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Eugen Bleuler

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Eugen Bleuler
Eugen Bleuler around 1900
Born
Paul Eugen Bleuler

30 April 1857 (1857-04-30)
Zollikon, Switzerland
Died15 July 1939(1939-07-15) (aged 82)
Zollikon, Switzerland
NationalitySwiss
Alma materUniversity of Zürich
Known forCoining the terms schizophrenia, schizoid, autism
SpouseHedwig Bleuler–Waser
Children2
Scientific career
FieldsPsychiatry
InstitutionsRheinau-Zürich clinic
Burghölzli clinic
University of Zürich
Doctoral advisorJean-Martin Charcot
Bernhard von Gudden
Doctoral studentsManfred Bleuler
Carl Jung
Other notable studentsMedard Boss

Paul Eugen Bleuler (/ˈblɔɪlər/;[1] German: [ˈɔɪɡeːn ˈblɔɪlər]; 30 April 1857 – 15 July 1939)[2] was a Swiss psychiatrist and eugenicist[3][4] most notable for his contributions to the understanding of mental illness. He coined many psychiatric terms, such as "schizophrenia",[5][6] "schizoid",[7] "autism",[8] depth psychology and what Sigmund Freud called "Bleuler's happily chosen term ambivalence".[9]

Personal life

Bleuler was born in Zollikon, a town near Zürich in Switzerland, to Johann Rudolf Bleuler, a wealthy farmer, and Pauline Bleuler-Bleuler.[10] He married Hedwig Bleuler–Waser, one of the few women to receive her doctorate from the University of Zurich.[11]

Career

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.[10] 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.[10] Thereafter he returned to Zürich to briefly work as assistant to Auguste Forel at the Burghölzli, a university hospital.[12]

In 1886 Bleuler became the director of a psychiatric clinic in Rheinau,[12] which was a hospital located in an old monastery on an island in the Rhine. It was noted at the time for being functionally backward and largely ineffective, and Bleuler set about improving conditions for the patients residing there.[citation needed]

Bleuler returned to the Burghölzli in 1898 where he was appointed director and served at this post until 1927.[13]

Relationship with Freud

Following his interest in hypnotism, especially in its "introspective" variant,[14] Bleuler became interested in Sigmund Freud's work. He favorably reviewed Josef Breuer and 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, Bleuler performed a self-analysis with Freud, beginning in 1905.[15]

He found Freud's movement to be overly 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".[16] Bleuler remained interested in Freud's work, citing him favorably, for example, in his often reprinted Textbook of Psychiatry (1916). He also supported the nomination of Freud for the Nobel Prize in the late twenties.[17]

Dementia Praecox, or the Group of Schizophrenias

Bleuler introduced the term "schizophrenia" to the world in a lecture in Berlin on 24 April 1908.[18] However, perhaps as early as 1907 he and his colleagues had been using the term in Zurich to replace Emil Kraepelin's term dementia praecox. He revised and expanded his schizophrenia concept in his seminal study of 1911, Dementia Praecox, oder Gruppe der Schizophrenien (Dementia Praecox, or Group of Schizophrenias), which was translated into English only in 1950 (by Joseph Zinkin).[19]

Like Kraepelin, Bleuler 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 symptoms", 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.[20]

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".[21] The eugenic sterilization of persons diagnosed with (and viewed as predisposed to) schizophrenia was advocated by Bleuler.[3] He argued that racial deterioration would result from the propagation of "mental and physical cripples" in his Textbook of Psychiatry:[4]

The more severely burdened should not propagate 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.

He believed the disease's central characteristics to be the product of a process of splitting between the emotional and the intellectual functions of the personality.[22] He favored early discharge from hospital into a community environment to avoid institutionalization.[23]

Further contributions

Bleuler also explored the concept of moral idiocy,[24] and the relationship between neurosis and alcoholism.[25] He followed Freud in seeing sexuality as a potent influence upon anxiety,[26] 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).[27]

Bleuler was known for his clinical observation and willingness to let symptoms speak for themselves, as well as for his skillful expository writings. Bleuler is not credited of ever having healed a single patient. Like Sigmund Freud he experimented on patients in his care; many were sterilised and many committed suicide.[28]

See also

References

  1. ^ "Bleuler". Random House Webster's Unabridged Dictionary.
  2. ^ Eugen Bleuler at the Encyclopædia Britannica
  3. ^ a b Jay, Joseph (2004). The Gene Illusion. Genetic Research in Psychiatry and Psychology Under the Microscope. Algora Publishing. p. 160. ISBN 0-8758-6344-2.
  4. ^ a b Bleuler E. (1924). Textbook of Psychiatry. New York: Macmillan. p. 214. See: Read J, Masson J (2004). "Genetics, eugenics and mass murder (p. 36)". In Read J, Mosher RL, Bentall RP (eds.). Models of Madness. Psychological, Social and Biological Approaches to Schizophrenia. Hove, East Sussex: Brunner-Routledge. ISBN 1-5839-1905-8. {{cite book}}: External link in |chapterurl= (help); Unknown parameter |chapterurl= ignored (|chapter-url= suggested) (help)
  5. ^ Berrios, G E (2011). "Eugen Bleuler's Place in the History of Psychiatry". Schizophrenia Bulletin. 37 (6): 1095–1098. doi:10.1093/schbul/sbr132. PMC 3196935. PMID 21914646.
  6. ^ Yuhas, Daisy. "Throughout History, Defining Schizophrenia Has remained a Challenge". Scientific American Mind (March 2013). Archived from the original on 13 April 2013. Retrieved 2 March 2013.
  7. ^ Details recorded in: Akhtar, Salman (1987). "Schizoid Personality Disorder: A Synthesis of Developmental, Dynamic, and Descriptive Features". American Journal of Psychotherapy. 41 (4): 499–518. doi:10.1176/appi.psychotherapy.1987.41.4.499. PMID 3324773.
  8. ^ Peter Gay, Freud: A Life for Our Time (1989) p. 198
  9. ^ Sigmund Freud, Three Essays on the Theory of Sexuality, p. 65.
  10. ^ a b c Dalzell, Thomas G. (2011). Freud's Schreber Between Psychiatry and Psychoanalysis On Subjective Disposition to Psychosis. London: Karnac Books. p. 201. ISBN 978-1-855-75883-4.
  11. ^ Herrmann, Anne (15 April 2014). Coming Out Swiss: In Search of Heidi, Chocolate, and My Other Life. University of Wisconsin Press. p. 143. ISBN 9780299298432. Retrieved 15 October 2019.
  12. ^ a b Crown, Sidney; Freeman, Hugh; Freeman, Hugh Lionel, eds. (1994). The Book of Psychiatric Books. Lanham, Maryland: Jason Aronson. p. 64. ISBN 0-8766-8510-6.
  13. ^ Kallivayalil, Roy Abraham (April–June 2016). "The Burgholzli Hospital: Its history and legacy". Indian Journal of Psychiatry. 58 (2). Mumbai: Medknow Publications: 226–228. doi:10.4103/0019-5545.183772. PMC 4919972. PMID 27385861.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  14. ^ Mayer, Andreas (2001). "Introspective hypnotism and Freud's self-analysis: procedures of self-observation in clinical practice". Revue d'Histoire des Sciences Humaines. 5 (2): 171–96. doi:10.3917/rhsh.005.0171.
  15. ^ Marinelli, Lydia; Mayer, Andreas (2003). Dreaming by the Book: Freud's 'The Interpretation of Dreams' and the History of the Psychoanalytic movement. Fairfield, Susan. New York: Other Press. pp. 159–176. ISBN 1590510097. OCLC 52728852.
  16. ^ Quoted in Gay, p. 215
  17. ^ Gay, p. 456 and p. 486
  18. ^ Fusar-Poli, Paolo; Politi, Pierluigi (2008). "Paul Eugen Bleuler and the Birth of Schizophrenia (1908)". American Journal of Psychiatry. 165 (11): 1407. doi:10.1176/appi.ajp.2008.08050714. PMID 18981075.
  19. ^ Dementia Praecox, or Group of Schizophrenias at the HathiTrust Digital Library
  20. ^ Moskowitz, A; Heim, G (2011). "Eugen Bleuler's Dementia Praecox or the Group of Schizophrenias (1911): A Centenary Appreciation and Reconsideration". Schizophrenia Bulletin. 37 (3): 471–9. doi:10.1093/schbul/sbr016. PMC 3080676. PMID 21505113.
  21. ^ Noll, Richard (2011). American Madness: the Rise and Fall of Dementia Praecox. Cambridge, Mass.: Harvard University Press. pp. 236–242. ISBN 9780674062658. OCLC 761325052.
  22. ^ Gregory, Richard L. (2004). The Oxford companion to the mind (2nd ed.). Oxford: Oxford University Press. p. 697. ISBN 0198662246. OCLC 56627645.
  23. ^ Warner, Richard (2004). Recovery from schizophrenia : psychiatry and political economy (3rd ed.). Hove: Brunner-Routledge. p. 146. ISBN 0415212669. OCLC 52091966.
  24. ^ Eugene Bleuler
  25. ^ Otto Fenichel, The Psychoanalytic Theory of Neurosis (1946) p. 379 and p. 599.
  26. ^ Gay, p. 486.
  27. ^ Sigmund Freud, On Psychopathology (PFL 10) p. 181 and p. 203.
  28. ^ L. L. Hvens/S. N. Ghaemi, Psychiatric Movements (2004) p. 334 and p. 353.

Further reading

  • Tölle R (January 2008). "Eugen Bleuler (1857–1939) und die deutsche Psychiatrie" [Eugen Bleuler (1857–1939) and German psychiatry]. Der Nervenarzt (in German). 79 (1): 90–6, 98. doi:10.1007/s00115-007-2379-9. PMID 18058081.
  • Falzeder E (June 2007). "The story of an ambivalent relationship: Sigmund Freud and Eugen Bleuler". The Journal of Analytical Psychology. 52 (3): 343–368. doi:10.1111/j.1468-5922.2007.00666.x. PMID 17537145.
  • Bernet B (2006). "Associative disorder. On the relationship between the interpretation of disorder and society in the early writings of Eugen Bleuler" [Associative disorder. On the relationship between the interpretation of disorder and society in the early writings of Eugen Bleuler]. Medizin, Gesellschaft, und Geschichte (in German). 26: 169–93. PMID 17144374.
  • Möller A, Hell D (December 2003). "Das Gesellschaftsbild von Eugen Bleuler - Anschauungen jenseits der psychiatrischen Klinik" [The social understanding of Eugen Bleuler - his viewpoint outside of the psychiatric clinic]. Fortschritte der Neurologie · Psychiatrie (in German). 71 (12): 661–6. doi:10.1055/s-2003-45344. PMID 14661160.
  • Möller A, Scharfetter C, Hell D (December 2002). "Development and termination of the working relationship of C. G. Jung and Eugen Bleuler 1900-1909". History of Psychiatry. 13 (52 Pt 4): 445–53. doi:10.1177/0957154X0201305206. PMID 12645573.
  • Möller A, Hell D (2002). "Eugen Bleuler and forensic psychiatry". International Journal of Law and Psychiatry. 25 (4): 351–60. doi:10.1016/S0160-2527(02)00127-9. PMID 12613049.
  • Möller A, Scharfetter C, Hell D (January 2003). "Das "psychopathologische Laboratorium" am "Burghölzli"" [The "Psychopathologic laboratory" at Burghölzli.]. Der Nervenarzt (in German). 74 (1): 85–90. doi:10.1007/s00115-002-1282-7. PMID 12596032.
  • Möller A, Hell D (September 2000). "Prinzipien einer naturwissenschaftlich begründeten Ethik im Werk Eugen Bleulers" [Fundamentals of scientifically based ethics in the works of Eugen Bleuler]. Der Nervenarzt (in German). 71 (9): 751–7. doi:10.1007/s001150050660. PMID 11042871.
  • Möller A, Hell D (July 1999). "Scientific psychology in the works of Eugen Bleuler". Psychiatrische Praxis (in German). 26 (4): 157–62. PMID 10457965.
  • Scharfetter C (April 1999). "Recht- und Andersgläubige" [Orthodoxy against heretics. Correspondence of Gaupp and Kretschmer to Eugen Bleuler]. Fortschritte der Neurologie · Psychiatrie (in German). 67 (4): 143–6. doi:10.1055/s-2007-993991. PMID 10327309.
  • Möller A, Hell D (November 1997). "Zur Entwicklung kriminalpsychologischer Grundanschauungen im Werk Eugen Bleulers" [The development of criminal psychology in the work of Eugen Bleuler]. Fortschritte der Neurologie · Psychiatrie (in German). 65 (11): 504–8. doi:10.1055/s-2007-996356. PMID 9480292.
  • Kruse G (September 1996). "Autistic-undisciplined thinking in medicine and overcoming it by Eugen Bleuler". Psychiatrische Praxis (in German). 23 (5): 255–6. PMID 8992526.
  • Wilhelm HR (1996). "Eugen Bleuler und Carl Gustav Jungs habilitation" [Eugen Bleuler and Carl Gustav Jung's habilitation]. Sudhoffs Archiv (in German). 80 (1): 99–108. JSTOR 20777526. PMID 8928214.
  • De Ridder H, Corveleyn J (1992). "Eugen Bleuler (1857–1939) and psychoanalysis". Zeitschrift für Klinische Psychologie, Psychopathologie und Psychotherapie (in German). 40 (3): 246–62. PMID 1519383.
  • Bleuler M, Bleuler R (November 1986). "Dementia praecox oder die Gruppe der Schizophrenien: Eugen Bleuler". The British Journal of Psychiatry. 149 (5): 661–2. doi:10.1192/bjp.149.5.661. PMID 3545358.
  • Bleuler M (March 1984). "Eugen Bleuler and schizophrenia". The British Journal of Psychiatry. 144: 327–8. PMID 6367878.
  • Menuck M (March 1979). "What did Eugen Bleuler really say?". Canadian Journal of Psychiatry. 24 (2): 161–6. doi:10.1177/070674377902400209. PMID 371780.
  • Gärtner JK (February 1965). "Significance of Eugen Bleuler in the development of general medical practice". Der Landarzt (in German). 41 (5): 187–91. PMID 5320265.
  • Klaesi, Jakob (December 1957). "Zum hundertsten Geburtstag Eugen Bleulers" [On the hundredth birthday of Eugen Bleuler]. Psychiatria et Neurologia. 134 (6): 353–61. doi:10.1159/000138783. PMID 13505951.
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