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R. D. Laing
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| Ronald David Laing | |
|---|---|
 The author of Knots (1970) perusing in 1983 The Ashley Book of Knots |
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| Born | 7 October 1927 Govanhill, Glasgow, Scotland. |
| Died | 23 August 1989 (aged 61) |
| Cause of death | Heart attack |
| Occupation | Psychiatrist |
| Known for | Author of psychiatry books |
Ronald David Laing (7 October 1927 – 23 August 1989), was a Scottish psychiatrist who wrote extensively on mental illness– in particular, the experience of psychosis. Laing's views on the causes and treatment of serious mental dysfunction, greatly influenced by existential philosophy, ran counter to the psychiatric orthodoxy of the day by taking the expressed feelings of the individual patient or client as valid descriptions of lived experience rather than simply as symptoms of some separate or underlying disorder. Often associated with the anti-psychiatry movement, he himself rejected the label as such, as did certain others critical of conventional psychiatry at the time.
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Laing was born in the Govanhill district of Glasgow on 7 October 1927 to David Park MacNair Laing and Amelia Glen Laing (ne Kirkwood).[1] He was educated at Hutchesons' Grammar School, going on to study medicine at the University of Glasgow failing his exams on his first attempt, in 1950, but passing in a subsequent re-sit.
Laing spent a couple of years as a psychiatrist in the British Army (Royal Army Medical Corps; drafted despite his asthma that made him unfit for combat), where he found an interest in 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.[2] In 1956 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.[3]
In 1965, Laing and a group of colleagues created the Philadelphia Association and started a psychiatric community project at Kingsley Hall, where patients and therapists lived together.[4] The Norwegian author Axel Jensen became a close friend and Laing often visited him 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 or her.[citation needed]
Laing is regarded as an important figure in the anti-psychiatry movement, along with David Cooper, though he never denied the value of treating mental distress. He challenged the core values of a practice of psychiatry which he thought considered mental illness as a biological phenomenon without regard for social, intellectual and cultural dimensions.
He also challenged psychiatric diagnosis itself, arguing 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, according to Laing, psychiatry was founded on a false epistemology: illness diagnosed by conduct but treated biologically.
The popular term "medical model of mental illness" is oxymoronic, since according to Laing diagnosis of mental illness did not follow what he viewed was a traditional medical model. The accepted understanding that biological psychiatry is a real science and genuine branch of medicine has been challenged by other critics as well.
Laing's parents led a life of extreme denial, exhibiting bizarre behaviour. His father David, an electrical engineer, seems often to have come to blows with his own brother, and himself had a breakdown when Laing was a teenager. His mother Amelia was described as "still more psychologically peculiar". According to one friend and neighbour, "everyone in the street knew she was mad".[5]
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,[6] 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 friend Robert W. Firestone.[7]
Laing fathered six sons and four daughters by four women. His son Adrian, speaking in 2008 said, "It was ironic that my father became well-known as a family psychiatrist, when, in the meantime, he had nothing to do with his own family."[8]
Adam, his oldest son by his second marriage, was found dead in May 2008, in a tent on a Mediterranean island, following what might have been a "suicidal binge" following the breakup of a long-term relationship with his girlfriend Janina. He had died of a heart attack, aged 41.[9]
His daughter Susan died in March 1976, aged 21, of leukemia.
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" (his term). 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, in Palo Alto, Gregory Bateson and his colleagues Paul Watzlawick, Donald Jackson, and Jay Haley[10] articulated a related theory of schizophrenia as stemming from double bind situations where a person receives different or contradictory messages.) The perceived symptoms of schizophrenia were therefore an expression of this distress, and should be valued as a cathartic and trans-formative experience.
Psychiatrist and philosopher Karl Jaspers had previously pronounced, in his work General Psychopathology, that many of the symptoms of mental illness (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 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 in stark contrast to psychiatric orthodoxy (in the broadest sense we have of ourselves as psychological subjects and pathological selves). 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 psychosis, and therefore start addressing the concerns which are the root cause of the distress.
Laing expanded the view of the "double bind" hypothesis put forth by Bateson and other anthropologists, and came up with a new concept to describe the highly complex situation that unfolds in the process of "going mad" - an "incompatible knot". Laing compared this to a situation where your right hand can exist but your left hand cannot. In this untenable position, something has got to give, and more often than not, what gives is psychological stability; a self-destruction sequence is set in motion.
Laing never denied the existence of mental illness, but viewed it in a radically different light from his contemporaries. For Laing, mental illness 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 (supposedly) important insights, and may have become (in the views of Laing and his followers) a wiser and more grounded person as a result. This was consistent with the critique of the validity of "value judgements" prevalent in Western society, which was common amongst academics in the 1960s and 1970s (for example, the views of Michel Foucault).
In The Divided Self (1960), Laing contrasted the experience of the "ontologically secure" person with that of a person who "cannot take the realness, aliveness, autonomy and identity of himself and others for granted" and who consequently contrives strategies to avoid "losing his self".[11] 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 Self and Others (1961), Laing's definition of normality shifted somewhat.[12]
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 humankind against its will, taking away individual freedom. Left to their own devices, people are healthy, and people with so-called mental illness 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. An idea typical of his work is the following quote in his book, The Politics of Experience, "We are effectively destroying ourselves with violence masquerading as love".
A paradox arising from Laing's interpretations is that it is the very need for ontological security Laing discussed in his first book that is the driving force that builds societies. Laing characterised 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. The family members are usually unaware that they are doing such things, and are just as confused as the children within the situation. The Preface to the Second Edition and Introduction to Sanity, Madness and the Family offer a concise articulation of this issue.
Laing's ideas are not currently generally espoused by the psychiatric establishment. Significant critiques of his ideas have been published by contemporary psychiatric authorities.[13] Lack of perceived success of "care in the community" programmes for the mental health patients in the UK, and the absence of clear evidence that patients can be practically assisted, or their lives significantly enhanced, by Laingian therapies (especially without the use of pharmaceuticals) has impeded their acceptability.[citation needed]
In 1965 Laing co-founded the UK charity the Philadelphia Association, which he also chaired.[14] His work influenced the wider movement of therapeutic communities, operating in less "confrontational" (in a Laingian perspective) psychiatric settings. Other organizations created in a Laingian tradition are the Arbours Association [15] and the New School of Psychotherapy and Counselling in London [16].
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