M Guy Thompson
The Legacy of R D Laing: An Appraisal of His Contemporary Relevance
Routledge, New York, 2015. 168pp., £29.99 pb
Reviewed by Alex Miller Tate
Alex Miller Tate is studying for a PhD in Philosophy at The University of Birmingham. He studies emotions, psychopathology, critical social theory and philosophical logic. (email@example.com)
In General Psychopathology, Karl Jaspers (1913) wrote that psychotic speech and behaviour were in principle impossible to interpret. Their relevance to the study of human psychological distress was therefore restricted to providing evidence of an underlying, presumably more intelligible, disorder. Laing became renowned for leading a revolt against this notion. The expression, in both action and voice, of his patients’ own lived realities were often, to him, legitimate reactions to distress. Thus, their interpretation and (at least partial) resolution, rather than mere identification and elimination, played a central role in his therapeutic practice. Critics have thought of Laing’s attempts to interact with his patients’ deeply idiosyncratic expressions of meaning as barely more intelligible than the symptoms themselves are supposed to be. This volume puts that myth to bed. The value of this collection comes from its many important reflections on Laing’s active, idiosyncratic, and occasionally bizarre approach to therapy, and its connection to his revolutionary praxis in the realm of psychiatry.
One of the recurrent themes across these essays is the relationship between Laing’s existentialist and relational approach to therapy, and his wider, highly complex, views on the relationship between toxic social circumstances, distress, and ‘madness’. Laing is often misunderstood as advocating merely a friendlier, or kinder, approach to interacting with those suffering from psychosis. What he was really shooting for, as Thompson points out in chapter 2, was authenticity in the relationship between psychotherapist and patient. Schulman further elaborates in chapter 6, arguing that Laing’s vision of the practitioner involved being an active component in a therapeutic dyad, rather than merely a mirror to the patient’s expressions of their world. This relationship, however, had to involve the therapist letting the patient ‘be’; avoiding an imposition of the therapist’s lens on the world. They had to be allowed to come to their own resolutions, in their own way, to ensure that such resolutions were suitably meaningful to the patient in question. The therapist’s role was to aid in the construction of a relationship in which the patient felt able to express and enact those resolutions. These ideas are particularly well discussed and illustrated in Thompson’s personal reflection in chapter 11 on living with, and accepting the oftentimes inexplicable and self-destructive behaviour of a young man named Jerome, as well as Gans’ arguments in chapter 8 that the form of interpersonal ‘relatedness’ Laing aimed towards rebuilding in his patients was love.
A commitment to this therapeutic method sprang from Laing’s hostility to the psychiatric and political practices of his time. According to Laing they “subordinated love to power” (108). Interestingly, it was not so much the aggressive treatments (such as electroconvulsive therapy) that he objected to, as much as the way they were imposed upon patients by medical doctors. This imposition regularly disregarded both the patient’s consent to the procedures in question, as well as their own views on their difficulties. As Thompson suggests, Laing’s primary concern throughout his career was building a way of doing therapy that embodied an ethics of practice at its core, rather than figuring out when the application of a purely procedural method to a patient could be deemed ‘ethical’ (at best a secondary concern to many practitioners, a fact that Laing reviled). By the time he wrote The Politics of Experience, Laing had recognised how deep mainstream psychiatric violence went as a method of social control. Psychiatry was punishing deviance from behind the veil of ‘treatment’. Understanding this perspective is, in part, a matter of understanding Laing’s ever-present interest in alienation and social transgression. On these topics, argues Heaton in chapter 4, Laing embodies the spirit of dialectical thinking (55), offering a subtle interpretation of the rights and wrongs of psychiatric practice without endorsing the simple acceptance of the mainstream discipline, or the blunt opposition of the anti-psychiatrists of Laing’s day (including Guattari and Basaglia).
It was not just the methods by which people were kept in line and forced to adopt the norms of the society in which they lived that fascinated Laing, but also the selves, personalities and behavioural patterns that resulted. As argued by Andrew Pickering in chapter 5, while the intellectual Laing noted and analysed the processes by which people were disciplined so as to stay within particular behavioural norms, it is the active and performative Laing that really defined him as an anti-psychiatrist. The value he placed on authenticity naturally extended to a rejection of the restricted set of norms that brought about an ideal ‘modern self’. This schema of an ideal personality was, he believed “not a norm we should admire and seek to impose on others … [but] a functional requirement of modern capitalism and militarism” (65). In Laing’s eyes, this particular self was the ‘healthy’ norm at which psychiatry aimed. This explained the mainstream discipline’s theoretical and moral inadequacies.
The tendency of psychiatry to incorporate problematic notions of ‘normal’ or ‘functional’ into its definition of the psychologically healthy person will be familiar to many critically minded persons today, irrespective of their familiarity with Laing. The goal of therapy and treatment is still a person who wants and is able to hold down a nine-to-five job. To Marxists this is objectionable; we should not aim to create persons able and willing to participate in their own exploitation. Similar worries exist regarding pernicious norms that regulate the behaviour, dress, and treatment of patients in accordance with their perceived gender, sexuality, and race.
Given that these worrisome ideological presumptions clearly pervade psychiatry to this day, and that many and varied essays collected in this volume shed new light on Laing’s approaches to the problem, Kirsner’s chapter 6 sits ill-at-ease with the most interesting elements of the rest of this volume. He seems to be engaging in a (undoubtedly well-meaning) attempt to de-politicise Laing, suggesting that The Politics of Experience is a significant break from what came before; a book caught-up in the revolutionary, and he believes overly pessimistic, spirit of the New Left. To my mind, Kirsner leaves frustratingly unanswered the question of why this should be objectionable in itself. Engaging Kirsner on his own ground however, it seems as if his essay: a) underestimates the explanatory role of social relations in Laing’s earlier work on schizophrenia, The Divided Self; and so b) over-states the suddenness of the change from early to later Laing. In this sense, Laing’s incorporation of the politics of the New Left into his later work is not only explicable, but arguably necessary. His explicit commitment to New Left ideology in The Politics of Experience is, at least in part, an attempt to answer the pressing question of what factors contribute to the production of relationship patterns that may tend to elicit psychosis.
Pickering argues that Laing’s breed of anti-psychiatry (which distinguished itself from that which rejected any intervention at all in the sphere of mental illness) aimed to undermine the mechanisms by which the behavioural norms of his historical era were imposed via the psychiatry of his day. It aimed to achieve this through creation of “new spaces [in order to] foster the emergence of new sorts of selves, new sorts of people.” (65). To the extent that it was successful, Laing’s anti-psychiatry did this through what Pickering calls ‘dances of agency’ – a process of experimenting with actions towards others and subsequently discovering and reacting to their responses (60). To the degree that Pickering is correct, this reveals that Laing’s praxis, as well as his focus on the material elements of psychiatry and the patient-therapist dyad, is his enduring legacy.
This rejection of any single model of ideal thought and behaviour, as well as the often violent methods by which these norms are imposed, extended to Laing’s view on himself. Peter Mezan reveals in chapter 1 that one of the reasons many people found Laing such an enigma was due to his habit of allowing his mind “perfect freedom” (22) while ruthlessly interrogating his every state of mind so that “where he stood with himself was always in motion.” (20) Further, he constantly acted so as to undermine any absolute claim somebody might be tempted to make about him – at least insofar as such distinctions were based in binaries (saint/sinner, enlightened leader/unregenerate drunk (23)). One may generously read this as an attempt to destabilise binaristic thinking at the level of his own thoughts and behaviour so as to necessitate its rejection in people’s responses to him as well. Slightly less generously, it seems as if it often made him a tremendous pain in the neck. When Fritjof Capra recalls, in chapter 3, a debate he had with Laing about the possibility and importance of science having access to the realm of subjective experience, we are treated to striking evidence of precisely this complex Laing; at once abrasive, contrary, friendly and cooperative.
This collection of essays is quite an achievement; an important rejuvenation of Laing’s thought, in many cases accomplished by those who knew the man personally. One gets the impression that few others would have been up to the task. While Laing’s writings and practice were constantly aimed at demystifying the effects of toxic environments on the human psyche, with the goal of going some way to re-establish the loving human relationships that late-capitalist society so often alienates us from, his work is too often felt to be that of a guru, or a spiritual leader, rather than a serious psychiatrist, philosopher, or social theorist. In truly Laingian spirit, this volume successfully de-mystifies many elements of “Ronnie’s” thought, by putting the reader into an occasionally uncomfortably intimate relationship with many of the most important elements of his writings and practices. As a result, while the chapters reflecting on others’ personal experiences and recollections of Laing will be accessible and valuable to someone new to the area, many of those reflecting on his theory and practice presume significant prior knowledge of the source material. Nevertheless, in an era where mental illness is increasingly becoming a topic of both academic and everyday conversation, often with a discernible neurocentric bias, it is important that reflections on human relationships, and the effect of certain social orders upon them, do not drop out of the conversation. This book is well worth reading for anybody, clinician or academic alike, who agrees.
13 May 2016