Ernst Kretschmer
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Ernst Kretschmer (8 October 18888 February 1964) was a German
psychiatrist A psychiatrist is a physician who specializes in psychiatry, the branch of medicine devoted to the diagnosis, prevention, study, and treatment of mental disorders. Psychiatrists are physicians and evaluate patients to determine whether their sy ...
who researched the human constitution and established a typology.


Life

Kretschmer was born in
Wüstenrot Wüstenrot is a municipality in the Mainhardt Forest with about 6,800 inhabitants, more than half of them in small incorporated villages. The village is the birthplace of the Wüstenrot Bausparkasse (Wüstenrot Building Society). Geography ...
near
Heilbronn Heilbronn () is a city in northern Baden-Württemberg, Germany, surrounded by Heilbronn District. With over 126,000 residents, it is the sixth-largest city in the state. From the late Middle Ages, it developed into an important trading centre. A ...
. He attended Cannstatt Gymnasium, one of the oldest Latin schools in
Stuttgart Stuttgart (; Swabian: ; ) is the capital and largest city of the German state of Baden-Württemberg. It is located on the Neckar river in a fertile valley known as the ''Stuttgarter Kessel'' (Stuttgart Cauldron) and lies an hour from the Sw ...
area. From 1906 to 1912 he studied
theology Theology is the systematic study of the nature of the divine and, more broadly, of religious belief. It is taught as an academic discipline, typically in universities and seminaries. It occupies itself with the unique content of analyzing th ...
,
medicine Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care pr ...
, and
philosophy Philosophy (from , ) is the systematized study of general and fundamental questions, such as those about existence, reason, knowledge, values, mind, and language. Such questions are often posed as problems to be studied or resolved. ...
at the universities of Tübingen,
Munich Munich ( ; german: München ; bar, Minga ) is the capital and most populous city of the German state of Bavaria. With a population of 1,558,395 inhabitants as of 31 July 2020, it is the third-largest city in Germany, after Berlin and ...
and
Hamburg Hamburg (, ; nds, label=Hamburg German, Low Saxon, Hamborg ), officially the Free and Hanseatic City of Hamburg (german: Freie und Hansestadt Hamburg; nds, label=Low Saxon, Friee un Hansestadt Hamborg),. is the List of cities in Germany by popul ...
. From 1913 he was assistant of Robert Gaupp in Tübingen, where he received his habilitation in 1918. He continued as assistant medical director until 1926. In 1926 he became the director of the psychiatric clinic at
Marburg University The Philipps University of Marburg (german: Philipps-Universität Marburg) was founded in 1527 by Philip I, Landgrave of Hesse, which makes it one of Germany's oldest universities and the oldest still operating Protestant university in the wo ...
. Kretschmer was a founding member of the
International General Medical Society for Psychotherapy International General Medical Society for Psychotherapy was a society founded in 1926. The German physicians Gustav Richard Heyer and Carl Haberlin were among the organization's founders. The prefix ''international'' was added in 1934, after Carl Gu ...
(AÄGP) which was founded on January 12, 1927. He was the president of AÄGP from 1929. In 1933 he resigned from the AÄGP for political reasons. After he resigned from the AÄGP, he started to support the SS and signed the "Vow of allegiance of the professors of the German universities and high-schools to
Adolf Hitler Adolf Hitler (; 20 April 188930 April 1945) was an Austrian-born German politician who was dictator of Germany from 1933 until his death in 1945. He rose to power as the leader of the Nazi Party, becoming the chancellor in 1933 and the ...
and the National Socialistic state." (german: "Bekenntnis der Professoren an den deutschen Universitäten und Hochschulen zu Adolf Hitler und dem nationalsozialistischen Staat"). Ernst Klee: ''Das Personenlexikon zum Dritten Reich. Wer war was vor und nach 1945?'' Fischer Taschenbuch Verlag, Zweite aktualisierte Auflage,
Frankfurt am Main Frankfurt, officially Frankfurt am Main (; Hessian: , " Frank ford on the Main"), is the most populous city in the German state of Hesse. Its 791,000 inhabitants as of 2022 make it the fifth-most populous city in Germany. Located on it ...
2005, S. 339.
From 1946 until 1959, Kretschmer was the director of the psychiatric clinic of the
University of Tübingen The University of Tübingen, officially the Eberhard Karl University of Tübingen (german: Eberhard Karls Universität Tübingen; la, Universitas Eberhardina Carolina), is a public research university located in the city of Tübingen, Baden-Wà ...
. He died, aged 75, in Tübingen.


Scientific contributions


Persistent vegetative state and sensitive paranoia research

Kretschmer was the first to describe the persistent vegetative state which has also been called ''Kretschmer's syndrome''. Another medical term coined after him is ''Kretschmer's sensitive
paranoia Paranoia is an instinct or thought process that is believed to be heavily influenced by anxiety or fear, often to the point of delusion and irrationality. Paranoid thinking typically includes persecutory beliefs, or beliefs of conspiracy c ...
.'' This classification has the merit of singling out "a type of paranoia that was unknown" prior to Kretschmer, and which "does not resemble the stereotypical image ..of sthenic paranoia".Miller, J.-A., in de Georges, P. (2012). "The Meaning of Kretschmer". '' Hurly-Burly'' 8: 161. Furthermore, between 1915 and 1921 he developed a differential diagnosis between schizophrenia and manic depression.


Types of physique

Kretschmer is also known for developing (in the first quarter of the 20th century) a classification system that can be seen as one of the earliest exponents of a constitutional (the total plan or philosophy on which something is constructed) approach. He based his classification system on four main body-types: * a) asthenic (thin, small, weak) * b) athletic (muscular, large–boned) * c) pyknic (stocky, fat) * d) dysplastic (unproportionate body) The concept of two great psychopathological types of manic-depressive or 'circular' insanity and dementia praecox (i. e.
schizophrenia Schizophrenia is a mental disorder characterized by continuous or relapsing episodes of psychosis. Major symptoms include hallucinations (typically hearing voices), delusions, and disorganized thinking. Other symptoms include social w ...
) was developed by Emil Kraepelin (1856-1926). Kretschmer associated each of his body types with certain personality traits and, in a more extreme form, with different
mental disorder A mental disorder, also referred to as 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 and remitti ...
s. He wrote that there is only a weak relation between
schizophrenia Schizophrenia is a mental disorder characterized by continuous or relapsing episodes of psychosis. Major symptoms include hallucinations (typically hearing voices), delusions, and disorganized thinking. Other symptoms include social w ...
and pyknic body type on the one hand, and between Circulars (with the tendency to circular type of manic-depressive psychosis) and asthenics, athletics, and dysplastics on the other. Among people with schizophrenia, the asthenico–athletic types are very prevalent. Kretschmer believed that pyknic persons were friendly, interpersonally dependent, and gregarious. In a more extreme version of these traits, this would mean for example that the obese are predisposed toward manic-depressive illness. Thin types were associated with introversion and timidity. This was seen as a milder form of the negative symptoms exhibited by people with withdrawn schizophrenia. However, the idea of the association of body types with personality traits is no longer influential in
personality psychology Personality psychology is a branch of psychology that examines personality and its variation among individuals. It aims to show how people are individually different due to psychological forces. Its areas of focus include: * construction of a ...
.


Asthenic type

The essential characteristic of the asthenic type, in Kretschmer's words, is "a deficiency in thickness combined with an average unlessened length". The deficiency is present in all parts of body:
muscle Skeletal muscles (commonly referred to as muscles) are organs of the vertebrate muscular system and typically are attached by tendons to bones of a skeleton. The muscle cells of skeletal muscles are much longer than in the other types of mus ...
,
bone A bone is a rigid organ that constitutes part of the skeleton in most vertebrate animals. Bones protect the various other organs of the body, produce red and white blood cells, store minerals, provide structure and support for the body, ...
,
neck The neck is the part of the body on many vertebrates that connects the head with the torso. The neck supports the weight of the head and protects the nerves that carry sensory and motor information from the brain down to the rest of the body. In ...
, face, trunk, extremities, and in all the tissues ( skin, bone, fat, muscles and vessel system. The average weight as well as the other body measurements are below the general value for males. An Asthenic man would be lean and narrowly-built, with narrow shoulders, thin muscles, delicately boned hands, and a narrow, long, flat chest, on which one can usually see the ribs. Asthenic females are not only thin, but also have a short height. In their general appearance they're the same as asthenic men.


Athletic type

Kretschmer's male athletic type is characterized by the strong development of the musculature,
skeleton A skeleton is the structural frame that supports the body of an animal. There are several types of skeletons, including the exoskeleton, which is the stable outer shell of an organism, the endoskeleton, which forms the support structure inside ...
, and skin. We have, therefore, in the clearest cases the following general impression: a middle-sized to tall man, with a superb chest, wide projecting shoulders ("particularly the hypertrophied shoulders" as Kretschmer said), firm stomach, magnificent legs. The expression "hypertrophied" means a development which oversteps the average, not in the sense of a pathological disturbance. The athletic type among females corresponds to the male form. The certain characteristic deviation is the development of fat, it's rich, but not electively abnormal as with pyknics. Besides these athletic-type women with feminine rounded figures, there are also those women who have outstanding musculature in body and face. In many cases, athletic-type women are actually masculine in muscle relief.


Pyknic type

Kretschmer's pyknic type is characterized by the peripheral development of the body cavities (
breast The breast is one of two prominences located on the upper ventral region of a primate's torso. Both females and males develop breasts from the same embryological tissues. In females, it serves as the mammary gland, which produces and sec ...
, head, and stomach), and a tendency to a distribution of fat about the
torso The torso or trunk is an anatomical term for the central part, or the core, of the body of many animals (including humans), from which the head, neck, limbs, tail and other appendages extend. The tetrapod torso — including that of a hu ...
. They also have a more graceful construction of the motor apparatus ( limbs and shoulders). The characteristics of the well-developed cases include: rounded figure, middle height, a soft broad face on a short massive
neck The neck is the part of the body on many vertebrates that connects the head with the torso. The neck supports the weight of the head and protects the nerves that carry sensory and motor information from the brain down to the rest of the body. In ...
, sitting between the shoulders, shoulders are not broad; soft, rounded, and displaying little
muscle Skeletal muscles (commonly referred to as muscles) are organs of the vertebrate muscular system and typically are attached by tendons to bones of a skeleton. The muscle cells of skeletal muscles are much longer than in the other types of mus ...
relief limbs, the
hand A hand is a prehensile, multi-fingered appendage located at the end of the forearm or forelimb of primates such as humans, chimpanzees, monkeys, and lemurs. A few other vertebrates such as the koala (which has two opposable thumbs on each "h ...
s soft, rather wide and short. The pyknic type tends emphatically to a covering of fat. The
obesity Obesity is a medical condition, sometimes considered a disease, in which excess body fat has accumulated to such an extent that it may negatively affect health. People are classified as obese when their body mass index (BMI)—a person's ...
of the pyknic is restricted within moderate limits for the most part. The female pyknics' covering of fat is more strongly concentrated over the hips and chest. The ratio of chest to shoulder of the female pyknics is the same as in the male pyknics.


Distribution of the body types among the schizophrenics and circulars


The temperaments

Kretschmer divided the temperaments into the two "constitutional groups":
schizothymic Schizothymia is a temperament related to schizophrenia in a way analogous to cyclothymia's relationship with bipolar disorder. Schizothymia was proposed by Ernst Kretschmer when examining body types of schizophrenic patients. Schizothymia is def ...
, which contain a "psychæsthetic proportion" between sensitive and cold poles, and cyclothymes which contain a "diathetic" proportion between raised (
happy Happiness, in the context of mental or emotional states, is positive or pleasant emotions ranging from contentment to intense joy. Other forms include life satisfaction, well-being, subjective well-being, flourishing and eudaimonia. Sin ...
) and sad. The modern term for light version of 'circular' insanity is
cyclothymia Cyclothymia ( ), also known as cyclothymic disorder, psychothemia/psychothymia, bipolar III, affective personality disorder and cyclothymic personality disorder, is a mental and behavioural disorder that involves numerous periods of symptoms of ...
. Psychic tempo of schizothymic people is between unstable and tenacious and they have alternation mode of feeling and thought, and cyclothymes psychic tempo is between mobile and comfortable. Schizothymic's psychomotility is often inadequate to stimulus: inhibited, restrained, lamed, stiff, etc., and psychomotility of cyclothymes is adequate to stimulus and natural. Cyclothymes are often pyknics, schizothymes – athletic, asthenic, dysplastic, and their mixtures. The Schizoids consist of the hyperæsthetic (sensitive) and anæsthetic (cold) characters.


Works

* ''Wahnbildung und manisch-depressiver Symptomenkomplexe,'' Berlin, (1914, dissertation) (development of delusion and manic-depressive symptom complex) * ''Der sensitive Beziehungswahn'', Berlin (1918), 2. Aufl. Berlin (1927), habilitation) (the sensitive relative delusion) * ''Physique and Character (International Library of Psychology)'' (1931), Routledge, * ''Medizinische Psychologie'', (1922) (medical psychology) * ''Hysteria, Reflex, and Instinct'', Leipzig (1923) Greenwood, * ''Die Veranlagung zu seelischen Störungen'', mit Ferdinand Adalbert Kehrer (1883–1966), Berlin (1924) (the disposition for psychic disturbances) * ''Störungen des Gefühlslebens, Temperamente'', Handbuch der Geisteskrankheiten. Band 1. Berlin (1928) (psychic disturbances and temperaments) * ''The Psychology of Men of Genius (International Library of Psychology)'', Berlin (1929), Routledge, * ''Das apallische Syndrom'', in Ztschr. Neurol. Psychiat, 169,576-579 (1940) (the apallic syndrome) * ''Psychotherapeuthische Studien'', Stuttgart (1949) (psychotherapeutic studies) * ''Robert Gaupp zum Gedächtnis'', Deutsche medizinische Wochenschrift, Stuttgart (1953) 78: 1713. (in memory of Robert Gaupp) * ''Gestufte Aktivhypnose - Zweigleisige Standardmethode'', In: V. E. Frankl, V.v. Gebsattel and J.H. Schultz, Hrsg.: Handbuch der Neurosenlehre und Psychotherapie, Band IV, pp. 130–141. Urban & Schwarzenberg, München-Berlin (1959) * ''Gestalten und Gedanken'' (1963) (characters and thoughts)


See also

* Posture (psychology) *
Eugène Minkowski Eugène (Eugeniusz) Minkowski (; 17 April 1885 – 17 November 1972) was a French psychiatrist of Jewish Polish origin, known for his incorporation of phenomenology into psychopathology and for exploring the notion of "lived time". A student of E ...


Notes


References

* Ideology and ethics. The perversion of German psychiatrists' ethics by the ideology of National Socialism. by L. Singer, Eur. Psychiatry 1998 * Un apercu sur la psychiatrie sociale allemande en 1934. by J. Bieder, Ann. Med. Psychol. 1996 * Priwitzer, Martin, ''Ernst Kretschmer und das Wahnproblem'', (Ernst Kretschmer and the problem of delusion
Dissertation, 2004
published - Stuttgart: Franz Steiner, 2007, xiv + 314 S. * Millon, T., Grossman, S., Millon, C., Meagher, S & Ramnath, R. (2004). ''Personality disorders in modern life'' (2nd edition). Hoboken: John Wiley & Sons, Inc. * de Georges, P. (2012). "The Meaning of Kretschmer". '' Hurly-Burly'' 8: 149–168. * Trizzino, A. (2014). "Il mondo nella testa. Sul delirio di rapporto sensitivo di Ernst Kretschmer". ''Comprendre. Archive International pour l'Anthropologie et la Psychopathologie Phénoménologiques'' 24: 217-22


External links


Images in Psychiatry: Ernst Kretschmer (1888–1964)
* Burkhart Brückner, Ansgar Fabri
Biography of Ernst Kretschmer
in
Biographical Archive of Psychiatry (BIAPSY)

Cartesian Coordinate Classification of Body Type and Personality
{{DEFAULTSORT:Kretschmer, Ernst 1888 births 1964 deaths Förderndes Mitglied der SS People from Heilbronn (district) People from the Kingdom of Württemberg German psychiatrists Commanders Crosses of the Order of Merit of the Federal Republic of Germany Members of the German Academy of Sciences at Berlin