Erik Erikson at 120: Social Approach to Mental Health Proves Enduring

Above: Erik Erikson with Fellows at the Austen Riggs Center, circa 1985

By John Zollinger

June 15, 2022 marks the 120th birth anniversary of Erik H. Erikson, the noted developmental psychologist and psychoanalyst whose pioneering work centered on the social as well as psychological factors that impact mental health. With the field focusing more intently on the social determinants of mental health as well as on challenges in access to care and to serving more diverse segments of society, Erikson’s theories are as critical now as when he introduced them over a half century ago.

“I have nothing to offer except a way of looking at things,” Erikson wrote in Childhood and Society in 1950, the book in which he laid out eight stages of individual human development influenced by biological, psychological, and social factors throughout the lifespan.

Joining the Riggs staff a year later, Erikson’s sense that we both shape and are shaped by the world around us, and that who we are depends on our individual psychology, our experiences, and the social context in which we live, would become a critical organizing principle for Riggs. (Erikson was on the Riggs staff from 1951 until 1960 and served as consultant until 1973.)

“Erikson’s work was important because he took what he learned in Vienna from the Freuds and then he enlarged that,” said Jane Tillman, PhD, Evelyn Stefansson Nef Director of the Erikson Institute for Education, Research, and Advocacy, which was created and named in honor of Erikson in 1994. “Freud thought that development stopped at puberty, but Erikson countered that development goes on throughout life. Naturally, over time, Erikson’s approach has been challenged and modified, but his basic construct of lifelong development and working through conflict in the context of relationships—remains vital to this very day.”

“One area where Erikson’s legacy continues to resonate is in recognition of the social determinants of mental health,” said Eric M. Plakun, MD, Riggs’ Medical Director and CEO. “When I look at statements from groups like the American Psychiatric Association, the National Alliance on Mental Illness, and the World Health Organization, I see Erikson’s influence—his focus on understanding how a person’s history and environment directly impact well-being.”

At Riggs, those same values are key drivers in a number of different initiatives. The recently launched Remote Access Intensive Outpatient Program is bringing Riggs’psychodynamic approach to treatment to a highly diverse group of students at colleges and universities throughout Massachusetts. Advocacy efforts through the Erikson Institute seek to promote access to mental health care and parity, including Plakun serving as plaintiffs' expert on adult mental disorders in the landmark Wit v. United Behavioral Health case, and by providing practical tools for clinicians and patients to secure insurance coverage for medically necessary treatment based on generally accepted standards of care.

Stephen Schlein, PhD, a clinical psychologist and psychoanalyst, did clinical training at Riggs from 1971 to 1973, where, as a Riggs Fellow, he met and studied with Erikson. “It was an incredibly meaningful experience to be in his presence,” Schlein said. Reflecting on Erikson's approach, “He was ahead of his time utilizing an interpersonal/relational orientation of extraordinary richness,” added Schlein, who penned The Clinical Erik Erikson: A Psychoanalytic Method of Engagement and Activation that provided unpublished clinical case illustrations, utilizing an interactive technique, and creating a portrait of Erikson in action that added to our understanding of the restorative processes of treatment.

In addition to Erik Erikson’s work at Riggs, his wife Joan Erikson also made enduring contributions to the Center through the creation of the Activities Program. The program features artisans and teachers—specialists in their fields, and not trained as clinicians—who work with individuals and groups, opening possibilities for creative expression and the development of new skills. Joan Erikson also established the on-campus nursery school in which patients work directly with area children and teaching staff as teacher’s aides. Both remain essential parts of the Riggs community today.