Eugen Bleuler

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The Swiss psychiatrist Eugen Bleuler (1857-1939), noted primarily for his work on schizophrenia, was a renowned dissenter from the orthodox Freudian psychoanalytic approach to psychopathology.

Eugen Bleuler was born in Zurich on April 30, 1857. After taking his medical degree at the University of Zurich, he spent his professional life as director of the Burghölzi hospital, a neurological clinic near Zurich, and as professor of psychiatry at the University of Zurich. Bleuler's approach to mental illness included an appreciation of the importance of motivational factors in abnormal behavior, as well as an understanding that some of these motivational factors may be "unconscious," that is, not recognized by the patient himself. Consequently, he was attracted to certain aspects of Sigmund Freud's psychoanalytical theory. Bleuler began an early correspondence with Freud, and he appointed as his chief assistant at the Burghölzi one of Freud's followers, Carl Jung. Also on the staff of the Burghölzi was another Freudian psychiatrist, Karl Abraham.

Bleuler was present at the first International Psycho-Analytic Congress in Salzburg in April 1908. The first periodical devoted exclusively to psychoanalysis, Jahrbuch für psychoanalytische und psychopathologische Forschungen, was directed by Freud and Bleuler and edited by Jung. Disagreements, both professional and personal, arose between Jung and Bleuler and, eventually, between Freud and Bleuler. Jung finally resigned his position at the Burghölzi, and Bleuler resigned from both the Swiss and the International psychoanalytic associations.

Defining Schizophrenia

Bleuler's contributions to psychiatry were in the field of psychosis. At the time he began his work, psychiatrists tended to think of dementia praecox (early insanity) as a single disorder. Bleuler argued that it was in fact a group of disorders which shared certain symptoms, such as a lack of contact with reality. He coined the term "schizophrenia" (splitting of the mind) as a general classification for these abnormalities. His choice of the term was dictated by his belief that the most characteristic aspect of the disorder was a splitting or dissociation of the patient's total personality. In this regard, Bleuler also introduced the term "ambivalence," which refers to the often conflicting feelings and emotions, both positive and negative, that schizophrenics, and indeed even normal individuals, feel toward the same person, idea, or object. It has been suggested that Bleuler's own conflict with orthodox Freudian psychoanalysis may have been motivated in part by his puritanical feelings about sex and alcohol and may provide an example of his own concept of ambivalence.

Another aspect of schizophrenic behavior studied by Bleuler was the tendency of some patients to withdraw from contact with the reality of the outside world and to live in an "inner world" of their own making. He termed this escape from outer to inner life "autism." Bleuler died in Zurich on July 15, 1939.

Further Reading

There is no full-length biography of Bleuler. Bleuler's Textbook of Psychiatry, edited by A. A. Brill (1951), contains a biographical sketch by Jacob Shatzky. Bleuler's life and work are often discussed in works on Freud. Ernest Jones's comprehensive The Life and Work of Sigmund Freud (3 vols., 1955) contains numerous references to Bleuler, especially vol. 2: Years of Maturity. Vincent Brome, Freud and His Early Circle: The Struggles of Psycho-Analysis (1968), deals with the pioneers in the field, including Bleuler. See also H. F. Ellenberger, Discovery of the Unconscious (1970).

1857-1939

Paul Eugen Bleuler, a Swiss professor of medicine, holder of the chair of psychiatry at the University of Zurich and director of the university psychiatric clinic of Burghölzli in Zurich (1898-1927), was the son of Johann Rudolf Bleuler and Pauline Bleuler-Bleuler. Born April 30, 1857, near Zurich, he died July 15, 1939. Bleuler came from a family of well-to-do farmers. He went to several schools, then studied medicine in Zurich, graduating in 1881. From 1881 to 1884 he was an assistant physician at the university psychiatric clinic of Waldau-Bern. From 1884-1885 he went to Paris to study with Charcot and then to London and Munich, where he studied with Gudden. From 1885 to 1886 Bleuler worked as an assistant physician to August Forel at Burghölzli. From 1886 to 1898 he was director of the psychiatric clinic of Rheinau-Zürich, finally assuming the position formerly held by Forel in Burghölzli in 1898, where he remained until 1927.

His first scientific contact with Freud occurred in 1892, during his work on aphasia. In 1896 Bleuler prepared a favorable report on Breuer and Freud's work, Studien über Hysterie (Studies on Hysteria, 1895). The first correspondence with Freud took place in 1898. In 1900 Bleuler asked his assistant, Carl Gustav Jung, for a report on the Interpretation of Dreams (1900) for the clinic. Extensive correspondence between Freud and Bleuler did not begin until 1904, however. Moreover, it was through Jung's work and therapeutic success, between 1900 and 1909, that Bleuler came to appreciate the possibilities and usefulness of Freudian psychoanalysis. His liberal attitude and open-mindedness only make sense when we consider the influence of August Forel, who saw himself as the vehement defender of hypnotherapy, a man open to a dynamic, scientific, and public comprehension of psychic pathologies (Forel himself was a violent critic of Freudian ideas).

Bleuler's publications between 1906 and 1911 reveal his caution—not entirely uncritical—regarding Freud's work. In 1907, under his direction, the Freudian Association of Zurich was founded at his clinic. Through his work and attitudes, Bleuler unleashed a storm of scientific criticism, especially in German and Swiss psychiatric circles. He also had to withstand personal attacks from those close to him, including Forel and Constantin von Monakow. Additionally, there was pressure from Freud and Jung who, impelled by tactical interests, wanted to secure his active participation in the Zurich regional branch of the International Psychoanalytic Association. These efforts came to a head during a meeting between Freud and Bleuler in December 1910 in Munich. Bleuler's ambivalence, often hinted at and now out in the open after Freud read his article "Die Psychoanalyse Freuds" (Freud's psychoanalysis; 1911), can be explained by the number of constraints that impeded his desire for knowledge and his critical scientific mind. Bleuler was unable to overcome these conflicts and after eleven months he gave up his position. With his "Kritik der Freudischen Theorien" (1913), he lost his position in the orchestra of Freudian science. That same year he, along with Jung, gave up his responsibilities in psychoanalytic circles. Unlike Jung, Bleuler maintained a distant but polite relationship with Freud.

Bleuler's scientific contribution to psychoanalysis is modest. But the scope of his influence, which should not be underestimated, is largely based on his political and medical activities. Through his personality and responsibilities, Bleuler opened the doors of international scientific discourse to Freud and psychoanalysis. "After this it was impossible for psychiatrists to ignore psycho-analysis any longer. Bleuler's great work on schizophrenia (1911), in which the psychoanalytic point of view was placed on an equal footing with the clinical systematic one, completed this success" (Freud, 1914d, p. 28)

Bibliography

Bleuler, Eugen. (1892). Zur Auffassung der subcorticalen Aphasien. Neurologisches Zentralblatt, 18, 562-563.

——. (1896). Buchanzeige über Breuer-Freuds "Studien über Hysterie." Münchner medizinische Wochenschrift, 22, 524-525.

——. (1911). Dementia præcox, oder die Gruppe der Schizophrenien. Aschaffenburg, Handbuch der Psychiatrie. Leipzig: n.p.

——. (1913). Die Kritik der Freudschen Theorie. Allgemeine Zeitschrift für Psychiatrie und psychisch gerichtliche Medizin, 52 (5), 665-718.

Freud, Sigmund. (1914d). On the history of the psychoanalytic movement. SE, 14: 7-66.

—BERNARD MINDER