Eugen Bleuler

Eugen Bleuler
Eugen Bleuler
Born	Paul Eugen Bleuler; April 30, 1857; Zollikon, Switzerland
Died	July 15, 1939 (aged 82); Zollikon, Switzerland
Nationality	Swiss
Citizenship	Swiss
Alma mater	University of Zürich
Known for	Coining the terms schizophrenia, schizoid, autism
	Scientific career
Fields	Psychiatry
Institutions	Rheinau-Zürich clinic; Burghölzli clinic; University of Zürich
Doctoral advisor	Jean-Martin Charcot; Bernhard von Gudden
Doctoral students	Manfred Bleuler; Carl Jung
Other notable students	Medard Boss

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

Biography

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.^[8] 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.^[8] 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,^[9] Bleuler became interested in Sigmund Freud's work. He favorably reviewed 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 a self-analysis with Freud, beginning in 1905.^[10]

He found Freud's movement to be 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".^[11] Bleuler remained interested in Freud's work, citing him favourably, 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.^[12]

Dementia Praecox, or the Group of Schizophrenias

Bleuler introduced the term "schizophrenia" to the world in a lecture in Berlin on April 24, 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 the Group of Schizophrenias). Like 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.^[13] He believed racial deterioration would result from the propagation of mental and physical cripples in his Textbook of Psychiatry:^[14]

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.^[15] He favoured early discharge from hospital into a community environment to avoid institutionalisation.^[16]

Further contributions

Bleuler also explored the concept of moral idiocy,^[17] and the relationship between neurosis and alcoholism.^[18] He followed Freud in seeing sexuality as a potent influence upon anxiety,^[19] 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).^[20]

Bleuler was known for his clinical observation and willingness to let symptoms speak for themselves, as well as for his skillful expository writings.^[21]

References

^ Eugen Bleuler. www.whonamedit.com. URL: http://www.whonamedit.com/doctor.cfm/1294.html. Accessed on: May 2, 2007.
^ http://www.snf.ch/SiteCollectionDocuments/horizonte/Horizonte_gesamt/Horizons_72_F.pdf
^ Berrios, G E (2011). "Eugen Bleuler's Place in the History of Psychiatry". Schizophrenia Bulletin. 37 (6): 1095–1098. doi:10.1093/schbul/sbr132.
^ Yuhas, Daisy. "Throughout History, Defining Schizophrenia Has remained a Challenge". Scientific American Mind (March 2013). Retrieved 2 March 2013.
^ 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
^ ^a ^b Dalzell, Thomas G. (2011). Freud's Schreber Between Psychiatry and Psychoanalysis On Subjective Disposition to Psychosis. London: Karnac Books. p. 201. ISBN 978-1-85575-883-4.
^ 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.
^ 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: 159–76. {{cite journal}}: Cite journal requires |journal= (help)CS1 maint: multiple names: authors list (link)
^ Quoted in Gay, p. 215
^ Gay, p. 456 and p. 486
^ Joseph, Jay (2004). The Gene Illusion: Genetic Research in Psychiatry and Psychology Under the Microscope. Algora Publishing. p. 160. ISBN 0875863442.
^ Bleuler E. (1924). Textbook of Psychiatry. New York: Macmillan. p. 214. See: Read J, Masson J (2004). "Genetics, eugenics and mass murder". In Read J, Mosher RL, Bentall RP (eds.) (ed.). Models of Madness: Psychological, Social and Biological Approaches to Schizophrenia. Hove, East Sussex: Brunner-Routledge. p. 36. ISBN 1583919058. {{cite book}}: |editor= has generic name (help); External link in |chapter= (help)CS1 maint: multiple names: editors list (link)
^ 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

External links

Paul Eugen Bleuler and the Birth of Schizophrenia (1908)

[1] Eugen Bleuler. www.whonamedit.com. URL: http://www.whonamedit.com/doctor.cfm/1294.html. Accessed on: May 2, 2007.

[2] ttp://www.snf.ch/SiteCollectionDocuments/horizonte/Horizonte_gesamt/Horizons_72_F.pdf

[3] Berrios, G E (2011). "Eugen Bleuler's Place in the History of Psychiatry". Schizophrenia Bulletin. 37 (6): 1095–1098. doi:10.1093/schbul/sbr132.

[4] Yuhas, Daisy. "Throughout History, Defining Schizophrenia Has remained a Challenge". Scientific American Mind (March 2013). Retrieved 2 March 2013.

[5] Details recorded by Salman Akhtar in Schizoid Personality Disorder: A Synthesis of Developmental, Dynamic, and Descriptive Features. American Journal of Psychotherapy, 41, 499-518

[6] Peter Gay, Freud: A Life for Our Time (1989) p. 198

[7] Sigmund Freud, On Sexuality (PFL 7) p. 118

[Dalzell_p._201-8] Dalzell, Thomas G. (2011). Freud's Schreber Between Psychiatry and Psychoanalysis On Subjective Disposition to Psychosis. London: Karnac Books. p. 201. ISBN 978-1-85575-883-4.

[9] 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.

[10] 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: 159–76. {{cite journal}}: Cite journal requires |journal= (help)CS1 maint: multiple names: authors list (link)

[11] Quoted in Gay, p. 215

[12] Gay, p. 456 and p. 486

[Joseph-13] Joseph, Jay (2004). The Gene Illusion: Genetic Research in Psychiatry and Psychology Under the Microscope. Algora Publishing. p. 160. ISBN 0875863442.

[Textbook-14] Bleuler E. (1924). Textbook of Psychiatry. New York: Macmillan. p. 214. See: Read J, Masson J (2004). "Genetics, eugenics and mass murder". In Read J, Mosher RL, Bentall RP (eds.) (ed.). Models of Madness: Psychological, Social and Biological Approaches to Schizophrenia. Hove, East Sussex: Brunner-Routledge. p. 36. ISBN 1583919058. {{cite book}}: |editor= has generic name (help); External link in |chapter= (help)CS1 maint: multiple names: editors list (link)

[15] R. Gregory, The Oxford Companion to the Mind (1987) p. 697

[16] Richard Warner, Recovering from Schizophrenia (2004) p. 146

[Eugene_Bleuler-17] Eugene Bleuler

[18] Otto Fenichel, The Psychoanalytic Theory of Neurosis (1946) p. 379 and p. 599

[19] Gay, p. 486

[20] Sigmund Freud, On Psychopathology (PFL 10) p. 181 and p. 203

[21] L. L. Hvens/S. N. Ghaemi, Psychiatric Movements (2004) p. 334 and p. 353

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