Adolf Meyer (psychiatrist)

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Adolf Meyer
Adolf meyer.jpg
Born September 13, 1866
Niederweningen near Zurich
Died March 17, 1950 (age 83)
Baltimore
Nationality Switzerland
Fields Psychiatry
Doctoral advisor August Forel
Influences August Forel, Constantin von Monakow, William James, Emil Kraepelin

Adolf Meyer (September 13, 1866 – March 17, 1950), was a psychiatrist who rose to prominence as the president of the American Psychiatric Association and was one of the most influential figures in psychiatry in the first half of the twentieth century. His focus on collecting detailed case histories on patients is the most prominent of his contributions; along with his insistence that patients could best be understood through consideration of their "psychobiological" life situations. He is most remembered for reframing mental disease as biopsychosocial "reaction types" rather than as biologically-specifiable natural disease entitites. In 1906 he reframed dementia praecox as a "reaction type," a discordant bundle of maladaptive habits that arose as a response to biopsychosocial stressors.[1]

Biography[edit]

Meyer received his M.D. from the University of Zürich after studying psychiatry with Auguste Forel and neuropathology with Constantin von Monakow, and subsequently began his professional career as a neuropathologist.

Unable to secure an appointment with the university, he emigrated to the United States in 1892, at first practicing neurology and teaching at the University of Chicago, where he was exposed to the ideas of the Chicago functionalists. From 1893 to 1895 he served as pathologist at the new mental hospital at Kankakee, Illinois, after which he worked at the state hospital at Worcester, Massachusetts, all the while publishing papers prolifically in neurology, neuropathology, and psychiatry. In 1902 he became director of the Pathological Institute of the New York State Hospital system (shortly afterwards given its present name, The Psychiatric Institute), where in the next few years he shaped much of American psychiatry by emphasizing the importance of keeping detailed patient records and by introducing both Emil Kraepelin's classificatory system and Sigmund Freud's ideas. While in the New York State Hospital system Meyer adopted Freud's ideas about the importance both of sexuality and of the formative influence of early rearing on the adult personality. Meyer was Professor of Psychiatry first at Cornell University from 1904 to 1909 and from 1910 to 1941 at Johns Hopkins University, where he was also Director of the Henry Phipps Psychiatric Clinic from its inception in 1913. Henry Phipps Psychiatric Service at Johns Hopkins Hospital, which in 1912 made possible the first inpatient facility in the United States for the mentally ill, was constructed as part of an acute care hospital. While he served as the director of the psychiatric department at Johns Hopkins, the first academical child psychiatry department in the world was founded by Leo Kanner in 1930 under Meyer's direction.

His principal contributions were through his ideas of psychobiology (or alternatively, ergasiology, a term he coined from the Greek words for working and doing), by which Meyer designated an approach to psychiatric patients that embraced researching and noting all biological, psychological, and social factors relevant to a case — thus his emphasis on collecting detailed case histories for patients, paying particular attention to the social and environmental background to a patient's upbringing. Meyer believed that mental illness results from personality dysfunction, rather than brain pathology. His later teachings resisted some of the ideas of Sigmund Freud, which Meyer thought placed too much emphasis on factors that were tangential to the functional needs of patients in their everyday lives. Though Meyer's own system of nomenclature never caught on, his ideas, especially those emphasizing the importance of social factors, and his insistence on understanding the life of the patient through careful interviewing, did exert some influence but perhaps remain largely unappreciated in the history of American psychiatry. Meyer is also considered a significant early supporter of occupational therapy. He believed that there was a critical link between an individual's activities and activity patterns and his or her physical and mental health. In his vision for the mental hygiene movement, he advocated for community-based services to help people develop skills to cope with the demands of everyday living.

It was Meyer who suggested the term mental hygiene to Clifford Beers, after which Beers founded, with the support of Meyer and William James, the Connecticut Society for Mental Hygiene (1908) and the National Committee for Mental Hygiene (1909).

Legacy[edit]

Meyer wrote no books; his pervasive influence on American psychiatry stemmed instead from his numerous published papers, his prestige, and his students, both at Manhattan State and, especially, at Johns Hopkins. Many of his students went on to make significant contributions to American psychiatry or psychoanalysis, though not necessarily as Meyerians. Always eclectic and willing to absorb ideas from whatever sources he found relevant, Meyer never formed his own discrete school of thought with disciples. Most of the founders of the New York Psychoanalytic Society had worked under Meyer at Manhattan State Hospital, including its chief architect Abraham Arden Brill, and Charles Macfie Campbell. Though Meyer found Freud's ideas interesting, he never practiced psychoanalysis and increasingly distanced himself from it as the years went on. As he wrote in his presidential address to the 84th Annual Meeting of the American Psychiatric Association: "Those who imagine that all psychiatry and psychopathology and therapy have to resolve themselves into a smattering of claims and hypotheses of psychoanalysis and that they stand or fall with one's feelings about psychoanalysis, are equally misguided" [page 18 in the Collected Papers, volume II, originally published in the American Journal of Psychiatry, LXXXV, 1928, 1–31]. This address, "Thirty-Five Years of Psychiatry in the United States and Our Present Outlook" gives Meyer's own account of American psychiatry during the time when he himself was important in helping to shape it.

Meyer was a strong believer in the importance of empiricism, and advocated repeatedly for a scientific approach to understanding mental illness. Meyer was skeptical of autointoxication and focal infection theories (then viewed as the cutting edge concept of scientific medicine) as biological causes of behavioral abnormalities. He was involved with the Eugenics Records Office, which he viewed as a natural extension of the mental hygiene movement which he helped to create. Meyer's work was greatly influenced by Charles Sanders Peirce, William James, and John Dewey.

Works[edit]

For Meyer's writings see The Collected Papers of Adolf Meyer, edited by Eunice E. Winters. Baltimore: The Johns Hopkins University Press, 1950–1952. 4 vols. Volume I covers neurology; volume II psychiatry; volume III medical teaching; volume 4 mental hygiene. The introductions to each volume provide biographical background for the volume's subject area.

A good selection of Meyer's published work can be found in The Commonsense Psychiatry of Dr. Adolf Meyer: Fifty-two Selected Papers, edited by Alfred A. Lief. New York: McGraw-Hill, 1948.

Probably the best exposition of Meyer's psychobiology is to be found in Psychobiology: a Science of Man, compiled and edited by Eunice E. Winters and Anna Mae Bowers. Springfield, IL: Charles C Thomas, (1957). This posthumous book was based on the first Thomas W. Salmon Lectures, which Meyer gave in 1931.

George Kirby's Guides for History Taking and Clinical Examination of Psychiatric Cases (Utica: State Hospitals Press 1921) is essentially the form Meyer created and used at Manhattan State Hospital in 1905–1906. It provides an excellent view of Meyer's early approach to taking case histories.

Meyer's paper "The Nature and Conception of Dementia Praecox," originally published in the Journal of Abnormal Psychology, was one of three papers collected in Dementia Praecox: a Monograph (Boston: Richard G. Badger, 1911). This was the first book authored by Americans on dementia praecox, a mental disease/disorder/reaction that would also be referred to more commonly as schizophrenia by the late 1920s. The other two papers were by Smith Ely Jelliffe and Meyer's colleague in New York, August Hoch. All three papers were originally read at a symposium on dementia praecox during the annual meeting of the American Neurological Association in 1910.

Meyer's critical role in reframing Emil Kraepelin's dementia praecox disease concept into a uniquely American psychogenic republic of "reactions" is detailed in Richard Noll, American Madness: The Rise and Fall of Dementia Praecox (Cambridge, MA: Harvard University Press, 2011).

The most sensitive and comprehensive study of Meyer to date is Susan D. Lamb, "Pathologist of the Mind: Adolf Meyer, Psychobiology and the Phipps Psychiatric Clinic at the Johns Hopkins Hospital, 1908–1917" (Doctoral dissertation, The Johns Hopkins University, 2010) Lamb is the first to gain access to, and analyze, patient records from the HPPC. This study will be the starting point for much future Meyer scholarship in the decades to come.

Meyer's influence on American psychology can be explored in Defining American Psychology: the Correspondence Between Adolf Meyer and Edward Bradford Titchener, edited by Ruth Leys and Rand B. Evans. Baltimore/London: The Johns Hopkins University Press, (1990).

An unflattering portrait of Adolf Meyer is offered in Andrew Scull, Madhouse: A Tragic Tale of Megalomania and Modern Medicine(New Haven and London: Yale University Press, 2005). Although the book focuses on Henry A. Cotton, the superintendent of the Trenton State Hospital in New Jersey, Meyer is criticized by Scull for condoning and then participating in a cover-up of Cotton's radical surgical treatments for insanity which resulted in a high mortality rate.

Though there is no biography of Meyer, his work and significance for American psychoanalysis are discussed in John C. Burnham's Psychoanalysis and American Medicine, 1894–1917: Medicine, Science, and Culture. New York: International Universities Press, 1967. Meyer's importance to the development of American psychoanalysis is also extensively discussed and interpreted in John Gach's "Culture & Complex: On the Early History of Psychoanalysis in America," pages 135–160 in Essays in the History of Psychiatry, edited by Edwin R. Wallace IV and Lucius Pressley. Columbia, SC: William S. Hall Psychiatric Institute, 1980. Brief but salient is John Burnham's entry on Meyer, pages 215–216 in volume seven of the International Encyclopedia of Psychiatry, Psychology, Psychoanalysis, & Neurology, edited by Benjamin B. Wolman. New York: Van Nostrand Reinhold Company for Aesculapius Publishers, (1977). See also Theodore Lidz, "Adolf Meyer and the Development of American Psychiatry." The American Journal of Psychiatry, 123(3), pp 320–332 (1966) and C.H. Christiansen "Adolf Meyer Revisited:Connections between Lifestyle, Resilience and Illness". Journal of Occupational Science 14(2),63‐76. (2007).

Notes[edit]

  1. ^ Yuhas, Daisy. "Throughout History, Defining Schizophrenia Has Remained a Challenge (Timeline)". Scientific American Mind (March 2013). Retrieved 2 March 2013. 

References[edit]