MEYER, ADOLF (1866-1950)

Meyer, the founder of the holistic approach in psychiatry, was bom in Switzerland and received his medical degree at the University of Ziirich. While still a young man he came to America to serve as pathologist at the Illinois Eastern Hospital for the Insane, and later at the State Hospital in Worcester, Massachusetts. In these positions he attempted to discover the neurological and anatomical bases of psychiatric disorders by making post-mortem examinations of cases of general paresis, acute mania,MEYER, ADOLF senile dementia, and epilepsy. His investigations yielded such meager results that he concluded that studies of pathology can be made only while the patient is alive, and that they must ultimately be geared to prevention.Meyer was given a full opportunity to study living patients when he was appointed director of the New York State Psychiatric Institute in 1902. There he began to develop an integrated, dynamic approach that included not only the physiological but the emotional and social aspects of behavior (Meyer, 1951). In 1910 he accepted the chair of psychiatry at Johns Hopkins Medical School, and soon afterwards established the school’s Henry Phipps Psychiatric Clinic. He remained at Johns Hopkins until his retirement in 1941. From that center he exerted a profound and widespread influence on practically every aspect of the mental health field—therapy, prevention, professional education and hospital organization—an influence that earned him the title of Dean of American Psychiatry.Meyer adopted the “common sense” view that mental illness is a function of maladaptive habit patterns, and that psychotherapy is essentially a process of re-education in which faulty patterns are replaced by more effective ones (Lief, 1948). This relatively simple approach did much to change the character of American mental hospitals. It helped to counteract the air of hopelessness that pervaded these institutions by showing the therapist that something concrete and effective could be done to help the patient. It stimulated an interest in the individual history of the patient and the environmental forces which acted upon him, since a full knowledge of his background and situation were considered a key to his inefficient functioning. He turned the attention of psychiatrists away from nosological categories, and encouraged them to come to grips with the patient himself. See anamnesis, re-education.Meyer took an equally affirmative stand on the subject of prevention, believing that an enlightened public could avoid many of the faulty habit patterns which constitute mental illness. He therefore devoted himself to mass education on mental health and became a dominant force in the mental hygiene movement. When Clifford Beers got in touch with him during his campaign for mental hospital reform, Meyer urged him to publish The Mind That Found Itself because he felt the book might help to stimulate the public to action. He was instrumental in establishing the Connecticut Society for Mental Hygiene and, shortly afterward, the National Committee for Mental Hygiene, an organization which devoted itself to improving conditions in mental institutions and to educating the public on the nature of mental illness and its prevention. See beers, national association FOR MENTAL HEALTH.Finally, Meyer recognized that the patient’s relationship with the “outside” world must be considered an integral aspect of the treatment program. First, if the patient is to live comfortably at home and in the community, the stigma of “insanity” must be removed so that he will be accepted simply as a person who has recovered from an illness. Meyer sought to get this idea across through the mental hygiene movement. And second, he realized the importance of finding out about the character of the patient’s home, the milieu to which he was to return. He therefore took a simple but revolutionary step. He sent his wife to the homes of his patients to gather information about their life history, the course of their illness, and the family’s attitudes toward them. This procedure provided valuable information in planning both the treatment process and the after-care program. It was also the origin of psychiatric social work. Most important, his visits with the family not only helped to create an atmosphere of understanding and acceptance toward the returning patient, but helped to relieve conflicts and tensions that were instrumental in bringing on his disorder. This new program was in a sense an epitome of Meyer’s entire approach. It put the emphasis on practical adjustment to life, on re-education of both the patient and his family, and on prevention of future emotional difficulties.

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