|Born||Paul Eugen Bleuler
April 30, 1857
|Died||July 15, 1939
University of Zürich
|Alma mater||University of Zürich|
|Doctoral advisor||Jean-Martin Charcot
Bernhard von Gudden
|Doctoral students||Manfred Bleuler|
|Other notable students||Medard Boss|
Paul Eugen Bleuler (April 30, 1857 – July 15, 1939) was a Swiss psychiatrist most notable for his contributions to the understanding of mental illness and for coining the terms "schizophrenia", "schizoid", "autism", and what Sigmund Freud called "Bleuler's happily chosen term ambivalence".
Bleuler was born in Zollikon, a big town near Zürich in Switzerland, to Johann Rudolf Bleuler, a wealthy farmer, and Pauline Bleuler-Bleuler. He studied medicine in Zürich and following his graduation in 1881 he worked as a medical assistant to Gottlieb Burckhardt at the Waldau Psychiatric Clinic in Bern. Leaving this post in 1884 he spent one year on medical study trips to Jean-Martin Charcot in Paris, to Bernhard von Gudden in Munich and to London. Thereafter he returned to Zürich to take a post as an intern at the Burghölzli, a university hospital.
In 1886 Bleuler became the director of a psychiatric clinic at Rheinau, a hospital located in an old monastery on an island in the Rhine. It was noted at the time for being backward, and Bleuler set about improving conditions for the patients resident there.
Bleuler returned to the Burghölzli in 1898 where he was appointed director.
Relationship with Freud
Following his interest in hypnotism, especially in its "introspective" variant, Bleuler became interested in Sigmund Freud's work, favorably reviewing Josef Breuer and Sigmund Freud's Studies on Hysteria. Like Freud, Bleuler believed that complex mental processes could be unconscious. He encouraged his staff at the Burghölzli to study unconscious and psychotic mental phenomena. Influenced by Bleuler, Carl Jung and Franz Riklin used word association tests to integrate Freud's theory of repression with empirical psychological findings. As a series of letters demonstrates (published in English in 2003), Bleuler performed from 1905 a self-analysis with Freud.
However he found the movement Freud was creating over-dogmatic, and resigned from the International Psychoanalytic Association in 1911, writing to Freud that "this 'all or nothing' is in my opinion necessary for religious communities and useful for political parties...but for science I consider it harmful".
He remained interested in Freud's work however, citing him favourably for example in his often reprinted Textbook of Psychiatry (1916), and supporting his claim for the Nobel Prize in the late twenties.
Dementia Praecox, or the Group of Schizophrenias
Bleuler introduced the term "schizophrenia" to the world in a lecture in Berlin on 24 April 1908. However, perhaps as early as 1907 he and his colleagues had been using the term in Zurich to replace Kraepelin's term dementia praecox. He revised and expanded his schizophrenia concept in his seminal study of 1911, Dementia Praecox, oder Gruppe der Schizophrenien. Like Emil Kraepelin, he argued that dementia praecox, or "the schizophrenias," was fundamentally a physical disease process characterized by exacerbations and remissions. No one was ever completely "cured" of schizophrenia -- there was always some sort of lasting cognitive weakness or defect that was manifest in behavior. Unlike Kraepelin, he believed that the overall prognosis was not uniformly grim, the "dementia" was a secondary symptom not directly caused by the underlying biological process (three other "fundamental symtpoms," deficits in associations, affectivity and ambivalence, were), and that the biological disease was much more prevalent in the population due to its "simple" and especially "latent" forms. Bleuler wrote in 1911: "When the disease process flares up, it is more correct, in my view, to talk in terms of deteriorating attacks, rather than its recurrence. Of course the term recurrence is more comforting to a patient and his relatives than the notion of progressively deteriorating attacks." (See Noll, American Madness, pages 236-242). The eugenic sterilization of persons diagnosed with (and viewed as predisposed to) schizophrenia was advocated by Bleuler who presumed racial deterioration because of mental and physical cripples in his Textbook of Psychiatry:
The more severely burdened should not propogate themselves… If we do nothing but make mental and physical cripples capable of propagating themselves, and the healthy stocks have to limit the number of their children because so much has to be done for the maintenance of others, if natural selection is generally suppressed, then unless we will get new measures our race must rapidly deteriorate.
Instead, he saw its central characteristics to be the product of a process of splitting between the emotional and the intellectual functions of the personality; and favoured early discharge from hospital into a community environment to avoid institutionalisation.
Bleuler also explored the concept of moral idiocy, and the relationship between neurosis and alcoholism. He followed Freud in seeing sexuality as a potent influence upon anxiety, pondered on the origins of the sense of guilt, and studied the process of what he termed switching (the affective shift from love to hate, for example).
Bleuler was known for his clinical observation and willingness to let symptoms speak for themselves, as well as for his skilful expositary writings.
- Eugen Bleuler. www.whonamedit.com. URL: http://www.whonamedit.com/doctor.cfm/1294.html. Accessed on: May 2, 2007.
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- Details recorded by Salman Akhtar in Schizoid Personality Disorder: A Synthesis of Developmental, Dynamic, and Descriptive Features. American Journal of Psychotherapy, 41, 499-518
- Peter Gay, Freud: A Life for Our Time (1989) p. 198
- Sigmund Freud, On Sexuality (PFL 7) p. 118
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- Marinelli, L, Mayer, A . (2003). Dreaming By the Book. Freud's 'The Interpretation of Dreams' and the History of the Psychoanalytic Movement. The Other Press. pp. 159–76.
- Quoted in Gay, p. 215
- Gay, p. 456 and p. 486
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- R. Gregory, The Oxford Companion to the Mind (1987) p. 697
- Richard Warner, Recovering from Schizophrenia (2004) p. 146
- Eugene Bleuler
- Otto Fenichel, The Psychoanalytic Theory of Neurosis (1946) p. 379 and p. 599
- Gay, p. 486
- Sigmund Freud, On Psychopathology (PFL 10) p. 181 and p. 203
- L. L. Hvens/S. N. Ghaemi, Psychiatric Movements (2004) p. 334 and p. 353
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