Eugen Bleuler around 1900
Paul Eugen Bleuler
30 April 1857
|Died||15 July 1939 (aged 82)|
|Alma mater||University of Zürich|
|Known for||Coining the terms schizophrenia, schizoid, autism|
University of Zürich
|Doctoral advisor||Jean-Martin Charcot|
Bernhard von Gudden
|Doctoral students||Manfred Bleuler|
|Other notable students||Medard Boss|
Paul Eugen Bleuler (//; German: [ˈɔɪɡeːn ˈblɔɪlər]; 30 April 1857 – 15 July 1939) was a Swiss psychiatrist and eugenicist most notable for his contributions to the understanding of mental illness. He coined many psychiatric terms, such as "schizophrenia", "schizoid", "autism", depth psychology and what Sigmund Freud called "Bleuler's happily chosen term ambivalence".
Bleuler was born in Zollikon, a town near Zürich in Switzerland, to Johann Rudolf Bleuler, a wealthy farmer, and Pauline Bleuler-Bleuler. He married Hedwig Bleuler–Waser, one of the few women to receive her doctorate from the University of Zurich.
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 briefly work as assistant to Auguste Forel at the Burghölzli, a university hospital.
In 1886 Bleuler became the director of a psychiatric clinic in Rheinau, 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.
Relationship with Freud
Following his interest in hypnotism, especially in its "introspective" variant, 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.
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". 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.
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 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).
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.
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". The eugenic sterilization of persons diagnosed with (and viewed as predisposed to) schizophrenia was advocated by Bleuler. He argued that racial deterioration would result from the propagation of "mental and physical cripples" in his Textbook of Psychiatry:
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. He favored early discharge from hospital into a community environment to avoid institutionalization.
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 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.
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- Eugen Bleuler at the Encyclopædia Britannica
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- Quoted in Gay, p. 215
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- Dementia Praecox, or Group of Schizophrenias at the HathiTrust Digital Library
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- Warner, Richard (2004). Recovery from schizophrenia : psychiatry and political economy (3rd ed.). Hove: Brunner-Routledge. p. 146. ISBN 0415212669. OCLC 52091966.
- 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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- 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.
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- 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.
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- 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.
|Wikimedia Commons has media related to Eugen Bleuler.|
- Eugen Bleuler Affectivity, suggestibility, paranoia 1912 translation
- Eugen Bleuler The theory of schizophrenic negativism 1912 translation
- Paul Eugen Bleuler and the Birth of Schizophrenia (1908)
- Burkhart Brückner, Ansgar Fabri: Biography of Eugen Bleuler in: Biographical Archive of Psychiatry (BIAPSY).
- "Eugen Bleuler". Encyclopædia Britannica. 23 April 2018.