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 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 worked as assistant to Auguste Forel 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.
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 (published in English in 2003), Bleuler performed a self-analysis with Freud, beginning in 1905.
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". 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.
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." (See Noll, American Madness, pages 236–242.) 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 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 skillful expository writings.
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- Quoted in Gay, p. 215
- Gay, p. 456 and p. 486
- 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.
- Dementia Praecox, or Group of Schizophrenias at the HathiTrust
- 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. doi:10.1093/schbul/sbr016. PMC 3080676. PMID 21505113.
- Jay, Joseph (2004). The Gene Illusion. Genetic Research in Psychiatry and Psychology Under the Microscope. Algora Publishing. p. 160. ISBN 0-8758-6344-2.
- 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. Models of Madness. Psychological, Social and Biological Approaches to Schizophrenia. Hove, East Sussex: Brunner-Routledge. ISBN 1-5839-1905-8.
- 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.
- 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.
- Noll R, (2011) American Madness: The Rise and Fall of Dementia Praecox. Cambridge, MA, and London: Harvard University Press.
- Falzeder E (June 2007). "The story of an ambivalent relationship: Sigmund Freud and Eugen Bleuler". The Journal of Analytical Psychology. 52 (3): 343–68. 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. Development and termination of the working relationship of C.G. Jung and Eugen Bleuler]. 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" [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" [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 and Carl Gustav Jung's habilitation" [Eugen Bleuler and Carl Gustav Jung's habilitation]. Sudhoffs Archiv (in German). 80 (1): 99–108. PMID 8928214.
- De Ridder H, Corveleyn J (1992). "Eugen Bleuler (1857–1939) and psychoanalysis" [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. PMID 371780.
- Gärtner JK (February 1965). "Significance of Eugen Bleuler in the development of general medical practice" [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.
|Wikimedia Commons has media related to Eugen Bleuler.|
- 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.