BRILL, ABRAHAM ARDEN (1874— 1948)

Brill, chiefly known as one of the first exponents of psychoanalysis in America, was bom in Austria and came to the United States as a boy. After graduating from New York University and receiving his medical degree from Columbia College of Physicians and Surgeons, he served as assistant physi BROMIDE INTOXICATION dan at the Central Islip State Hospital for four years, then went to Europe to study under Sigmund Freud. Following a period as chief of the psychiatric clinic at the University of Zurich, he studied under Eugen Bleuler. Returning to the United States, he became head of the Columbia University Clinic of Psychiatry in 1911, and in the same year founded the New York Psychoanalytic Society. In the years that followed he became a lecturer on psychoanalysis and abnormal psychology at Columbia, New York University and Postgraduate Medical Center. At the same time he devoted himself to the translation of Freud’s works, and made many important contributions of his own through such books as Psychoanalysis, Its Theories and Practical Applications (1921) and Fundamental Conceptions of Psychoanalysis (1922).Brill’s studies in Europe had brought him into contact not only with Freud’s theory of psychoanalysis but with Bleu- ler’s views on the psychodynamics of psychoses. Although these developments were practically unknown in the United States, he recognized their significance and sought to introduce them into American psychiatry.The Freudian theories, with their revolutionary emphasis on unconscious determinants of behavior, met with open hostility. The profession did not take kindly to the idea that men are not the masters of their fate and have little insight into their own motivations. Moreover, the treatment of the neurotic, which Freud stressed, had been largely neglected in America as well as Europe, since most psychiatrists were solely concerned with the more extreme disturbances. It was largely through Brill’s translations of one after another of Freud’s works, as well as his persistent and astute efforts to explain the theory, that the psychoanalytic approach gradually gained a foothold in this country. He was also instrumental in introducing the psychoanalytic treatment of neurotic disorders, and within the relatively short span of two to three decades it had become the dominant technique in the field.The second major approach which Brill brought to America resulted from the studies he made with Bleuler on patients with chronic dementia praecox (later termed schizophrenia). These studies suggested that even though the schizophrenic’s behavior appeared bizarre, it nevertheless had an underlying meaning in terms of the patient’s own life experiences. Brill therefore felt that if the therapist would establish a relationship with the patient and adopt a flexible approach which departed from the orthodox Freudian techniques, he might discover the hidden meaning of the patient’s symptoms and help him gain insight into his reactions. In his own words, he attempted to treat the schizophrenic analytically in the hope that “an unknown something might change him to a normal human being.” Like others who have made similar attempts, he had little success with this approach, but his work did give impetus to further experiments with psychotherapy for psychotic patients. See BLEULER.