Adolf Meyer (psychiatrist)

Swiss American psychiatrist (1866–1950)

Adolf Meyer (September 13, 1866 – March 17, 1950) was a Swiss born 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 was one of the most prominent of his contributions. He oversaw the building and development of the Henry Phipps Psychiatric Clinic at Johns Hopkins Hospital, opened in April 1913, making sure it was suitable for scientific research, training and treatment.

Adolf Meyer was born in Niederweningen, Switzerland, in 1866. He was the son of a Zwinglian pastor. Meyer received his MD 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 Potter Brooks, of Newburgh, New York, on September 15, 1902. Meyer died on March 17, 1950, at his home at 4305 Rugby Road in Baltimore, Maryland, of a heart attack. He was buried in Druid Ridge Cemetery in Pikesville, Maryland.

After moving to the United States, Meyer first practiced neurology and taught 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; serving from 1892 to 1895. 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 from 1895 to 1902, all the while publishing papers prolifically in neurology, neuropathology, and psychiatry. He also served as docent at Clark University. 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.

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, which he described as "the most important professorship [in psychiatry] in the English speaking domain." 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 were 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. Adolf Meyer worked at Johns Hopkins until his retirement in 1941. Under Meyer's direction, Leo Kanner founded the first child psychiatry clinic in the United States at the Johns Hopkins Hospital in 1930.

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 one 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, and, particularly, a biological 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. Meyer was also involved with the Eugenics Records Office, which he viewed as a natural extension of the mental hygiene movement which he helped to create. He served on the advisory council of the American Eugenics Society for 12 years, from 1923 to 1935. Meyer's views on eugenics have not yet been studied closely and his association with the Eugenics Record Office cannot be equated straightforwardly with the extremism of some eugenicists, especially in light of the fact that the fundamental premise of Meyerian psychobiology contradicted the genetic determinism that underpinned scientific racism in the first half of the twentieth century. Meyer had oversight over Henry Cotton, who ran a psychiatric hospital which regularly extracted the teeth and organs from patients, resulting in about a 45% death rate. Cotton believed that nearly all psychiatric problems could be resolved through the complete removal of teeth and subjected hundreds of patients to this treatment, over their objections and resistance. Although Meyer knew that Cotton's psychiatric hospital was a torture chamber, he actively prevented news of this from reaching the general public and praised Cotton publicly while burying investigations by other doctors. In Madhouse: A Tragic Tale of Megalomania and Modern Medicine, Andrew Scull faults Meyer for this decision.