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Eckardt, M.H. (2012). Treatment Resistance and Patient Authority: The Austen Riggs Reader, Edited by Eric M. Plakun, WW Norton & Company, New York, 2011, $35. Psychodyn. Psych., 40(2):354-357.

(2012). Psychodynamic Psychiatry, 40(2):354-357

Treatment Resistance and Patient Authority: The Austen Riggs Reader, Edited by Eric M. Plakun, WW Norton & Company, New York, 2011, $35

Review by:
Marianne Horney Eckardt, M.D.

This is an amazing book, a light of hope in the present depressive, unproductive climate of psychiatric education and treatment, where doctors, patients, diseases, symptoms, and treatment are too often treated as standardized objects and the human being is obliterated. This book is about more than treatment-resistant patients. It is about the dignity of man. The Austen Riggs Center has been intensely engaged, for close to one hundred years, in the treatment of severely mentally ill patients who may suffer from schizophrenic illnesses, bipolar disorders, depressions, and borderline disturbances. The Center has been at the forefront of innovative treatment. Psychoanalytic therapy was introduced into the U.S. by Karl and William Menninger in their clinic in Topeka, Kansas, and by Frieda Fromm-Reichmann at Chestnut Lodge in Rockville, Maryland. Robert Knight, an outstanding psychoanalyst, left Topeka to become medical director at Riggs in 1947. Otto Will, a star pupil of Fromm-Reichmann's, became medical director at Riggs in the late 1960s. Riggs built on this psychoanalytic perspective to develop a comprehensive integrative psychodynamic approach. For many years the clinical and research mission has focused on studying and treating treatment-resistant psychiatric patients. They looked for meaning in the resistance or their symptomatologies. They found meaning and heard the patients' non-spoken messages and changed their treatment approach not only to the patient but to their own therapeutic ways and the therapeutic atmosphere of the institution.

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