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Revolution in the Burgholzi - The Work of Jung and Bleuler

Posted March 6th, 2011 at 01:12 PM by Gile na Gile
Updated March 6th, 2011 at 02:55 PM by Gile na Gile

It is well known that when scientists, researchers or explorers encounter a new entity, place or condition they select carefully the new signifier that will henceforth come to represent the phenomenon. For example, the word malaria was chosen from the mediaeval Latin mal aria or 'bad air' because it was then thought that the disease somehow had its origins in the putrescent vapours that were common in the swampy regions where people were afflicted. So too, the 16th century anatomist Giulio Aranzi wisely declined to name the hippocampus after any supposed function it may have and instead opted for a signifier based upon its visual resemblance to a seahorse. (from the Greek; hippo = horse and kampos = monster)

Likewise, when Eugen Bleuler bequeathed the world the term schizophrenia, literally ' split mind', deeply unfortunate though the subsequent connotations have proven to be, he had at heart at least the noble intention of attempting to improve the living conditions for the patients on his ward. He tried to emphasise that a particular form of cognitive impairment; the loosening of associations or linkages between thoughts were giving rise to the observed symptoms. What this meant in practice was that rather than being left abandoned to their fate -which was the tendency of psychiatry at that time, regarding them more as burnt out husks of humanity unamenable to treatment due to some unfathomable congenital disorder - the patient could instead be approached by the physician with a view to re-establishing these broken linkages and effecting a bridge between their inner imaginative world and that of the world around them.

It is perhaps little known outside of the small circle of historians concerned with the development of the psychiatric diagnoses that Bleuler was directly influenced by the work of both Freud and Jung. Freud's work on the unconscious, essentially the search for these 'associations' compelled Bleuler to join, albeit briefly, the newly formed International Psychoanalytical Association. This decision can only have been prompted by the recognition that these fragments of speech experienced by the listener as 'loose' or close to meaningless isolates were only the outward manifestation of a rich and complex inner world, a world which when unravelled bore a striking resemblance to the unconscious of Freud, whose ideas were only beginning to gain currency around this time (1906-09).

Carl Jung, who was Bleuler's colleague at the Burgholzi was engaged in his pioneering work on word association tests at a time when Bleuler was evidently becoming increasingly dissatisfied with Kraepelin's notion of dementia praecox (literally: premature dementia - and which shouldn't come as a surprise given the living conditions that were endured). Jung had also begun to pay close attention to those patients who seemingly fitted Kraepelin's category of dementia praecox and concluded the name an unhappy one for the dementia; "was not
always precocious, nor in all cases was there dementia".

Instead, he listened carefully, night after night, day after day and soon determined that the speech of these forgotten souls, most of whom had been kept for years on end at the Burgholzi, and who had previously been regarded so desultorily as incurably 'catatonic' or 'hebephrenic' was not 'inchoate babble' as previously thought but had a sense and meaning that could be understood given the proper qualities of skill, time and patience in the physician.

In time, a quiet revolution took place in the Burgholzi that brought the inmate, now 'patient', back into the fold of the properly human domain. For it stood to reason that if sense and meaning could be found in these utterances then a cure may be better effected once a line of rudimentary communication was established. I'm placing the word cure in inverted commas to emphasise the type of approach which was required in order to satisfactorily begin this communication -

For then, as today, you cannot start off on the assumption that the mental region inhabited by the patient is some kind of locus desperatus for this is where nature has seen fit to deposit them - and in response to what exigencies we can only begin to guess. The code to this fortress likewise should not be pursued in the spirit of the safecracker who will ungratefully bolt once he is thought to have secured the Oedipal diamond.

If this is all that is being valued then quite rightly the whole process will bear the hallmarks of an unwanted intrusion. Having a pre-prepared schematic of what constitutes the unconscious; what is by definition the unspoken, the unarticulated, the unknown, and then foisting these ill-conceived schemata atop our patient will only result in the process being experienced as just another form of mental colonization - hastening thereby further retreats into the inner, imaginative world.

Through Jung and Bleuler's work, in this respect, and in the early days at least, analysis was on the right track.
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