The Value of the Open Setting at the Austen Riggs Center
“All behavior in the open setting is taken as communication.”
- John Muller, Ph.D.
In his remarkable and thorough piece on the open setting, Riggs’ staff psychologist John Muller, Ph.D. reflects on the meaning of the open setting at Riggs, the implications it has for treatment, both for patients and staff, and the importance of maintaining the open setting for the benefit of the treatment.
Dr. Muller outlines the three essential components of the open setting as “the [therapeutic] community program, individual psychotherapy, and the activities program.”
It is the therapeutic community program that provides direct instruction and feedback about behavior as community members live and interact with each other. Dr. Muller notes, “continual failures must be interpreted through communal reflection through an ongoing kind of conversation that looks at the various, interesting ways in which none of us lives up to the ideal of the rational, sane community. We expect failures to take place and they provide the material for us to interpret together.”
The intensive, four-times-a-week individual psychotherapy at Riggs Dr. Muller views as a type of “unlearning” where the therapist is entrusted by the therapeutic community to “interpret unconscious repetitive behavior in the transference and thereby assist the patient to alter, to unlearn certain ways of thinking, feeling and perceiving.”
The activities program is a unique and revolutionary program originally conceived by Joan Erikson in 1954. Dr. Muller states that it is an important “forum for recognition independent of the group dynamics of the community program as well as independent of the transference in the individual psychotherapy” which provides patients an opportunity to develop skills in specific ways.
The open setting is a crucial element of the treatment at Riggs. “What is at stake…is the creation and transmission of a culture” says Dr. Muller. He goes on to remark that “patients in our setting are required to actively plan their treatment. That is to say, we do treatment with, not to our patients.”
To read Dr. Muller’s entire piece on the open setting, please view the PDF at the bottom of this blog post. Also, tune in next week to read the first in a series of blog posts by Riggs’ staff that answers the question “What does the open setting mean to you?”