Goldstein, Kurt
Goldstein, Kurt
Kurt Goldstein, American neurologist, psychiatrist, and psychologist, was born in 1878 in Kattowitz, Germany, and died in 1965 in New York City.
Goldstein entered medicine with the intention of devoting his life to the treatment of patients with mental diseases. In 1903 he received his medical degree at Breslau, Germany. He studied psychiatry with Karl Wernicke and neuroanatomy with Ludwig Edinger. His first ten papers, all published between 1903 and 1904, are studies of the anatomy of spinal pathways, of the embryology of the brain, and of comparative neuroanatomy. Clinical papers soon followed: one, in 1906, on memory problems and deficits created by neuro logical and psychiatric disturbances, foreshadowed important distinctions that underlie present-day differential diagnostic testing. In 1906 he joined the staff of the psychiatric clinic at the University of Königsberg, where he found his high expectations thwarted: mental patients were relegated to custodial care without any attempt at treatment. Nor did the prevailing Kraepelinian nosology indicate any conceivable direction for therapy. Goldstein used the opportunity for careful examination and observation of patients and published papers on neurological and psychiatric topics—motor disturbances, sensory disturbances, the nature of hallucinations, alcoholism, manic-depressive states, schizophrenia—and comparisons of clinical symptoms with post-mortem findings.
In 1919 he was appointed professor of neurology and director of the Neurological Institute at the University of Frankfurt. There he established the Institut zur Erforschung der Folgeerscheinungen von Hirnverletzungen, where, under his aegis and in collaboration with the psychologist Adhémar Gelb and many students, a large number of brain-injured soldiers were studied intensively and for long periods of time. These studies led to entirely novel conceptions of such problems as aphasia, agnosia, and tonus disturbances and generally to systematic descriptions of behavioral changes wrought by brain injury. In 1930 Goldstein became professor of neurology at the University of Berlin and director of the Neurological Hospital Moabit, a post he held until Hitler’s advent in 1933. After a year’s writing in Amsterdam he came to New York City in 1935; until 1940 he was clinical professor of neurology at Columbia University and head physician at Montefiore Hospital. In 1939 Harvard invited him to deliver the William James lectures, which were published under the title Human Nature in the Light of Psychopathology (1940). From 1940 to 1945 he continued research and teaching as professor of neurology at Tufts Medical School, Boston. He then returned to New York, where he practiced privately and taught at the College of the City of New York, Columbia University, and the New School for Social Research. For many years he was also a guest pro fessor at Brandeis University.
Goldstein’s experimental papers and monographs provoked lively discussions among neurologists and psychologists; yet his greatest impact came with the publication of The Organism: A Holistic Approach to Biology Derived From Pathological Data in Man (1934), written during his year’s exile in Amsterdam. Goldstein viewed behavior as the unified activity of the whole organism, whose basic “motive” is optimum self-actualization in a given environment. Reflexes, clinical symptoms, or functions subjected to laboratory investigation are part processes, and failure to consider that their isolation is artificial results in erroneous interpretation. Study of brain-injured patients reveals the general change underlying specific symptoms and manifestations, namely, an impairment of the patients’ “ab stract attitude” and a preponderance of “concrete” modes of behavior, affecting all performance fields. The “abstract attitude” is defined, basically, as man’s capacity to reason deliberately, to plan and account for his actions, to view particular objects or events as instances of a class. Upon loss of these capacities the individual is at the mercy of the immediate, concrete sensory or mnemonic stimulus situation and is unable to transcend it. The aphasic patient cannot name an object, that is, supply the class symbol, yet he may spontaneously produce the word within a sentence or an action. Thus, aphasia is not a loss of words or word images. Rather, it is a dedifferentiation of language, a loss of concepts and their symbols; in other words, it is the manifestation in language of impaired abstraction. This view has important implications for the problem of cerebral localization. Functions cannot be localized, although defects can be, if we keep in mind the problem of isolated part processes and integrated organismic activity.
Impairment of abstraction is not limited to brain-injured patients. It manifests itself also in psychotic processes. Whatever its cause, impaired abstraction restricts the patient’s opportunities for self-realization. Consequently, his conduct becomes rigid; he is vulnerable to anxiety, to the “catastrophic reaction,” that is, to the threat of being unable to actualize himself, and to the danger of “losing existence.”
Goldstein was only peripherally associated with the gestalt psychologists Wertheimer, Köhler, and Koffka; however, he was an editor of Psychologische Forschung, the house organ of gestalt psychology. While he never established a school, his views on aphasia profoundly influenced the English neurologist Sir Henry Head, as well as philosophers concerned with problems of normal language, particularly Goldstein’s cousin Ernst Cassirer and the followers of Edmund Husserl. Generally critical of psychoanalytic theory, Goldstein acknowledged the importance of some of Freud’s views, especially his broad emphasis on motivation and his discussion of the nature of symptoms. Existential psychology has claimed Goldstein somewhat unsuccessfully. Although phenomenological observation and analysis were fundamental to his work, he did not share the metaphysics of existential psychology and psychiatry.
Marianne L. Simmel
[For the historical context of Goldstein’s work, seeGestalt theoryand the biographies ofKoffka; KÖhler; Wertheimer. For discussion of subsequent development of his ideas, seeLanguage, article onSpeech Pathology; Mental Disorders, article onOrganic Aspects; Nervous System; Systems Analysis, article onPsychological Systems; and the biographies ofCassirerandHusserl.]
WORKS BY GOLDSTEIN
1927 Die Legalisation in der Grosshirnrinde. Pages 600-842 in Handbuch der normalen und pathologischen Physiologie, mit Berücksichtigung der experimentellen Pharmakologie. Volume 10: Spezielle Physiologie des Zentralnervensystems der Wirbeltiere. Berlin: Springer.
(1934) 1939 The Organism: A Holistic Approach to Biology Derived From Pathological Data in Man. New York: American Book. → First published as Der Aufbau des Organismus.
1940 Human Nature in the Light of Psychopathology. Cambridge, Mass.: Harvard Univ. Press.
1941 Goldstein, Kurt; and Scheerer, Martin. Abstract and Concrete Behavior: An Experimental Study With Special Tests. Psychological Monographs 53, no. 2, serial no. 239.
1942 Aftereffects of Brain Injuries in War, Their Evaluation and Treatment: The Application of Psychologic Methods in the Clinic. New York: Grune.
1948 Language and Language Disturbances: Aphasic Symptom Complexes and Their Significance for Medicine and Theory of Language. New York: Grune.
1959 Notes on the Development of My Concepts. Journal of Individual Psychology 15:5–14.
SUPPLEMENTARY BIBLIOGRAPHY
Goldstein Anniversary Number. 1949 Confinia neurologica 9:1–272.
Head, Henry 1926 Aphasia and Kindred Disorders of Speech. 2 vols. Cambridge Univ. Press.
Meiers, Joseph I. 1958 Kurt Goldstein Bibliography, 1903–1958. Document No. 5816. Washington: American Documentation Institute, Photoduplication Service.
Mourgue, Raoul 1937 La conception de la neurologie dans l’oeuvre de Kurt Goldstein. Encephale 32, part 1:32–56.
Papers in Honor of Kurt Goldstein. 1959 Journal of Individual Psychology 15:1–99.
Riese, Walther 1948 Kurt Goldsteins Stellung in der Geschichte der Neurologie: Versuch einer Würdigung aus Anlass seines 70. Geburtstages, 6 November 1948. Schweizer Archiv für Neurologie und Psychiatrie 62: 2–10.