Architecture at the Sonia Shankman Orthogenic School of the University of Chicago

“Whatever a human activity may be, its success is facilitated by a particular setting; the more so when complex and subtle issues are at stake. The structure of family life, and the nature of the human relations within it, will be quite different in a one-room hovel and in a palace, though either may be less than ideal when the goal is to promote good mental health” (Bettelheim, 1974, p. 7).

Thus Bruno Bettelheim begins his last of four books about the Sonia Shankman Orthogenic School, the University of Chicago's residential institution for the study and treatment of children and adolescents with severe emotional disturbances. Bettelheim, who started at the school in 1944, was director for more than two decades. I was at the helm from 1973 to 1993. Though he had not been formally trained in psychoanalysis, he developed an approach, psychoanalytically oriented milieu therapy, that brought to him and the school worldwide acclaim. Those years were the heyday of residential treatment for children, years when a number of eminent professionals were applying the lessons of psychoanalytic theory to the treatment of children so disturbed as to require residential care; children whose disturbances before that time had been considered untreatable. Bruno was the most publicly known spokesperson for this effort.

He devoted a good third of this last book on the school, A Home for the Heart, to the physical surround of the mental patient, using the example of the Orthogenic School to explicate and elaborate his meaning. He explains the importance of the physical environment in treatment thus:

“For the patient, once we can convince him to try climbing our ladder out of his dark hole, it is a long pull, rung by rung, toward self-discovery and rediscovery