Paul Tournier and 'Médecine de la Personne'-The man and his vision.

Paul Tournier (1898–1986), physician and writer from Geneva, Switzerland, made an outstanding pioneering contribution to the understanding and practice of an integrative approach of medicine, psychology and pastoral counselling, which had an impact on many professionals and laymen alike in all continents. He was the founder of ‘Médecine de la Personne’ (‘Medicine of the Person’) [1]. His work and his message is best understood against the background of his biography. His attitude and challenge were derived from his own experiences and insights, yet even today seem equally valid for health care systems across the world that are striving to meet the wish of patients and service users for more person-centered and holistic health care.


Introduction
Paul Tournier (1898Tournier ( -1986)), physician and writer from Geneva, Switzerland, made an outstanding pioneering contribution to the understanding and practice of an integrative approach of medicine, psychology and pastoral counselling, which had an impact on many professionals and laymen alike in all continents.He was the founder of 'Médecine de la Personne' ('Medicine of the Person') [1].His work and his message is best understood against the background of his biography.His attitude and challenge were derived from his own experiences and insights, yet even today seem equally valid for health care systems across the world that are striving to meet the wish of patients and service users for more person-centered and holistic health care.

Early biography
Paul Tournier became an orphan after his father, pastor of the Geneva Cathedral, had died shortly after Paul's birth and his mother had died from breast cancer when Paul was only six years.He described the feeling of painful emptiness and vanishing into nothingness, afraid of being totally insignificant to anybody in the future.He grew up with his aunt and uncle, a businessman.Unable to accept affection, he withdrew into himself and had no friends.He felt he did not really exist ('Je n'existais pas') [2].
It was a key experience when at age 16 his greek teacher invited him home regularly.Like never before he felt someone took him seriously and respected his ideas.'He introduced me to dialogue and saved me from my loneliness.He gave me the feeling that I existed' ('Il m'a fait exister!') [2].
The transformation was evident.He gained self-confidence to move more into society.He started participating passionately in public discussions.From 1917 to 1923 he studied medicine at the University of Geneva.He became leader of a national student movement.He served with the Red Cross in Vienna, organized fund-raising for Russian children etc. However he stated: "I had found a relationship with society, but on an intellectual level …still hiding my inner loneliness.I could lead discussions in front of thousands of people, but I was unable to enter into a deeper personal relationship" [2].After completing his studies he was intern in Paris and Geneva.In 1925, he opened his private practice.
In 1924, he married Nelly Bouvier in Geneva.Two sons were born: Jean-Louis, 1925 and Gabriel, 1928.Nelly reflected on their early relationship: 'You are my teacher, my doctor, my psychologist, my pastor, but you are not my husband' [2].Paul commented: "… I was too intellectual … giving private lectures to her … but I could not develop true fellowship with her.My escape into intellectualism was my problem.I had found my way on an intellectual basis, but the personal, the affective emotional dimension was still hidden and closed to me".

Transforming emotional experience, learning from a patient
In 1932, Paul Tournier had a transforming encounter.A difficult patient had unexpectedly improved and seemed no longer selfcentered and aggressive.She told him she had participated in a seminar organized by a lay movement from Oxford.In personal reflection and in small groups they were trying to develop more openness, honesty and transparency.
Tournier was then introduced to four outstanding representatives of that movement [2].He had expected intellectual discussion on principles and results, instead these men were silent for some time, followed by very personal sharing of experiences and failures.Tournier was first disappointed, but also deeply touched.For the first time in his life he shared about his inner suffering as an orphan and cried over his mother and father.'It was the second level of becoming more of a person, not just the intellectual reflection of ideas, but rather the emotional encounter from person to person' [2].
Tournier discovered in the approach of the Oxford Group parallels to the psychotherapeutic process.'I opened up to friends about my life, my feelings, my fears, about my shames and my longings.Without being conscious of it, there was everything that constitutes psychotherapy: catharsis, emotional discharge, awareness and transference' [3].
From then on Paul Tournier spent one hour per day in silence.He would take notes if some impressions crossed his mind.To him it was the beginning of a lifelong journey of inner listening in an attitude of openness that would balance, focus and redirect his outward activities.

General practice and psychotherapy
This daily discipline transformed his marriage and family, his relationships to patients and others.Patients started opening up to him like never before.In 1937, he informed officially about his focus on psychosomatics trying to integrate medical and counselling aspects, scientific and faith aspects.In the psychological field he deepened his knowledge and experience in autodidactic ways.
Famous Freudian and Jungian Psychoanalysts adviced him to continue unbiased in his particular personal calling to pursue "a synthesis of psychology, classical medicine and even religious belief ". "So I did not become a psychoanalyst; I opted for the medicine of the whole person, the non-specialized attitude par excellence, which seeks to understand man as a whole" [3].

Tournier as author and conference host
In 1940, he published his first book under the programmatic French title 'Médecine de la Personne' [4], meaning 'Medicine of the Whole Person' or 'Person-centered Medicine'.Translations followed in German and English.He was surprised by the positive response.
In 1947, Tournier invited medical doctors for a retreat near Geneva as 'Group for the Research on Medicine of the Person'.Annual conferences have since then taken place in different European locations and in USA (see www.medicinedelapersonne.org).Besides lectures and intellectual discussions, Tournier wanted to give opportunities for personal encounters and sharing.
Paul Tournier published 20 books, translated into over 20 languages with millions of copies sold, inspiring professionals and laypeople alike.He also wrote articles and gave radio interviews.Tournier had an anecdotal, intimate and often personalized style of writing.All his books touched on existential themes, such as The Whole Person in a Broken World, The Strong and the Weak, A Doctor's Casebook in the Light of the Bible, The Meaning of Persons, To Resist or to Surrender, Guilt and Grace, etc. Towards his eighties he wrote books, such as Learning to Grow Old, The Gift of Feeling (La Mission de la Femme) and Creative Suffering.
He was invited for speaking tours throughout Europe, USA, South Africa, Japan and Iran.Always he stood for his Christian roots, but was very tolerant and open to dialogue with anyone: Atheists, Buddhists or Muslims alike.He was offered professorships but turned them down.In his view 'Médecine de la Personne' could not just be taught from the pulpit, but primarily had to be shared by personal example and experience.

Death of Nelly and Paul Tournier
The death of his wife in 1974 was a great loss to him.She had meant so much to him for developing as a person.He remained active and vital until old age.In 1984, he was remarried to Corinne, 50 years old pianist from Geneva.Paul Tournier died age 88 in his home near Geneva.
Many people, especially in the medical, psychotherapeutic and psychiatric field, have testified to the impact Paul Tournier had on them through his books, speeches, conferences and his vast correspondence.The basic attitudes and concepts of 'Médecine de la Personne' seem very relevant even for contemporary health care.

Medicine of the person
For Tournier and his colleagues 'Medicine of the Person' is an approach to medical care that emphasizes attention being given to the whole person-to the biological, psychological, social and spiritual aspects of health problems.It is about a basic attitude rather than a theoretical concept and a technique only.It refers to the uniqueness and dignity of man, also in his suffering, with his ressources and not just deficits, with all his desires to be accepted, experiencing sincere validation and finding purpose in life.It is based on dialogue and encourages listening to one another, to oneself and to the transcendent dimension.It involves the person of the professional helper being transparent and to disclose oneself to a certain degree.It is not only for psychiatrists and psychotherapists, but for all medical specialties [6].
The French expression of 'Medicine de la Personne' probabaly encompasses all aspects that were brought out so clearly by Juan Mezzich, President of the World Psychiatric Associaton (WPA) 2005-2008: a person-centered medicine should be a 'Medicine of the Person, for the Person, by the Person and with the Person' [7].
Paul Tournier had the vision of bringing that focus back to all of medicine.