Ronald David Laing

Ronald David Laing (7 October 1927 – 23 August 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.

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Biography

Laing was born in the Govanhill district of Glasgow, and educated at Hutchesons' Grammar School, going on to study medicine at the University of Glasgow. He spent a couple years as a psychiatrist in the British Army, where he found he had a particular talent for communicating with mentally distressed people. In 1953 Laing left the Army and worked at Gartnavel Royal Hospital, Glasgow. During this period he also participated in an existentialism-oriented discussion group in Glasgow, organised by Karl Abenheimer and Joe Schorstein. ^[1]

In 1956, at the invitation of John ("Jock") D. Sutherland, Laing went on to train on a grant 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 John Bowlby, D. W. Winnicott and Charles Rycroft. He remained at the Tavistock Institute until 1964. ^[2]

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.

Inspired by the work of American psychotherapist Elizabeth Fehr, Laing began to develop a team offering 'rebirthing workshops' in which one designated person chooses to re-experience the struggle of trying to break out of the birth canal represented by the remaining members of the group who surround him/her.

Laing was troubled by his own personal problems, suffering from both episodic alcoholism and clinical depression (according to his self-diagnosis in his 1983 BBC Radio interview with Dr. Anthony Clare ^[3], 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 with his colleague and dear friend Robert W. Firestone.

Laing created the Philadelphia Association with colleagues, which continues to offer training and therapy. Other organizations created in a Laingian tradition are the Arbours Association and the New School of Psychotherapy and Counselling in London, where Laingian therapy is taught.

Laing's view on mental illness

Laing argued that the strange behavior 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, Palo Alto, Gregory Bateson and his colleagues Paul Watzlawick, Donald Jackson, and Jay Haley^[4] articulated a related theory of schizophrenia as stemming from double bind situations where a person receives different or contradictory messages.) Madness was therefore an expression of this distress, and should be valued as a cathartic and trans-formative experience.

Laing saw psychopathology as being seated not in biological or psychic organs -- whereby environment is relegated to playing at most only an accidental role as immediate trigger of disease (the 'stress diathasis model' of the nature and causes of psychopathology) -- but rather in the social cradle, the urban home, which cultivates it, the very crucible in which selves are forged. This re-evaluation of the locus of the disease process-- and consequent shift in forms of treatment-- was, indeed still is, perhaps now more than ever, in stark contrast to psychiatric orthodoxy (in the broadest sense we have of ourselves as psychological subjects and pathological selves). 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 behavior and speech as a valid expression of distress, albeit wrapped in an enigmatic language of personal symbolism which is meaningful only from within their situation. According to Laing, if a therapist can better understand his or her patient, the therapist can begin to make sense of the symbolism of the patient's madness, and therefore start addressing the concerns which are the root cause of the 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 trans-formative episode whereby the process of undergoing mental distress was compared to a shamanic journey. The traveler 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. However, like many of his contemporaries, labeling 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.

But as Laing was, moreover, a critic of psychiatric diagnosis, he 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. Hence, psychiatry was founded on a false epistemology: illness diagnosed by conduct but treated biologically.

The fact that medical doctors had annexed mental disorders did not mean they were practicing medicine; hence, the popular term "medical model of mental illness" is oxymoronic, since, according to Laing, diagnosis of mental illness did not follow the traditional medical model. The notion that biological psychiatry is a real science or a genuine branch of medicine has been challenged by other critics as well.

Ontological insecurity, family nexus, and the double-bind

In Self and Others (1961) Laing's definition of normality shifted somewhat. In The Divided Self (1960), Laing equated normality with ontological security.[1]

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 existing 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 (1964) 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 (with a contribution from Laing, 1977). 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 Laing exposed in his first book that is the driving force that builds societies. Laing exposed the family nexus as often placing children in a 'double bind', unable to obey conflicting injunctions from family members, but he does not 'blame' those family members, pointing out that they are in turn victims of their own family. Like Silvano Arieti, Theodore Lidz and other psychiatric colleagues who worked in “schizophrenogenic mother” models, Laing did not tackle the issue of parental abuse to its ultimate consequences, as Alice Miller and other child abuse activists have in more recent times, because, as stated in the preceding sentence, "he does not 'blame' those family members", and as stated in Laing's view of madness above: "... he had maintained throughout his career that parents are equally mystified, and unaware of the disturbed nature of the patterns of communication."

For further clarification on this issue, the Preface to the Second Edition and Introduction to Sanity, Madness and the Family offer a concise articulation.

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. excerpt, movie (IMDB)
• 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

• 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.
• 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.
• Kotowicz, Z. (1997) R.D. Laing and the Paths of Anti-Psychiatry. London: Taylor & Francis.
• Mullan, B., Ed. (1997) R.D. Laing: Creative Destroyer. London: Cassell & Co.
• Mullan, B. (1999) R.D. Laing: A Personal View. London: Duckworth.
• 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 and Plays 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? (1989). A documentary by Kirk Tougas and Tom Shandel, produced by Third Mind Productions, Vancouver Canada. — Frequently drawing on stories from his own life, and from his patients' experiences, Laing presents his insight into the art of therapy, the lies we tell each other in the name of love, the recurring patterns of behaviour which sometimes can be traced to birth, and the regrettable human instinct to suppress any behaviour and thought which is strange or disturbing. A 90 minute portrait of the psychiatrist, philosopher, poet and prankster.

• Did you used to be R.D. Laing? (2000 Play). Edinburgh Festival Fringe Award winning play written and performed by Mike Maran.

Miscellaneous

• English progressive rock band Gentle Giant wrote a song named Knots (on the album Octopus, 1973), inspired by R.D. Laing. Reference to Laing is mentioned in the sleeve text.

• English Psyche Punk band The Psycho Surgeons wrote the song RD Laing named after the psychiatrist

See also

• David Smail (psychologist) - A more modern writer with similarly unconventional views
• Joseph Berke - Psychoanalyst and therapist to Mary Barnes
• Eugène Minkowski - A psychiatrist commended by Laing
• The Trap (television documentary series) - A 3 part BBC series which concentrates on Laing's work in the first episode.

References