Austen Riggs held a blog competition among staff members where we asked them to answer the question: “What does the open setting mean to you?” Over the next few weeks you will read entries from a diverse field of respondents. The entry below comes from Nancy Peck, Admissions and Resource Manager.
Our totally open and voluntary setting, a microcosm of society, sets us apart from other psychiatric facilities and is the most important — and difficult — concept to explain in a way others can understand. While the open setting is difficult to put into words and explain to those who are about to join us, it is the foundation of treatment here and the key to “examined living,” which allows us to function as a community.
At a minimum, a patient here must want treatment, be able to take responsibility for his or her own behavior and, together with peers, be motivated to explore problematic interpersonal relationships. Balancing individual choice and community responsibility is a paramount struggle in Riggs treatment, and an integral part of making the community program work.
The transmission of this culture, with its open setting and examined living, is handed down through words and behavior, but fully joining and understanding the culture and how the community does its work can only be mastered by living it over time. Trust and participation from community members are required to make it work.
Examined living is a unique opportunity with a degree of candor that goes beyond usual social constraints. It not only invites, but calls upon its members to think out loud, speak freely, authentically but civilly, and express feelings, while listening to the feelings engendered in others. Taking the risk of living this way requires trust in each other — patients and staff — to manage this kind of culture with care and sensitivity.
This is a constantly growing and changing environment, a moving target, and to dare to participate in it is the ongoing work of treatment. This is sometimes a scary proposition, but also an exciting and life-changing one. We have the opportunity to be part of powerful moments when something truly brilliant or insightful is said, and we feel lucky then to have been witness to it.
Tune in next week for the final installment of our “What does the open setting mean to you?” blog series.