“And that is what greatness is...”*
(An abridged version of the speech given by Prof. Dr. Nilgün Taşkıntuna during the “Leyla Zileli Commemoration Meeting” at the 44th National Psychiatry Congress)
In 1925, a young girl was born to Tevfik Kâmil Bey and Hayriye Hanım, and they called her Leyla. Her father was one of the architects of the Treaty of Lausanne and one of Atatürk’s most trusted foreign service officers. Due to his father’s assignments, she spent a considerable part of her childhood in different countries. She grew up with strict French governesses whom she did not quite understand, but this resulted in French becoming her second native language after Turkish. For primary and secondary education, she attended the Notre Dame de Sion French boarding school with her sister.
Leyla Zileli would always tell us how the education she received from the priestesses at Dame de Sion was challenging, and sometimes even cruel, yet how it also had a major role in the process of her own humanization. She would depict, with excitement, the mischief she and her friends engaged in, which was followed by punishment, and especially the time in high school when they climbed over the school wall to go to the cinema.
It was her own decision to study medicine, and she graduated from the Faculty of Medicine of Istanbul University in 1950 and received a specialized degree in psychiatry from the same faculty in 1955. Although she was one of the trusted residents of İhsan Şükrü Aksel, she was told that it was not possible for her to continue to work in the institution after her graduation and was offered the management of the psychiatric department at French La Paix hospital. Leyla Zileli would often describe, to our residents, her great disappointment at not being able to work in the institution in which she was once a resident, but believing that when one door closes, another one opens, she used this as an opportunity to make her own way. She also explained how the anger she once felt for Aksel developed, over time, into a feeling of appreciation. For Leyla Zileli, a door had indeed closed but another one opened when she decided to go to the United States of America to study psychoanalysis.
In 1957, she started to work in the Psychiatric Receiving Center in Kansas City as a resident, and in 1959, she began her formal psychoanalytic training program at the New York Postgraduate Center, receiving her psychoanalyst diploma in 1962. After the wonderful years studying under Wolberg, she was offered a position as an instructor in the institution, but she opted to return to Turkey. She would often relate, with a smile, what Wolberg said to her when she told him she was leaving: “I see, you are going to be a big fish in a small pond.” Those who know her, however, would also know that this statement in no way referred to her humble nature, since the underlying reason for her decision to return home was to follow the family tradition.
Leyla Zileli reminisced about her years in America with both pleasure and sadness. She often spoke of the poverty she and her husband Turgut Zileli, a neurology fellow at Cornell University, underwent, how she worked in three hospitals at the same time to make ends meet, and how she read Fenichel, who she found very boring but continued to read while waiting for the washing to finish in the laundry room. Remembering the difficulties in those years when it was legally prohibited to carry money abroad, she said, “You forget the misery you have gone through; what remains is the nice memories”.
Immediately after returning to Turkey, Leyla Zileli opened a clinic in İstanbul-Şişli. At around the same time, Prof. Dr. İhsan Doğramacı was working on the establishment of the Faculty of Medicine at Hacettepe University and trying to gather qualified scientists with overseas experience; so, he contacted her and invited her to join the faculty. Stating that she could not leave her patients suddenly, for two years Leyla Zileli spent half of her time in İstanbul and half in Ankara before finally settling in the latter. She would tell us how, during her frequent train trips between İstanbul and Ankara, she had plenty of opportunities to read books and get to know people from Anatolia. At Hacettepe, she became an associate professor of psychiatry in 1965 and received her professorship in 1970.
Leyla Zileli also served as the head of the psychiatry department at Hacettepe, but for her, titles were never important. Being residents at that time, we personally witnessed that she once went into Orhan Öztürk’s room and said, “Orhan, are you the head of department, or is it me?”. During her administration, sometimes chaotic situations inevitably arose because she acknowledged that everybody was right in their own way, and in such cases, she would, half-joking and self-mockingly, say that being the head of a department meant reaching a “level of incompetence”.
I would now like to say something about some of the letters of condolences after Leyla Zileli’s death commenting that she was not that productive; she did not write much. Orhan Öztürk already addressed this issue in the preface he wrote for the Turkish Journal of Psychiatry and explained that Leyla Zileli did not write a lot perhaps due to working hard, but in fact, she did not like writing and she spoke openly about it: “If the current rules had been valid in my time, I would have never become an academician”, she said. She did not boast about this side of her, and she would always encourage her young colleagues to write and give them ideas, and during their supervision sessions, she said to them, "Maybe you will write these after me”. Leyla Zileli was one of the faculty members that "most deserved to be an academician”.
She liked working at the inpatient service, with the newly recruited residents, and she also considered this an opportunity to test whether they were fit for the job. She ensured that we learned the most basic principles of interviewing patients directly from her. She would arrive at the clinic early in the morning, join us in our interviews with every patient we had difficulty with, and guide us.
As also mentioned in her interview with one of her distinguished students, Dr. Nevzat Yüksel, for the Journal of Clinical Psychiatry in 2001, for her residents Leyla Zileli stood where the theory and practice merged. In a very good master-apprentice relationship, almost through passive diffusion, she passed her occupational skills on to us.
At this point, I would like to share with you a memory from the years of my inpatient service rotation I can never forget: As the inpatient service team, we were about to see a 50-year-old female patient with severe major depression, who had made two serious suicide attempts. Before letting the patient into the room, Leyla Zileli slightly moved to the edge of her seat, and as was customary, clasped her arms around her chest and said, “My dear colleagues, no matter how much experience I have gained in this occupation, I still get anxious before I meet a new patient, and this is how I feel now”, and then she spent almost two hours with the patient. That was the point I believed in psychoanalysis for the first time. The entire service team, including the patient, saw the patient’s rage toward her mother being introjected and her suicide attempts as a way of destroying this rage, all as vividly as if it was happening in the room. After not having eaten, drunk or slept for days, the patient was almost touched by a magic wand by the time the interview was over; she went straight to queue in the food line, ate something and chatted with people, and then went back to bed to sleep.
During our resident training hours and supervision sessions, from her bag that reminded me of Mary Poppins, she would take out scissors, pencils, paper, pocket knife, colorful ribbons, and sparkling cellophane to make paper rabbits and geometric drawings. Hours of this effort sometimes made us feel like she was not paying attention to us, but every time, to our admiration, we would realize that within her own world, she listened to the case to its finest detail and addressed it with great talent. She was extremely meticulous in her professional interpretations that offered insights to residents, and she was very careful not to hurt anyone’s feelings. To us, the residents, she would say, “You are all at the beginning of the road; you will be honed.” We would look at each other in an attempt to understand what she meant, thinking that if we hadn’t matured enough, we would naturally not have been there, thus secretly feeling slightly angry with her comment. We would soon realize that our reaction to phrase ‘being honed’ was similar to what we first felt when our parents told us that we would change and develop but had not realized that at the time. Over time, we noticed the changes in us after the supervision sessions with Leyla Zileli. Her statements and comment that poured out of her rich inner world helped us understand the patient, ourselves, and the world from a different perspective. This is exactly what being honed meant. Despite all her authority, her necklace with giant stones would dazzle us and her pure joy and sincere laughter warmed the cockles of our heart.
She knew a lot, but she was also aware of what she did not know. She acknowledged that she did not offer structured training and said, “Fortunately, we have Orhan Öztürk. We complement each other”. During our residency, we were lucky to have experienced the coexistence of Leyla Zileli and Orhan Öztürk, who were two senior faculty members competent in different aspects of their profession, as well as their mutual interaction enriching and sustaining each other.
Leyla Zileli was an incredible clinician and humanist. She did not have stereotypes, she was not afraid to stretch her ideas, she never gave credit to dogmatism, she was self-confident, and as a therapist, she was sublime in terms of her approach to the patients. Her intuition was incredibly strong. The comments she directed at the unconscious mind through her extraordinary understanding-comprehension ability would, to everyone’s amazement, always hit the target, but she never used this ability outside teaching and patient sessions in daily life. “What we do here stays within these four walls; taking it beyond would be invasion”, she believed. In her private life, with her very modest stance and clothing style, she did not attract much attention but once she opened her mouth, she had a tremendous effect on people with her astounding charisma.
Leyla Zileli retired from Hacettepe in 1992, but continued to give dynamic psychotherapy training and supervision for a few more years. When she was about to retire, she slowly removed herself, and perhaps on the days she had most difficulty coming to terms with it, she would say, “one should know when to leave”. From 1992 to 1997, she gave post-graduate education-psychoanalytic psychotherapy training to residents in various institutions in Ankara, in addition to Hacettepe University. In 1997, upon the request of the Rector of Başkent University, Prof. Dr. Mehmet Haberal, she accepted to be one of the founders of the psychiatry department of the university. She only worked half-time as an instructor at Başkent, but until her last days, upon the insistence of Prof. Dr. Haberal, she was the head of the psychiatry department. At Başkent, her goal was to train residents equipped with dynamic psychotherapy knowledge and skills as she had previously done at Hacettepe, and she achieved this goal. She often emphasized the importance of respect for the institution she was working with, stating that it was parallel to self-respect, thus made a person more productive.
As someone who followed her in both institutions, I must say that despite her similar way of working, her behavior toward the residents was different. She laughingly admitted the truth in our joke that Hacettepe was her child and Başkent was her grandchild. The Leyla Zileli at Başkent was much more gentle, tolerant, accepting and non-judgmental. The ‘honing’ was still there, but it was even softer. She encouraged residents and specialists to take advantage of training from any opportunity, saying “there is always something new to learn from everyone and everywhere. Don’t forget, pride is the malignant love of self”. As at Hacettepe, during her time at Başkent University, Leyla Zileli, with her charismatic personality, became the faculty member most admired by students, but she achieved this without even making any effort, and she was also the most applauded faculty member during diploma ceremonies. On one of my visits to the hospital, I was surprised to see that her students had filled the room with balloons floating above the hospital bed and stuffed toys on the chair.
Despite her advanced age, she followed the literature. She had a clear desire to acquire new knowledge from neuroscience to psychoanalysis. Leyla Zileli, who had originally studied classical psychoanalysis, later developed her knowledge about ego psychology, object relations, and self-psychology. She always emphasized that we should be flexible in using the theoretical knowledge which can be most useful to understand the patient, and to this end, she was guided by the theories of sometimes Freud, sometimes Klein, and other times Kohut.
While working at Başkent, Leyla Zileli was accepted as a member of the International Autonomous Psychoanalytic Psychotherapy Association, to which the New York Postgraduate Center where she received her formal training was affiliated, and she also became a trainer-supervisor analyst in the Institute for Relational Psychoanalysis in Italy. As a training analyst and supervisor, she greatly contributed to the training of three people; Dr. Füsun Çuhadaroğlu, Dr. Gamze Özçürümez and me. In addition to Başkent, she offered dynamic psychotherapy supervision for psychiatry residents at Hacettepe and Gazi Universities. She encouraged all of us to make our own way.
Just like her beloved sister Necla Koperler, Leyla Zileli had a very young soul. She liked going to new restaurants and tasting different food, and except during her severe illness, she would frequently meet with her friends. I fondly remember that once a friend referred to their group as “us old hags”, to which Leyla Zileli responded, “excuse me, speak for yourself, I am a lady”. On the other hand, when discussing severe personality disorders, which, she considered, had gradually increased especially in recent years, and the rapidly changing society and values, she would say, “I am glad I am mortal”. She often addressed death and separation themes in supervision, commenting, “you should be able to talk to your patients about these matters comfortably. If you are comfortable, they will talk to you comfortably”. She was always impressed by the work of Elizabeth Kübler-Ross with terminal patients and Leyla Zileli also worked with quite a few terminal patients.
Faced with her advanced age and the difficulties brought by her illness, Leyla Zileli gained even more wisdom and became someone that was more flexible, embraced life, and accepted life as it was, and I respected her stance toward death. She often stated in her last days that she was making an effort to continue living for her loved ones, but in fact she really wanted to die and she believed that those left behind should learn how to let go of those who wanted to leave, and get on with their own lives. Even in the process of dying, Leyla Zileli taught us how to accept the reality of death.
I owe a lot to Leyla Zileli. I know that I would not be who I am if it had not been for times, both good and bad, I spent with her. I loved her and I miss her. I feel her beside me whenever I need her presence, knowledge, and wisdom. I remember her with respect, with love, with gratitude. And I know that “separation is part of love” (Attila İlhan) ...
I would like to conclude my speech about Leyla Zileli, who engaged in her profession with the sensitivity of an artist and poet, with the following lines from Edip Cansever:
“...And that is what greatness is
If poetry runs through you like a fully-lived life
Then you would write poems even after you die
And surely people will read them even when you’re gone...”
*This speech was delivered at “Leyla Zileli Commemoration Meeting” held on October 18, 2008 within the scope of the 44th National Psychiatry Congress.