Chestnut Lodge, Then And Now

IN THE THREE SECTIONS of this article I summarize the history and evolution of Chestnut Lodge (Silver, 1989), present aspects of my ten-year ongoing treatment of a woman with both schizophrenia and obsessive compulsive disorder, and then comment on the work. The Lodge opened in 1910. It has had four medical directors: Ernest Bullard, then his son Dexter, Sr., then the latter’s oldest son Dexter, Jr., and now Wayne Fenton. Each is a forceful and creative representative of his times. It has had five directors of psychotherapy: Frieda Fromm-Reichmann, then Otto Will, Ping-Nie Pao, Robert Cohen, and now E. James Anthony in the adolescent hospital and Christopher Keats in the adult hospital. Tracing the orientations and written contributions of each of these clinicians provides a history of the Lodge (Fromm-Reichmann 1950; D. Bullard, 1959; Sacksteder, Schwartz & Akanabe, 1987; Pao, 1979; McGlashan & Keats, 1989; Anthony, 1990). It is a microcosm and model of American psychiatry, with a proud record of primary influence in two branches, one administrative, the other academic or theoretical. Currently, as throughout the mental-health field in the United States, we struggle to accommodate to rapidly shifting, externally imposed changes. Life is more hectic, less centered. Lodge clinicians usually work elsewhere part of the time, and have less time to confer with each other. We are burdened with nostalgia and grief. Our mentors have all died or retired. The Lodge boundaries probably will soon shrink from sixty to twenty acres. Our nonhuman environment (Searles, 1960) is diminishing.

The founder, Ernest Bullard, had previously been Superintendent of the Wisconsin State Hospital for the Insane, across Lake Mendota from Madison. He believed both in rest cure and work therapy, saying that it is better for people to grow real roses than to make artificial ones (E. Bullard, 1916), neatly foreshadowing Joanne G