Adolf Meyer (psychiatrist)

Adolf Meyer, M.D., LL.D., born September 13 1866 in Niederwenigen, near Zurich, Switzerland, died March 17 1950, was a Swiss psychiatrist who rose to prominence as the president of the American Psychiatric Association and was one of the most influential figures in psychiatry in the first half of the twentieth century. His focus on collecting detailed case histories on patients is the most prominent of his contributions; along with his insistence that patients could best be understood through consideration of their life situations.

Career
Meyer received his M.D. from the University of Zürich after studying psychiatry with Forel and neuropathology with Constantin von Monakow, and subsequently began his professional career as a neuropathologist.

Unable to secure an appointment with the university, he emigrated to the U.S. in 1892, at first practicing neurology and teaching at the University of Chicago, where he was exposed to the ideas of the Chicago functionalists. From 1893 to 1895 he served as pathologist at the new mental hospital at Kankakee, Illinois, after which he worked at the state hospital at Worcester, Massachusetts, all the while publishing papers prolifically in neurology, neuropathology, and psychiatry. In 1902 he became director of the Pathological Institute of the New York State Hospital system (shortly afterwards given its present name, The Psychiatric Institute), where in the next few years he shaped much of American psychiatry by emphasizing the importance of keeping detailed patient records and by introducing both Emil Kraepelin's classificatory system and Sigmund Freud's ideas. While in the New York State Hospital system Meyer adopted Freud's ideas about the importance both of sexuality and of the formative influence of early rearing on the adult personality. Meyer was Professor of Psychiatry first at Cornell University from 1904 to 1909 and from 1910 to 1941 at Johns Hopkins University, where he was also Director of the Henry Phipps Psychiatric Clinic from its inception in 1913.

His principal contributions were through his ideas of psychobiology (or alternatively, ergasiology, a term he coined from the Greek words for working and doing), by which Meyer designated an approach to psychiatric patients that embraced researching and noting all biological, psychological, and social factors relevant to a case — thus his emphasis on collecting detailed case histories for patients, paying particular attention to the social and environmental background to a patient's upbringing. Meyer believed that mental illness results from personality dysfunction, rather than brain pathology. His later teachings resisted some of the ideas of Sigmund Freud, which Meyer thought placed too much emphasis on factors that were tangential to the functional needs of patients in their everyday lives. Though Meyer's own system of nomenclature never caught on, his ideas, especially those emphasizing the importance of social factors, and his insistence on understanding the life of the patient through careful interviewing, did exert some influence but perhaps remain largely unappreciated in the history of American psychiatry.

It was Meyer who suggested the term 'mental hygiene' to Clifford Beers, after which Beers founded, with the support of Meyer and William James, the Connecticut Society for Mental Hygiene (1908) and the National Committee for Mental Hygiene (1909).

Legacy
Meyer wrote no books; his pervasive influence on American psychiatry stemmed instead from his numerous published papers, his prestige, and his students, both at Manhattan State and, especially, at Johns Hopkins. Many of his students went on to make significant contributions to American psychiatry or psychoanalysis, though not necessarily as Meyerians. Always eclectic and willing to absorb ideas from whatever sources he found relevant, Meyer never formed his own discrete school of thought with disciples. Most of the founders of the New York Psychoanalytic Society had worked under Meyer at Manhattan State Hospital, including its chief architect Abraham Arden Brill. Though Meyer found Freud's ideas interesting, he never practiced psychoanalysis and increasingly distanced himself from it as the years went on. As he wrote in his presidential address to the 84th Annual Meeting of the American Psychiatric Association: "Those who imagine that all psychiatry and psychopathology and therapy have to resolve themselves into a smattering of claims and hypotheses of psychoanalysis and that they stand or fall with one's feelings about psychoanalysis, are equally misguided" [page 18 in the Collected Papers, volume II, originally published in the American Journal of Psychiatry, LXXXV, 1928, 1-31]. This address, "Thirty-Five Years of Psychiatry in the United States and Our Present Outlook" gives Meyer's own account of American psychiatry during the time when he himself was important in helping to shape it.

Meyer was a strong believer in the importance of empiricism, and advocated repeatedly for a scientific approach to understanding mental illness. Meyer introduced the possibility of infections (then viewed as the cutting edge concept of scientific medicine) being a biological cause of behavioral abnormalities, in contrast to eugenic theories that emphasized heredity and to Freud's theories of childhood traumas. Meyer's work was greatly influenced by Charles Peirce, William James, and John Dewey.

Works
For Meyer's writings see The Collected Papers of Adolf Meyer, edited by Eunice E. Winters. Baltimore: The Johns Hopkins University Press, 1950-1952. 4 vols. Volume I covers neurology; volume II psychiatry; volume III medical teaching; volume 4 mental hygiene. The introductions to each volume provide biographical background for the volume's subject area.

A good selection of Meyer's published work can be found in The Commonsense Psychiatry of Dr. Adolf Meyer: Fifty-two Selected Papers, edited by Alfred A. Lief. New York: McGraw-Hill, 1948.

Probably the best exposition of Meyer's psychobiology is to be found in Psychobiology: a Science of Man, compiled and edited by Eunice E. Winters and Anna Mae Bowers. Springfield, IL: Charles C Thomas, (1957). This posthumous book was based on the first Thomas W. Salmon Lectures, which Meyer gave in 1931.

George Kirby's Guides for History Taking and Clinical Examination of Psychiatric Cases (Utica: State Hospitals Press 1921) is essentially the form Meyer created and used at Manhattan State Hospital in 1905-1906. It provides an excellent view of Meyer's early approach to taking case histories.

Meyer's paper "The Nature and Conception of Dementia Praecox," originally published in the Journal of Abnormal Psychology, was one of three papers collected in Dementia Praecox: a Monograph (Boston: Richard G. Badger, 1911). This was the first book authored by Americans on schizophrenia. The other two papers were by Smith Ely Jelliffe and Meyer's colleague in New York, August Hoch. All three papers were originally read at a symposium on dementia praecox during the annual meeting of the American Neurological Association in 1910.

Meyer's influence on American psychology can be explored in Defining American Psychology: the Correspondence Between Adolf Meyer and Edward Bradford Titchener, edited by Ruth Leys and Rand B. Evans. Baltimore/London: The Johns Hopkins University Press, (1990).

Though there is no biography of Meyer, his work and significance for American psychoanalysis are discussed in John C. Burnham's Psychoanalysis and American Medicine, 1894-1917: Medicine, Science, and Culture. New York: International Universities Press, 1967. Meyer's importance to the development of American psychoanalysis is also extensively discussed and interpreted in John Gach's "Culture & Complex: On the Early History of Psychoanalysis in America," pages 135-160 in Essays in the History of Psychiatry, edited by Edwin R. Wallace IV and Lucius Pressley. Columbia, SC: William S. Hall Psychiatric Institute, 1980. Brief but salient is John Burnham's entry on Meyer, pages 215-216 in volume seven of the International Encyclopedia of Psychiatry, Psychology, Psychoanalysis, & Neurology, edited by Benjamin B. Wolman. New York: Van Nostrand Reinhold Company for Aesculapius Publishers, (1977). See also Theodore Lidz, "Adolf Meyer and the Development of American Psychiatry." The American Journal of Psychiatry, 123(3), pp 320-332.

 Guide to the personal papers collection of Adolf Meyer at The Alan Mason Chesney Medical Archives of the Johns Hopkins Medical Institutions

Adolph Meyer is also considered the father of occupational therapy. He believed that men could influence the state of their own health through the use of their hands.

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