Noting its growth from literally “a little house on the prairie” to a thriving center of psychoanalytic teaching, research, and practice, the Topeka Institute for Psychoanalysis observed its fiftieth anniversary this fall with a three-day scientific conference (October 9-11) titled “A Celebration of the Mind.”
Although formal recognition as a psychoanalytic training center, the first one west of the Mississippi, was not accorded the Topeka Institute until 1942, records in the museum and archives of the Menninger Foundation reveal that psychoanalytic treatment was given patients of the clinic from its earliest days. Karl Menninger and his student John Stone offered analytic therapy as early as 1925. Stone, a psychologist, was later to become the chief administrative officer of the Foundation.
The history of the Topeka Society and Institute is intimately associated with the work of Drs. Karl and Will Menninger, and of the clinic and hospital they established with their father, Dr. C. F. Menninger, in 1925. Both Karl and Will Menninger served presidential terms in the American Psychoanalytic Association (Karl in 1942 and 1943, Will in 1947 and 1948). It was during the latter's presidency that The American voted to extend financial support to the publication of the Standard Edition of Freud's writings. Later ex-Topekans who served presidential terms in The American were Robert Knight in 1951 and 1952, Robert Wallerstein in 1971, Richard Simons in 1985 and 1986, and George Allison in 1990 and 1991.
Early Menninger Clinic annual reports and the minutes of staff meetings reveal that in the late 1920s psychiatrists and psychologists there began holding regular biweekly scientific meetings and that around 1932 psychoanalytic themes began to predominate as topics of discussion. Interestingly, in coincidental parallel to their colleagues in Vienna, the group met on Wednesday nights, eventually evolving into a small, informal training program under the guidance of the Chicago Institute, then directed by Franz Alexander. Completing his training in 1932, Karl Menninger was the first graduate of the Chicago program. The Topeka Psychoanalytic Society was officially recognized by The American in 1938 and during the next several years increasing numbers of candidates undertook training in Topeka under the auspices of Chicago. Anticipating what was to become a model for training at many developing institutes, the students were analyzed in Topeka and journeyed to Chicago fortnightly (no small feat in those days before jet engines) for seminars and supervision.
A number of analysts were on the staff of the Menninger Clinic during the early 1940s. They included, besides Karl and Will Menninger, Sylvia Allen, Elizabeth R. Geleerd, Martin Grotjahn, Mary O'Neil Hawkins, Bernard Kamm, Robert Knight, Ernst Lewy, Fritz Moellenhoff, Douglass W. Orr, David Rapaport, Charles W. Tidd, and Edoardo Weiss. A group of fourteen residents and other members of the Menninger Clinic and hospital staff at that time became psychoanalysts after 1941, either in Topeka or elsewhere, and they included Nathan Ackerman, Anne Benjamin, Carol Carlson, Harlan Crank, Alan R. Drumming, Merton Gill, Robert T. Morse, Norman Reider, Lewis L. Robbins, Earl Saxe, Daniel Silverman, Leo Stone, Carl-Gustaff D. Tillmen, and Robert L. Worthington.
In May 1942 the Topeka Society was approved as an independent institute. Holding its initial meeting in August of that year, it selected as its first officers Karl Menninger, Director; Robert Knight, Assistant Director; and Ernst Lewy, Secretary-Treasurer. Lecturers and speakers in the Topeka Institute's first year included David Rapaport, Margaret Mead, O. Spurgeon English, Elisabeth R. Geleerd, and Lawrence Kubie. The first class numbered eight students.
The sixth oldest institute in the United States, Topeka was originally made responsible for all psychoanalytic training in the area west of Chicago. Ernst Simmel, who had arrived in Los Angeles in 1934, was also an officer of the Topeka Institute, serving as its assistant director for training in California as well as the first president of the Los Angeles Study Group, in the creation of which he played a prominent role. Some time later, a study group was organized in San Francisco. Records show frequent consulting visits by Karl Menninger and Robert Knight to the two California groups.
The Topeka Institute was of consistent support to the California group in its organizational birth struggles, helping to work out a set of agreements around the status of nonmedical analysts which would be acceptable to the Los Angeles and San Francisco groups as well as to The American. In August 1941, Dr. Knight presided at the organizing meeting in Los Angeles of the California Psychoanalytic Society.
Between 1942 and 1945 ten or eleven candidates were in training at the young Topeka Institute. With the end of World War II and the sharply increased demand for psychoanalytic training, these figures rose steadily and rapidly: twenty-five in 1945, thirty-six in 1947, forty-four in 1948, fifty-four in 1949. The present level of between forty-five and fifty candidates appears to have remained relatively constant throughout the past four decades.
During its fifty years of teaching psychoanalysis, the Topeka Institute has had eleven directors. In addition to Karl Menninger, Knight, and Lewy, they include Jan Frank, Otto Fleischmann, Herman G. van der Waals, Gertrude R. Ticho, Ishak Ramzy, William Tarnower, Jack Ross, and the present director, Jerome B. Katz.
One hundred nineteen graduates have completed either full or partial training in Topeka, fourteen of whom have also graduated from the Program in Child and Adolescent Psychoanalysis.
The work of the Topeka Institute and of its “parent” organization, the Menninger Clinic, has, from the beginning of each entity, been a uniquely synergistic and mutually enhancing collaboration. The Clinic has been of generous and continuing support to the development of psychoanalysis and, in turn, the Institute has nurtured the psychoanalytic perspective that informs the treatment philosophies of the various Menninger programs. This mutual enrichment has been encouraged by Roy Menninger, president of the Clinic for the past twenty-five years and currently chairman of the board. Over the years its hospital directors — Will Menninger, Knight, Ruth Barnard, Lewis Robbins, Peter Fleming, Herman van der Waals, Otto Kernberg, Peter Hartocollis, Robert Obourn, Stuart Averill, and
Glen Gabbard—have all been analysts or students of psychoanalysis during their tenure. So have many of the directors of the Adult Outpatient Department: Carl Epstein, Fred Tetzlaff, Harold Meyers, Robert Menninger, Prescott Thompson, Ernst Ticho, Irwin Rosen, and Joseph Hyland. Similarly, for much of its existence the Children's Division has also had close ties to the Topeka Institute. Three of its former directors—Cotter, Hirschberg, Robert Switzer, and Harcharn Sehdev—were affiliated with the Institute, Hirschberg as a training and supervising analyst and Switzer and Sehdev as students.
Directing Menninger's educational efforts in the Karl A. Menninger School of Mental Health Sciences have been analytically trained psychiatrists including the eponymous Dr. Karl as well as William Rottersman, Herberg Klemmer, Cotter Hirschberg, Efirain Bleiberg, Martin Klapheke, and Walter Menninger (who as president currently administers all of the Foundation's clinical and educational activities).
As this pattern of Institute participation and leadership in the array of Menninger clinical services might suggest, psychoanalysis has played a central role in shaping the treatment programs that have brought the Menninger Foundation international recognition. The “Guide to the Order Sheet,” which provided hospital staff a psychoanalytic rationale for treating psychiatric patients, was the work of Will Menninger. Published in the mid-1930s and principally embedded in a drive model of psychoanalysis, the idea was not only extraordinarily ground-breaking for its time, but a current reexamination reveals that its practices (if not its theory) show an important prefiguration of some of the object relations ideas currently developing within psychoanalytically informed hospital treatment.
With the advent of the structural theory and the ascent of ego psychology in the 1940s and 1950s, the Menninger Clinic was the scene of a number of direct applications of that approach to clinical work with psychiatric patients. David Rapaport's work on diagnostic psychological testing (which changed forever that area of clinical practice, and the explication of ego activity as a critical area of patient assessment), shaped the Menninger zeitgeist of that era. Together with colleagues like Martin Mayman, Margaret Brenman, Merton Gill, Roy Schafer, Herbert Schlesinger, Sibylle Escalona, Paul Bergman, Mary Leach, Ben Rubinstein, Philip Holzman, George Klein, Howard Shevrin, Robert Holt, Lester Luborsky, and others at Menninger, Rapaport and his students wrote and inspired a host of clinical and research books and papers that demonstrated the seamless integration of psychoanalytic
theory and psychiatric practice that characterized the Topeka approach. Subsequent to their arrival in Topeka in 1952, Gardner and Lois Murphy broadened the research scope to include an admixture of psychodynamic, social-psychological, ethological, and psychopharmacological projects. Robert Wallerstein, who succeeded Gardner Murphy as Research Director, described the process as one of “broadening and centering,” of placing a psychodynamic perspective at the core of a widened array of research endeavors.
Later, in the 1970s under the direction of Otto Kernberg, the Menninger Hospital broadened its purview to include the contributions of object relational ideas to the treatment of regressed, primitive mental states and modes of functioning that were observed with greater frequency among the inpatient population.
In addition to the laboratory-based studies on perception and cognition that characterized earlier research at Menninger by its Institute staff and others, the Psychotherapy Research Project represented a meticulous joint effort, almost three decades long, by psychoanalysts and others to explore treatment process and outcome. Directed by Robert Wallerstein and later Otto Kernberg, the project has generated sixty-seven publications, including five books, culminating in Wallerstein's monumental 1986 summing-up, Forty-Two Lives In Treatment.
A direct spin-off of the Psychotherapy Research Project is the Treatment Interventions Project, now twelve years old. This work is being carried out by a seven-member research group comprising several Institute colleagues along with other Menninger staffers led by Leonard Horwitz. The investigation represents an effort to study the moment-to-moment unfolding of the psychotherapy process with a number of patients diagnosed as “borderline,” in order to discover which of them respond best to a supportive approach and, conversely, which fare better when a more exploratory or uncovering strategy is employed.
The Topeka Institute has hosted several major national and international conferences. In 1966, the Association for Child Psychoanalysis held its first annual meeting there, and Anna Freud, then a Visiting Professor at the Menninger Clinic, lent the fledgling organization her wisdom, encouragement, and guidance. Training and supervising analyst Ishak Ramzy chaired that conference and in 1975 served as president of the Association.
With the Chicago and Pittsburgh Institutes, Topeka helped organize the “Three Institute Conferences on Psychoanalytic Education,” acting as host in April 1969. Two monographs stemming from these meetings, appreciatively dubbed “The Green Giant” and “The Blue Giant,” have received wide and positive acceptance among training centers both here and abroad.
In 1976 the Institute provided the leadership and conceptual framework for the Menninger-sponsored International Conference on Borderline Conditions, a three-day event which brought more than 700 participants to Topeka. The conference was chaired by Peter Hartocollis who, along with Otto Kernberg, had led the two-year planning for the meeting.
Of specific interest is the role played by the Topeka Institute in shaping the consensus around the processing of applications for psychoanalytic training by nonmedical clinicians. The Topeka group had long been active in seeking appropriate CORST waivers on behalf of worthy applicants, and in December 1989, following extensive local discussion within the Institute, its chairman, Jack Ross, introduced to the Board on Professional Standards the motion that has since borne his name. The Ross Proposal clearly spelled out the areas of responsibility best carried out locally and those most usefully performed at the national level in the selection process. Its adoption has led to a smooth, efficient, and equitable way of processing waiver applications.
Within the past five years, the number of training analysts in the greater Kansas City area has grown to three. That locale, along with Topeka, forms the two-city base of training operations for the Institute. With Salomon Alfie, Sigmund Gundle, and Walter Ricci functioning in the greater Kansas City area, the Institute now offers several of its seminars there and looks confidently toward the future growth and development of psychoanalytic training in that metropolitan area.
Much might be written detailing the great enrichment of American psychoanalysis through the Menninger Clinic's pioneering advances in psychodynamic hospital treatment, psychotherapy, diagnosis, child psychiatry, clinical psychology, research, social applications, and education, and each of these areas has been significantly influenced (and in many instances led) by members of the Topeka Society and Institute. A list of the forty-four training and supervising analysts in the last five decades readily shows the wide dissemination throughout the country of distinguished contributors whose scientific work often has begun in the fertile soil of Topeka. This list includes Salomon Alfie, Sylvia Allen, Stuart Averill, Trygve Braatoy, Rudolf Ekstein, Michalina Fabian, Otto Fleischman, Jan Frank, Glen Gabbard, Hugh Galbraith, Ramon Ganzarain, Alfred Gross, Sigmund Gundle, Peter Hartocollis, Mary O'Neil Hawkins, Cotter Hirschberg, Philip Holzman, Leonard Horwitz, Joseph Hyland, Robert Jokl, Hellmuth Kaiser, Irving Kartus, Jerome B. Katz, Otto Kernberg, Ernst Lewy, Robert Knight, Karl A. Menninger, William C. Menninger, Harold Meyers, Alfredo Namnum, William Pious, Ishak Ramzy, Walter Ricci, Lewis Robbins, Irwin C. Rosen, Jack L. Ross, Herbert Schlesinger, Ellen Simon, Petronella Tibout, Ernst A. Ticho, Gertrude R. Ticho, William Tarnower, Herman G. van der Waals, and Robert S. Wallerstein.