Many people who come to Riggs have previously been diagnosed with a personality disorder, such as avoidant, narcissistic, 

 or others. Personality disorders are complex psychiatric struggles that are often defined by core challenges someone has with their sense of self (e.g., 

, self-direction) and relationships (e.g., the ability to form and sustain close connections) and often carry stigma. Nobody wants to think that their personality is inherently disordered, flawed, or off-putting to others. In this post, I want to clarify what personality is and how we think about it at Riggs.

The Big Five Traits in Personality Science

The most common framework in the personality science literature is the Big Five, a collection of traits that have been repeatedly found to describe meaningful differences between people across different age ranges, languages, and cultures (

 – vulnerability to emotional instability, anxiety, depression, distress, etc.

 – orderliness, reliability, responsibility, etc.

 – kindness, compassion, cooperativeness, etc.

 – creativity, willingness to risk new experiences, etc.

 – assertiveness, friendliness, seeking out social experiences, etc.

While these traits describe how a person generally acts, feels, and behaves across a range of situations, they do not answer the deeper question of why a person behaves the way they do. For instance, someone who is introverted may value solitude and enjoy solitary activities, or they may struggle with tremendous social anxiety and rejection sensitivity in ways that are negatively affecting their daily life. The psychoanalytic approach to personality focuses on underlying motivations, ways of managing distress (i.e., defense mechanisms), and core conflicts that drive a person’s emotions, thoughts, and behaviors 

Personality Style and Personality Organization

There are two ways to think about personality beyond the concept of personality disorder and specific traits:

 – Everyone has a personality style influenced by temperament, attachment behaviors, identity, sense of agency, and characteristic ways of managing distress (

). For example, someone with an obsessive personality style may rationalize away negative emotions such as anger rather than expressing them directly. Rather than experiencing anger, they may talk about it in a detached, intellectualized way while keeping the emotion at arm’s length. Over time, this avoidance can contribute to anxiety and depression or other mental health challenges. 

) refers to the developmental capacities that evolve over a lifetime, including identity, values, reality testing, social cognition (i.e., the capacity to accurately discern the motivations and thoughts of others) and attachment style. Difficulties in personality organization can result in mood swings, unstable identity, maladaptive defenses, or temporary dissociation. These challenges often play a role in conditions like borderline personality disorder. 

Listen to this fascinating podcast interview with Carla Sharp, PhD

, to learn more about personality organization and how researchers are rethinking the concept of personality disorders.

At Riggs, we are attentive to both aspects of a person’s personality; we try to learn about how someone’s personality style developed within a particular familial and sociocultural context, the way it serves a person and how it gets in the way of living a life of flourishing, which is fundamentally related to how someone handles distress. 

, we aim to help individuals notice the ways they may reflexively avoid distress and find more adaptive ways of handling and tolerating pain. Of course, suffering is an unavoidable part of the human experience, and we all must make choices about how we relate to the pain of our own lives and the pain of those around us.

One of the benefits of focusing on personality organization over personality disorders is that it reframes personality difficulties as challenges that are part of normal human development. Every human being is struggling to sort out who they are, what they value, how much of their pain they can handle, and how to communicate (or not communicate) it to others. Trusting that others will be there for you in moments of uncertainty is based on your personal history, experience of trauma, and potential moments of betrayal. We are all trying to contend with these questions and develop more robust capacities and new ways of thinking about ourselves and others to develop the resilience necessary to navigate our complex and complicated world. 

 encourages resilience by helping people understand how personality develops, how risk factors and life experiences play a role, and how treatment can foster healthier ways of relating to oneself and others.

Photo by Alexei Maridashvili on Unsplash. Woman looking at her reflection.

Woman Looking at Her Reflection

News

Jeremy Ridenour, PsyD, ABPP, clarifies what personality is and how we think about it at Austen Riggs.

What is Personality?

Understanding the Two Sides of Mental Health Recovery

Mental health professionals and researchers have long sought to understand what it means to "recover" from mental health challenges. One helpful framework breaks down the process into two categories: objective recovery and subjective recovery—two complementary, yet distinct, dimensions of progress in mental health treatment (

Substance Abuse and Mental Health Services Administration, 2012

What Is Objective Mental Health Recovery?

Objective recovery refers to the measurable aspects of recovery, including:

Reduction or remission of psychiatric symptoms (e.g., fewer depressive episodes or panic attacks)

Functional improvements (e.g., returning to work or school, managing daily responsibilities)

 because their mental health issues and symptoms interfere with their ability to meet life goals. For example, someone may struggle with chronic

, and persistent self-criticism that can lead to hopelessness, withdrawal, and distress—experiences that require professional clinical care.

What Is Subjective Mental Health Recovery?

Subjective recovery emphasizes a personal and emotional experience, including:

Fulfilling relationships and a sense of community belonging

These aspects can be more difficult to see from the outside but are crucial to long-term recovery. Someone may appear to be functioning “normally,” yet feel disconnected from themselves, ashamed of their pain, and isolated by the belief that no one truly understands them. The result? Painful experiences of 

 can leave the person feeling like their life lacks meaning or purpose.

Why Both Perspectives Matter in Mental Health Treatment

At Riggs, we take a comprehensive, person-centered approach that values both the objective and subjective elements of recovery. Treatment options begin with the individual’s goals and what matters most to them—not clinician assumptions—and center around collaborative therapeutic relationships, giving individuals a voice and allowing them to drive their treatment plan.

Some patients may seek help with emotion regulation and to stabilize mood swings, while others are navigating identity confusion or uncertainty about their life’s purpose. No matter where someone starts, our focus is on individualized care that addresses developmental, psychological, and relational struggles.

A Real-World Example of the Recovery Process

Consider a college student dealing with severe social 

, panic attacks, and suicidal thoughts, unable to attend classes or form meaningful peer connections. Beneath these symptoms may lie a deeper developmental conflict: the very normal challenge of separating from family and forming one’s distinct 

, building self-reliance, and managing the emotional, academic, and social responsibilities of adult life.

Through our comprehensive psychological evaluation, we explore how their mental health condition and symptoms are rooted in the individual’s life story, identity formation, personality structure, cultural context, and family dynamics. This depth-oriented work helps uncover the underlying sources of emotional pain, allowing for sustainable symptom relief and personal growth.

Moving Toward Meaningful, Long-Term Recovery

True recovery isn’t just about reducing symptoms. It’s about building a life that feels meaningful and connected. At Austen Riggs, we help people move beyond their mental health disorder toward flourishing—through care that addresses the full complexity of the human experience.

 or learn how we work with emerging adults and those navigating complex psychiatric conditions.

Austen Riggs Center Activities Program Greenhouse

Learn the difference between objective and subjective recovery in mental health. Discover how the Austen Riggs Center supports lasting, personalized healing through psychotherapy and a person-centered treatment model.

Recovery in Mental Health: Objective vs. Subjective

Photo by Brett Jordan on Unsplash. Tiles that spell who are you.

At the Austen Riggs Center, identity is central to how we understand and support human development. We build on the foundational work of Erik Erikson, who emphasized that identity forms within and across the context of a person’s life cycle and sociocultural environment. 

 described identity continuity—the sense that we are the same person over time—as essential for psychological well-being.

 outlined three vital elements of identity:

Distinctiveness – seeing oneself as unique

Coherence – maintaining consistency across social roles

Continuity – experiencing oneself as the same over time

People often come to Riggs when they're facing questions like: “Who am I?” or “How did I become this version of myself?” This search for a core sense of self may follow a psychiatric crisis—such as a 

—or may arise from a deeper sense of emptiness or disconnection.

Your social identity is shaped by the time, culture, and family system into which you were born. It includes elements such as:

At Riggs, we explore your sociocultural identity by taking a detailed 

 and conducting a comprehensive psychosocial assessment. We seek to understand the values and dynamics that shaped your identity—both consciously and unconsciously—and how you relate to those aspects today. Our 

 also offers a way for you to learn how you engage in social groups and how you are seen by others, which can deepen your understanding of your social context and social identity. 

Your personal identity reflects how you see yourself internally: your personality traits, physical appearance, skills, hobbies, goals, and values. Through 

, we explore your unique perspective and the ways you relate to yourself and others. This helps us understand how you’ve come to define who you are—and what that identity means to you.

Our identities are not just lists of traits—they're stories we tell ourselves. According to personality psychologists 

, we create a narrative identity to make sense of our past, understand our present, and imagine our future. 

At Riggs, patients spend the first six weeks of their treatment sharing their life story with their therapist and other mental health professionals. This narrative process helps uncover how trauma, memory, and social influences have shaped a person’s view of self. Some arrive with a fragmented or missing story, signaling identity diffusion or a loss of narrative due to trauma. Others may feel stuck in a story told by someone else—often their family members—and want to reclaim authorship over their own life. Constructing a robust and flexible narrative identity can allow you to gain greater perspective on the patterns of your life and enable you to make meaning as you move towards your future goals.

Many of our patients have long histories of mental health conditions and treatment in the mental health system and carry identities shaped by diagnoses, medications, and therapy experiences. At Riggs, we help patients examine how they see their psychiatric challenges and pay attention to the possible impact of stigma of shame on someone’s sense of self. While a diagnosis can be informative, we work to ensure that it does not become the sole definition of who a person is.

Why Identity Matters in Mental Health Treatment

Identity development is complex, contextual, and deeply personal. It cannot be reduced to a single label, story, or trait. At the Austen Riggs Center, we honor the diversity and complexity of identity. Our treatment approach is built on helping individuals discover:

We believe that fostering a cohesive identity is essential for lasting mental health and personal fulfillment.

Ready to explore your identity in a deeper, more meaningful way?


The journey to understanding yourself doesn’t have to be taken alone. At the Austen Riggs Center, we’re here to walk with you as you rediscover your story and reclaim your sense of self.

Photo by Brett Jordan on Unsplash. Who are you tiles.

Who Am I?

Social, personal, narrative, psychiatric—identity is complex. At Riggs, we explore every dimension to help individuals understand their past, present, and future.

Understanding Identity in Mental Health at the Austen Riggs Center 

Reunions conjure images of family gatherings, high school homecomings, or college weekends, but not psychiatric residential treatment. And yet, the 

, the staff, and the patients at the Austen Riggs Center create the kind of community that invites reunion.

Finding community and truly meaningful relationships is a rare and precious thing. Relationships, after all, are central in human life–a core value of the Austen Riggs Center. So, it was unsurprising to see more than 90 former and current staff and patients embracing, laughing, catching up, and connecting at our recent alumni reunion, held August 1-3.

Every three years, Riggs hosts this event—a unique and singular experience, much like working at or being in treatment here, which many experience as deeply personal, at times painful, and ultimately life-changing. Along with some current staff and patients, this year’s reunion brought alumni from as long ago as the 1960s and as recent as this year, representing a broad spectrum of experiences, knowledge, and perspectives.

In his opening remarks, Medical Director/CEO 

, captured the emotional complexity of the moment:, “For many of you—whether former patients or former staff—this place was both a crucible and a refuge. It was a setting where pain met purpose, where confusion met clarity, and where learning took hold in ways that continue to shape your lives.” He reminded attendees that Riggs is a place where relationships are central, where growth happens, and where people are empowered to 

find their voice and take charge of their lives

He also added personal reflection: “In many ways, I return today as an alumnus. Though never a patient, Riggs profoundly shaped the course of my career and my life.”

Acknowledging that both people and places evolve, he described moments of disorientation in coming back after 13 years—and moments of deep connection, such as a 

 from me?”—a reminder that learning flows both ways.
(Shapiro served as Medical Director/CEO from 1991-2011 and returned to the post this past January.)

After Shapiro’s remarks, he invited the audience to share what was on their minds. Former patients spoke movingly and honestly about their desire for more of an ongoing connection to Riggs and support for alumni who might still be navigating mental health challenges. Currently, there are quarterly Zoom gatherings open to all Alumni Community members as well as periodic, in-person Transitions meetings where former patients and current patients have an opportunity to meet, ask questions, and learn from one another. 

"The reunion weekend was a very meaningful event for me. Thank you all so much for putting it together. I felt so proud to be able to bring my family, a family which itself was unthinkable before my time at Riggs. There can be life on the other side of a grueling process. I had the experience of returning to Riggs feeling like a full person and finding myself treated like one as well. We will be returning," said former patient Peter G.

Making Meaning Through Art, History, and Community

After a mix of mid-morning patient-led tours and a history tour of the Riggs campus on Saturday, alumni reunion attendees congregated at 48 Main Street to experience and hear about the current 

. The exhibition, which opened earlier this summer, looks at the ways the 

 has shaped the patient experience at the Austen Riggs Center throughout its history with artifacts as well as new work from current and former instructors and patients (additional alumni work was also on display during the reunion weekend at the Lavender Door Gallery down the street). In addition, the exhibition honors Joan Erikson’s reimagining of the Activities Program and the founding of the 

 75 years ago. The public is encouraged to visit Thursdays-Saturdays, 10:00 a.m.-4:00 p.m. (Eastern), through October 13, 2025.

The Role of the Activities Program in Mental Health Treatment and Recovery

The Activities Program continued as a theme into the afternoon as four Riggs alumni, moderated by Riggs psychologist 

, offered reflections on their time in treatment, insight into the critical role the Activities Program played in their recovery, andreal-life examples of how what they learned continues to inspire and inform their lives and work now.

“I need love. I need people. I need community. I learned that at Riggs,” remarked one alum, while another recounted the “creativity through authority” that patient government in the 

 offered, and the indispensable “emotional sandbox” of the theater program. Another alum stated, “It [treatment at Riggs] allowed me to integrate my past self with my present self.” While each presenter utilized a different artistic medium, all noted art’s ability to hold, express, and reflect something central about their experience, an important facet in their work at Riggs.

Later in the afternoon on Saturday, attendees were invited to watch a screening of alum Michele Beck’s “

,” a personal documentary that chronicles the filmmaker's journey through mental illness, treatment, and self-discovery, and highlights the critical role the Activities Program played in her recovery. The screening was followed by an in-depth conversation with Shapiro and Beck and thoughtful Q&A with the audience.

In his remarks, Shapiro also spoke about Riggs’ defining feature: the Open Setting.

“Freedom at Riggs is not just the absence of locked doors. It’s the belief that trust and risk are essential to growth.”

This philosophy was tested in recent years as external regulations increasingly pushed for “safety and security” measures—code for locked doors and surveillance. To preserve its values, Riggs voluntarily gave up its hospital license and became a licensed Residential Treatment Center, ensuring the continuation of the same depth of treatment without compromising its relational structure. On Saturday evening, attendees connected over dinner at the Inn at Stockbridge and then gathered for brunch on Sunday to reflect on the weekend and say farewell until next time.

“The weekend was a powerful reminder of the enduring bonds between our community and our former patients and staff,” said Director of Development and Alumni Relations Jodi Shafiroff, “I felt the depth of those connections throughout the conversations and presentations.”

Shapiro closed with a sentiment that resonated throughout the weekend: “This is Riggs at its best—a place of ongoing dialogue, mutual respect, and continued learning.”


If you or your family member had a positive experience with Riggs, we would love to hear from you. 

Looking back and moving forward is the theme of the 20205 Austen Riggs Alumni Reunion.

2025 Austen Riggs Alumni Reunion

Alumni News

Along with some current staff and patients, this year’s reunion brought alumni from as long ago as the 1960s and as recent as this year, representing a broad spectrum of experiences, knowledge, and perspectives.

Reuniting at the Psychiatric Residential Treatment Center

For the past 40 years, the Austen Riggs Center has hosted leading scholars from diverse disciplines through its Erikson Institute Scholar-in-Residence Program. These scholars engage with us to share their expertise, deepen their research, and enrich the ongoing clinical and academic work at Riggs.

Introducing Our July 2025 Scholars-in-Residence

For the month of July, we are honored to welcome:

 – writer, clinical psychologist, and consultant

 – distinguished professor and acclaimed author in psychology and psychiatry

Both scholars will pursue innovative projects that explore intersections between psychiatry, culture, spirituality, and the arts.

Dr. Shira Nayman: Literature, Therapy, and Spiritual Inquiry

While at Riggs, Nayman will focus on two major initiatives:

 (Scribner), this work-in-progress explores the therapeutic relationship between a psychiatrist and a patient suffering from psychotic postpartum depression, raising compelling questions about trauma, memory, and identity.

Researching the Psychological Impact of Sacred Texts


Through interviews with clergy, scholars, and laypeople, Nayman investigates how sacred texts influence individuals' spiritual and psychological development. The project delves into personal narratives of faith, identity, and transformation.

Dr. Louis Sass: Cultural Psychiatry and Self-Disorder Theory

Sass will be pursuing two significant research efforts:

Ethnographic Study of Indigenous Mental Health Concepts in Mexico


This nearly complete project in psychiatric anthropology examines traditional mental health frameworks—Susto (Fright), Locura (Madness), and Nervios (Nerves)—as understood by curanderas in the Michoacán region.

Expanding the Ipseity-Disturbance Model (IDM) in Schizophrenia Research


Dr. Sass continues his groundbreaking work on the self-disorder model for understanding symptoms along the schizophrenia spectrum, known as the IDM (Ipseity Disturbance Model). This research bridges clinical psychology, phenomenology, and neurobiology.

About the Scholar-in-Residence Program at Austen Riggs

The Erikson Scholar Program creates and maintains an exchange of ideas between academicians and clinicians to explore interactions between the internal and external worlds. This interdisciplinary program enriches our understanding of each, which often has application to larger societal problems.

Learn more about the Erikson Scholar-in-Residence Program

Our July 2025 scholars will be studying literature, therapy, and spiritual inquiry, and cultural psychiatry and self-disorder theory. 

Riggs Welcomes Drs. Shira Nayman and Louis Sass as Erikson Scholars-in-Residence 

list of speakers and titles for 2025-26 FNGL series

The Erikson Institute for Research, Education, and Advocacy of the Austen Riggs Center announces its 2025-26 Virtual Friday Night Guest Lecture series. Lectures are held from 6:30-8:00 p.m. (Eastern) via Zoom, designed for mental health professionals, offered free of charge, and provide 1.5 continuing education credits (see registration pages for specific guild information). Pre-registration is required and available at 

The Paternal Function in Anorexia Nervosa

 with Tom Wooldridge, PsyD, ABPP, FIPA, CEDS-C 

Sun, Soil and Rain: Research on Patient Growth in Psychotherapy

The Question of Unworthy Life: Eugenics and Germany's Twentieth Century

Working Clinically with Overwhelm: The Cost and Growth-Inducing Possibilities of Undoing the Self

Becoming Raced-Psychic Consequences of Transgenerational Racial Trauma

For a complete list of live and recorded CME/CE courses and events, visit 

Speakers, dates, and topics for the 2025-26 Virtual Friday Night Guest Lecture series have been finalized.

Speakers and Dates Announced for 2025-26 Virtual Friday Night Guest Lecture Series

We all grow up in families where, inevitably, moments arise when a child’s needs exceed a parent’s capacity to meet them. In many cases, these mismatches remain minor and manageable. With time and communication, families adjust, and development continues.

But some mismatches disrupt development because they are emotionally overwhelming, unacknowledged, or simply too frequent. A child’s innate neurological makeup may lead them to be chronically out of sync with their parents. Or a parent’s previous trauma may limit their emotional availability. Or families may unconsciously carry the effects of trauma that were never recognized or understood in previous generations.

Children adapt to preserve the caregiving relationship, which they need to survive. If they decide a traumatic experience is their fault, they can still believe their parents are good. Over time, survival strategies like this continue to shape expectations, relationships, and identity long after the original context has changed.

Why Some Patients Receive the Label “Treatment-Resistant”

Although these adaptations once helped children cope, they often complicate adult relationships, including in treatment. Many of our patients find themselves unconsciously reenacting early family dynamics, experiencing their therapists or other staff members repeating the roles of misunderstanding or injurious caretakers. Even minor misattunements—an ambiguous tone, a missed cue—can trigger intense reactions: withdrawal, rage, or despair.

Clinicians in traditional settings may misinterpret these responses as resistance, defiance, or dysfunction, labeling patients as“noncompliant” or “untreatable.” At Riggs, we see these reactions not as pathology, but as meaningful expressions of unmet developmental needs and unresolved trauma. When such patterns emerge in the therapeutic relationship, they offer an opportunity for understanding and change.

Riggs’ Therapeutic Stance: Empathy and Accountability

At Riggs, we approach intense emotional reactions not as problems to be suppressed but as communications to be understood. This means approaching intense reactions with empathy while also holding ourselves and our patients accountable.

Empathy means asking: What might we have done that triggered this? Where did we fail to listen or understand? We seek the truth in the patient’s experience, validating emotional reality and helping them bear what once overwhelmed them. Understanding the present moment often frees patients to join in reflecting on the impact of their past.

Accountability reflects our confidence in each person’s capacity for adult insight and responsibility. By holding patients accountable for their behavior and helping them recognize their impact on others, we support their developing capacity for broader perspectives and more flexible relationships.

Balancing empathy and accountability foster psychological integration, trust, and a sense of agency.

We conduct treatment in a completely open setting—without locked units, seclusion, or restraints—because we trust our patients to share responsibility for their care.

In more restrictive environments, control measures like locked doors or restraints often unconsciously mirror the traumatic conditions many patients endured in childhood—conditions where autonomy was denied, emotions were punished, or the caregiver inspired both fear and dependence. These measures can retraumatize.

At Riggs, we respond to intense affect—rage, despair, suicidal feelings—not with coercion, but with shared emotional labor. Patients, families, and staff bear it together. This strengthens agency, mobilizes mature capacities, and deepens trust in the therapeutic process. We intervene more actively only when a patient’s safety is at risk.

Community Life: Creativity, Responsibility, and Strengths

Healing at Riggs extends beyond the therapy room. Our therapeutic community includes an 

 that fosters creative expression through art, music, writing, and performance. A work program gives patients the opportunity to contribute meaningfully in settings such as the nursery school, greenhouse, library, and kitchen, taking up roles that reinforce responsibility, competence, and connection. Through patient government, individuals help shape community life and exercise leadership.

These programs promote recovery by enhancing strengths, encouraging engagement, and restoring dignity through work, creativity, and shared governance. They support a shift from helplessness to agency.

Patients don’t just repeat early dynamics with their therapists; they live them out across the community. They may idealize some staff and hate others, unconsciously recreating childhood divisions. These enactments can strain the staff system itself.

At Riggs, we use a systems psychodynamic lens to understand these patterns. Rather than blaming individuals, we treat the staff system as a therapeutic instrument. We reflect, interpret, and metabolize the dynamics together.

In outpatient settings, patients often react strongly to people outside the therapist’s reach—family members, colleagues, or friends. At Riggs, where patients and therapists are members of the same community, we can often observe these dynamics as they unfold, making them readily available for exploration and understanding. The community becomes a living extension of the patient’s internal world, enabling deeper insight and fuller integration.

We don’t aim simply to relieve symptoms or change behavior. We join patients in exploring how they became who they are and how they might change. This frees them to identify and pursue their own goals.

In a community that fosters emotional honesty, mutual responsibility, and genuine participation, patients can become active agents in their healing. They can move from being passive recipients of care to active authors of their lives.

Patients walking around the open setting campus of the Austen Riggs Center on Main Street in Stockbridge, MA.

Voluntary Residential Treatment in an Open Setting

In a community that fosters emotional honesty, mutual responsibility, and genuine participation, patients can become active agents in their healing. 

Understanding Treatment at the Austen Riggs Center 

Learn the crucial differences between crisis stabilization and treatment aimed at recovery that allows one to live a self-directed life.

Understand how high-acuity mental health symptoms often reflect underlying developmental struggles, especially in college students and emerging adults.

Explore the essential components of a psychodynamic systems and team-based approach to intensive outpatient treatment (IOP), including the analysis of group dynamics, integration of dyadic and social learning, and promotion of trust, agency, and identity development.

In today’s fast-paced mental health system, treatment often begins and ends with crisis stabilization. Yet, for college students and emerging adults facing complex psychiatric challenges, this approach falls short of delivering long-term healing and personal growth. At the Austen Riggs Center, the 

online Intensive Outpatient Program (IOP)

 offers a groundbreaking psychodynamic systems approach that goes far beyond symptom reduction.

This blog draws from a free CE/CME course led by Riggs staff 

, and unpacks how this model fosters the development of a self-directed life, revealing why IOPs that integrate identity work, emotional meaning, and team collaboration are uniquely positioned to support sustainable recovery in young adults.

If this topic is of interest to you, check out the 

Toward a Self-Directed Life: A Psychodynamic Systems Approach to Treatment of College Students

 course in its entirety on our online catalogue and receive free CE/CME credit.

Crisis Stabilization vs. Recovery-Oriented Psychodynamic Treatment

One of the most misunderstood aspects of mental health care is the assumption that crisis stabilization equals recovery. Crisis stabilization refers to the short-term management of psychiatric emergencies—suicidal ideation, psychosis, or dangerous disorganization. While necessary, this intervention is not designed for long-term change.

In contrast, the goal of recovery in modern mental health—aligned with 

 standards—is to support individuals in living a self-directed and meaningful life. This requires restoring both psychological and functional capacities.

The Riggs online IOP uses a recovery-focused lens, particularly for individuals who cannot fully utilize conventional outpatient therapy. These include patients whose ability to attend, participate in, or benefit from therapy is compromised by deeper issues like trauma, developmental conflict, or comorbid conditions. IOPs become a transitional and restorative space—not just a holding tank between crisis and independence, but an engine for long-term growth.

Interpreting High-Acuity Symptoms as Developmental Striving

Rather than viewing acute psychiatric symptoms as random or purely biological, the psychodynamic systems model understands them as meaningful expressions of internal and social conflict. For emerging adults, symptoms often represent tensions between dependency and autonomy, perfection and failure, or connection and rejection.

A vivid example is Jane, a composite patient in the Riggs online IOP. Jane’s self-harm and depressive collapse did not merely signify distress—they were her unconscious strategies to express unmet attachment needs, grief over inconsistent caregiving, and rage she couldn't verbalize. Her symptoms were powerful attempts at adaptation, not just signs of illness. Understanding acuity as

developmental striving shifts the treatment approach. Instead of suppressing the symptom, the online IOP therapists work to decode its function, uncover the emotional truth it conceals, and support patients in discovering new, more adaptive ways of engaging the world.

Core Elements of a Psychodynamic Systems and Team-Based IOP

A psychodynamic IOP goes far beyond individual therapy or skill-based groups. At Riggs, the treatment structure integrates multiple services—individual therapy, group work, psychiatry, and family engagement—anchored by a team of clinicians working from a shared developmental and psychodynamic lens.

Patients with trauma or chronic relational disruptions often mistrust the intentions or reliability of others. Establishing epistemic trust—the belief that others can provide useful, reliable information—is an essential step, one typically preceded by taking seriously the sound reasons a person has for being mistrustful. Trust opens the door to deeper therapeutic work.

Coping skills are necessary, but insufficient. Patients need to explore how they came to be overwhelmed in the first place: How have early relationships shaped their responses to stress? Which strategies have helped or hurt? How does the form of their struggles reflect a family or social role? What’s at stake in their relationships if they change?

To live a self-directed life, patients need a coherent and flexible sense of self. This emerges not just in therapy sessions but through group interactions, feedback, and the cumulative experience of being seen, and learning to see oneself more fully, across different relationships.

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