Man Against Himself

by Karl A. Menninger

Man Against Himself

Genres: Psychology, Nonfiction, Philosophy, Self Help, Psychoanalysis, Mental Health, Psychiatry

429 pages, Paperback

First published January 1, 1938

About the author

Karl Augustus Menninger (July 22, 1893 – July 18, 1990) was an American psychiatrist and a member of the Menninger family of psychiatrists who founded the Menninger Foundation and the Menninger Clinic in Topeka, Kansas.

Reviews

[The Angry Lawn Gnome · Rating 3 out of 5]

I actually bit the bullet and plodded through this book because it was listed by Edwin S. Shneidman in Comprehending Suicide: Landmarks in 20th-Century Suicidology as being, well, a landmark in 20th century suicidology. I'm going to go out on a limb and say that Shneidman included it because Menninger had the cojones to address a topic that was simply not aired in 1938, at least in a book accessible to those who were not professional psychologists, and not so much because of anything that is actually written between the covers.

I say that because what you get here is Freudianism unfiltered as the theoretical construct underlying the work, almost to the point of Holy Writ, some exceedingly strange leaps of logic, and a couple of bits here and there that I'm fairly sure are flat-out wrong. Unfortunately, I did not take notes as I went along so I'm going to have to rely upon my rather faulty memory to get from general to specifics:

p.177 The older psychiatrists regarded this as a very important point because they considered alcoholism to be an hereditary trait. Of course, scarcely any scientist believes so today, although it is still a popular theory. Alcoholism cannot possibly be an hereditary trait,...

Swing and a miss, there, Karl, my man, at least as I understand it. Curiously, he also vehemently denies the concept of alcoholism as a disease, rather the same way Thomas Szasz does in our day....And Szasz is practically burnt in effigy for holding such a position.

p. 238 Clinical investigation has shown quite definitely that there is a close association between nail-biting and a less conspicuous but similar "bad habit" of childhood -- masturbation. Mechanically the parallelism is obvious; the fingers instead of being applied to the genitals are now applied to the mouth and instead of the genital stimulation there is the labial stimulation accompanied, as we have already pointed out, by the (mutilative) element of biting.

Alas, no details are offered as to the precise nature of said "clinical investigation," but hopefully we're talking strictly patient interviews here.(?) I confess I haven't the foggiest idea if this rather interesting conclusion has held up through the years, but it certainly wasn't the sort of thing I was expecting in a book on suicide. And, yeah, I'm probably going to be unable to avoid losing it next time I see some gal chewing on her fingernails. I wonder if Cyndi Lauper had that issue? Fingernail chewing, I mean.

In all seriousness, I think the biggest weakness in this 400+ page book is not that this or that fact may or may not be out of date, but that Menninger, in the final analysis, is not being fair to his readership. He is presenting the Gospel as revealed unto him, and those who disagree are "quacks," "charlatans," and so on. Nowhere is there a hint that reasonably intelligent, diligent practitioners in his field at the time this book was written might disagree with his approach and conclusions, and have at least some empirical basis for doing so. If nothing else, we get not so much as a peep about Durkheim by name (though he criticizes sociologists as a group in the last chapter), and seems to put Freud and Jung on the same page, in the one mention Jung gets.

Some stuff I'm willing to let slide (e.g. homosexuality as a perversion, seemingly, since there's a case where a woman is "cured" and goes onto a happily married life) as simply a result of the time he was writing*, but not the above. I think he was sincere in his desire to help, cared for his patients, and did try to be a careful researcher...as long as his personal applecart didn't get upset. I can't imagine this work as anything other than an interesting historical artifact, a point I'm not sure Shneidman would share with me, since it is a book he'd bring to a desert island were he limited in his library on said island.

* - Viktor Frankl, for one, uses very similar language regarding homosexuality, and indeed might have even used stronger terms than Menninger, though I'd have to go back and re-read him to confirm the exact phraseology.

[Sabtain Khan · Rating 4 out of 5]

I was referred to this book after it being mentioned in Blue Nights by Joan Didion. She read the book and included a few lines about how people 'over-react' (suicide, self-harm) to ordinary things: "What special circumstances are required before this woman throws it all in."

I think Dr. Menninger explains things quite while in his book.

"...we must reckon with an enemy within the lines..."

He explores many concepts of self harm, from self-preservation, "A weasel...gnaws off its own leg to escape from a trap...", to how we explain the cause of suicide in a various amount of scenarios, ...this man began to commit suicide long before he took the pistol.... It's a dark book in one sense, but its eye-opening in another. I never thought about how someone who is willing to kill someone is more aptly willing to kill themselves, and that in a sense they are 'objectifying' something to kill. Suicide and self-harm is an extension of that, you have to treat yourself as an 'object' separate from yourself.

He even looks at those who are Ascetic as self-harming, that is people who are characterized by abstinence from sensual pleasure to pursue some spiritual goal. When combined with someone who identifies with being a Martyr to a cause can lead to self-destructiveness.

Then there are topics around career, crime, inferiority, etc... when you get to self mutilation (something I never understood), he opened my mind into understanding what it takes to be able to partake in that. People who self-mutilate are essentially bargaining to kill a objectified part of their body rather than themselves: My arm was guilty...not I...I shall sacrifice my arm; more logical than death in their minds.

It was hard to read at times, but I think everyone needs to read this (or something like it) because we all have people or acquaintances who suffer, or maybe we ourselves do - the first step is sometimes understanding what makes you suffer, what the things are that you or someone else is doing that leads to it, and maybe - just maybe - that tiny bit of understanding and knowledge can help save someone else from similar suffering.

[Roberto Petrúcio · Rating 4 out of 5]

This is really a tough and fantastic book. You have to be strong to read it. I've read its portuguese translation, 'cause I'm brazilian.

[Kaouther Nouni · Rating 4 out of 5]

Compelling case studies, a very interesting read yet I find some gaps ( which he warned about) it made the reading a bit on an uneven theoretical framework.
A lot of emphasis on self-punishment and guilt.
Yet such a deep read!

[Douglass Morrison · Rating 5 out of 5]

Psychiatrist, Karl Menninger introduces his landmark text, Man Against Himself (first published in 1938): “It is nothing new that the world is full of hate, that men destroy one another, and that civilization has arisen from the ashes of despoiled peoples and decimated natural resources. But to make this destructiveness, this evidence of a spiritual malignancy within us, to an instinct, and to correlate this instinct with the beneficent and fruitful instinct associated with love, this was one of the later flowers of the genius of Freud. We have come to see that just as the child must learn to love wisely, so he must learn to hate expeditiously, to turn destructive tendencies away from himself toward enemies that actually threaten him rather than toward the friendly and the defenseless…”
Menninger develops the Freudian idea that men’s psychic or inner, lives are filled with conflict between instincts of love and hate, construction and destruction: “Freud makes the further assumption that the life and death instincts – let us call them the constructive and destructive tendencies of the personality – are in constant conflict and interaction just as are similar forces in physics, chemistry, and biology. To create and to destroy, to build up and to tear down, these are the anabolism and catabolism of the personality, no less than of the cells…”
Menninger makes a fraught observation, “… in the end, each man kills himself in his own selected way, fast or slow, soon or late… I believe that our best defense against self-destructiveness lies in the courageous application of intelligence to human phenomenology. If such is our nature, it were better that we knew it and knew it in all of its protean manifestations.” He then laid out a catalog of the range of human self-destructiveness gathered over a lifetime of providing psychiatric care, crediting throughout, the contributions of many teachers, mentors, and fellow clinicians.
Doctor Menninger acknowledges: “… the unevenness of the evidence to follow and the speculative nature of some of the theory… I submit that to have a theory, even a false one, is better than to attribute events to pure chance. Chance explanations leave us in the dark; a theory leads to confirmation or rejection (or modification)…” Accordingly, as I read his textbook early in my medical career, and have reread and studied it over the years, I have tried to remember his caveat, and tried to take each of his generalizations as a hypothesis asking to be confirmed, refuted, or perhaps modified, before being ‘taken to the clinic, or the patient’s bedside’.
The topic of self-destruction should be relevant to every healthcare professional who has cared for, or known: a victim of suicide, a non-compliant patient, or a victim of alcoholism or any other addiction; in other words, all of us. “It becomes increasingly evident that some of the destruction which curses the earth is self-destruction, the extraordinary propensity of the human being to join hands with external forces in an attack upon his own existence is one of the most remarkable of biological phenomena.”
“The doctor, for example, pursues his daily rounds in the steadfast belief that he is responding to the call of those who would prolong their lives and diminish their sufferings. He comes to place a great value on life and to assume it is a universal attitude… Suddenly, or perhaps gradually, he becomes disillusioned. He discovers that patients often don’t want to get well as much as they say they do… It was after such observations as this that led to the formulation by Sigmund Freud of the theory of a death instinct. According to this concept, there exists from the beginning in all of us propensities toward self-destruction and these come to fruition as actual suicide only in exceptional cases where many circumstances and factors combine to make it possible.”

Menninger’s catalog of self-destructive behaviors begins with one of the best summaries of suicide that I have read.
“There are certain subjects concerning which we speak often in jest as if to forestall the necessity of ever discussing them seriously. Suicide is one of them. So great is the taboo on suicide that some people will not say the word, some newspapers will not print an account of it, and even scientists have avoided it as a subject for research.”
“It (suicide) is everywhere more frequent than murder.”
The author describes three components of suicide and dissects their relative contributions: the wish to kill or murder; the wish to be killed or the demand of the subject’s conscience to be punished; and the wish to die.

Menninger introduces the idea of ‘chronic suicide’. He lists asceticism and martyrdom; neurotic invalidism; addiction including alcoholism; anti-social behavior and psychosis, as examples, and provides patient vignettes, accounts from the clinical literature, and suggests hypothetical generalizations to be considered.
‘Focal suicide’ is limited in space, or part of the body, by analogy to acute versus chronic suicide, in time. Menninger’s examples of ‘focal suicide’ include self-mutilations; malingering; polysurgery (repetitive, and unnecessary or not clinically indicated); purposive accidents (difficult to define in individual cases, as is the distinction between accidental and purposive overdose); impotence and frigidity.
The psychiatrist then questions some of our notions of the separation of mind and body to consider psychological factors in organic diseases including contributions to causation. Several of Menninger’s haunting caveats come in this holistic context:
“All of these theories of structural and chemical etiology are correct, but they are not true. They are part of the truth, but they ignore the psychological factor…”
“The doctor would like to shut his eyes to the fact that sometimes the foe with which the patient fights is not something outside of him but something inside, a part of himself, and this part is willing to have the doctor assume the responsibility for the combat, and often does its best to oppose his efforts.”
“People elect misfortune – they elect misery – they elect punishment – they elect disease. Not always, not all people, not all diseases; but this is a tendency to be dealt with and one which is not ordinarily considered… and which masquerades under various plausible but incorrect or incomplete explanations.”
Doctor Menninger spent his professional career trying to help patients, and his opus is ultimately directed toward concepts that might be useful in the prevention and cure of suffering from emotional, mental, and physical complaints. Among the most useful etiologic and therapeutic ideas:
Psychological Factors in Organic Disease likely include
o Aggressive Component – for example, the role of Anger in heart disease or hypertension (also explored by Menninger’s colleague Harriett Lerner, MD in The Dance of Anger, specifically emphasizing female anger)
o Self-Punitive Component - based on the centuries-old idea that illness is deserved punishment for sin or misbehavior – Guilt for something
o Erotic component – narcissism rather than love outside of oneself…

These factors suggest therapeutic implications:
o Efforts to reduce the Aggressive Element – William James’ “moral equivalent of war”…; recreation, play, and exercise as possible forms of therapeutic sublimation
o Efforts to reduce the Self-Punitive Element – anything that reduces Guilt, such as Atonement and forgiveness…
o Efforts to enhance the Erotic Element – “Nothing inhibits love so much as self-love and from no source can we expect greater ameliorative results than from the deflection of this love from a self-investment to its proper investment in outside objects… narcissism chokes and smothers the ego it aims to protect…”
Doctor Menninger’s summary of therapeutic efforts aimed at reducing self-destructive behavior include: Deflect aggressions to more harmless targets; Allay guilt by socially useful atonement; and Neutralize eroticism by sacrificing narcissism in favor of the cultivation of proper love objects…

Menninger’s acknowledgment of the limitations of his clinical knowledge, and clinical effectiveness, rings true to all clinicians: “No one knows better than we physicians that some of our patients get well in spite of us, rather than because of us…”
As a doctor, patient, man, husband, and father, I have found much useful information and inspiration, every time I have read Man Against Himself. I recommend it heartily.

[Robert Bogue]

One of the things about researching suicide is you get the very real sense that it’s somehow an internal conflict that boils over into an act of self-aggression. It’s this very real consideration that leads to Karl Menninger’s 1938 classic book, Man Against Himself. In it, he seeks to expose his experiences with people who choose to harm themselves – through suicide and other ways. His belief is that our best defense against self-destructiveness is to bravely expose the inner thoughts of those troubled souls who choose self-harm so we may design interventions against them.

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[Maria Fledgling Author Park · Rating 5 out of 5]

For it's time, this was a well conceived theory about why man (humans) were self sabotaging. The writing is thoughtful and clear, if perhaps a bit short sighted, about the capacity for human resiliency. Written in 1938, I found it disconcertingly not too far behind current psychological works. I believe we still have a long road ahead of us in understanding the human psyche.

[Anastasija Rossman · Rating 4 out of 5]

It is a very insightful book. Greatly explains many parts of self-destructive tendencies. It was a very personal book for me, It was a pleasure to tackle my own issues by seeing those answers so honestly described in the chapters.

[Nisha Dhandly]

i would like to write the review after read it.

[Psyguy · Rating 5 out of 5]

Surprisingly good insights with relevance to modern day mental health. Did not expect that from such an old book and iit has a psychoanalysis lens as well which makes it even more surprising that it has such good applicability.

[Bryan Larsen · Rating 2 out of 5]

So so very technical. It was like reading a philosophy book. Although there were some interesting stories.

[Islam Fares]

Thanx

[Jose · Rating 5 out of 5]

Great book

[Arun Kumar]

after reading this book, then I will comment it

[Benjamin · Rating 2 out of 5]

read for high school psychology class

[Jx · Rating 4 out of 5]

学到了很多，虽然有些理论已经跟不上时代了，毕竟20年前出版的。弗洛伊德关于性的讨论这部分属于是边骂边看，作者不时散发的男权思维让人不适