The Austen Riggs Center is a psychiatric treatment facility in Stockbridge, Massachusetts. It was founded by Austen Fox Riggs in 1913 as the Stockbridge Institute for the Study and Treatment of Psychoneuroses before being renamed in honor of Austen Riggs on July 21, 1919.
History
Founding to 1946
A New York City internist who repaired to Stockbridge, MA while suffering from tuberculosis, Austen Fox Riggs developed a treatment regimen that both anticipated the rise of psychosomatic medicine and therapeutic psychology and forged a new direction for residential care.
Riggs was influenced by the mental hygiene movement (also known as the social hygiene movement). He developed his residential model after observing a physician in Bethel, Maine named John George Gehring, who treated patients through strict daily regimens and treatments through suggestion.
Opened in 1913 as The Stockbridge Institute for the Study and Treatment of the Psychoneuroses, the Institute incorporated in 1919 as the Austen Riggs Foundation. Riggs grew quickly; it had 100 patients by 1924, with average stays of four to six weeks. A staff of doctors handled no more than 10 patients each, and physicians in training joined regular staff meetings and conferences. A series of "green books" summed up Riggs's "precepts for successful living" and an associate from the 1930s said that patients were encouraged to be "a valuable member of a united team." Patients included socially prominent figures such as Ruth Wales du Pont, who spent three weeks at the institution in 1924.
Riggs had what a colleague described as a "deep and almost Puritanic conviction that feeling must be kept under constant surveillance and control by doing." His hospital had an occupational therapy shop equipped for weaving, carpentry, painting, and other handicrafts, and rooms for games and recreation. Riggs also had what he called "10 commandments" of successful living.
Though he denounced what he called Freud's "mental gymnastics," and criticized the Vienna doctors' emphasis on sexual conflicts as the root of neurosis, Riggs's practices bore commonalities with the emerging field of psychoanalysis. He believed neurotics to be troubled by the "residues of past experience," and that they would heal in part by self-knowledge and adaptation to practical realities. Where Freud spoke of defense mechanisms, Riggs once said that a patient "cannot be deprived of the protection of his neuroses." Where Freud spoke of coming to grips with the ordinary unhappiness of the world, Riggs spoke of the problem of "magnifying suffering by making a personal quarrel with pain." The American Journal of Psychiatry has called Riggs' system "a fully integrated conceptual system of ego psychology" that preceded Sigmund Freud's attention to the field by ten years. Riggs also read Freud in the original German, as well as Pierre Janet and Jean-Martin Charcot in French.
Riggs's books included Play: Recreation In a Balanced Life, Intelligent Living and Just Nerves. The New York Times described him as an "internationally known psychiatrist" who was "widely known to the general public for his books."
1947–1967
In 1947, Dr. Robert P. Knight, the former chief of staff of the Menninger Foundation came to Riggs as medical director. A friend of Anna Freud's and well known in the burgeoning world of American psychoanalysis, Knight emphasized talk therapy and rehabilitation and avoided common practices in psychiatric hospitals of the time, including electroshock, insulin coma, and lobotomy. Knight regarded medications as useful to "lessen distress, improve the patient's behavior and increase his accessibility to psychotherapy," but believed that ultimately a patient's troubles "must be worked out in treatment if it is ever to be worked out at all."
A president of both the American Psychiatric Association and the American Psychoanalytic Foundation, Knight was an authority on borderline personality disorder, which he said referred to patients who were "quite sick but not frankly psychotic." Under his direction Austen Riggs began to receive more seriously ill patients and to explore ways to put into practice Knight's ideas that borderline patients needed a combination of structure and freedom in order to negotiate their own path toward health.
Early in Knight's tenure, when, facing some turmoil with a younger patient population, he convened a conference of patients and staff to work out the philosophy and procedures of a therapeutic community.