The Third Table

a. More: Ess White

2: CAMELOT    By Ess White

For me, the decade of the 60s really began about 1961. That was the year that my beloved teacher, Dr. Rapaport, died suddenly. His death was a profoundly moving experience for me and for all of us. That was also about the time Erik Erikson accepted a position at Harvard as Professor of the University. He continued to spend time with us in the summers but, of course, he was less involved.

By the 60’s,Riggs had developed enough to consolidate an excellence for therapeutic community work and for activities teaching. Intensive psychotherapy had made sufficient advances so that it was much more sophisticated. Lastly, and certainly not least, the decade of the 60’s was framed, both before and after in the life of the United States, in a way that stands out as a particular period. The period made its stamp upon life at Riggs and, I believe, life at Riggs made its stamp upon those children of the 60’s who came to us.

The 60’s was a time of social revolution that has also been called the sexual revolution. If there was a sexual revolution, it was already going on in the 50’s. We were aware that our patients quite often became sexually attached to one other and had affairs. It was always the policy of Riggs to be officially against sexual action between patients because we were concerned that this ‘acting out’ of feelings was probably being stirred up in the psychotherapy. We were concerned that it would result in some social disasters for people who were expressing their conflict in this way, not to mention diluting the necessity to see most of these feelings as displaced from the turmoil aroused in the psychotherapy. We were constantly urging patients to take such issues to the therapist’s office to try to resolve them in that relationship. It is usual in this kind of treatment, however, that such advice is not universally observed, so there were many sexual incidents in the hospital. The entire patient group tried to work with individuals to help them maintain a boundary between sexual impulse and sexual behavior.

In the 50s, there was great external social pressure against such behavior.  The hospital could legitimately worry about the reputation of Riggs if referring doctors and parents of prospective patients felt alarmed that their referee/child could experience such terrific pulls of desire that might be physically expressed.

In the 60’s the entire culture began to shift.  Young people were very openly sexual, even extravagantly so, and seemed to take great pleasure in demonstrating this before their more staid parents and social leaders. The dress code shifted to casual style. The acceptance of casual dress, in places that heretofore had been rather formal, became the order of the day. This experience was occurring all over the nation, with the older generations being shocked, or at least perplexed, by the behavior of the younger generation and the younger generation being openly scornful and defiant of the values held dear by their parents.

The struggle between the generations, of course, was not at all new. The difference was that, previously, it had been done on an individual basis and, more or less, contained within a family. But this was a nationwide expression which made it very difficult to help any individual see his own individual conflict and dilemma in this area.

Perhaps what marked that generation and that decade the most was a very special sort of idealism. I think we all tried – patients and staff  – to live out our ideals in that community. Together we created, for a time, a complex interwoven community- a little Camelot. And, I think we succeeded more than we had any right to expect.

So here we were in the 60’s and our operation was running smoothly, but we also, in the therapeutic community, needed an injection of life. In 1963 Marshall Edelson made a presentation to the staff which was riveting. He had run a unit at the University of Oklahoma with great success and had very definite ideas about what “therapeutic community work” should be, what sociotherapy should be, and how people should see themselves in such a program. In 1964 he was hired as the person who would be the sociotherapist and teach sociotherapy (meaning leadership function in therapeutic community work).

His effect on the place was quite decided and partly traumatic. He had a systems theory point of view toward social interaction based largely on the work of Talcott Parsons and others who now represent the Tavistock Clinic in England and the A. K. Rice Institute in this country. His ideas were not enormously different from what we had been doing, but they seemed so to us and the language was different. He was much more aware of boundaries and the importance of role functioning in social action than we had disciplined ourselves to be. There was a wrench, particularly in the staff, and a very welcome one in the patient group, who responded to his ideas with great enthusiasm, many becoming devoted personal followers of Edelson. He insisted that we all act within the boundaries of our role and that we ot use our power to usurp other people’s roles, authority, or responsibilities.  He was also a brilliant sociotherapist in meetings and was able to interpret the social process in a group interaction, thereby facilitating subsequent performance within role.  This was true, especially, for the patient group and, eventually, it was true for the staff.

During the 50’s a number of people came for an evaluation and stayed only two or three weeks. That means there is much more coming and going, whereas in the 60’s patients stayed for a long time and that led to more stability in the community.

When Marshall Edelson came he instituted a noon patient meeting and he did not allow the staff to go. Marshall didn’t want us. He felt that we had no “role” or “function” in the meetings. Some of Marshall’s notions of community and how you worked it seemed very strange to some of the people who were used to the analytic hour. That had to be worked out and it took a long time. Excluding the staff from the meetings did nothing to allay people’s paranoia. But that was Marshall. He should have made a role for somebody as they finally made a role for me in 1966 although I think that setting that role up was partly due to the patients like Marti and Mary and others who wanted to hear from the administration. The patients seemed to sense that there was a missing voice.

It seemed that almost no one on the staff, except the young people, could work with Marshall. He was very possessive and very put offish. He would not really discuss any of his ideas with others. He would lecture but he would not discuss. He managed to keep every thing in his briefcase or under lock and key. From 1964 until 1966, when I came on the program as a representative of the administration, there was a great deal of festering in the staff and a great deal of acting out by the patients (who tended to mirror any splits in the staff.) The patients who were very close to Marshall thought he was speaking scripture and soon began acting out against the rest of us.

Marshall was rigorous about the system that he was trying to put in place and thought that much of the behavior that took patients away from the community was like resistance in therapy and that some of the analysts were colluding with that unconscious drive.  When I joined the program, I finally understood what was happening.

Margaret Brenman was one of the senior staff who had a problem with Marshall. She felt that any patient she was seeing could go back to college if that was best for them, while Marshall wanted each patient to become a member of the community first and then they could go on to other endeavors.

Marshall came along, took over, stirred up a lot of controversy, was almost immediately idealized by most of the patient group, and taught us all a lot about the work. It took some of us old-timers a long time to make peace with Dr. Edelson and some of the most senior people wanted him to leave.

Of course, as I said, the patients picked up on the splits.

In the Inn it was obvious that there was a strong patient group that ran everything. Then there was a group on the edge. There was also a group that was terribly powerful but complained all the time about everybody else. The people who ran everything were always accepting positions of power on the committees that had been established back in the 50’s.

This power group may have fluctuated but it was also very consistent. It was fascinating to see people sort of wake up and take on a position of responsibility. After about a year I saw Mary do that.  Another time I walked over to Peter and said, “Isn’t it about time that you ran for this office?”  It was a C.C. election and everyone was sitting there looking very difficult about who was going to take over. Peter looked as if I had hit him in the face but he did run, he was elected and he did a very good job. Now I realize I had no business doing a thing like that but sometimes I guess you have to rise above principal, above role and do the right thing.

Mary, Turk, Marti, Peter, Beth – they were the power group. Well, Peter was not really in that group since he was then an outpatient. But he was behind the scenes and I imagine that the fact that he saw Edelson complicated everything. Judy fell into that group when she came. Ivan was also a power broker, but not for good as it turned out. And Bea, of course, was very much in the center although she didn’t run for office. She was dancing around outside and being outrageous. She had her own way of bringing things about.

I’ll tell you an incident with Bea….  I felt for her because obviously it hurt her but it was also hilariously funny. For some reason I had been invited to the Inn to have tea with one of my other patients and I decided to do it, don’t ask me why. We were there sitting on the floor having tea and some emergency had arisen. Bea was running up and down the halls screaming, “Shirley Cooley needs men!” As if someone needed restraining. She stuck her head into the room, saw me and froze- not a sound came from her throat. She turned around and left. Later she told me when we were together in my office that she had never been so mortified in all her life. When she ran off to tell Turk about finding me in “her room”, he quickly proclaimed, “That hussy!”

The patient power group could be rather cliquish and apart from being a group of friends, cliques have a sense of using power to keep people out, always. I think that can be very destructive to those who are kept out and who don’t have the raw material available to them at the time to become a member. I look back at that era in terms of the people I remember and the things that worked. If I really jogged my memories I’d find a lot of people who were there during the 60’s that did not get what that group of patients got.  They did not do very well and were not very happy. People who needed something slightly different. I suffer from a selective memory and it is hard to go back and pick that up.

I can almost remember all this easier with the staff. I can remember certain staff who came here as Fellows who somehow just didn’t make it. They didn’t get to be anybody’s favorite and they didn’t get to be invited to the clique parties.  They were just kind of ignored and left out.

But usually the Fellows who stayed distinguished themselves in some way either by brilliance, or excellence, or a good track record with patients or by just being good work horses- someone who could be of use to the staff.  Mainly people stayed or left because we couldn’t keep everybody.  The trainees have to keep moving along to make room for the new trainees.  And this is what we hold dear as a hospital.  We are a training hospital and we want people to get what we have.

The way it worked was that the new psychiatry Fellows would arrive around the first of July. The psychologists didn’t always come until September.  When they arrived they were brand new and didn’t know what we were like at all.  They would not know anything about an open hospital so there was a lot of orienting to do.  I always thought it was it was quite an ordeal – a trail by fire to introduce everyone at the annual forth of July picnic at the Inn.  That meant the new Fellows met the patients as well as the senior staff at that picnic.

I used to do a lot of training with the new people.  The way I did training was not the way it is done now.  We would go over the initial history that is taken during those first weeks while the patient is undergoing their pre – conference observation.  Going over the abstracts is a wonderful teaching ploy.  People find out very rapidly if they know anything by going over the report they had just written.  I’d tell them not to be repetitive, not to just fill things up with hot air.

I would also always try and prepare them for the forth of July picnic.

You see traditionally everyone always tried to come back for the forth – patients as well as staff.  There was a soft ball game, a tug of war, and capture the flag.  The Fellows would generally suffer from how they were supposed to behave.  In a place not like Riggs, the usual training is about how to maintain a boundary and a separation.  What we try and teach is how to make a boundary having to do with the work rather than just the social boundaries.

I remember a half way naughty remark from Marty who was also lolling about watching the soft ball game.  There was a great deal of yelling that the staff umpire had allowed a Fellow to get on base.  “Marty turned to me and imperiously asked, “What do you think?”  I said, “I think he is safe.”  “Oh, she said.  That seemed to settle it.  Those were the days when I was working closely with the community so I guess I was allowed in on the inside life.

Anyway most of the Fellows did leave after two years.  The ideal for the patient of course would be to stay with the same person as long as you needed to be in the hospital.  But dream on!  It is impossible to arrange that.  My experience was that practically no one who ever came here wanted to leave Riggs.  We were doing glorious work that no other place was doing.  No body else does what we do – especially what we were doing then.  Taking people who need to drop out of their lives long enough to go to a hospital for a significant period of time and still feel that what they are doing is a wonderful thing – that is truly extraordinary!

It took me a long time to tumble to knowing about the amount of drugs that were in the hospital.  We doctors were terrible, terrible about drugs in the beginning.  Even before the sixties I remember a man, who would have been in Bea’s group, saying in our small group ‘ “I wish you doctors understood something about drugs.  People spoke in those cryptic ways then. There was that girl with the prominent jaw who worked with Marshall.  She spoke like him all the time.  Like when we all went to Molly’s funeral.  In the car coming back she was saying, “I wish that the doctors understood about things….” She let that drift off.   She didn’t say openly, “I wish you doctors understood this or that and this is what I think. That open approach leads to an exchange and doesn’t keep us on the outside.  And of course if we don’t see it, then how are we going to learn?  That is the part about Marshall that drove me crazy.  He spoke in cryptic ways that kept people out and I couldn’t stand it.  Perhaps it is useful in a meeting when there is some resolution, but just as a way of dealing with other people, I don’t recommend it.

I could see the squaring off between the group who had tremendous power but was forever complaining and the group that was actively in power, in a way that had the sparks flying in the meeting.  But again the comments were so disguised and so cryptic that you had to be “in the know” to have any sense of what it was all about.  That cryptic talk kept the separation between “us”, the staff, and “them”, the patients alive.  I never noticed some things that were maybe obvious in retrospect like squaring off between the Jewish patients and the Wasps. (By that time I had almost forgotten to notice such things).  Yet the power group was pretty Waspy, now that I think about it and often reacted with entitled disregard and a kind of cliquish that was exclusive. There certainly was a great stand off.  One group complaining bitterly about the other and raising the cry of “Honesty” against all those who were somehow “dishonest”. I remember Dr. Cooperman used to used to talk about honesty in the service of hostility.  The real motivation is the hostility. All these splittings and sparings helped mask the issues about drugs. And we were so dumb about drugs, God knows!  It remained fringe awareness for a long time.  We certainly didn’t crack down the way we would today.

I remember Bea had stopped her prancing around, which she did all the time, but prancing around verbally in her therapy and seemed to be getting closer to wondering why she was so paranoid and what was really the matter.  I think it would have taken two or three years more but I was not discouraged.  I was still in there – feeling we had something going.  You have to have a connection – that is the bottom line necessity.  And how could you not have an attachment to Bea?  Bea was a force of nature.  There was no way to be bland around Bea.  You had to have some reaction.  Much of the time I wanted to shake her but we were working together, if you can call that work.

I was on the cape when the news came.  Ed Howard called me at my friend’s house and some guests were just about to walk in the front door and I called my hostess and said, “Two of my patients just died in an automobile accident and I’m not going to go up and be pleasant with the guests. I’m leaving right now.  So, I did and I came back to Riggs and then there was the Memorial service.  Everybody in the place was very kind to me.  I don’t know if they were kind to others, but they certainly were to me.  Nobody blamed me.  No body gave me a hard time.  People assumed I was suffering.  And I was.

The Memorial Service for Bea was at Saint Paul’s Church and coming out I was thinking to myself, “I really ought to say something comforting to Mary in particular and when I got out I saw her crying uncontrollably- and I didn’t know what to say but everyone else was trying to say something comforting to me.

When it came time – it was so awful – we crashed Molly’s funeral in Lakeville because, it turned out, it was a closed service but they didn’t tell me.  I called three times to say some of us wanted to come down, could they tell me what time it was and all they did was make evasions and circumlocutions.  If somebody had just said, “Look, it would just be a kindness to us if you people from Riggs would just stay away forever!”  I could have dealt with that better but a whole bunch of us went down.  And Marti naturally was the mother hen who was running everything…. It was Marti who managed the refreshments for Bea’s funeral and she got a car together to get us down to Lakeville and I went with her and Annie U.  And maybe someone else.  She was just terribly, terribly kind and supportive as if I were a bereaved one, which in a sense was true.

There is an attachment both ways in a therapy and this person had not only disappeared along with someone else I was seeing, but they did it in a way you can only have total ambivalence about because they must have been flying out of their minds on drugs on that trip down to N. Y. and I guess the only person I could be furious with was Ivan which isn’t fair at all.  He was driving, but that was that.

After the funeral I took a month off and went to New York and stayed at the Carlisle.  I surrounded myself with a little luxury and I went out doing the kinds of things I love – theater, and whatever.  I did nothing else for a month.

Of course I blamed myself.  I knew it wasn’t rational to blame myself but you always say, “What could I have done to prevent this?’ If I had made a bigger stand about drugs.  If I’d even said to Bea,  “ If you won’t follow my advice, if you won’t get off drugs, at least you mustn’t leave the Inn!”  Whatever.  None of which would have done the least bit of good probably, but…

What I think would have been different had I been seeing Bea, say over   last five or six years, I would have made her go someplace after it started, like the Brazleton drug place.  I’d say, “We will do psychotherapy once you get off it.”  I’m convinced now that somebody who is drugged all the time – you can’t do psychotherapy.  There used to be a rumor that Mary was on amphetamines for a year and I don’t know what that did or even if that was true.  But I think we blithely felt that psychotherapy would do it, and I don’t think that any more.  Alcohol either.

Of course what was so awful in Bea’s case was that it started at Riggs.  I don’t think she was much of a drugger before.  There was a patient, a married man, who used to introduce some of these girls into drugs.  Maybe he wasn’t the first and I know Bea was in a wild crowd before she came, but she was hooked here.

I remember Marti saying to me soon after I went over to be the consultant to the community committee, “I wasn’t prepared for you at all.  All I knew about you was what I heard from Bea.  Bea used to talk about how you would tell her where to get off all the time.  Bea was so tough and difficult; I was expecting someone like Dr. Bristol.  You’re not like him at all!  You’re very gentle and thoughtful.

You understand I have a great aversion to putting myself out, not only into print to be criticized, but to be used as a kind of model to anyone else to be indiscreet about one’s own patients.  I understand that because Bea is dead, legally we can talk about her.  But to me it is very, very important not to cross a line and this gets very close to being unethical.  Where to draw the line is not always easy and one is always in danger of fudging because one has a motivation to fudge.

Even case histories where patients are disguised bother me.  On the other hand I think we would be a much poorer place if we didn’t have Young Man Luther. Erik’s book was written largely as a result of Erik’s work with a young man here at Riggs who I knew very well and who I just heard from.  He wrote to say how wonderful it was to get the issue of Connections about Erik.  He knew he was in the book.  I feel less strongly about it if a patient is fully aware, but I still have a problem about conformed consent.  That is the same problem with Riggs’s fund raising and asking ex – patients for donations.  I really don’t have a problem with ex -patients wanting to help Riggs, but what I do have a problem with is when is someone in some kind of subjection without realizing it and therefore when we ask we are exploiting.  From our side we aren’t exploiting but… It is a very difficult issue. Of course to us on the staff this is all a burning issue since Managed care has threatened the ability of a place like Riggs to exist.  When is it ethical for us to participate at all?  Can a patient ever be anything else?

In this book we are trying to collaborate and hear all the different voices.  I am trying to give Mary what she wants and certainly we have been having a long dialogue during these interviews where these issues are central. We are discussing the relationship between therapist and patient.  Like fund raising or like sexual relationships you have to keep a boundary.  Power goes both ways.  Where doctors and patients have affairs it wouldn’t surprise me to learn that the patient were very seductive.  But you see that is the whole reason that we have to have a boundary.  Because if we don’t keep a boundary against the seductions of patients, not only sexual but otherwise too, then we can’t maintain that position where we can hear, more or less impartially what’s being said.  If you just join the dance, you’re lost.  That I feel very firmly about.  I believe this is one of the most important issues in the whole business and its lost because no one is doing psychotherapy anymore.  At least doctors aren’t.  These issues are such a different issue than medication since the ethical issues about ordering medication are not the same thing.  Oh, this is very dear to my heart!

It isn’t just a problem about patriarchy.  If you have ever been a man in the grip of a matriarchy you know how your own true voice is lost. Truly maternal people take over in certain ways.  We have had two long-standing women as clinical directors and I think that the favoring of talk and dependency is very clear.  It is so startling clear that anyone who wants to do something is seen as a violent person.  As Carol Gilligan says, women like to talk about feelings.  Men tend not to.  Men tend to want to do something.  But if the ruling voice says that is violent and what is good is to talk, and talk about feelings, then you have a suppression of any kind of ordinary male voice by a matriarchal order.  This is the problem we are having with getting the alumnae association off the ground, especially around the fund raising issue.  We have talked and talked; now when are we going out to raise some money?  The endless processing of feelings!  And I don’t think it is written in stone that the female way is better! Of course being a psychotherapist, I am probably much more maternal that most men in this culture.  And in the culture of Riggs many of the women were more connected to doing which is why in the culture of Riggs what is looked upon as strange in the outside culture is welcomed here.  No one here looks at the idea of this book as strange.  Mary wants to do a book.  She comes and states her opinions.  Seems to me that is basically what we welcome.  I may not always agree, but if Mary can keep herself in check and allow all the different voices to speak she will have done something remarkable, not only as a thing to do, but as a book.  This is one reason I am bending over backwards to give her what she wants – because I think if she can do it, it is going to be great! And if we can pull this off and the different voices are allowed to speak it will be a remarkable book.

Dr. Robert Knight is one of my great-unresolved transferences and it was one I didn’t particularly need to remedy.  He was the ideal boss and father and I loved him personally.  When he was on his deathbed and had to go to New York for a treatment I insisted on going on the charter plane so I could be with him.  His children weren’t around and Adele, his second wife, was my best friend – even before they got married- she was delighted to let me help.  I was very much wanted to step in and take charge of things. I was at his bedside when he breathed his last breath.

Transferences never feel objective.  I was obviously most attached to the man and it was a very favorable attachment to me and I don’t think it did him any harm.  He was not my father of course and yet the feelings were very real.  Something of that sort would always take place between a Medical Director and a young staff member.  That goes without saying.  On the other hand I’m saying I’m quite convinced I brought something extra to it that goes beyond that.  Something that came from my inner need and was partly recreating my relationship with a saintly kind of father – but a distant one.  I’m sure I was trying to solve something by that relationship.

Dr. Knight’s illness had gone on for a long while and we were feeling the splits over Edelson very keenly.   Because I had the complete trust of the old timers here, I was asked to take over and run the place:  while Dr. Knight was ill and then dead.

I did it well and it suited me.  I became the consultant to the patient group on administrative matters and I reported back to the administration about what was going on with the patients.

By this time Marshall had so much influence in the Inn that it was almost as if there were two places and the staff was almost split in two.  Because I was somebody both sides trusted, I decided to make a move to go and join Marshall’s program and to be the person who would represent the administration in the Community Meeting. Once I had a legitimate role and could watch what was happening in the meetings, then I quickly came on board.  In fact Marshall and I saw eye to eye about a great many things.  I lost all my paranoia about what he was doing and began to explain to the rest of the staff why this kind of thing was necessary – why I should go to the meetings as the administrative rep. and why I should not speak as a psychotherapist.  That was the key to a great deal of the philosophical problem – therapists were accustomed to make interpretations and Marshall wanted none of that.  He wanted group work and felt that a therapist using interpretations usurped the patient’s authority to learn for themselves in the group.  Since I was somebody that everyone in the MOB trusted, I was able, when I went over there, to make common cause with Marshall and we got on beautifully.  I learned a lot from him and he learned a lot from me.  Then it was fine.

I tried to keep communications open in that way and to smooth things – smooth the machinery.  I tried to help the patients see what help the administration needed and to help the administration see what the patient group wanted to do and what it needed.  I became the consultant to the C.C. (Community Committee which was responsible for the running of the day to day aspects of life in the Inn.).   I remember my first visit to the C.C.  Marti was the chairman and I was the only staff member.  I sat there and saw work being done all over the place.  Marti ran the meeting with an iron hand and everyone was snapping to and doing the work.  I remember saying at the end of the meeting, “ I had no idea that you people were so talented and so good.”  I remember that very well!

Besides being a consultant to the C.C. I would sit in on the Community Meeting (that had been closed to us all) I remember sitting up on the sofa next to Mary who was the patient co – chairmen of the meeting.  I remember somebody, who had recently been discharged, committed suicide and it was a miserable meeting but I came back to the M.O.B. and said the patients were doing good things.  The staff settled down.  In reverse I would go back to the patients and say that the administration was really trying to help.  Then the patient group would settle down.  And I saw to it that both sides did settle down.  That was my job.

One story about Marshall:  we were going someplace – maybe I was going to his house for supper – we were buddies after a while. We parked on Elm Street and we were going to go to the P.O.  We got out of the car and he said, “ Aren’t you going to lock your car?”

“No.”  I answered

“What about my brief case with all these things in it?”

“ What about it?”

He gave up then and said, “O.K. – It’s your responsibility!”

And he walked into the post office without my locking the car.  I knew we had finally made common cause.

After a while I was quite comfortable in my role as the administrative representative to the community meeting yet I did get into trouble during the great gonorrhea scandal.  I was asked shortly after the scandal broke to describe something or other and give a medical opinion.  I remember turning to Pat P. and saying, “Pat, what do you think the medical thing is here?”  Now Pat was a medical doctor as well as a patient but the other M.D.s in the room were furious that I had turned to her instead of to them.  They were right.  After all, they were the official M.D.s in the room and she wasn’t there to be a M.D. She was there to be a patient member of the group.

I always felt the patients should get involved wherever possible.  I was looking at in that way rather than who was here in what role because she was not there in that role.  Now Edelson himself never mentioned it, but the Fellows in training, people like Curtis Bristol, jumped all over me.

What is so great about working in a place like Riggs is that it encourages examined living.  In other words, if I am supposed to represent the administration at those meetings and I hear myself doing something like the incident with Pat P., I have to say something to myself like, “How am I behaving?  Why do I think that is what the ‘role’ is?  Am I in role?” I have to stop and reflect and reexamine.  I see that issue not as an issue of power but of authority – which is the exact opposite from power.  The person with authority has to take responsibility for action and no one else should usurp that authority.  Because that is a power move – when someone tries to usurp the authority from someone who properly has it.  That is what I call a power play.

Obviously Pat was a doctor and a woman and a patient and she should not split herself off into being just a patient.  On the other hand, if I have colleagues who are there for that purpose, then what am I doing by turning to a patient instead of to them?  Civilization depends virtually on people being able to manage group action.  And group action depends largely on a delegation of authority of people functioning in role.  I believe that firmly.

Of course the gonorrhea problem just should not have been there.  I remember discussing it at a staff meeting – that was when it had just broken and everyone was floundering about not knowing what to do!  We discussed it but there was no conclusion and at the end of the meeting I thought,  “Well, no one told me what to do!”  Then I thought,  “Well, that is my job! I will decide what to do and I’ll do it.”  And I did.  That was when we had the meeting and we talked about the epidemic and I turned to Pat P. That was the beginning of my saying it was a public incident.  Maybe everybody knew it, but this was the official statement in an official meeting.

I can’t remember how the epidemic was resolved but it created a hazard for everyone in the hospital.  The mores were a little looser during that decade than maybe they have been since and of course we had no idea how it was going to spread.  There wasn’t any great notion of who was doing the spreading.  The public health officials had come in and they had their requirements. We did what we had to do.

On another vein, I think we held to a party line – the analytic view about homosexuality during the sixties.  Back in those days people were filled with curiosity…  I remember going to a party at a friend’s house whose husband was a macho show off and the first thing he said trying to make polite small talk about my being at Riggs was, “ I assume most of your patients are homosexual?”  I said, “Almost none of them are.”

In those days we viewed it as a perversion rather than a common variation of human desire.  That view came into respectability in the mid – seventies.  We seem to be loosing it again, nationally, in the 90’s.  Hard on the homosexuals, of course, just as the views about women were hard on them.  Most of us did privately question the views on homosexuality, but never said so in public.  In the case of women, I feel we didn’t have much of a clue, until a lot of people like Mary, Marti and Bea shook us up in a delighting way.

By 1967 things were changing so fast that we were barely keeping up.  This reflection brings to mind the arrival of our first genuine hippie at Riggs.  We had lots of people with long, unkempt hair, lots of people who were casually dressed, lots of people who, by this time, had experimented with drugs, lots of people who were sexually quite active but this one young man, Glenn, was everything rolled into one.  He had long, stringy hair, his clothes were disheveled, and he managed to look dirty, whether or not he actually was.  He could have been straight out of Haight-Ashbury and, in fact, his general approach showed a kind of happy, flower-child manner that was not at all studied.  He was the real thing.  His appearance caused consternation in some parts of the patient group and it certainly caused consternation within the town of Stockbridge.

As far as I know, he never did anything out of the way, except to be himself and to alarm people who thought that, surely, the hippie invasion had begun.  One woman, a longtime friend of mine, actually complained to Police Chief Obanheim (of Alice’s Restaurant fame) about this young man and asked him to take action.  She represented the old line, conservative aristocracy of the town and the Chief felt obliged to do something.  Since I was then the person in charge of the hospital, he made an appointment to see me.  After listening to his angry list of complaints about Glenn, which consisted mainly of his appearance, I politely suggested to Chief Obanheim that he should be careful about what he did as an official in relation to this young man, unless he had actually committed some kind of crime or misdemeanor.  I told him he would not want to make himself subject to an accusation of false arrest and that, perhaps, he and the young man could try to establish some friendly contact so he could help him on his way through town.  Chief Obanheim, to his credit (not the only one I can give him), backed down immediately and talked about how he explained to everyone in town, if they complained about the looks or behavior of Riggs’ patients, that they were, in many ways, not any more discordant than some of the young people in Stockbridge who were not at Riggs.  He always added, in his gruff manner, “and they’re paying good money to do something about it.”

Glenn continued to have his hippie look for all of the time that he was at Riggs. He found acceptance in town after he volunteered to help fight a nasty forest fire on West Stockbridge Mountain, working as long and as hard as our local stalwarts.

Almost a year after Robert Knight died we finally got a new Medical Director who came from Chestnut Lodge Hospital. Otto Will came we had to fight hard to keep Riggs open.  He wanted to put in a closed ward and to move the place to the end of a road so that it would not be intruded upon by the county. He thought that Marshall’s program was completely disrespectful to the patients and had no use for the community program.

With Otto’s first patient it was all quite clear.  She had been put into a room that was decorated with yellow wallpaper and she couldn’t stand yellow – it was going to drive her even crazier.  So Otto up and had her room changed.  That was a no -no in he kind of community we were running.  You got your name on a list and you waited your turn.  Everybody had an equal shot in a fair way.  That was one of the beginnings of the end.

The common work program finally died towards the end of the sixties although it had been very sick ever since Otto was made Medical Director.  The shop got dirty and no one was going over to clean it and somebody went over to look at it and said, “We can’t allow patients to work here in this mess!  We have to close the shop!”  Then Otto ordered a janitorial service to come in and clean it.  Well, you know that was not the way we were doing community.  People should have been made to face up to their mess, or what they weren’t doing or made to get back on track.  There was never any work program after that.

Marshall left and the man who continued on running the community meeting didn’t have the skill to pull it off.  Well it has changed again now.  The real glue in the place today is the community program.  There isn’t much nursing time now for private stuff.  The downstairs of the Inn is now community oriented and is where the zillion meetings take place.  All the semi – public rooms they can pull together, like the living room, the library and there are even meeting rooms in the MOB that are, rather than doctor’s offices, devoted to patient meetings.  If you are not doing anything you can just go to a meeting.

There are a lot of people who aren’t living in the Inn anymore so it is the group cement that is keeping the place together behaviorally.  I think it is closer now to the way it was in the sixties than it has been over the past thirty years.

My retrospective reflection about the Riggs of these last 47 years is surprisingly sanguine and personally satisfying. My simple, inelegant statement of our mission is:  We provide a psychoanalytically informed psychotherapy (searching for meanings, searching for what is not in awareness) for people who, in a major way, are not making it where they are living in their society. We provide, crucially, a community that examines the experience of living with others in a way which leads to the ability to thrive alongside one’s neighbors. We sponsor the creative use of one’s abilities and talents for their own sake, as well as personal growth. We do all this in a totally open, physically unrestrained environment, which depends for its survival on everyone’s taking responsibility for themselves and their behavior.

We have sponsored an ideal and have tried to live up to it. Our failures are many and often serious, but probably fewer than those of other places (including the family) which set lesser goals — particularly the goals of achieving uncomplaining conformity and loss of vitality.

I am dissatisfied with my accomplishments, but I am at peace with who I am. For many years I have been pretty much the same person in or out of my consulting room. These personal comments are not only a way of telling you about me, but also a way of talking about Riggs and its successes and failures. An ideal is never reached, only striven for. No one, in therapy, gets all that s/he hoped for. But s/he often gets wonderful things that were not even anticipated. That happened in my analysis, and I believe it has happened for most of my patients. Even the tragic and wasteful death of Bea doesn’t make me feel that she would have been better off not to have had her Riggs experience.

This book is a testament to the longtime sense of our– patients and staff — attachment to fellow patients, staff, treatment and Riggs, itself. Not bad, especially for a group of patients who often had little sense of self or connection to others. So it wasn’t ideal; so it wasn’t always curative. We all have continued to try, and, for the most part, to move ahead. To paraphrase Dr. Riggs’ patient, Olive Higgins Prouty: All of us reach for the stars — perhaps we already have a piece of the moon.

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