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Paul Eugen Bleuler (; ; 30 April 1857 – 15 July 1939) was a Swiss
psychiatrist A psychiatrist is a physician A physician (American English), medical practitioner (English in the Commonwealth of Nations, Commonwealth English), medical doctor, or simply doctor, is a professional who practices medicine, which is c ...
and
humanist Humanism is a philosophy, philosophical stance that emphasizes the individual and social potential and Agency (philosophy), agency of Human, human beings. It considers human beings as the starting point for serious moral and philosophical ...

humanist
most notable for his contributions to the understanding of
mental illness A mental disorder, also called a mental illness or psychiatric disorder, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. Such features may be persistent, relapsing In internal medici ...
. He coined several psychiatric terms including "
schizophrenia Schizophrenia is a mental disorder A mental disorder, also called a mental illness or psychiatric disorder, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. Such features may b ...

schizophrenia
", "
schizoid Schizoid personality disorder (, often abbreviated as SPD or SzPD) is a personality disorder characterized by a Asociality, lack of interest in social relationships, a tendency toward a solitary or sheltered lifestyle, secretiveness, emotiona ...
", "
autism Autism is a developmental disorder Developmental disorders comprise a group of psychiatric conditions originating in childhood that involve serious impairment in different areas. There are several ways of using this term. The most narro ...

autism
",
depth psychology Depth psychology (from the German term ''Tiefenpsychologie'') refers to the practice and research of the science of the unconscious, covering both psychoanalysis Psychoanalysis (from Greek language, Greek: + ) is a set of Theory, theories and ...
and what
Sigmund Freud Sigmund Freud ( , ; born Sigismund Schlomo Freud; 6 May 1856 – 23 September 1939) was an Austrian neurologist Neurology (from el, νεῦρον (neûron), "string, nerve" and the suffix -logia, "study of") is a branch of medicine M ...

Sigmund Freud
called "Bleuler's happily chosen term ''
ambivalence Ambivalence is a state of having simultaneous conflicting reactions, beliefs, or feelings towards some object. Stated another way, ambivalence is the experience of having an attitude Attitude may refer to: Philosophy and psychology * Attitude ( ...
''".


Personal life

Bleuler was born in
Zollikon Zollikon is a Municipalities of Switzerland, municipality in the district of Meilen (district), Meilen in the Cantons of Switzerland, canton of Zurich (canton), Zürich, Switzerland known for being one of Switzerland's most exclusive districts. Be ...

Zollikon
, a town near
Zürich Zürich () is the in and the capital of the . It is located in north-central Switzerland, at the northwestern tip of . As of January 2020, the municipality has 434,335 inhabitants, the urban area (agglomeration) 1.315 million (2009), and the 1. ...

Zürich
in Switzerland, to Johann Rudolf Bleuler (1823–1898), a wealthy farmer, and Pauline Bleuler-Bleuler (1829–1898). He married Hedwig Bleuler–Waser, one of the few women to receive her doctorate from the
University of Zurich The University of Zurich (UZH, german: Universität Zürich) is a public university, public research university located in the city of Zürich, Switzerland. It is the largest university in Switzerland, with its 28,000 enrolled students. It was ...

University of Zurich
.


Career

Bleuler studied
medicine Medicine is the science Science () is a systematic enterprise that builds and organizes knowledge Knowledge is a familiarity, awareness, or understanding of someone or something, such as facts ( descriptive knowledge), skills (proced ...

medicine
in Zürich. He trained for his psychiatric residency at Waldau Hospital under Gottileb Burckhardt, a Swiss psychiatrist, from 1881-1884. He left his job in 1884 and spent one year on medical study trips with
Jean-Martin Charcot Jean-Martin Charcot (; 29 November 1825 – 16 August 1893) was a French neurologist Neurology (from el, νεῦρον (neûron), "string, nerve" and the suffix -logia, "study of") is a branch of medicine Medicine is the Art (skill), ...

Jean-Martin Charcot
, a French neurologist in
Paris Paris () is the Capital city, capital and List of communes in France with over 20,000 inhabitants, most populous city of France, with an estimated population of 2,175,601 residents , in an area of more than . Since the 17th century, Paris ha ...

Paris
,
Bernhard von Gudden Johann Bernhard Aloys von Gudden (7 June 1824 – 13 June 1886) was a German neuroanatomist Neuroanatomy is the study of the structure and organization of the nervous system In Biology, biology, the nervous system is a Complex system, highly ...

Bernhard von Gudden
, a German psychiatrist in
Munich Munich ( ; german: München ; bar, Minga ) is the capital and most populous city of Bavaria. With a population of 1,558,395 inhabitants as of 31 July 2020, it is the List of cities in Germany by population, third-largest city in Germany, ...

Munich
, and to
London London is the capital Capital most commonly refers to: * Capital letter Letter case (or just case) is the distinction between the letters that are in larger uppercase or capitals (or more formally ''majuscule'') and smaller lowerc ...

London
. After these trips, he returned to Zürich to briefly work as assistant to
Auguste Forel Auguste-Henri Forel (1 September 1848 – 27 July 1931) was a Swiss people, Swiss myrmecologist, neuroanatomist, psychiatrist and eugenicist, notable for his investigations into the structure of the human brain and that of ants. For example, he i ...

Auguste Forel
while completing his psychiatric residency at the
Burghölzli The ''Psychiatrische Universitätsklinik Zürich'' (Psychiatric University Hospital Zürich) is a leading psychiatric hospital in Switzerland. As a research hospital, it is associated with the University of Zürich. It is also called Burghölzli, a ...
, a university hospital. Bleuler became the director of a psychiatric clinic in Rheinau, a hospital located in an old monastery on an island in the
Rhine ), Surselva Surselva Region is one of the eleven administrative districts Administrative division, administrative unitArticle 3(1). , country subdivision, administrative region, subnational entity, first-level subdivision, as well as many s ...

Rhine
. At the time, the clinic was known for being functionally backward and largely ineffective. Because of this, Bleuler set about improving conditions for the patients residing there. In the year 1898, Bleuler returned to the
Burghölzli The ''Psychiatrische Universitätsklinik Zürich'' (Psychiatric University Hospital Zürich) is a leading psychiatric hospital in Switzerland. As a research hospital, it is associated with the University of Zürich. It is also called Burghölzli, a ...
and became a psychiatry professor at Burghölzli, the same university hospital at which he completed his residency. He was also appointed director of the mental asylum in Rheinau. He served as the director from the years 1898 to 1927. While working at this asylum, Bleuler cared for long-term psychiatric patients. He also implemented both psychoanalytic treatment and research, and was influenced by Sigmund Freud. During his time as the director of psychiatry at Burghölzli, Bleuler made great contributions to the field of psychiatry and psychology that made him known today. Given these findings, Bleuler has been described as one of the most influential Swiss psychiatrists.


Relationship with Freud and Jung

Following his interest in
hypnotism Hypnosis is a human condition involving focused attention Attention is the behavioral and cognitive process Cognition () refers to "the mental action or process of acquiring knowledge and understanding through thought, experie ...
, especially in its "introspective" variant, Bleuler became interested in Sigmund Freud's work. He favorably reviewed
Josef Breuer Josef Breuer (; 15 January 1842 – 20 June 1925) was a distinguished physician A physician (American English American English (AmE, AE, AmEng, USEng, en-US), sometimes called United States English or U.S. English, is the set of ...
and Freud's ''
Studies on Hysteria ''Studies on Hysteria'' () is an 1895 book by Sigmund Freud Sigmund Freud ( , ; born Sigismund Schlomo Freud; 6 May 1856 – 23 September 1939) was an Austrian neurologist Neurology (from el, νεῦρον (neûron), "string, nerve" and ...
''. 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 Carl Gustav Jung ( ; born Karl Gustav Jung, ; 26 July 1875 – 6 June 1961), was a Swiss psychiatrist A psychiatrist is a physician A physician (American English), medical practitioner (English in the Commonwealth of Nations ...

Carl Jung
and
Franz Riklin Franz Beda Riklin (22 April 1878, in St. Gallen , neighboring_municipalities = Eggersriet Eggersriet is a Municipalities of Switzerland, municipality in the ''Wahlkreis'' (constituency) of St. Gallen (Wahlkreis), St. Gallen in the Cantons of S ...
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. Bleuler laid the foundation for a less fatalistic view of course and outcome of psychotic disorders along with C.G. Jung, who further used Bleuler's theory of ambivalence and association experiments to diagnose neurotic illnesses. Bleurer found Freud's movement to be overly dogmatic and resigned from the
International Psychoanalytic Association The International Psychoanalytical Association (IPA) is an association including 12,000 psychoanalysts as members and works with 70 constituent organizations. It was founded in 1910 by Sigmund Freud Sigmund Freud ( , ; born Sigismund Schlomo F ...
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 The Nobel Prizes ( ; sv, Nobelpriset ; no, Nobelprisen ) are five separate prizes that, according to Alfred Nobel Alfred Bernhard Nobel ( , ; 21 October 1833 – 10 December 1896) was a Swedish chemist, engineer, inventor, busines ...
in the late twenties.


''Dementia Praecox, or the Group of Schizophrenias''

Bleuler introduced the term "schizophrenia" in a Berlin lecture on 24 April 1908. However, he and his colleagues had been using the term in Zurich to replace
Emil Kraepelin Emil Wilhelm Georg Magnus Kraepelin (; ; 15 February 1856 – 7 October 1926) was a German psychiatrist. Hans Eysenck, H. J. Eysenck's ''Encyclopedia of Psychology'' identifies him as the founder of modern scientific psychiatry, psychopharmacolo ...
's term
dementia praecox Dementia praecox (meaning a "premature dementia" or "precocious madness") is a disused psychiatric Psychiatry is the specialty (medicine), medical specialty devoted to the diagnosis, prevention, and treatment of mental disorders. These includ ...
since 1907. 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''). This was translated into English in 1950 (by Joseph Zinkin). Bleuler distinguished between positive and negative symptoms of schizophrenia. Positive symptoms include symptoms not found in unaffected people. These may include hallucinations or delusions. Negative symptoms describe the absence of typical experiences such as social withdrawal or lack of pleasure. Bleuler also distinguished between basic and accessory symptoms as well as primary and secondary symptoms. Basic symptoms are those that are present in every case of schizophrenia, whereas accessory symptoms are those that may or may not occur depending on the patient. Bleuler defined primary symptoms as those that are directly related to neurobiological processes. Secondary symptoms, he said, are behavioral reactions to primary symptoms. The ability to differentiate these symptoms contributed to an increased understanding of schizophrenia in general. Like Kraepelin, Bleuler argued that dementia praecox, or "the schizophrenias", was a physical disease process characterized by exacerbations and remissions. He argued that 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, Bleuler believed that the overall prognosis was not uniformly grim. He believed "dementia" was a secondary symptom not directly caused by the underlying biological process. There were three other "fundamental symptoms" that included deficits in associations, affectivity, and ambivalence. He believed the biological disease was much more prevalent in the population due to its "simple" and "latent" forms. Bleuler's changes to Kraepelin's dementia praecox were accepted by countries such as Switzerland and Britain. However, some countries, such as Germany, did not accept these changes at first. Bleuler's concept of schizophrenia was pushed aside due to its similarities to Kraepelin's dementia praecox. It was only widely accepted after Kraeplin's disease classification did not have direct evidence nor was it directly expressed in his patients. In 1911, Bleuler wrote, "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 Compulsory sterilization, also known as forced or coerced sterilization, is a government-mandated program to Sterilization (medicine), sterilize a specific group of people. Compulsory sterilization removes a person's capacity to reproduce, usuall ...
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'', Bleuler states, See: In 1917, Bleuler discussed the heredity involved in schizophrenia after psychiatrist Ernst Rudin published his findings. Bleuler agreed with Rudin in that having a family member with schizophrenia increases an individual's chance of also having the disease. However, Bleuler also found that Rudin's study did not use sufficient sampling methods, which threatened the integrity of the study. While looking further into the heredity of schizophrenia, Bleuler made several conclusions that differed from Rudin's. One conclusion Bleuler made was that the schizophrenic gene was not a dominant trait. He also concluded that the disease involves a dihybrid, complex gene and does not include a monohybrid gene. Bleuler also said that there may be a polymorphic aspect to schizophrenia, meaning it presents itself in different forms. Bleuler found that in order for schizophrenia to present itself in patients, several elements must come together. He found that there are a wide variety of symptoms associated with schizophrenia that can lead to a potential diagnosis. Bleuler concluded that several aspects of the disease are not genetically inherited. These tend to be behavioral aspects and positive symptoms, including hallucinations, delusions, and strange ideas. He believed the disease's central characteristics were the product 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 In sociology Sociology is a social science Social science is the branch The branches and leaves of a tree. A branch ( or , ) or tree branch (sometimes referred to in botany Botany, also called , plant biology or phy ...
.


Further contributions

Bleuler also explored the concept of moral idiocy,Eugene Bleuler
/ref> as well as the relationship between neurosis and
alcoholism Alcoholism is, broadly, any drinking of alcohol In , alcohol is an that carries at least one (−OH) bound to a atom. The term alcohol originally referred to the primary alcohol (ethyl alcohol), which is and is the main alcoho ...
. He followed Freud in seeing sexuality as a potent influence upon
anxiety Anxiety is an emotion Emotions are mental state, psychological states brought on by neurophysiology, neurophysiological changes, variously associated with thoughts, feelings, behavioural responses, and a degree of pleasure or suffering, disp ...

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. He was also known for his skillful expository writings. Bleuler has never been credited with healing his patients. Like Sigmund Freud he experimented on patients in his care; many were sterilised and many committed suicide.L. L. Hvens/S. N. Ghaemi, ''Psychiatric Movements'' (2004) p. 334 and p. 353. Later in his life, Bleuler studied and published works on psychoids. Within these works, he proposed that social, mental, and physical aspects of life are not separate from each other. Instead, he argued, they are seen as aspects of a sole life principle. These ideas were not particularly popular among the scientific community and did not receive a great deal of attention.


See also

* *
Emil Kraepelin Emil Wilhelm Georg Magnus Kraepelin (; ; 15 February 1856 – 7 October 1926) was a German psychiatrist. Hans Eysenck, H. J. Eysenck's ''Encyclopedia of Psychology'' identifies him as the founder of modern scientific psychiatry, psychopharmacolo ...
*
Hermann Rorschach Hermann Rorschach (; 8 November 1884 – 2 April 1922) was a Swiss psychiatrist A psychiatrist is a physician A physician (American English), medical practitioner (English in the Commonwealth of Nations, Commonwealth English), medi ...
*
Pierre Janet Pierre Marie Félix Janet (; 30 May 1859 – 24 February 1947) was a pioneering French psychologist A psychologist is a professional who practices psychology and studies normal and abnormal mental states, perceptual, cognitive, emoti ...
*
Wilhelm Wundt Wilhelm Maximilian Wundt (; ; 16 August 1832 – 31 August 1920) was a German physiologist, philosopher, and professor, known today as one of the fathers of modern psychology Psychology is the scientific Science (from the Latin L ...

Wilhelm Wundt


References


Further reading

* * * * * * * * * * * * * * * * * * *


External links

* Eugen Bleule
''Affectivity, suggestibility, paranoia''
1912 translation * Eugen Bleule
''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)
* {{DEFAULTSORT:Bleuler, Eugen 1857 births 1939 deaths Schizophrenia researchers Swiss eugenicists Swiss psychiatrists People from Meilen District