A Letter from Manfred Bleuler to Edward Podvoll

Edward Podvoll (left) and Manfred Bleuler (right)

Prof. Dr. Med. M. Bleueler

Zurich

October 6th, 1984

Doctor Edward Mitchell Podvoll, MD

1507 Pine Street

Boulder, Colorado 80302 USA

Dear Doctor Podvoll,

Your message of September 16th and your paper have interested me in an exceptionally high degree and they have engaged me emotionally so much that I ask you a favor: I mean the favor to write to you in an informal way as one writes to a friend and to accept my letter in spite of my English which has become very awkward since I finished my psychiatric and neurological graining in the USA 52 years ago. You also will excuse my bad typing as I have no more secretaries who type in English.

The treatment of schizophrenic patients and the care for them you have described is outstanding. I asked myself immediately in what way it corresponds to the conception of my father and myself—and to our practical work. In regard to your conception it is in many respects more systematic and clearer than ours but the correspondence in regard to the main ideas is overwhelming. In regard to the correspondence of our practical work with schizophrenics I have to confess painful differences: during my life time and even more during my father’s life time we had not the possibilities to form teams of helpers—there was by far not enough money to support them. And just as sufficient money was lacking, there was sufficient time, which was lacking—as we were both responsible for large psychiatric hospitals with my hundreds [of patient] admissions and discharges a year. Many of the activities you mention in the treatment and care for patients were also our activities, but many other ones have not been possible and played only a role in our day-dreaming. One common activity with our patients, which is hardly possible in modern time and in Colorado, which played a great role in our country and our time was farming together with patients. It seemed to us to have a very good effect.

May I mention some particular points in regard to which I found your presentation particularly excellent: the importance of the “history of sanity” is rarely mentioned in the psychotherapeutic literature. As far as I know you are the first who describes it in such a convincing way. It plays also a great role in my psychiatric work—the need to be free from the prejudice that a person who has become insane will always be so, is extremely urgent and you are formulating it very well. I have been much attacked within the last years as I have seen and described many schizophrenics who had been severely sick for long periods to recover. The critic of my teaching and my experience consists in the following opinion: “A schizophrenic patient can never recover—if you imagine to have seen recoveries of schizophrenic patients the reason is: you have made a wrong diagnosis.” In my mind this criticism is unrealistic and is harmful to our patients. I am glad to know that you fight with me against this criticism.

I am glad you agree with my Aubrey Lewes Lecture of 1973. I have, however, described my experience with schizophrenics in many other papers ever since then. I am sorry that I have not more reprints of these papers in English and I suppose that it is senseless to send you papers in German. I hope, however, to soon get reprints of my last summary of my experience with schizophrenics which will appear in the “Handbook on studies of schizophrenia” edited by Burrows (Elsevier Biomedical Press). I hope I can send you a reprint.

With many thanks for your good message.

And very sincerely yours,

M. Bleuler