Eugen Bleuler

Eugen Bleuler (Zollikon (close to Zurich) 1857 - 1939) is a known Swiss psychiatrist to have introduced the terms Schizophrénie and Autisme.

Biography

Eugen Bleuler obtains its doctorate of medicine in 1881. From 1881 to 1883, he is assistant in psychiatry with (close to Bern), under the direction of Wilhelm von Speyr. In 1884 Bleuler travels to England and France and follows in particular the courses of Jean Martin Charcot. After having worked as assistant with Munich in the laboratory of Johann Bernhard Aloys von Gudden, it is engaged as assistant with the psychiatric private clinic of Burghölzli in 1885 by Auguste Forel.

From 1886 to 1898, he will be the director of a psychiatric private clinic with Rheinau (close to Zurich). In 1889 it publishes Zur Psychologie der Hypnose , delivers in which it gives an account of the experiments that it made when it was hypnotized by von Speyr and Forel. Succeeding this last, of 1898 to 1927, he is director of the psychiatric private clinic of the Burghölzli and professor of psychiatry to Zurich.

One counts in particular among his assistants Carl Jung (of 1900 to 1909), Karl Abraham (of 1904 to 1907) and Ludwig Binswanger (of 1907 to 1910). Bleuler will be also the professor of Hermann Rorschach. Bleuler meets Sigmund Freud in 1904 and in 1906 to the members of Burghölzli the book of Freud the interpretation of the dreams requires of Carl Jung to present. It takes part in the first international psychoanalytical congress in Salzburg in 1908 and contributes to the creation of the International Psychoanalytical Société in 1910.

In 1911, in the dementia praecox or the group of schizophrenias , it challenges the term of Dementia praecox of Emil Kraepelin, and replaces it by that of Schizophrénie to illustrate the idea of a fragmentation of the spirit. For Bleuler, schizophrenia corresponds to a group of Syndrome S private clinics, different but always organic origins, joined together by common psychopathological mechanisms.

In 1920, it takes part in experiments with the Austrian medium with Carl Jung and.

Its nosography

The Schizophrénie, which replaced the old term of Dementia praecox, indicates a group of chronic mental diseases characterized by the association of 3 great orders of disorders:

the discordance (or dissociation),
the Is delirious paranoid
and the Autisme.

The Is delirious paranoid

Topics: polymorphic

Syndrome of depersonalization (body transformation, dysmorphophobie, distress parcelling out, of body dislocation)
Étrangeté of the world (feeling of ambient hostility, derealisation…)
Syndrome of influence (an external force imposes its will on the subject)
Persécution, megalomania, mystic,…

Mechanisms: prevalence of the Hallucination S psychic or psychosensorielles. Not systematized: set of themes badly organized without guiding idea, impression of bizarrery, is delirious not very communicable…

The dissociative syndrome

The dissociative Syndrome is in the middle of the schizophrenic syndrome. It translates a scission which takes place in the conscience and the personality of the subject. It makes lose any cohesion, as well with the unit of sound Me as in the world as it perceives. It consists of 4 characteristic features:

the Ambivalence: contradiction infiltrates all the feelings and acts of S.
the bizarrery: it results from its odd conduits and expressions and illogiques.
the Impénétrabilité: the inconsistency of the remarks and conduits makes them incomprehensible.
the Detachment: bound to the Return to oneself and the apparent indifference.

intellectual Sphere

Disorder S of the course of the thought: blur, discontinuity, stopping (suspension of the speech), Fading (deceleration).
Turbid of the contents of the thought: déréelle (not directed towards real situations).
Turbid of the attention and the concentration.
Turbid of the use of the intelligence.
Turbid of the fields of conscience: upheaval of the temporo-space immediate data.
Schizophasia (distortion of the verbal system): Dumbness, Neologism (creation of a word which does not exist), Paralogisme (use of a word in an inappropriate direction), Agrammatisme (not respect of syntax), Logolâtrie (worship of the magic words),…

Relâchement of associations, deterioration of the logical system (the opposites can be allowed).
morbid Rationalism (the thought is lost in a number of inappropriate associations).
Speech abstracted with symbols and very subjective metaphors, hermetism.
Associations by assonances.
tangential Answers (the subject does not answer really, but not at side either).
Speech circonlocutoire (the subject does not arrive at the end of its idea).

instinctivo-emotional Sphere

Athymhormie (loss of the vital dash).
Emotional ambivalence (coexistence of 2 opposite emotions) with ignorance of contradictions.
Émoussement of the affects, “schizophrenic coldness”.
Alexithymie (incapacity to express its affects).
Deterioration of the sexual behavior: loss of reserves, auto-erotism, unused…

behavioral Sphere

schizophrenic Mannerism (gestural unusual, left)
driving Stereotypies: swinging, scraping,…

the autistic syndrome (overdrawn, negative).
Loss of the contact with reality, fold.
Absence of initiative, Apragmatisme (lowers activities).
Coldness, émoussement emotional, loss of the interests, anemotivity
Anhédonie (incapacity to test pleasure).
rather poor and stereotyped Speech.
poor and not very expressive Mimicry.
Gestural poor.
Poverty in the visual contact, loss of prosody, your monocorde.
Can go until major social insulation.
Incurie.
Abulia (loss or reduction in the will).

The syndrome catatonic

Negativism: attitude of active opposition, dumbness, voluntary absence of speech.
Catalepsy: muscular Hypertonicity, maintenance of the imposed attitudes, enraidissement.
driving Impulses: crises clastic auto- or hétéro-aggressive, impulsive, short.

Clinical forms

Schizo. paranoid: be delirious paranoid continuous, evolution towards enkystement of is delirious.
Hébéphrénie : intellectual and psychoaffective discordance major, little of are delirious, evolution towards intellectual deficit.
Hébéphréno-catatonie : deficit hebephrenic and psychomotor syndrome catatonic major.
Schizo. simple: evolution slowly progressive, not of is delirious, disinterest for the pragmatic life.
Dysthymie .
Héboïdophrénie: pseudo-psychopathic.

Etiology

According to Bleuler, at the base of schizophrenia is a biological process (the basal deterioration of the associative functions) which makes emerge the primary education signs of the disease over which appear secondary signs (psychological reactions of the subject vis-a-vis its suffering) which constitute true fight plans against the basic biological process.

Among the primary education signs, Bleuler integrates the blocking of the thought and the signs appearing at the time of the acute pushes without any external reason: states of obtusion, episodes of excitation or depression, predisposition to the hallucinations, the syndrome catatonic and some signs physical.

Bleuler showed that the psychoanalysis makes it possible to find the direction of the secondary signs, symptoms coming from an unconscious psychogenesis. All the signs of the instinctivo-emotional sphere above are secondary signs. Bleuler spoke about emotional load of the complexes…

These secondary signs are thus opposed to the primary education signs which, resulting from a biological process, cannot be interpreted.

This constitutes a real introduction to psychopathology, the comprehension of the signs and of their direction.

For the organicists, the reality of the genetic factor of certain schizophrenias seems shown thanks to the family statistics.

The environmental approach (cultural or psychosocial) of schizophrenia is from the different point of view. Contradicting the universality of schizophrenia it remarks its extreme diversity according to the cultures, and its sensitivity to the rupture of the traditional social relations… Schizophrenia can become a “attempt at cure” by the S itself of the disease created by the oppression of the company. It chooses to escape some by the madness.

For certain psychoanalysts, schizophrenia would be related to early interactions with the mother, the parents, who would not have allowed the constitution of a good internal object. The anguish related in the schizo-paranoid Position ((Melanie Klein) to the fear of invasion by the object or the collapse (Donald Winnicott) of the object, would become thus an anguish of loss and destruction of the object.

Works

Zur Psychology DER Hypnosis , 1889
Affectivity, suggestibility, paranoia , 1906
the dementia praecox and the group of schizophrenias , 1911
the discovery of the autism , 1912
Lehrbuch DER Psychiatry , 1916
Natural history of the heart , 1920

Comments

Authors comment on work of Bleuler in the light of their clean discovered:

Request in Bleuler by Daniel Blanchard (2005)

External bonds

Pierre Janet' S influences one off Bleuler' S concept Schizophrenia by Andrew Moskowitz JANETIAN STUDIES vol. 2 (2005)

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