Paul Eugen Bleuler was a Swiss psychiatrist and eugenicist most notable for his contributions to the understanding of mental illness. He coined many psychiatric terms, such as "schizophrenia", "schizoid", "autism", depth psychology and what Sigmund Freud called "Bleuler's happily chosen term ambivalence".
Following his interest in hypnotism, especially in its "introspective" variant, Bleuler became interested in Sigmund Freud's work. He favorably reviewed Josef Breuer and Freud's Studies on Hysteria. 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 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. He found Freud's movement to be overly dogmatic and resigned from the International Psychoanalytic Association 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. 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" to the world in a lecture in Berlin on 24 April1908. However, perhaps as early as 1907 he and his colleagues had been using the term in Zurich to replace Emil Kraepelin's term dementia praecox. He revised and expanded his schizophrenia concept in his seminal study of 1911, Dementia Praecox, oder Gruppe der Schizophrenien, which was translated into English only in 1950. Like Kraepelin, Bleuler argued that dementia praecox, or "the schizophrenias", was fundamentally a physical disease process characterized by exacerbations and remissions. 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, he believed that the overall prognosis was not uniformly grim, the "dementia" was a secondary symptom not directly caused by the underlying biological process, and that the biological disease was much more prevalent in the population due to its "simple" and especially "latent" forms. Bleuler wrote in 1911: "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 of persons diagnosed with 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: He believed the disease's central characteristics to be the product of a process 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, and 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. Bleuler was known for his clinical observation and willingness to let symptoms speak for themselves, as well as for his skillful expository writings. Bleuler is not credited of ever having healed a single patient. Like Sigmund Freud he experimented on patients in his care; many were sterilised and many committed suicide.
