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The famous Swiss psychiatrist, Eugen Bleuler (figure 1), is well known for his seminal work on psychosis, for having coined the term ‘schizophrenia’ and for his disputes about psychoanalysis with Sigmund Freud. Less known is the fact that Bleuler was a harsh critic of many of the methods and practices of his colleagues. In a small book, first issued in 1919, when he was 61 years old, he castigated many of his contemporaries for sloppy thinking and poor methods, both in medical practice and research.1
The title of the book sounds too good in German not to quote it fully: Das Autistisch-Undisziplinierte Denken in der Medizin und seine Überwindung. This provocative title can be translated as Autistic and undisciplined thinking in medicine, and how to overcome it. In the first chapter, Bleuler asserts that many of the cognitive habits of doctors can be compared with what he observed in his patients: a magical way of thinking, more aimed at the fulfilment of wishes and hopes than reflecting and analysing reality: hence ‘autistic thinking’.2 According to Bleuler, this pathological cognitive style is paramount in medicine, far more than in other sciences.3 He explains this by the complexity and obscurity of most medical knowledge, in combination with the need to defy sickness and death. The combination of our limited knowledge and the need to act causes what …
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