Dr. Adolf Meyer (1866-1950), one of sixteen charter members of the American Psychoanalytic Association, may well have been its leading spirit. Graduating from medical school in Zürich in 1890, he spent two years in Paris and London, studying with Charcot, Déjerine, and Hughlings Jackson, and then emigrated to the U.S. hoping for an academic career. In this he was eminently successful, serving as Professor of Psychiatry at Johns Hopkins from 1910 until his death.
In the summer of 1937 I attended the International Congress for Mental Hygiene in Paris with my father, Professor Martin Pappenheim. I knew that Meyer was closely associated with the Mental Hygiene movement and that he had suggested the name to Clifford Beers. In fact, according to Albert Deutschs History of Mental Hygiene, the term had appeared in the U.S. as early as 1841, as the title of a book by Dr. William Sweetser. My father pointed Meyer out to me from a distance. It never occurred to us that I would join his staff a year and a half later.
On December 22, 1938, two days after having landed in the U.S., I sat in the lobby of the Henry Phipps Psychiatric Clinic, full of trepidation and expectation. An elegant, vivacious lady approached me, introduced herself as Mrs. Meyer, and invited me to their annual Christmas dinner. A few minutes later, Dr. Ruth Willmanns came to escort me to Dr. Meyer's office. I had not met her previously, but our parents had been friends before we were born.
Dr. Meyer greeted me rather warmly. He seemed shorter than I had remembered him from Paris. In spite of a certain stiffness, almost an awkwardness, in his behavior, he looked friendly with his bright blue eyes and white goatee. His office was a light, spacious room with trees outside the window. There were books and papers everywhere: on shelves, piled high on his desk, on the floor and on chairs, except for the two leather armchairs in which we sat. He inquired formally about my father, but asked no other personal questions. I was struck by his heavy Swiss accent and his rambling speech, but at least I could understand him. He praised the “Viennese school” of psychiatry, referring to Meynert, Wagner-Jauregg, and Poetzl, none of whom ever considered himself the founder of a school. He also remarked that there would be no psychiatry without Freud, in apparent acknowledgment of my analytic training. My obligations would be to attend the daily morning staff conference and to work in the outpatient department under Dr. Esther Richards.
Three days later, at the Meyer's home for Christmas dinner, I was seated as a first-time guest, to the right of my host, a very thoughtful but embarrassing gesture on the part of Mrs. Meyer.
The daily staff conferences were bewildering affairs. They took place in the library adjacent to Dr. Meyer's office. He sat with his back toward his office door, as if guarding his sanctuary. To his left sat the two attending physicians, Dr. Wendell Muncie and Dr. Thomas A.C. Rennie. Neither said very much and never exchanged a word with me. Dr. Muncie seemed rather dry and businesslike. He later wrote a textbook on Meyer's teaching which rendered it somewhat intelligible. Dr. Rennie struck me as rather prim, too well spoken and too immaculately dressed. Next to him sat the chief resident, Dr. Henry Fox, who later became an analyst. Then came the residents and guests, including on occasion child analyst Lillie Peller. Paul Federn visited once.
The patient material came exclusively from the resident in charge and one attending physician. Dr. Meyer was only rarely consulted and almost never saw patients. A story recounted by Dr. A.R.T. D'Amore sounds characteristic. When Dr. Dexter Bullard, Sr. consulted Meyer and William Alanson White about a difficult case, Dr. White came to Chestnut Lodge to examine the patient. By contrast, Dr. Meyer had Dr. Bullard come to Baltimore to present a case report.
The case conferences started with the elaborate presentation of a case, all in the patient's absence. The residents rotated every three months, so that the patient would not develop a “transference.” The resident's report started with the details of the patient's birth, time of teething, walking, talking, until the complaints were finally reached. The conclusion was a summary and description of the “reaction pattern.” Then a plan for rehabilitation was proposed and discussed, mostly by Dr. Meyer. After this, he would turn to Dr. Joseph Wortis, a resident at the time, and ask: “And what would Freud have said?” To my amazement, Wortis always had an answer. He once laughingly explained to me that of course he did not know; his entire training consisted of four months of analysis with Freud, but he knew what Meyer wanted and it made the old man happy. I was forever grateful that Meyer never asked me.
Dr. Meyer had created a “life chart” in the form of a tree which the resident had to fill out. This chart seemed the crowning achievement of his teaching. He also demanded a soul-searching autobiography from every staff member in writing, and often complained that nobody complied. This report, however, was compulsory for medical students. I heard rumors that they either lied or were so distressed, attempting to be truthful, that some broke down. He had introduced a psychiatric course for each of the four years of medical school. His lectures were read aloud from a typewritten script, which each student had in front of him. There were no patients, no questions, no discussion.
I frequently heard the term “psychobiology,” but it took quite a while for me to understand its meaning. The term was an encapsulation of Meyer's favorite saying: “Body and soul are a unit.” Years later I learned that the phrase had been introduced by Ernst von Feuchtersieben (1806-1849), the first academic psychiatrist in Austria. This source was never mentioned by Meyer. And there was little reference to the body, as Dr. Meyer rejected organicity and heredity. Mental diseases were
“reaction patterns to stressful life events.” They were “faulty habit formations producing a ‘wrong working of the mind’,” i.e., “ergasias” (from the Greek ergon, meaning work). Although Meyer had introduced Kraepelin's terminology when he first came to this country, he had by now rejected his teacher and introduced his own terms. Schizophrenia became parergasia, manic-depressive psychosis hypothymergasia, and so on.
Gradually it dawned on me how much Meyer wanted to be the founder of a new school. Deep inside he knew that he had not; though he was respected and well known, nobody would carry on his teaching. Essentially a very optimistic person, he objected to Freud's pessimism. He believed firmly that patients could be made well, their habits changed, by a thorough dicussion of their life with the psychiatrist.
I had the impression that Meyer was interested only in psychoses, not in neuroses. He never rejected outright the concept of an unconscious, but always emphasized the patient's conscious experience of life events. The patient's “active response” to real life he called “dynamic.”
Meyer's obsessive manner of thinking became clear to me in several ways. He often told us that he had studied seven languages in order to find the right expression for a specific situation. He even extended his descriptive accuracy to the definition of the patellar reflex: “a kicking reaction to a sharp tap on the patellar tendon.”
His almost religious zeal for creating a school and a new terminology may also be understood as the outcome of an early dilemma he often spoke of: whether he should become a minister or a physician. (His father had been a Zwinglian minister.)
“Gradually it dawned on me how much Meyer wanted to be the founder of a new school.”
Meyer's ambivalence about Freud was most poignant for me the morning after Freud's death had been announced on the radio. I fully expected Meyer to say something, but the conference went on as usual. Had he not heard the news? Later, I do not remember the context, he specifically looked at me, referred to some leader in the field and said: “He has died since; I did not, because I did not want to die.” (In retrospect, I believe he was speaking of William Alanson White, who had died in 1937.)
A very positive part of Meyer's teaching was an absolutely outstanding course in brain anatomy. Clear, precise, fascinating. His idea of having us make a three-dimensional model of the brain from plasticine, based on brain slides, was ingenious.
Privately, Dr. Meyer was a different person. Relaxed and outgoing at his parties, he seemed really to enjoy himself. My fondest memory is of a visit I made after I had moved to New York. He and Mrs. Meyer had invited me to lunch and greeted me like a long-time friend. He spoke mostly in German, with obvious pleasure, and showed an unexpected sense of humor. It would have meant a great deal to me to have known him better when I first came to Hopkins. I regret that I had no further opportunity to see the Meyers again.
There is something tragic, almost pathetic, about this controversial man who strove so hard to be remembered. Once an important though barely understood figure, often referred to as the dean of American psychiatry, he deserves to be remembered as one of the founding fathers of our Association.