Early Life and Education

Born in Vierlingsbeek, the Netherlands, Terruwe was raised in a devout Catholic family. Her mother, a midwife, influenced her exposure to medical practice early on, while her father’s steadfast faith shaped her spiritual outlook. These dual influences of medicine and religion would define her career path. She pursued medicine at Utrecht University, an unusual choice for women then, and specialized in psychiatry. Her academic journey was marked by dedication and a clear sense of mission—to integrate her Catholic faith with her medical practice.

Professional Career

In 1945, Terruwe opened her private psychiatric practice in Nijmegen. Her innovative approach combined the valid Freudian observations on repression —but not Freud’s explanations— with the rational psychology of St. Thomas Aquinas. Thanks to this approach, Terruwe is recognized mainly for two contributions. First, she identified the mechanisms by which one emotion is capable to repress another, contributing to the understanding of many psychopathologies listed in diagnostic manuals. Second, she argued that the lack of affirmation —the unconditional recognition and acceptance of a person’s intrinsic worth— also hampers emotional development, hence the name she addopted for this kind of disorder: Deprivation Neuroses, and the fact that Terruwe proposed affirmation as a powerful therapeutic tool. Her emphasis on affirmation was revolutionary, challenging the erroneous views that often associated psychological struggles with moral failings.

Terruwe’s patients included clergy, seminarians, and laypeople. Her therapeutic methods sparked controversy within the Church. Despite resistance, her work gained support from prominent Catholic thinkers, such as Willem Duynstee, a theologian who became her mentor.

The “Terruwe Affair"

The so-called “Terruwe Affair" epitomized the tension between her approach and some priests who disagreed with her synthesis of Thomas Aquinas’ teachings and, therefore, Terruwe's clinical practice. From 1949 to 1965, Terruwe faced intense scrutiny from ecclesiastical authorities. Critics accused her of undermining Catholic moral teachings by promoting psychological theories that prioritized individual well-being over adherence to Church doctrines. The conflict highlighted broader debates about the roles of psychiatry and religion in addressing human suffering.

In 1965, the Church concluded its investigation, exonerating Terruwe and allowing her to continue her work. This resolution marked a turning point, solidifying her reputation as a trailblazer in integrating faith and science.

The Theory of Affirmation

Following the resolution of the “Terruwe Affair" she focused on refining and disseminating her theory of affirmation. This concept was rooted in the belief that psychological well-being depends on the experience of being unconditionally accepted by others. Terruwe argued that affirmation was not merely a therapeutic technique but a principle applicable to all human relationships, from family dynamics to societal interactions.

Her books, such as De liefde bouwt een woning (Love Builds a Home, 1967) and Geloven zonder angst en vrees (Believing Without Anxiety and Fear, 1969), popularized her ideas. Her engaging lectures drew large audiences, and her practice attracted patients seeking guidance for various psychological issues. By emphasizing affirmation as a universal need, she extended her influence beyond the realm of psychiatry into broader cultural and spiritual discussions.

Philosophical and Religious Orientation

Terruwe’s philosophical framework was deeply influenced by Thomism, the theological and philosophical system developed by St. Thomas Aquinas. She applied Aquinas’s ideas on the nature of the human soul to explain psychological disorders. In her view, deprivation neuroses were not merely medical conditions but disruptions of a person’s ability to experience their intrinsic dignity as beings created in the image of God, which is caused by a lack of affirmation from significant figures during the early stages of development, and not by the repression of emotions.

The latter, explained Terruwe in the light of Thomas Aquinas philosophy, does not arise because the “superego” oppresses unacceptable emotions, generating neurosis when these impulses struggle to reach consciousness. Rather, the phenomena observed by Freud would respond to the conflict between two emotions in relation to the same object (or one that bears similarity to the original object), where one is capable of repressing the other. Thus, for example, a girl's obsessive-compulsive disorder, in which she constantly and against her will imagines hurting her parents —cutting her mother's new dress or spilling coffee on her father's computer— can be explained by the anger she feels toward her biological parents who abandoned her, which is repressed by fear of losing the love of those who adopted her.

This integration of Thomistic thought and Freudian observations was groundbreaking. Terruwe bridged the gap between two seemingly opposing paradigms, presenting a model of care that emphasized both spiritual and psychological dimensions. Her approach was inherently optimistic, focusing on human potential and the transformative power of love and understanding.

Challenges and Legacy

Terruwe’s career was not without its challenges. As a woman in a male-dominated field, she faced skepticism and discrimination. Her outspoken views made her a polarizing figure. Despite this, she remained committed to her mission, often describing her work as a divine calling.

Her collaboration with Conrad Baars, a Dutch psychiatrist who emigrated to America after the second World War, further extended her influence. Together, they brought the affirmation theory to an international audience, particularly within Catholic circles in the United States. Their work inspired a new generation of Catholic mental health professionals and enriched discussions about the intersection of faith and science.

Final Years and Enduring Influence

In her later years, Terruwe continued to write, lecture, and treat patients. She remained deeply committed to her faith, viewing her work as a form of ministry. Her death in 2004 marked the end of a remarkable life devoted to healing and understanding.

Terruwe’s legacy endures through her contributions to psychiatry, integration of faith and science, and emphasis on the transformative power of affirmation. Her work continues to inspire professionals in mental health and pastoral care, offering a model for compassionate and holistic healing.

In short, Anna Terruwe’s life and work exemplify the integration of intellectual rigor, spiritual depth, and humanitarian concern. Her affirmation theory remains a testament to her belief in the intrinsic worth of every individual. By bridging the worlds of modern psychology and Thomistic thought, she opened new pathways for understanding and addressing human suffering, leaving an indelible mark on both fields.