In the preface to his Menninger: The Family and the Clinic (1990), distinguished biographer, historian, and activist Dr. Lawrence J. Friedman reminds readers just how famous this Kansas institution was in its heyday. The Menninger patriarch and sons were depicted on a stained-glass window installed in Washington Cathedral in 1979; but also, far from the house of God, the family inspired The Exorcist’s Barringer Clinic, whose medical men knew a case of possession when they saw one! Dr. Friedman is aware that we Americans have a penchant to allow mediocre men to rise to the highest stages, only to turn on them suddenly and chase away their ill-gotten fame with new knowledge of their most personal, mostly moral failings. But there is no Citizen Menninger because the Menninger story is not about a single figure but rather an American clan whose internal dynamics, as Dr. Friedman shows, help us account for their unlikely rise to the apex of American psychiatry. Was the family blindsided by a sudden disgrace, an ignoble fall from a noble height? It was more like a slow fade, with the once-prominent Clinic, a quondam trendsetter in health care, now watching other more integrated research hospitals set the course.

However, instead of following up these remarks with a summary of the institutional aspects of the narrative, I wish to illustrate the merits of Menninger through a psychobiographical reading of the main players on Dr. Friedman’s stage: Mother Flo, father Charles, eldest son Karl, and youngest son Will. The theoretical lens will be adult attachment theory, with its distinction between the insecurely attached, who are either too dependent or too independent in their important relationships, and the securely attached, who are typically able to rely upon their significant others and to be relied upon by them, even when distressing situations present themselves.

All my information gleaned about the Menningers in this

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article comes from Friedman’s Menninger: The Family and the Clinic. Flo Vesta Knisely, born in 1863, found herself pressed into caring for her numerous siblings following her father’s unexpected death in 1873. Flo’s mother, Amanda, decided to move to the small town of Industry, Kansas where she became a farmer and a prohibitionist. Flo soon met a teacher at a nearby college at which she was studying part-time. His name was Charles Menninger, and, unlike Flo, he was outgoing and confident, having been reared in a stable, well-heeled family. The couple soon found themselves engaged, but, in place of the standard courtship rituals, Flo and Charles would spend evenings in the apartment Flo shared with her brother Elmer, each absorbed in his or her own book. In essence, the insecure Flo tried to obviate her need to make a clean break from her family by retaining her brother as a permanent chaperone in an endless study session. The point bears a little belaboring: Flo’s distress over not only being called upon to parent her siblings, but also to endure unrelenting economic insecurity, was kept at bay by her recreation of the family situation as a most peculiar type of study group. Also, Charles adapted to Flo’s obsession with social activism, becoming himself a teetotaler and lending support to his fiancé’s lofty educational goals, which were rather unusual for a Midwestern woman of the time.

Already within the first dozen or so pages, Dr. Friedman has vividly depicted a young Flo putting into play a (perhaps unconscious) life strategy to deflect concern away from the strained family dynamic that she simultaneously will smuggle into her newfound romance with Charles Menninger. But, far from overloading his narrative with commentary, Dr. Friedman has rather planted subtle seeds that only sprout shoots once a sizable part of the story has been unfolded. Over its 350 or so pages, Menninger will picture Flo and Charles, the insecurely attached and the securely attached, raising two sons who will import the imperfect yet adaptive family constellation into the daily workings of the Menninger Clinic.

The oldest of these sons, Karl, became a particularly keen source of distress for his mother. Dr. Friedman gives us an apt analysis of this mother-son relationship: Flo was harsh and domineering toward Karl, but at the same time she showered praise upon him and made sure the young boy knew that as a Menninger he was destined to make a progressive mark on the world. Thus, just as Flo controlled and castigated her husband, for instance badgering him to earn more money by making the leap from college instructor

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to physician, so did she dominate Karl, winching the hapless boy closer, only to push him down with her dizzyingly high expectations and cutting criticisms.

Dr. Friedman calls Flo and Karl’s type of deficient relationship “ambivalent.” Attachment theory might label the Flo-Karl tie “insecure” in that it combines aspects of both the “avoidant” and the “anxious-ambivalent.” That is, Karl’s rise to the zenith of his profession cannot be separated from his double-bind relation to Flo. In essence, Karl attempted to distance himself from his mother by drawing closer to the positive self-image template Flo herself provided for him. The more independence Karl achieved, the more he both repressed a negative self-image and pursued a positive self-image, this eddying psychic motion being tied inextricably to his internal images of his larger-than-life mother. Ironically, Karl escaped his mother’s caustic put-downs and gained independence by taking steps to embody her missionary idealism through his career at the Menninger Clinic. As we shall see, this avoidant pattern of emulation-at-a-distance will be repeated when Karl’s brother Will moves far beyond the borders of the family business by becoming a General in the United States Army. Through his bolstering of the Clinic’s cause in the highest governmental circles, Will established the Menninger name firmly in the consciousness of world psychiatry. In the process, he managed to avoid the full brunt of his hypercritical brother, who was left behind in Topeka to distress staff and associates with his temperamental actions.

Throughout Karl’s long career, Dr. Friedman shows that an ambivalent or avoidant pattern can be detected (though, once again, terms from attachment theory are not found in Menninger): Just as Flo had to deflect her fear outside of the family and onto the world outside, first as a child in a fatherless family of women struggling to make ends meet, then as an unhappy housewife who redirects her attention away from her domestic limits by founding a bible society, so does Karl learn that one can afford to be difficult and confrontational as long as the interaction with the significant other is in the service of a social or institutional goal. We need only recall Karl’s shifting attitudes toward the Jewish émigré analysts employed by the Clinic, along with the alternating messages of praise and blame he directed toward the Menninger Foundation in the mid-1960s, when he desired to retain some influence in an organization that had successfully distanced itself from its creator, to see this insecure attachment pattern in action.

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From his childhood days, Karl’s youngest brother, Will, seems to have followed in the footsteps of his father, Charles, thus forming a counter-alliance vis-à-vis the Karl-Flo axis. The Menninger patriarch’s tendency to compromise, especially as regards his wife’s ideas about family and vocational life, was passed on to Will, who lived in his older brother’s shadow until openly opposing Karl’s growing emphasis on the Menninger psychiatric programs (which de-emphasized the Will-headed Menninger Clinic proper) in the late 1940s. But even through these postwar conflicts, during which Will eclipsed Karl’s influence in the psychiatric world, the younger brother tacitly accepted the long-established Menninger pecking order. An example is Will’s turning against associate John Stone when the latter suggested Karl be denuded of his powers at the Foundation. Will made it clear that, though he had many reservations about his brother’s misuse of power in the Menninger organization, he would nonetheless always back up Karl the moment an outsider proposed taking any adverse action against a family member. Business was never just business at the Menninger; it was a family affair, and non-Menningers were there to support and extend the clan’s vision. To be an insider, one had to be a Menninger (such was the unspoken rule). If an outsider challenged a Menninger, a rebuke was sure to follow.

However, as the decades wore on in the Menninger saga, it became clear that Will’s deference to Karl had a neurotic side, though the younger man, Will, appears to have found ways to adapt to this darker side of the relationship. Will’s willingness to spend most of his time on military missions as well as on fund-raising trips, Dr. Friedman points out, can be interpreted as an attempt by Will as the younger brother to serve the Karl-centered Menninger vision while forging a more independent role for himself, a role that far exceeded Charles’ blueprint for a Karl-led family clinic. Eventually, in the mid-1960s, Will tired of Karl’s self-aggrandizing ways and made the fateful step of removing his brother from power. However, this move came at a price, as many close to the family came to believe that Karl’s dismissal, far from bestowing a sense of self-assurance upon Will, rather hastened his death by lung cancer soon thereafter.

In the final pages of Menninger, Dr. Friedman paints a picture of an aging Karl, a man who remained an enigma until the very end. By turns irascible and serene, the great man would show signs of having come to terms with his dwindling influence upon the

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Clinic’s affairs, only to launch suddenly into an angry tirade against his grandson Roy’s leadership. Because Dr. Friedman has an enviable ability to control the unfolding of a complex narrative, readers of Menninger can gather insights into the inner dispositions of each of the major players in the historical drama—Flo, Charles, Karl, and Will—and marvel as the author enriches the picture by sprinkling evaluative comments into descriptions of the interactions between his historical dramatis personae. Is Menninger a psychobiography? In the broadest sense, certainly. However, I am tempted to proclaim this worthy volume, the first panel in Dr. Friedman’s triptych of psychological biographies, a bridge between psychobiography (with its bold juxtaposition of theory to life history) and classical biography (with its austere attention to the source material and its lighter evaluative touch).

It has been said that a salient characteristic of a classic work is its capacity to continue to yield insights over the course of innumerable readings. In this sense, Menninger will continue to prove itself a classic in the years ahead. It is hoped that the present author’s attempt to cast light on the details of Dr. Friedman’s analysis of the Menninger family dynamic by bringing them into contact with adult attachment theory, though more a vignette than an extended treatment, will nevertheless be deemed an appropriate tribute to a man of such unsurpassed scholarly achievement.

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References:

  • Friedman, Lawrence J. (1990). Menninger: The family and the clinic. Alfred A. Knopf, Inc.

Authors:

James L. Kelley

James L. Kelley has published three books and over a dozen peer-reviewed articles. His research interests include psychobiography, psychiatric theory, and philosophy. He has taught at East Central University and the University of Oklahoma and resides in Norman, Oklahoma. He can be contacted at .

How to Cite This:

Kelley, J. L. (2023). Dr. Lawrence Friedman on the Menninger family: An attachment theoretical perspective. In M. I. West, P. H. Elovitz, & N. D’Andria (Eds.), Lawrence Jacob Friedman Festschrift. Clio’s Psyche, 29(3), 277-281.

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