Welcome to the Very Best Asylum Money Can Buy
On the first day of school in the fall of 1972, Tammy Snodgrass stood up for show-and-tell in her green and tan plaid gauchos, white cotton turtleneck, and single blond side pony-tail, and smugly announced, “This summer my dad went to Germany for the Olympics and saw Mark Spitz win seven gold medals.” As proof, she held up a photograph so grainy and blurry it could have depicted a German male stripper with her father.
My dad had not been watching sexy mustachioed swimmers in Munich that summer, because he had been committed to McLean, the private psychiatric hospital just outside Boston, for alcoholism. My mother was a poet, so when she spoke of McLean it was with reverence, even awe. Both Anne Sexton and Sylvia Plath had stayed there.
“Your father could meet Elizabeth Taylor. Wouldn’t that be exciting?” she asked, her eyes wide and wild. “I should think about what I might serve. Do you think my chicken l’orange is good enough for Liz?”
Soon after my father’s return, my mother was committed to the Brattleboro Retreat in Vermont, another old-school private psychiatric hospital. For the remainder of my childhood and adolescence, she would be “sent up” to Brattleboro for the intense psychotic episodes she experienced every autumn.
When I was 14, I myself was briefly committed to a private mental hospital, and at 30 I entered rehab for alcohol abuse. As you can see, psychiatric facilities are in my DNA, so I know the best of them are on the East Coast. Just ask yourself: Where would Katharine Hepburn go?
The post–World War II Minnesota Model for the treatment of addiction remains the basis of most abstinence-focused 12-step programs. The Hazelden Betty Ford Foundation is the gold standard for in-patient treatment of alcoholism and drug addiction. But what if your issue is not addiction but depression or anxiety, or your 19-year-old kid has borderline personality disorder? Maybe you suffer from a “treatment-resistant” diagnosis. How about if you’re a rock star or an A-list actress or the CEO of a Fortune 500 company and you feel broken or your marriage is falling apart or you’re about to retire and don’t even know who you are? What if you “have it all,” yet you feel empty?
Personally, I would never seek mental health treatment on the West Coast, especially not in Malibu. My feeling is, if there’s a Barbie named after your city, you need to go somewhere else to deal with your bipolar II. Stylish California places seem to advertise heavily and lure celebrities with exotic services that blur the line between treatment and spa.
In New England you have the oldest, most elite private mental health treatment facilities in the country. McLean (founded 1811) is still around, though it’s now associated more with Harvard Medical School than with suicidal midcentury poets, which I’m not sure is an improvement. The Brattleboro Retreat (1834) has continued to evolve and expand its range of treatment from the days when my mother was literally strapped to the bed. But there are unique 21st-century treatment options at high-end facilities that, while luxe, are about more than meditation and cucumber water.
Silver Hill Hospital is a private, non-profit psychiatric hospital nestled on 44 bucolic acres in New Canaan, Connecticut. It resembles a small, exclusive liberal arts college, but you can’t get electroconvulsive therapy at Wellesley.
Founded in 1931, Silver Hill provides treatment to about 3,000 patients a year. It’s primarily self-pay; the exception is the heavily supervised ward where they have 39 beds for patients in a state of acute psychiatric crisis. The remainder of Silver Hill is organized around numerous houses, in which each patient typically shares a room with another patient. The average stay is a month, and it’s historically popular with celebrities, since the secluded location offers privacy, with limited cell phones or laptops. (Plus, it’s a mere 75-minute drive from the Upper West Side.)
Dr. John Santopietro was made president and medical director in September 2017, a transplant from the world of public mental health into the rarefied world of the private clinic. “I needed to be at a place where I knew I could send a member of my family,” he says. “That’s a pretty strong litmus test.” At first I misunderstand him and think he’s confiding that he has had his wife committed, but no. He is clearly proud of and impressed by his staff. “Extraordinary clinicians-smart, curious, always wanting to learn more.”
In describing the Silver Hill culture, he says, “It’s a strong mission-driven clinical culture that fiercely believes in individuality. The individual who comes into treatment here, in this clinical moment-I don’t care what diagnosis they had in the past-I want to know who is this human being, this totally unique human being. It’s this fierce, fighting spirit that protects this space for that human being to tell their story.”
I ask Santopietro if I’m being unfair about my aversion to West Coast treatment centers. Without being specific, he says, “There is an exuberance to get into the market and business of providing care-in part because they see it as a market opportunity, in part because they are driven for health. But I think, going forward, we need to be really careful about figuring out what is good, solid, evidence-based, excellent mental health and addiction treatment and what is something that is trying to look like that.”
After our meeting I’m given a brief tour of the campus. I visit one of the houses for “male dual-diagnosis patients.” The communal area is tastefully decorated and comfortable. The kitchen has upscale appliances and a clay tile floor. The table is handmade, artisanal. I ask my tour guide,“If Adele came, would she have to share her bedroom with somebody else?” She smiled and said, “If Adele were to come, she could have a private room, but she also might have a roommate. I’ve seen that a lot. The celebrities who come here, they’re often at rock bottom. Humble, you know?”
Stockbridge, Massachusetts, is located among the Berkshire Mountains and has remained seemingly unmolested by time. It looks like a town Norman Rockwell conjured (which isn’t surprising, since Rockwell lived here for years), and it’s home to one of America’s most venerable private residential psychiatric hospitals, the Austen Riggs Center, founded in 1919.
The expansive white brick building resembles one of the more modest Newport “cottages” enjoyed by the Gilded Age elite. There are no locked wards at Austen Riggs. Having an identity crisis? The phrase itself was popularized at Austen Riggs by legendary developmental psychologist Erik Erikson.
Dr. Andrew Gerber has been the medical director and CEO for two and a half years. In his mid-forties, Gerber looks younger and speaks with the excitement of someone half his age. As any listener will understand immediately, he is also brilliant. He radiates genuine warmth and exhibits not a trace of arrogance; this is a new breed of psychiatrist. The first thing I notice in his office is that he has not one but two Apple monitors for the MacBook Pro on his desk (thus, three screens), plus a 65-inch touchscreen Windows PC on the adjacent wall.
“The first step seems to be to acknowledge how little we know,” he tells me. “We understand exactly how the heart works, how the kidney functions. We should be in the same place with the brain, but it turns out this three-pound organ is orders of magnitude more complicated than the rest of the body put together.” He becomes animated, speaking passionately. “Okay, it’s really nice to have a name for something. Like chair. But chair doesn’t describe every chair. Book doesn’t describe every book.”
He leans forward, resting his wrists on his knees.“When somebody isn’t feeling well, we say they have, for example, depression, as if this somehow explains the majority of what they’re experiencing. And, of course, anybody who has been depressed knows that’s not true; every depression is different. The individuality of something as simple as depression is unique, and when you add in anxiety, some psychosis, bipolar disorder, you get that every diagnosis in psychiatry is a weak approximation or model of the person sitting across from you.”
Gerber glances down at the floor, then right back up at me. “This is where psychiatry has done the worst: believing too much that these terms are wholly descriptive. I don’t mean to say every term should be thrown out. We need words to describe PTSD, but that’s the starting point. We must recognize the limitations of the language and understand the subjectivity of the individual. You have to understand the narrative of their personal experience.”
In our Snapchat-paced society, Austen Riggs stands alone with its unique long-term residential program based on intensive psychotherapy. The minimum length of a residential stay is six weeks, the average is 10 months, and some patients stay for years. The depth and quality of the exploration is made possible by the length of the stay. Gerber says, “For something as complicated as a human being, the notion that difficulties that have evolved over decades-and powerful experiences-that all of this is going to be reversed in a week or two is not only crazy, it’s an insult to what it means to be a human being. Some things need more time. We work with each individual on a personal level with what they need, what they want, what they decide for themselves. From six weeks to six years. It’s not based on a manual.”
The majority of patients have been in other facilities and often come labeled “treatment resistant,” a phrase that irks the doctors at Austen Riggs. As one psychiatrist says, “It implies the patient somehow failed, and not the treatment.” Austen Riggs was instrumental in identifying borderline personality disorder, one of the most complex and most studied psychological conditions.
“Our patients will always tell you, the most important thing here was the relationships-with therapists, with each other. They help each other. It gets them better,” Gerber says.
This is echoed by the director of nursing, Barbara Turner Hart. “We think about, how is this person unique? How are they different from the diagnosis they have? What are their strengths?” She continues,“We operate in a non-authoritarian way. We’re citizens of the world with you, trying to make sense of your understanding, of why you get into trouble in your relationships.” What she says next I find startlingly insightful. “Many of our patients are experts at what has not worked for them. It’s for us to listen, listen, listen. I mean listen as in, say nothing.”
Spencer Biel, the associate director of the therapeutic community program, is youthful and sharp and speaks of how symptoms are often attempted solutions. “If there’s a patient who has decided to cut herself, in a lot of settings they would say, ‘We have a cutter.’ The conversation kind of ends there.” I admit that I’ve never understood cutting. Biel studies me for a moment and replies, “What an experience it is to have a pain that ends.”
Goosebumps rise on my arms, because I get it and it breaks my heart.
If what you require is the most exclusive, under-the-radar, fully bespoke treatment, entirely one-on-one, you have but one choice: Prive?-Swiss. You have probably not heard of this facility on the Connecticut coast; it is stealth. It does not advertise. It does have a website but no social media presence whatsoever. The Connecticut and California branches may be the most expensive private mental health treatment centers in the world, though because their clients are all titans of industry and A-list celebrities, cost is entirely beside the point. This is the customized, handmade Rolls-Royce of psychiatric treatment centers.
They accept a maximum of three people at a time, who stay in either private houses or beach front villas. The villas have kitchens with high-end Viking appliances, a contemporary gas replace, two bedrooms, two bathrooms. A Prive?-Swiss “companion” normally stays in the smaller bedroom to serve the guest’s needs 24/7; one companion is Kim, the first person I meet. She’s warm, professional, and easy to talk to-no gossip, all compassion. A private chef prepares the meals. It all sounds and looks amazing, but I need to meet the woman who founded this mysterious place. If she’s an opportunistic charlatan, I will know it.
Prive?-Swiss is the singular creation of American-Swiss entrepreneur and visionary Heidi Kunzli, an alcohol addict herself until she got sober at 33. The 58-year-old is polished, stylishly dressed in Eileen Fisher; the only evidence of her former life is her jet-black hair worn in a modified shag. After getting sober, Kunzli knew she wanted to help other people recover their lives. She got her bachelor’s degree and then her master’s in psychology. She became a chemical dependency counselor in Rhode Island, Massachusetts, and Connecticut. She didn’t spend time in fancy clinics.
When her sister-who was living in Switzerland and had a high-power marketing job with a tech company-experienced “a total stress breakdown at age 30,” Kunzli flew over to be at her side. “I spent three weeks with her in this secret Swiss clinic,” she says, where “it clicked in my mind: I wanted to take this really cool, progressive, natural, holistic-based treatment that I was seeing in Switzerland and combine it with what was happening in U.S. rehabs.”
But her vision was to create a program designed for a person of real power with enormous influence. “The key executive, how that person presents themselves throughout the corporation. Through that figurehead, everybody in the corporation is affected. I wanted to do that with treatment. That’s why I targeted the one percent of the one percent.” That may sound like a glib tagline, but she’s serious. “My little part is getting to that person at the top that can affect thousands-and with celebrities, millions. I know three executives who have started wellness programs in their own companies because of this program.”
She is intense and emotional as she speaks, and her eyes water. It’s no act. Heidi Kunzli is fully authentic. I say, “You’re not doing this so you can have a larger infinity pool in your backyard, are you?” She scoffs at the mere suggestion. “That stuff doesn’t matter to me. I drive an eight-year-old car.” Then she smiles and adds, “It’s a Mercedes, but still.”
The model for Prive?-Swiss began in California. “I had an idea in my head as to how I thought high-functioning, successful people may benefit more than from simply the 12-step protocol that was out there.” Her vision was for something that did not yet exist, so she created it.
On Christmas Eve 2001, she signed a lease on a $6 million house in Newport Beach, and Beau Monde was born. “I put up a cheap website, and my philosophy was, all one-on-one, no group. I was very convinced that for a short-term rehab stay you needed to focus on the individual. It’s very easy for highly motivated people to hide in a group setting. I wanted to get right into a person’s underlying self. I wanted to delve deep immediately. I still feel this, and it has worked. One-on-one broke all the rules. I priced us far beyond anything else in the country. Cocktail chatter in Newport Beach is, ‘You pay $200 an hour for your therapist? Well, I pay $500 an hour for mine.’ ” Her vision had aligned perfectly with a previously unseen demand. “In the first year we grew the business 653 percent.”
She opened new facilities to keep up with demand. “I had seven locations in California: Newport, Laguna Beach, Laurel Canyon, Hollywood Hills. I had so many celebrities, lots of musicians. And then all these Malibu places copied my model. Passages came right on my heels. And then all the ‘luxury’ rehabs that opened up copied my program, but I didn’t want to be associated with that. First and foremost, I am a recovering person. Most of these rehab programs aren’t owned by somebody with long-term recovery. They’re out for the money. I shut everything down and opened Prive?-Swiss.” So now she has just two locations: “Southern California and the Connecticut shoreline.”
The Prive?-Swiss program includes traditional psychotherapists and psychiatrists, as well as life coaches, alternative health-care providers, and fitness trainers, each of whom has a minimum of 20 years’ experience and each of whom is at the top of his or her field. This is no spa. As one therapist told me, “Some clients, they come here because everybody in their life is on the payroll. They just don’t know who to trust.”
A typical day would involve a blend of intense emotional/psychological work with a psychotherapist and/or a life coach, and bodywork in the form of yoga, Pilates, or mindful meditation training. All your meals would be prepared by your personal chef. There is no menu; your chef can prepare anything you like. There’s a doctor of naturopathic medicine and an acupuncturist, along with a massage therapist. “Some people need and desire a program of more intensive therapy, and most people have been living in their head for so long they’ve lost touch with their body,” Kunzli says.
I ask if there’s a common denominator among the clients. Kunzli nods and says,“ There is no deep connection to anything profound or personally meaningful anymore. That’s the number one feeling that people come in with. Lack of feeling. A lot of fear involved. Transition from one identity to another. So many people will say, I’m not who everybody thinks I am. Many people who come here have had difficult childhoods. A lot of our clients are very future-oriented. You’re a success because you can anticipate the future and can plan for it; you can put something into play, and that’s amazing. But you’re a nervous wreck.”
When asked to define the intensity and interior focus of Prive?-Swiss, Kunzli says, “There is no Prive?-Swiss program. The program is created the moment we sit down with the patient. It’s a collaboration. We’re humans, being. Co-creating, co-laborating. I am the place where people go when they don’t want people to know they’re in rehab. They wouldn’t consider going anywhere else.”
She pauses for a moment, and then she leans forward, as if she’s going to tell me a secret. “It’s the most exciting journey. To see people come in broken and battered and then watch them transformed. I’ve suffered in my life. And I’ve wanted to die. What an awful black place that was, and I don’t want people to feel that way. The first time you’re able to help someone, it’s an amazing feeling. This is what I’m here for. I’ve never deviated from my vision. I never sold out. Everything about this program was meant to work with superachievers, people who have really flourished with their gifts. But there comes a time when it stops working. Then you’re left with a shell of yourself. You’re existing as opposed to truly thriving and participating in your life. You’re not going to find this kind of treatment in rehab.”
The first thing my father did when he returned home from McLean was pour himself a tumbler of gin.
Both psychiatric care and treatment centers have evolved immeasurably over the last several decades, but one thing remains unchanged. And it’s the one thing my father just didn’t get: No treatment center anywhere can fix you. It can guide you, lead you, enlighten you, inspire you, keep you safe, restore your body, electrify you with insights, and challenge you to be your best self, but ultimately you and you alone will have to do all the heavy lifting.
You have to fix yourself. You just don’t have to do it alone.
This article appears in the May 2018 issue of Town & Country. Subscribe Now
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