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.»