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Listen to thisAs a college student, Karl Menninger was young, smart, and perplexed. The direction of his life lay ahead of him, a mystery waiting to unfold. His mother, Flo, a deeply spiritual woman, saw in him what so many mothers see in their sons “a potential for greatness. She had already discussed with Karl the possibilities of a literary life or one in banking or perhaps an evangelical calling by which the nation's collective soul would fall into sure and righteous hands. His father, C.F., by then a respected medical doctor in Topeka, Kansas, was far less vocal about Karl’s future, except for a vociferous expectation “clearly stated “that he would excel in his academic studies, wherever they might lead him.
A glimpse of the young man's future would emerge at an unlikely moment, as he was receiving relief from pain through medical treatment, an affirming metaphor for the rest of Karl Menninger’s life.
It was in a dentist’s chair suffering from a toothache that young Karl saw the light. Discussing what Karl might do with his life, the dentist, Dr. Fred Koester, said most young men would consider it a great opportunity and an honor to go into medical practice with Karl’s father. A moment’s thought transformed into a jarring revelation and Karl’s epiphany was complete. He loved the sciences, did well in them, and the very idea of working beside his father emerged in him like a lost ship finally sighting land.
Before leaving the office, Karl announced, “I am going to be a doctor.”
“Of course you are,” Dr. Koester agreed.
Hearing the news, Dr. C.F. hugged his son, his eyes tearfully welling up in joy. It was a harbinger of things to come. Now that the oldest of his three sons had committed to a life in medicine, Dr. C.F.'s wish that his boys would be doctors was beginning to coalesce.
Turning point
When Karl returned from his medical internship at Boston Psychopathic
Hospital, Dr. C.F. recalled in an interview, “He told me that he had
been greatly inspired and moved by what he had learned about mental
illness and the need for a better understanding of the great number of
forgotten, neglected, and suffering people outside the fold of general
medicine.”
But Dr. Karl voiced doubts whether he could follow in the footsteps of his great teacher, E.E. Southard, chief of psychiatry at Harvard, and actually have an opportunity to practice such an unconventional medical discipline as psychiatry while remaining in his native Kansas.
His father “ever the optimist “encouraged him to stay in Kansas, where father and son could work together.
"I told him that, far from considering his new interest in psychiatry bizarre and foolhardy, I thought it the most interesting field he could enter.”
Though psychiatry was then something practiced quietly, the Menningers opened a clinic in the practice of neurology and psychiatry, and sought out other physicians to join them in a cooperative practice, a novel concept with a unique application. Patients would receive conventional medical examinations, but their psychological status would also be explored and recorded. Now, anxieties and sadness would be examined with the same scrutiny given tumors and infections.
Getting organized
The Menninger Diagnostic Clinic was formed in 1919 and suffered several
false starts. Doctors didn’t readily flock to the Menninger idea of a
medical cooperative. Dr. Karl’s enthusiasm for the little known field of
psychiatry was meeting some resistance. Alarmed citizens went to court
to stop him from operating a “maniac ward” at the local hospital, and
thereafter he had to smuggle his patients surreptitiously, disguising
them under erroneous diagnoses.
But gradually, physicians and patients were attracted to the clinic and by 1925 local investors helped found the Menninger Sanitarium on a 20-acre site.
"I am not looking at this just with the idea of seeing how many patients I can see or how many dollars I can drag in,” Dr. Karl wrote to his younger brother Will, who would join the sanitarium after graduating from medical school the same year. “... The joy you’re going to get out of your work is not directly related to the amount of money you make.”
A year later saw the formation of the Southard School for mentally retarded children, which eventually embraced treatment of all psychiatric conditions. The facility was named after Dr. Karl’s mentor, Dr. Southard, who told him, “... go back to Kansas, but don’t forget the children. ...”
New facilities continued to be constructed, although the operation did not necessarily turn a profit. In fact, Southard School, a ripe environment for research into children's personality disorders, was expected to operate at a loss simply because families were apt not to pay as much for a child's care as they might for an adult’s.
Milieu therapy replaced the popular “rest cure” of the times, and embraced the concept of combining activities like farm work or landscaping with treatment that fit an individual’s needs, the entire day scheduled.
With the specialists of the Menninger medical cooperative working together so well, it became apparent that specialized psychiatric training for nurses was necessary and a formal course of instruction was created. Soon, Menninger received approval to offer training to physicians in the specialty of psychiatry and in 1933 three residents began training, doubling the psychiatric staff treating 30 patients.
A burgeoning fame
Dr. Karl specialized in neurology and psychiatry, but his writing
brought him fame. His first book, The Human Mind, attempted to educate
the public in psychiatry. Writing the book was not an easy task for a
busy psychiatrist, and Dr. Karl alluded to this in his preface: “One
can’t stop living to write a book and I’ve had to put together this
manuscript under difficulties.”
He says he wrote it “aboard trains, in depots, in cabooses, in hospital wards, and under the light of a farmer’s coal-lamp, all the while coping with the important and mundane interruptions that will come into a human life.”
Despite his hard work, the 37-year-old psychiatrist didn’t have much faith in the success of his self-imposed project, writing to a friend, “(the book) will probably not set the world by the ears.” He was very wrong.
The Human Mind was published in 1930 and immediately became a Literary Guild selection and sold 200,000 copies. It was one of the first books in which a psychiatrist explained the everyday workings that went on in his office, and showed the world as it is seen through the eyes of a psychiatrist.
Freud's influence
It was once said of Dr. Karl that in using his skill for imagery and
clear, vivid writing, he had translated Sigmund Freud, the world's first
psychoanalyst, into American literature. Many of Freud's insights into
the human mind, which seemed so revolutionary at the turn of the 20th
century, are now widely accepted by schools of psychological thought.
The Human Mind's unraveling of Freud was the key to Dr. Karl’s initial fame and popularized his name with a public hungry to learn more
about its inner self.
"Freud's great courage,” Dr. Karl would say years later, “led him to look honestly at the evil in man's nature. But he persisted in his researches to the bottom of the chest and he discerned that potentially love is stronger than hate, that for all its core of malignancy, the nature of men can be transformed with the nurture and dispersion of love.”
“This was the hope that Freud's discoveries gave us. This was the spirit of the new psychiatry. It enabled us to replace therapeutic nihilism with constructive effort, to replace unsound expectations, first with hope, and then with sound expectations.”
Battling stigmas
Dr. Karl was a lifelong crusader against the stigma surrounding mental
illness, and brought mental disorders out of the dark through teaching,
letters, lectures, magazine articles, newspaper columns and more than a
dozen books. It was a battle he and his brother, Dr. Will, waged
throughout their lives. Dr. Karl also spoke out against social injustice
and for nuclear disarmament. He supported the rights of neglected and
abused children and Native Americans, and counseled understanding for
inmates while raging against the system that imprisoned them.
"I sometimes feel as if I would like to scream out to the American public that they are squirting gasoline on the fire,” Dr. Karl told a congressional hearing in 1971. “The prison system is now manufacturing offenders, it is increasing the amount of transgression, it is multiplying crimes, it is compounding evil.”
The personal Karl
In his senior years, Karl Menninger could be contrary, swaying between
moods both kind and brusque. Those who knew him say he was loving and
mercurial, embracing a host of emotions at any given time as only a
great man can.
This was the same charismatic man who told the world, “Love is a medicine for the sickness of the world; a prescription often given, too rarely taken.” And the man who insisted that “love is the touchstone of psychiatric treatment ... to our patient who cannot love, we must say by our actions that we do love him.”
At 82, Dr. Karl was to have said that he spent the first 50 years of his life in treating people, and he was going to spend the last 50 years in prevention.
And he kept his eye the horizon:
"Anybody as old as I am is thinking about dying – thinking about it quite often. You want to get as much done as you can before you die.” He did that and more.
At 96, he complained of rusty knees, bad hearing and forgetfulness, but he felt as though he were still plugging along: “I’ve tried to make life easier for people,” he said. “You hold a coat when you can and tie a man's shoe when you can. You try to do what you can.”
Honors and awards
During his lifetime he toured Europe to assess the need for psychiatric
care among returning military personnel, established the Menninger
School of Psychiatry, the Topeka Institute for Psychoanalysis, then the
only training facility west of the Mississippi, testified before
Congress and elsewhere on mental health issues, was a vigorous
participant in the formation of psychiatric organizations, and of
course, ran Menninger wearing a variety of executive hats.
He received numerous honors and awards from his professional peers, from government, and from national groups. In 1981 he became the only psychiatrist ever to receive the Medal of Freedom “the highest civilian honor the country can bestow" from then-President Jimmy Carter, whose wife Rosalynn has been a Menninger Trustee since 1986.
After a career whose span embraced so many roles – teacher, orator, first-rate writer, administrator, activist, philosopher, psychiatrist, and more – Dr. Karl died four days short of his 97th birthday.
Spreading the light
Late in his life, Karl Menninger, cane in hand, posed before the
Menninger Tower, the most recognizable symbol of Menninger itself.
Reminiscent of Independence Hall in Philadelphia, the Tower was erected
for the Security Benefit Association and taken over by Menninger in
1954. Erected in 1930, the same year The Human Mind was published, the
Tower and the man share similarities.
The landmark can be seen from a far distance, its four-sided clock face illuminating the night like a lighthouse beacon, much as Karl Menninger towered over psychiatry for a lifetime, directing light into the shadows of the human condition.
Wit and wisdom from Dr. Karl
Karl Menninger, MD, co-founded The Menninger Clinic in 1925. During his
long career in medicine, he was known as the “dean of American
psychiatry.” A prolific writer and a dynamic speaker, Dr. Karl’s ability
to capture a thought with a pithy comment or render an insight in a few
brief words, reflected a sharp, and often witty, mind. Before he died in
1990, Dr. Karl had expressed opinions across a range of subjects. Some
are presented here:
On prevention
Dr. Karl was asked what a person should do if he felt a “nervous
breakdown” coming on. He said: “Lock up your house, go across the
railroad tracks, find someone in need, and do something for them.”
On facts
“One of the most untruthful things possible, you know, is a collection
of facts, because they can be made to appear so many different ways.”
On ignorance
“The voice of intelligence...is drowned out by the roar of fear. It is
ignored by the voice of desire. It is contradicted by the voice of
shame. It is biased by hate and extinguished by anger. Most of all it is
silenced by ignorance.”
On unrest
"Unrest of the spirit is a mark of life; one problem after another
presents itself and in the solving of them we can find our greatest
pleasure.”
On hope
"Man can’t help hoping even if he is a scientist. He can only hope more
accurately.”
On living
"... Our conception of psychiatric hospitals here is not confinement; we
think they are places in which to be treated, places in which to learn
to understand one’s self, to learn how to live.”
On soothing
"It is doubtless true that religion has been the world's psychiatrist
throughout the centuries.”
On self
“To 'know thyself' must mean to know the malignancy of one’s own
instincts and to know, as well, one’s power to deflect it.”
On love
"Love cures people – both the ones who give it and the ones who receive
it.”
On love II
"Love is a medicine for the sickness of the world; a prescription often
given, too rarely taken.”
On love III
“One does not fall into love; one grows into love, and love grows in
him.”
On life’s mission
“The central purpose of each life should be to dilute the misery in the
world.”
On retribution
“What’s done to children, they will do to society.”
On generosity
"Money giving is a very good criterion, in a way, of a person's
mental health. Generous people are rarely mentally ill people.”
On hope
"Hope is an adventure, a going forward, a confident search for a
rewarding life.”
On guilt
Someone once asked Dr. Karl to name the mistake most common to all
humankind. “Feeling guilty,” he replied.
On mental health
“The ones to worry about are those who don’t ever suspect themselves of
any mental infirmity but are always sure that it is all the other people
in the world who are crazy or wicked or disloyal.”
On psychiatrists
“The psychiatrist as a person is more important than the psychiatrist as
a technician or scientist. What he is has more effect upon his patients
than anything he does.”
On changing
"Every once in a while someone speaks to me about 'mellowing.' I never
know whether this is a compliment or an insult.”
On tolerance
"I can’t prove it, but I am pretty sure that when people overcome their
fear and prejudice against mental illness, they become healthier-minded,
and hence, more tolerant in other ways.”
On a busy life
"No one but doctors and mothers know what it means to have
interruptions.”
On giving
“Some don’t dare give, they might run out. My dear friends, of course
you are going to run out. You can’t take it with you. I don’t know how
many hundreds of my patients are now asleep in their graveyard, leaving
behind far more money than they could handle, far more money than their
children could peacefully divide. The ill individual narrows his vision
until he ceases to see the multiplicity of opportunity.”
Weller than well
"Not infrequently we observe that a patient who is in a phase of
recovery from what may have been a rather long illness shows continued
improvement, past the point of his former “normal” state of existence.
He not only gets well, to use the vernacular; he gets as well as he was,
and then continues to improve still further. He increases his
productivity, he expands his life and its horizons. He develops new
talents, new powers, new effectiveness. He becomes, one might say, “weller than well.” ...Every experienced psychiatrist has seen it....
What could it mean? It violates our conventional medical expectations,
so perhaps it is often overlooked and occurs more often than we know. It
may contain a clue for better prevention and better treatment.
...Transcendence does occur. And perhaps it is not an exception but a
natural consequence of new insights and new concepts of treatment.”
The Vital Balance, The Viking Press, 1963
On listening
"Listening is a magnetic and strange thing, a creative force. The
friends who listen to us are the ones we move toward. When we are
listened to, it creates us, makes us unfold and expand.”
On searching
”... Peace or something near it is often achieved by those who do not
seek it, who, seeking truth, forget themselves.”
