted an invitation from Helmut Thomä to take up a scientific position in the Department of Psychotherapy at Ulm University, Germany. He combined his research activities with his psychoanalytic training at the Ulm Institute for Psychoanalysis (1970–1975).

In 1990, Horst Kächele succeeded Helmut Thomä as the Director of the Department of Psychotherapy of the Clinic of Psychiatry, Psychosomatic Medicine and Psychotherapy at Ulm University. In 1996, this structure was revised, and he became the Director of the University Clinic of Psychosomatic Medicine and Psychotherapy. On 1 October 2009, one day after his retirement as Professor Emeritus at Ulm University, he started his professorship at the International Psychoanalytic University (IPU), Berlin, continuing his enthusiastic engagement in research and teaching for the forthcoming decade. The IPU, as he put it, became a “new institutional home”. He was a passionate teacher and continued his research cooperations, for example with Anna Buchheim, Michael Buchholz and many others, until his final months of life.

At the same time, he still lived in Ulm and supported his successor at the University in fundraising and many other activities, for example offering Balint groups, supervision, etc.

Psychotherapy research

With great passion Horst Kächele championed a vision of open, self-critical and empirically based psychoanalysis, which, through careful, demanding research, opens doors to the academic world of universities, psychiatric clinics and evidence-based medicine, without neglecting art and literature. He was a marathon runner for empirical research in psychoanalysis in Germany and internationally.

To understand his career it is important to mention that Horst Kächele was born in the 1940s. He thus belonged to the so-called “war generation”, the ’68 generation, of psychoanalysts in Germany (see, for example, Bohleber 2019; Leuzinger-Bohleber and Plänkers 2019). He completed his psychoanalytic training in the 1970s, during the international heyday of psychoanalysis. Many young doctors and psychologists in Germany chose psychoanalysis at that time because it offered an instrument of insight to critically deal with the guilt of the fathers and their entanglements during the Nazi era, often combined with the unconscious hope to free themselves from their own transgenerative damage. Psychoanalytic personalities such as Alexander Mitscherlich, Horst-Eberhard Richter, Johannes Cremerius – or, in Zurich, Paul Parin, Fritz Morgenthaler and, in a different way, Ulrich Moser – exerted a great attraction over many of the students of that time precisely for these reasons.

Horst had undergone a successful therapeutic analysis during his medical studies, this probably being one of the reasons for his academic choice of psychoanalysis. For further professional development it was decisive that he completed his psychoanalytic training not in Frankfurt, Gießen, Freiburg, Berlin or Zurich, but as an assistant to Helmut Thomä at the Department of Psychotherapy in Ulm. Thomä and Kächele developed into an internationally unique duo in the clinical practice, training and research of psychoanalysis. They complemented each other in a unique, one could almost say ingenious, way.

Helmut Thomä (born 1921) belonged to the “sceptical generation” (Schelsky) of German psychoanalysts born in the 1920s. They had all taken part in World War II, as soldiers or in the medical service. Like Helmut Thomä, many had already completed their medical studies during or shortly after the war. With great dedication, but also a pragmatic basic attitude, they built up psychoanalysis in Germany, trained abroad with leading psychoanalysts and invited many of the emigrated psychoanalysts to Germany. Psychoanalysis conquered important positions at universities and in the German health system.

Various psychoanalytic centres with different profiles were established. Alexander Mitscherlich, for example, founded the Sigmund Freud Institute (SFI) in Frankfurt in 1960 with its close ties to the Institute for Social Research, and therefore a focus on psychoanalytic social psychology and critical theory (developed mainly by Adorno and Horkheimer) (Leuzinger-Bohleber and Plänkers 2019). Horst-Eberhard Richter built up a tripartite interdisciplinary centre in Giessen with a psychosomatic clinic and departments for medical psychology and medical sociology, involving many socially committed projects. Empirical research was conducted in all centres. However, in Ulm, empirical psychotherapy research became a figurehead precisely because Helmut Thomä, among other reasons because he was President of the DPV and an internationally renowned clinician and theorist of psychoanalysis, joined forces with Horst Kächele, an enthusiastic supporter of empirical research methods and innovative, technical possibilities, and with a great personal and professional talent for international networking.

As in Zurich, and in many other countries, questions of empirical research sparked off fierce controversies in philosophy of science. Together with Helmut Thomä, Horst Kächele in 1973 wrote two long papers for the journal Psyche discussing the state of psychoanalysis as a science, in preparation for their further empirical projects. Among other things they wrote:

According to the authors, a purely psychological foundation of psychoanalytic knowledge is a psychological utopia and extremely restricts the experiential scientific basis of psychoanalysis; objectifying procedures are an indispensable corrective. (Thomä and Kächele 1973, 205)

Their critical thoughts on Alfred Lorenzer, for example, who worked at the SFI at that time and whose hermeneutic research (Tiefenhermeneutik), as well as his well-known concept of the “scenic understanding”, continues to inspire many of the ’68 generation to this day, created many opponents for them. Although Thomä and Kächele outlined a differentiated research position of their own and distanced themselves from naive positivism, Ulm psychoanalysis increasingly gained a reputation of positivistic psychoanalysis and was fiercely opposed by many (Kächele and Mergenthaler 1984; Thomä and Kächele 1973). Horst often expressed how much he regretted the tendencies towards splittings within the psychoanalytic movement, the withdrawals into the ivory towers of psychoanalytic institutions and affinities to religious group processes, and how much it hurt him to be pushed into a corner by some psychoanalytic colleagues, being labelled an empiricist, a “positivistic researcher” who was “not a real psychoanalyst”, etc. A detailed history of psychoanalysis as a (traumatized) discipline (Bohleber 2019; Leuzinger-Bohleber and Plänkers 2019) and its influence on its attitude to empirical research has yet to be written. Horst would certainly have welcomed such a piece of necessary research.

Wolf Singer, the famous brain researcher from Frankfurt, who had studied medicine with Horst Kächele in Munich and who remained a close friend of Horst all his life, answered the question of why Horst developed into such a passionate advocate of empirical research in psychoanalysis: “Horst, as a physician, was convinced that mental disorders are based on processes that obey the laws of nature and thus follow rules that should be empirically ascertainable” (email, 6 July 2020).

Horst also was fascinated by new technical, “objectifying” possibilities of psychotherapy research. Together with Erhard Mergenthaler, he set up the Ulm Text Bank, which centrally stored tape-recordings of psychoanalyses in various languages and made them available to international research teams (Kächele and Mergenthaler 1984; Mergenthaler and Kächele 1991, 1994). This is an example of the open and generous spirit of the Ulm Workshop for Empirical Research that Horst, as a young professor, founded in 1978. This annual conference received great national and international acceptance and admiration among the international community of empirical psychotherapy researchers (Kächele 1988). Many of the leading psychoanalytic research groups from all over the world presented their projects in the innovative, creative and inspiring atmosphere of the famous building of the Ulm School of Design (Hochschule for Gestaltung), where Horst’s clinic was located and where they networked with each other.

A second milestone was the German Research Foundation’s Sonderforschungsbereich 129 Psychotherapeutic Processes (1980–1988), which brought psychoanalysis a great deal of recognition in the world of science and supported many young scientists, who were able to write their doctoral theses and habilitations within this framework (Kächele, Novak, and Traue 1989). Thus, many of them, including myself (M. L. B.), owe their academic careers to Horst Kächele. He also remained in active scientific exchange with many of his former doctoral and postdoctoral students and with researchers from all over the world.

A look at his approximately 900 publications shows how extensively Horst networked with around 400 co-authors. This reflects another of his personality traits: great curiosity about previously unfamiliar fields such as forensic psychotherapy (Pfäfflin and Kächele 1996; Kächele 1998) or cognitive science, or other research traditions such as the unwieldy psychoanalytic research tradition of Ulrich Moser at the Department of Clinical Psychology in Zurich (Kächele, Eberhardt, and Leuzinger-Bohleber 1999; Leuzinger-Bohleber and Plänkers 2019).

Only a few of Horst's other research activities can be singled out here. In the 1990s he had already gathered around him most of the psychotherapy researchers active at that time in the German-speaking countries. In order to explore the epistemologically and methodologically relevant question of what influence the choice of research methods has on the results achieved in studies, a wide variety of research methods (Structural Analysis of Social Behavior, Core Conflictual Relationship Theme, Grawe's schema analysis, computer-aided, theory-based content analysis, etc.) were applied to investigate tape-recorded sessions from two short therapies: a psychoanalytic focal therapy (therapist: Horst Kächele) and a schema therapy (therapist: scientific assistant of Klaus Grawe). This project showed Horst's attempt to contribute to a constructive dialogue between therapy schools. The attempt was abruptly called into question when it turned out that Klaus Grawe had, parallel to this research project, been working on his book Von der Konfession zur Profession (From Confession to Profession), a book that radically attacked psychoanalysis as a science and therapy (Kächele 1995). This led to great tensions and also massive anxieties in many psychoanalytic societies. The DPV's outcome study of psychoanalyses and psychoanalytic long-term therapies was an attempt to limit the destructive political consequences of this attack (Leuzinger-Bohleber et al. 2003).

In the following years, Horst, as one of the few psychoanalysts with a broad knowledge of empirical research, was intensively involved in the Scientific Advisory Board for Psychotherapy, a highly influential institution in Germany. He made a significant contribution to the fact that psychoanalysis – in addition to cognitive behavioural therapy (CBT) – continued to be recognized as an evidence-based treatment by the German health insurance companies in 2004, due to the many randomized studies on short therapy that were available at that time. This commitment was also a Herculean task: last year Horst told me (M. L. B) with resignation how disappointed he was that, on this Advisory Board, it turned out that the main role was played not by the scientific evidence for certain psychotherapeutic schools, but rather by the power struggles between the therapeutic schools. Since the 1980s, CBT had systematically conquered the decisive positions, for example in clinical psychology, in German universities in psychology and in medical faculties. Unfortunately, some psychoanalysts had long denied these developments, partly because they had fallen prey to self-idealization, seduced by their admired societal positions during the 1970s.

In contrast Horst always kept a critical eye on psychoanalytic institutions (Kächele 1990, 1994; Kächele et al. 1988; Kächele, Richter, et al. 1999; Thomä and Kächele 1999). Therefore he was a gifted bridge-builder to the non-psychoanalytic world of empirical research. As creator of the so-called Ulm School of Psychotherapy, as well as chief of the Center for Psychotherapy Research in Stuttgart (1988–2004), he built many bridges between psychoanalysis and the international community of psychotherapy researchers. In 1987 he organized the international Conference of the Society for Psychotherapy Research in Ulm and became president of this most important organization in psychotherapy research.

These activities led to many years of research cooperation and deep friendships, for example with Hans H. Strupp, David Orlinsky, Adolf Ernst Meyer, Lester Luborsky, Hartwig Dahl, Merton Gil, John Kafka, Joe Schachter and above all Juan Pablo Jiménez, to name but a few. The exchange was particularly close with Juan Pablo, who had spent an academic year in Ulm. A whole series of joint publications and research projects resulted from this. Horst became Professor visitande permanente of the Universidad de Chile. Over more than 30 years, during which Horst visited universities and psychoanalytic societies in Latin America, Horst has come to be recognized as a pioneer of research in psychoanalysis in that region. The Latin American chapter of the Society for Psychotherapy Research considers him as its “founding father”.

Thus Horst made a significant contribution to the fact that empirical psychoanalytic research, as Peter Fonagy once called it, in Germany took a leading place in the world of psychotherapy research. He initiated many discourses, for example on the combination of process and outcome research, of qualitative and quantitative research, of naturalistic and randomized studies.

Apart from research on psychotherapy and psychoanalytic effectiveness, there were many other fields that Horst initiated and/or supported in his clinic and in cooperation with other clinics in Ulm's medical faculty, as well as in cooperation with clinics in other cities and abroad. These fields included liaison medicine, attachment research, perinatal psychosomatic therapy, eating disorders (anorexia and bulimia), psycho-oncology, neurobiology of mental disorders, music and art therapy, ethics in medicine, clinical economy and forensic psychotherapy. Apart from the university context, he supported the Dokumentationszentrum Oberer Kuhberg, Ulm, founded in 1977, an archive and concentration camp memorial of one of the first concentration camps in Germany, located right in the vicinity of his clinic, and later he was one of the co-founders of Ulm Remembrance Foundation, for Democracy, Tolerance and Human Rights.

The Ulm textbook of psychoanalysis

Helmut Thomä and Horst Kächele became one of the most fruitful of psychoanalytic research teams. Together they wrote a three-volume textbook on psychoanalytic therapy. When Horst took over the chair of the Psychotherapy Department in 1990 from Helmut Thomä, the first two volumes (Volume 1, Principles; Volume 2, Clinical Studies) had been published in German by Springer-Verlag, and the first volume was also available in English and Hungarian. The third volume (Research) was published in 2006. This textbook, considered a classic, is now available in 23 languages, and some further translations are under way. We know of no other psychoanalytic textbook that has been distributed so widely during the lifetime of its author(s). In March 2020, the thoroughly revised and updated English version of the first volume was published by Psychosozial Verlag, Gießen, and the manuscript of the thoroughly revised and updated English version of the second volume had been finished except for the indexes at the end of the book. As long as Horst was still able to use his laptop, he was busy completing this work. In 2002, the two authors received the Sigmund Freud Price of the City of Vienna, and in 2004 the Mary Sigourney Award, for this achievement.

Commitment to psychoanalytic institutions in Germany and worldwide

For many years, Horst was also the president of the Psychoanalytische Arbeitsgemeinschaft Ulm (PAU), his local psychoanalytic institute. As a result of his many journeys to other countries, he repeatedly brought psychologists and medical doctors to Ulm who stayed there for training. Some of them later returned to their home countries, others settled in Germany. In 1975, three years before the above-mentioned annual Ulm Workshop for Empirical Research had been established, Helmut Thomä and Horst created an annual conference in cooperation with the Clinic and the PAU, which took place in Hintertux, an Austrian ski resort; the mornings and early afternoons were spent skiing, and the late afternoons and evenings on psychoanalytic lectures, scientific exchange and case discussions. Participants came from many psychoanalytic institutes from all over Germany and from abroad.

Horst was also passionately committed to the dissemination of psychoanalysis, especially in Eastern Europe, where he is revered with great gratitude as a teacher (Kächele 1996). In 1996 he became Honorary Professor of the Faculty of Psychoanalytic Medicine, University of St Petersburg. Russia. As a staff member of the Research Training Program (RTP) of the International Psychoanalytical Association, he made a significant contribution to the international promotion of young researchers in psychoanalysis. Especially among his colleagues in South America he is revered as a messenger of psychoanalytic research. He remained in intensive exchange with many of them via the mailing list of the RTP Fellows, the Open Door Review and joint research projects.

The picture is of Horst as a most productive researcher and a great master of intergenerational networking. In a generous manner, with a unique dedication and passion, he carried his psychoanalytic and scientific knowledge all over the world, always ready to engage in fierce controversy and debate and to set out for new shores of knowledge. He leaves behind a large gap as a psychoanalyst, researcher and dear friend.

Horst always seemed to us like a candle burning at both ends. At the age of 76 the candle was too soon burnt out. We share our grief with his wife Beate, his three daughters, the grandchildren and his brothers, friends and colleagues. We will miss him.