R.D. Laing

Ronald David Laing (October 7, 1927–August 23, 1989), was a Scottish psychiatrist who wrote extensively on mental illness and particularly the experience of psychosis. He is noted for his views, influenced by existential philosophy, on the causes and treatment of mental illness, which went against the psychiatric orthodoxy of the time by taking the expressions or communications of the individual patient or client as representing valid descriptions of lived experience or reality rather than as symptoms of some separate or underlying disorder. He is often associated with the anti-psychiatry movement although, like many of his contemporaries also critical of psychiatry, he himself rejected this label. He made a significant contribution to the ethics of psychology.

Biography
Laing was born in the Govanhill district of Glasgow, and went on to study medicine at the University of Glasgow. He spent several years as an army psychiatrist, where he found he had a particular talent for communicating with mentally distressed people. In 1953 Laing left the army and worked at Gartnaval Hospital, Glasgow. During this period he also participated in an existentialism-oriented discussion group in Glasgow, organised by Karl Abenheimer and Joe Schorstein.

During the late 1950s he went on to study at the Tavistock Clinic in London, widely known as a centre for the study and practice of psychotherapy (particularly psychoanalysis). At this time, he was associated with D. W. Winnicott and Charles Rycroft.

In 1965 Laing started a psychiatric community project at Kingsley Hall, where patients and therapists lived together. The Norwegian author Axel Jensen got to know Laing at this time. They became close friends and Laing often visited Axel Jensen onboard his ship Shanti Devi in Stockholm.

Laing was troubled by his own personal problems, suffering both from episodic alcoholism and clinical depression, although he reportedly was free of both in the years before his death. He died at age 61 of a heart attack while playing tennis.

Laing's view of madness
Laing argued that the strange behaviour and seemingly confused speech of people undergoing a psychotic episode were ultimately understandable as an attempt to communicate worries and concerns, often in situations where this was not possible or not permitted. Laing stressed the role of society, and particularly the family, in the development of madness. He argued that individuals can often be put in impossible situations, where they are unable to conform to the conflicting expectations of their peers, leading to a 'lose-lose situation' and immense mental distress for the individuals concerned. (In 1956, Gregory Bateson articulated a related theory of schizophrenia as stemming from Double Bind situations.) Madness was therefore an expression of this distress, and should be valued as a cathartic and transformative experience.

This was in stark contrast to the psychiatric orthodoxy of the time (and is still contrary to the majority opinion of mainstream psychiatry). Psychiatrist and philosopher Karl Jaspers had previously pronounced, in his seminal work General Psychopathology, that the content of madness (and particularly of delusions) were 'un-understandable', and therefore were worthy of little consideration except as a sign of some other underlying primary disorder. Laing was revolutionary in valuing the content of psychotic behaviour and speech as a valid expression of distress, albeit wrapped in an unusual personal symbolism. According to Laing, if a therapist can better understand the person they can begin to make sense of the symbolism of their madness, and therefore start addressing the concerns which are the root cause of their distress.

It is notable that Laing never denied the existence of mental illness, but simply viewed it in a radically different light from his contemporaries. For Laing, madness could be a transformative episode whereby the process of undergoing mental distress was compared to a shamanic journey. The traveller could return from the journey with important insights, and may even have become a wiser and more grounded person as a result.

Laing was involved in research linking development of psychosis to family background. Despite supporting evidence, this has been controversial ever since, and the influence of parents who feel 'blamed' for a child's diagnosis of schizophrenia accounts for most of Laing's unpopularity in many circles. It was an inappropriate attribution by commentators who had not grasped the breadth of Laing's view of the nature of pathogenesis in families, as he had maintained throughout his career that parents are equally mystified, and unaware of the disturbed nature of the patterns of communication. Laing's most enduring and practically beneficial contribution to mental health, however, is probably his co-founding and chairmanship in 1964 of the Philadelphia Association and the wider movement of therapeutic communities, adopted in more effective and less confrontational psychiatric settings.

Laing is often regarded as an important figure in the anti-psychiatry movement, along with David Cooper and Michel Foucault. However, like many of his contemporaries, labelling him as 'anti-psychiatry' is a caricature of his stated views. Laing never denied the value of treating mental distress, but simply wanted to challenge the core values of contemporary psychiatry which considered (and some would say still considers) mental illness as primarily a biological phenomenon of no intrinsic value.

Laing, was, however, a critic of psychiatric diagnosis and argued that diagnosis of a mental disorder contradicted accepted medical procedure: diagnosis was made on the basis of behavior or conduct, and examination and ancillary tests that traditionally precede diagnosis of viable pathologies like broken bones or pneumonia occurred after (if at all) the diagnosis of mental disorder. The notion that biological psychiatry is a real science or a genuine branch of medicine has been challenged by other critics as well Psychiatry, a pseudo-science.

Ontological insecurity, family nexus, and the double-bind
In 'The Divided Self' Laing explains how we all exist in the world as beings, defined by others who carry a model of us in their heads, just as we carry models of them in our heads. In later writings he often takes this to deeper levels, laboriously spelling out how 'A knows that B knows that A knows that B knows ....'! Our feelings and motivations derive very much from this condition of 'being in the world' in the sense of exisiting for others, who exist for us. Without this we suffer 'ontological insecurity', a condition often expressed in terms of 'being dead' by people who are clearly still physically alive.

In 'Sanity Madness and the Family' Laing and Esterton give accounts of several families, analysing how their members see each other and what they actually communicate to each other. The startling way in which lies are perpetuated in the interest of family politics rings true to many readers from 'normal' families, and Laing's view is that in some cases these lies are so strongly maintained as to make it impossible for a vulnerable child to be able to determine what truth actually is, let alone what the truth of their situation is.

He uses the term 'family nexus' to describe the consensus view within the family, but from there on much of his writing appears ambivalent, as Andrew Collier has pointed out in The Philosophy and Politics of Psychotherapy. One strand of Laing's thinking, traceable to Marx and Sartre, condemns society for shackling mankind against its will, taking away individual freedom. Left to his own devices, man is healthy, and the mad are just trying to find their way back to their natural state. This was the basis for his approach to psychotherapy, as in the case of his most famous 'patient' Mary Barnes.

Yet it is the very need for ontological security which Laing exposed in his first book which is the driving force that builds societies. Laing correctly exposed the family nexus as often placing children in a 'double bind', unable to obey conflicting injunctions from family members, and he does not 'blame' those family members, pointing out that they are in turn victims of their own family. He fails, however to get to the bottom of the problem and find a way out for his patients. Freud, by comparison, recognises the repressive effect of society, especially in his later works like 'Civilization and Its Discontents', but seeks to strengthen the patient's ability to cope with this. Neither of these men appeared willing to tackle the issue of good and bad family, or society, nexus.

The real double bind, Collier seems to suggest, is that we all need to exist in a nexus, but sometimes the only one we've got is not one we can continue to exist with.



Selected bibliography

 * Laing, R.D. (1960) The Divided Self: An Existential Study in Sanity and Madness. Harmondsworth: Penguin.
 * Laing, R.D. and Esterson, A. (1964) Sanity, Madness and the Family. London: Penguin Books.
 * Laing, R.D. and Cooper, D.G. (1964) Reason and Violence: A Decade of Sartre's Philosophy. (2nd ed.) London: Tavistock Publications Ltd.
 * Laing, R.D., Phillipson, H. and Lee, A.R. (1966) Interpersonal Perception: A Theory and a Method of Research. London: Tavistock.
 * Laing, R.D. (1967) The Politics of Experience and the Bird of Paradise. Harmondsworth: Penguin.
 * Laing, R.D. (1969) Self and Others. (2nd ed.) London: Penguin Books.
 * Laing, R.D. (1970) Knots. London: Penguin.
 * Laing, R.D. (1971) The Politics of the Family and Other Essays. London: Tavistock Publications.
 * Laing, R.D. (1976) Do You Love Me? An Entertainment in Conversation and Verse New York: Pantheon Books.
 * Laing, R.D. (1976) Sonnets. London: Michael Joseph.
 * Laing, R.D. (1976) The Facts of Life. London: Penguin.
 * Laing, R.D. (1977) Conversations with Adam and Natasha. New York: Pantheon.
 * Laing, R.D. (1982) The Voice of Experience: Experience, Science and Psychiatry. Harmondsworth: Penguin.
 * Laing, R.D. (1985) Wisdom, Madness and Folly: The Making of a Psychiatrist 1927-1957. London: Macmillan.
 * Mullan, B. (1995) Mad to be Normal: Conversations with R.D. Laing. London: Free Association Books.

Books on R.D. Laing

 * Barnes, M. and Berke, J. (1971) Two Accounts of a Journey Through Madness. London: MacGibbon and Kee. (Personal Report from a Kingsley Hall patient and her therapist)
 * Boyers, R. and R. Orrill, Eds. (1971) Laing and Anti-Psychiatry. New York: Salamagundi Press.
 * Burston, D. (1996) The Wing of Madness: The Life and Work of R. D. Laing. Cambridge, MA: Harvard University Press.
 * Burston, D. (2000) The Crucible of Experience: R.D. Laing and the Crisis of Psychotherapy. Cambridge, MA: Harvard University Press.
 * Clay, J. (1996) R.D. Laing: A Divided Self. London: Hodder & Stoughton.
 * Collier, A. (1977) R.D. Laing: The Philosophy and Politics of Psychotherapy. New York: Pantheon.
 * Evans, R.I. (1976) R.D. Laing, The Man and His Ideas. New York: E.P. Dutton.
 * Kotowicz, Z. (1977) R.D. Laing and the Paths of Anti-Psychiatry. London: Taylor & Francis.
 * Friedenberg, E.Z. (1973) R.D. Laing. New York: Viking Press.
 * Miller, G. (2004) R.D. Laing. Edinburgh: Edinburgh University Press.
 * Laing, A. (1994) R.D. Laing: A Biography. New York: Thunder's Mouth Press.
 * Mullan, B. (1999) R.D. Laing: A Personal View. London: Duckworth.
 * Mullan, B., Ed. (1997) R.D. Laing: Creative Destroyer. London: Cassell & Co.
 * Raschid, S., Ed. (2005) R.D. Laing: Contemporary Perspectives. London: Free Association Books.
 * Russell, R. and R.D. Laing (1992) R.D. Laing and Me: Lessons in Love. New York: Hillgarth Press.

Films on R.D. Laing

 * Asylum (1972). A documentary directed by Peter Robinson showing Laing's psychiatric community project where patients and therapists lived together. Laing also appears in the film.
 * Did You Used to be R.D. Laing? (1988). A documentary by Tom Shandel and Kirk Tougas mainly consisting of a series of lectures and interviews conducted at Simon Fraser University in Canada.