Eugen Bleuler, one of the most
influential psychologists of his time, made difficulties for himself by
being attracted to both the theories of Sigmund Freud (1856-1939) and
Wilhelm Max Wundt (1832-1920), striving to unify somehow the teachings
of the two, despite the fact that the differences were much greater than
what united them. Bleuler is best known today for his introduction of
the term schizophrenia – in 1908 - to describe the disorder previously
known as dementia praecox, from the Latin meaning prematurely out of
one's mind, a name given by Emil Kraepelin; and for his study of
schizophrenics.
He tended to oppose the view that schizophrenia is caused by an
irreversible brain damage, but did not believe in the possibility of a
healing. Bleuler emphasised the associative disturbances, not the
demens. His work for this group of diseases went so far that he even
learned to understand and interpret these patients way of expressing
themselves.
Bleuler attended the universities of Zürich, Bern, and Munich,
becoming a licensed physician in 1881. He was conferred doctor of
medicine in 1883, and from 1881 to 1883 was assistant physician in
Waldau near Bern. In 1884 he travelled to France and England, in the
winter term of 1884/1885 worked in the laboratory with Johann Bernhard
Aloys von Gudden (1824-1886) in Munich. In 1885 he became assistant
physician in Burghölzli near Zürich, and subsequently, from 1886 to 1898
was director of the nursing home – Pflegeanstalt – Rheinau near
Zürich.
In 1898 Bleuler was appointed professor psychiatry at the University
of Zürich and director of the University Psychiatric Hospital, the
Burghölzli Asylum, where he served from 1898 to 1927. He first advanced
the term schizophrenia in 1908 in a paper based on a study of 647
Burghölzli patients and then expanded on his work in Dementia Praecox
oder Gruppe der Schizophrenien; 1911. (Dementia Praecox; or the Group of
Schizophrenias, 1950). Characterized by Zilboorg (1941) as "the classic
work of twentieth century psychiatry.”
Bleuler explains the title of his famous monograph in the following manner:
The older form [dementia praecox] is a product of a time when not
only the very concept of dementia, but, also that of precocity, was
applicable to all cases at hand. But it hardly fits our contemporary
ideas of the scope of this disease-entity. Today we include patients
whom we would neither call "demented" nor exclusively victims of
deterioration early in life. (1911, p 7).
I call dementia praecox "schizophrenia" because (as I hope to
demonstrate) the "splitting" of the different psychic functions is one
of its most important characteristics. For the sake of convenience, I
use the word in the singular although it is apparent that the group
includes several diseases. (1911, p 8).
Bleuler concluded that the disease was not one of dementia, a
condition involving organic deterioration of the brain, but one that
consisted of a disharmonious state of mind in which contradictory
tendencies exist together. He showed that Kraepelin’s dementia praecox
should include all the schizophrenic disorders. He argued that
schizophrenia was not invariably incurable, and did not always progress
to full dementia - all conclusions at odds with the accepted wisdom of
his time.
Bleuler is credited with the introduction of two concepts fundamental
to the analysis of schizophrenia: autism, denoting the loss of contact
with reality, frequently through indulgence in bizarre fantasy, and
ambivalence, denoting the coexistence of mutually exclusive
contradictions within the psyche.
Bleuler was one of the first psychiatrists to apply psychoanalytical
methods in his research. He was an early proponent of the theories of
Sigmund Freud, and he attempted to show how the various mechanisms Freud
had found in neurotic patients could also be recognised in psychotic
patients. Bleuler challenged the prevailing belief that psychosis was
the result of organic brain damage, insisting instead that it could have
psychological causes.
Bleuler's works also concern studies of hypnotism, subcortical
aphasia, osteomalacy, moral idiocy (based on a study of the national
assemblies of the major European powers 1897-1923), the physiology of
ventricology, etc in various journals. He was the publisher of Jahrbuch
für psychoanalytische Forschung.
Bleuler’s textbook, Lehrbuch der Psychiatrie, published in 1916, went
through countless new editions and has, like the Bleuler
Psycho-syndrome, prevented his name from falling into oblivion.
During the early 1900s Bleuler's assistant was Carl Gustav Jung
(1875-1961), and the two were early members with Freud in the Vienna
Psycho-Analytical Society.
His son, Manfred Bleuler, continued his work with respect to familial
(hereditary) aspects, early intra-familial environment and
personalities, long term outcome, and therapeutic interventions.
«Senility often becomes a disease only as a result of the sudden cessation of the ordinary attractions of life.»
