The Rich History and Evolution of Treatment at Riggs



As part of our Winter Chat series provided for patients and staff, three long-time staff members Donna M. Elmendorf, Ph.D., Diane Heckman, R.N. and Cornelia Kalischer facilitated a fun and freewheeling trip through the 95-year history of the Austen Riggs Center, stopping at several milestones along the way and engaging the specific interests of the audience by utilizing a question and answer format.

Founder, Austen Fox Riggs, M.D. was originally an internist who took an interest in the mental hygiene movement of his time, which examined the relationship between the mind and body. Originally called The Stockbridge Institute for the Study and Treatment of the Psychoneuroses, the organization began as an outpatient clinic in 1913, eventually becoming incorporated as the Austen Riggs Foundation six years later in 1919. Dr. Riggs developed a set of “Ten Commandments” for healthy living that outlined the importance of attaining balance in work, play, rest and activity. While the relationship with the town of Stockbridge began as an uncertain one, Dr. Riggs’ outreach and involvement in the town along with the positive patient presence led to a formal reconciliation from the town within a decade. To this day, the collegial relationship between Riggs and Stockbridge can be attributed to the patient community’s active and positive role as citizens of the town and the town’s open, respectful attitude.

Riggs has always maintained an “open setting,” although the “living out” of that openness has evolved over time. In 1947, with the arrival of Robert Knight, M.D. from Menninger as the Medical Director, the focus of treatment at Riggs took a turn away from Dr. Riggs’ original model and toward psychoanalysis. With a shift toward the open exploration of the psychoanalytic approach and treating a somewhat younger population, the staff recognized a need to integrate the freedom of the open setting with an expectation of responsibility. Out of this recognition came the development in the early 1950’s of the therapeutic community with a system of patient self-governance with an aim toward establishing guidelines and expectations for the entire Riggs community.

The early 1950s also saw the arrival of Erik Erikson to Riggs, whose work establishing that individuals could not be understood apart from their psychosocial and historical contexts had an immediate and long-lasting impact on the work at Riggs. Erikson’s wife Joan made her own contribution to Riggs by instituting a revolutionary Activities Program, which continues to thrive today.

The late 1960s to late 1970s, under the direction of Dr. Otto Will, there was a deepening interest in using psychoanalytic approaches with patients with psychotic disorders.  Dr. Will was noted as someone who did whatever it took to reach a patient, even if it meant conducting sessions in their rooms at the Inn, a practice that no longer exists today.

In 1978, Daniel Schwartz, M.D. became Medical Director of Riggs. A former director of the Yale psychiatric hospital, Dr. Schwartz oversaw Riggs during a time in which managed care and biological psychiatry became increasingly popular. At the same time, hospitals with a focus on long-term psychotherapy, including Chestnut Lodge, McLean and Menninger changed their missions considerably. Riggs, however, steadfastly held to its belief in intensive psychodynamic psychotherapy. 

As Medical Director from 1991 through the first decade of the new century, Edward Shapiro, M.D. sharpened the focus on psychodynamic systems theory, examining every element of Riggs as part of a larger system that contributes to the overall function or dysfunction of the organization. In addition, he oversaw a necessary and important increase of the social work element, creating greater connectivity between patients, their families and the community beyond Riggs. Today, every patient has a therapist, psychopharmacologist, nurse and a social worker guiding their care.

Riggs is home to a rich and fascinating history marked by great minds and great leaders. While much has changed over the last 95 years, what remains constant throughout the thread of time is the unwavering commitment to patients.  The pillars of care that extend throughout our care include patient authority and responsibility, the importance of relationships and the discovery of meaning.

Thank you to Dr. Elmendorf, Diane Heckman and Cornelia Kalischer for hosting such an informative and engaging event.

Blog Tags: