Adolf Meyer (psychiatrist)

Adolf Meyer
File:Adolf meyer.jpg
Born	September 13, 1866 Niederweningen near Zurich, Switzerland
Died	March 17, 1950 (age 83) Baltimore, Maryland, U.S.
Citizenship	American
Nationality	Switzerland
Fields	Psychiatry
Alma mater	University of Zurich
Doctoral advisor	Auguste Forel

Adolf Meyer (September 13, 1866 – March 17, 1950) was a psychiatrist who rose to prominence as the first psychiatrist-in-chief of the Johns Hopkins Hospital (1910-1941). He was president of the American Psychiatric Association in 1927-28 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.

Personal Life and Education

Adolf Meyer was born in Niederweningen, Switzerland in 1866. He was the son of a Zwinglian pastor. Meyer received his M.D. from the University of Zurich in 1892, where he studied neurology under Auguste Forel. During his time at the university, he studied abroad in Paris, London and Edinburgh, working under John Hughlings Jackson and Jean-Martin Charcot. Unable to secure an appointment with the university, he emigrated to the United States in 1892. Meyer married Mary Brooks on September 15, 1902. They had one daughter, Julia Lathrup Meyer, on February 14, 1916. Meyer died on March 17, 1950 in Baltimore, Maryland at the age of 83 due to an unspecified cause.

Medical career

Early career

After moving to the United States, Meyer first practiced neurology and teaching at the University of Chicago, where he was exposed to the ideas of the Chicago functionalists. He was unable to find a paid full-time post at the University of Chicago, so his time at the university was short-lived. 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.

Time in New York

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. 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" Meyer was Professor of Psychiatry at Cornell University from 1904 to 1909.

The Phipps Clinic and Johns Hopkins Medical School

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The Henry Phipps Psychiatric Clinic

In 1908, Meyer was asked to become the director of a new psychiatric clinic at the Johns Hopkins Hospital after Henry Phipps Jr. donated 1.5 million dollars to open the clinic. Meyer accepted the offer, though not immediately. He oversaw the building and development of the clinic and made sure the building was suitable for scientific research, training and treatment. The Henry Phipps Psychiatric Clinic opened in April 1913.

Meyer's work at the Phipps Clinic is arguably the most significant aspect of his career. His model for the Phipps Clinic combined clinical and laboratory work, which was the first time these elements had been combined in a mental institute in the United States. Though the Phipps Clinic did not use the clinical model of Emil Kraepelin, Meyer did incorporate some of Kraepelin's practices into the clinic. These practices include extensive observations of the patients and studying both the presymptomatic and remissive phases of mental illness along with the periods of acute illness.

Meyer also served as a Professor of Psychiatry at Johns Hopkins Medical School from 1910-1941. In his beginning years at Johns Hopkins, Meyer helped oversee the work of a few of his aspiring students. Phyllis Greenacre, from the University of Chicago, and Curt Richter, a Harvard graduate, both got the opportunity to study under Meyer. Most notably, Richter studied the behavior of rats with Meyer and John Watson, a behavioral psychologist.

Adolf Meyer worked at Johns Hopkins until his retirement in 1941.

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Legacy

People

Many of Meyer's students went on to make significant contributions to American psychiatry or psychoanalysis, though not necessarily as Meyerians. 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, and Charles Macfie Campbell.

Meyer and William Henry Welch played an instrumental role in Clifford Beers' founding of the Connecticut Society for Mental Hygiene in 1908. Under Meyer's direction, Leo Kanner founded the first child psychiatry clinic in the United States at the Johns Hopkins Hospital in 1930.

Contributions to psychology

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Meyer

Meyer’s main contribution was in his ideas of psychobiology, where he focused on addressing all biological, social and psychological factors and symptoms pertaining to a patient. Meyer coined the term “ergasiology”, which has Greek roots for “working” and “doing”, as another way to classify psychobiology. One of his ideas was that mental illnesses were a product of a dysfunctional personality and not from the pathology of the brain. He also stressed the idea that social and biological factors that affect someone throughout their entire life should be heavily considered when diagnosing and treating a patient. Another contribution of Meyer was that he was of the earlier psychologists that supported occupational therapy. He thought there was an important connection between the activities of an individual and their mental health. Taking this into consideration he looked for community based activities and services to aid people with everyday living skills.

Meyer was a strong believer in the importance of empiricism, and advocated repeatedly for a scientific approach to understanding mental illness. He hoped that the Phipps Clinic would help put mental illness on the same ground as every other human illness. He insisted that patients could best be understood through consideration of their "psychobiological" life situations. He reframed mental disease as biopsychosocial "reaction types" rather than as biologically-specifiable natural disease entities. In 1906 he reframed dementia praecox as a "reaction type," a discordant bundle of maladaptive habits that arose as a response to biopsychosocial stressors. Meyer was involved with the Eugenics Records Office, which he viewed as a natural extension of the mental hygiene movement which he helped to create. He was in the American Eugenics Society, serving on its advisory council for 12 years from 1923-1935.

Publications

Though Meyer never published a book, he published over 250 articles in various journals in the United States and Europe. Listed below are a few of Meyer's publications. For a more extensive list of his publications, see the "Further Reading" section.

• The Anatomical Facts and Clinical Varieties of Traumatic Insanity (1904)[1]
• The Nature and Conception of Dementia Praecox (1910)
• Constructive Formulation of Schizophrenia (1922)[2]

Notes

• Guide to The Adolf Meyer Collection at http://www.medicalarchives.jhmi.edu; a Guide to the personal papers collection of Adolf Meyer at The Alan Mason Chesney Medical Archives of the Johns Hopkins Medical Institutions with a short biography and timeline
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• Scull, Andrew, and Jay Schulkin. "Psychobiology, Psychiatry, and Psychoanalysis: The Intersecting Careers of Adolf Meyer, Phyllis Greenacre, and Curt Richter." Medical History. National Institute of Health, Jan. 2009. Web. 22 Feb. 2015.

Further reading

The Collected Papers of Adolf Meyer, edited by Eunice E. Winters. Baltimore: The Johns Hopkins University Press, 1950–1952. 4 vols.

The Commonsense Psychiatry of Dr. Adolf Meyer: Fifty-two Selected Papers, edited by Alfred A. Lief. New York: McGraw-Hill, 1948.

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.

Richard Noll, American Madness: The Rise and Fall of Dementia Praecox (Cambridge, MA: Harvard University Press, 2011).

S. D. Lamb, Pathologist of the Mind: Adolf Meyer and the Origins of American Psychiatry (Baltimore: Johns Hopkins University Press, 2014).

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.

See also Theodore Lidz, "Adolf Meyer and the Development of American Psychiatry." The American Journal of Psychiatry, 123(3), pp 320–332 (1966) and C.H. Christiansen "Adolf Meyer Revisited:Connections between Lifestyle, Resilience and Illness". Journal of Occupational Science 14(2),63‐76. (2007).