Eugene Bleuler
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Paul Eugen Bleuler (; ; 30 April 1857 – 15 July 1939) was a Swiss
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 ...
and humanist most notable for his contributions to the understanding of
mental illness 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 ...
. He coined several psychiatric terms including " schizophrenia", " schizoid", "
autism The autism spectrum, often referred to as just autism or in the context of a professional diagnosis autism spectrum disorder (ASD) or autism spectrum condition (ASC), is a neurodevelopmental condition (or conditions) characterized by difficulti ...
", depth psychology and what Sigmund Freud called "Bleuler's happily chosen term '' ambivalence''".


Personal life

Bleuler was born in Zollikon, a town near Zürich in Switzerland, to Johann Rudolf Bleuler (1823–1898), a wealthy farmer, and Pauline Bleuler-Bleuler (1829–1898). He married
Hedwig Bleuler–Waser Sophie Hedwig Bleuler-Waser (born Sophie Hedwig Waser; 29 December 1869 – 1 February 1940) was a Swiss suffragette who founded the Swiss Federation of Abstinent Women. Personal life Bleuler-Waser was born on 29 December 1869 in Zurich. Bleule ...
, one of the few women to receive her doctorate from the University of Zurich.


Career

Bleuler studied medicine in Zürich. He trained for his psychiatric residency at Waldau Hospital under Gottlieb Burckhardt, a Swiss psychiatrist, from 1881 to 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 neurology, neurologist and professor of anatomical pathology. He worked on hypnosis and hysteria, in particular with his hysteria patient Louise Augustine Gleizes. Charcot ...
, a French neurologist in Paris,
Bernhard von Gudden Johann Bernhard Aloys von Gudden (7 June 1824 – 13 June 1886) was a German neuroanatomist and psychiatrist born in Kleve. Career In 1848, von Gudden earned his doctorate from the University of Halle and became an intern at the asylum in Siegbu ...
, a German psychiatrist in Munich, and to London. After these trips, he returned to Zürich to briefly work as assistant to Auguste Forel while completing his psychiatric residency at the
Burghölzli The ''Psychiatrische Universitätsklinik Zürich'' (Psychiatric University Hospital Zürich) is a psychiatric hospital in Switzerland. As a research hospital, it is associated with the University of Zürich. It is also called Burghölzli, after th ...
, a university hospital. Bleuler became the director of a psychiatric clinic in
Rheinau Rheinau may refer to: *Rheinau, Switzerland, a town in the canton of Zürich *Rheinau Abbey, in Rheinau, Switzerland *Rheinau (Baden), a town in Baden-Württemberg, Germany *a part of Mannheim, Germany {{geodis ...
, a hospital located in an old monastery on an island in the 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 psychiatric hospital in Switzerland. As a research hospital, it is associated with the University of Zürich. It is also called Burghölzli, after th ...
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 (the selective attention/selective inattention hypothesis, SASI), reduced peripheral awareness, and an enhanced capacity to respond to suggestion.In 2015, the American Psychologica ...
, especially in its "introspective" variant, Bleuler became interested in Sigmund Freud's work. He favorably reviewed Josef Breuer and Freud's ''
Studies on Hysteria ''Studies on Hysteria'' () is an 1895 book by Sigmund Freud, the founder of psychoanalysis, and the physician Josef Breuer. It consists of a joint introductory paper (reprinted from 1893); followed by five individual studies of hysterics – Breue ...
''. 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 Franz Beda Riklin (22 April 1878, in St. Gallen – 4 December 1938, in Küsnacht) was a Swiss psychiatrist. Early in his career, Franz Riklin worked at the Burghölzli Hospital in Zurich under Eugen Bleuler (b.1857–d.1939), and studied ex ...
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 the 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. Bleuler 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, from an idea proposed by Sándor Ferenczi. His ...
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" in a Berlin lecture on 24 April 1908. However, he and his colleagues had been using the term in Zurich to replace Emil Kraepelin's term dementia praecox 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 Kraepelin'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 Involuntary treatment, involuntarily Sterilization (medicine), sterilize a specific group of people. Sterilization removes a person's ca ...
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.


Further contributions

Bleuler also explored the concept of moral idiocy,Eugene Bleuler
/ref> as well as 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. 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

* Bleuler's psycho syndrome * Emil Kraepelin * Hermann Rorschach *
Pierre Janet Pierre Marie Félix Janet (; 30 May 1859 – 24 February 1947) was a pioneering French psychologist, physician, philosopher, and psychotherapist in the field of dissociation and traumatic memory. He is ranked alongside William James and ...
*
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. Wundt, who distinguished psychology as a science from philosophy and ...


References


Further reading

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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