Glasgow Caledonian University Student : Petrovan Florentina Arianna

Ronald David Laing

Madness need not be all breakdown. It may also be break through. It is potential liberation and renewal as well as enslavement and existential death

The above quote reflects, in my opinion, the essence of Laing `s approach in explaining the drift into insanity. Madness seen as an existential revolt against social norms, inner journey of healing and transformation, rational strategy of withdrawal under crushing demands of over-socialization, attempt to preserve the true self `s autonomy from the pressure of family and psychiatric power, control and obedience, it makes it easy to understand why all these ideas were dismissed by some or seen as controversial, revolutionary in the 1960s and 1970s. Challenging the traditional psychiatric standpoint, it offered a change in perspective regarding the understanding of mental illness and implicitly, of the individuals labeled as deviant by those in power to do so. Despite its original impact, this theory has faded away and it is rarely encountered in contemporary sociology. This is a curious fact, especially now, given the increasing sociological interest in questioning the effectiveness of medicalization of deviance, medical power and labeling of people under different categories. According to Conrad et. al. (1981), medicine always functioned as an agent of social control but, along with the growing success of modern biomedicine and acceptance of deterministic social and medical concepts, there was a change of the concept of deviance, shifting from what was once referred to as badness to sickness. Along with this shift came a change in imputed responsibility for deviance, as behavior once labeled bad and considered responsible gained diminished responsibility in sickness, making the social response to deviance therapeutic rather than punitive. As the author states, medical intervention as social control seeks to limit, modify, regulate, isolate or eliminate socially defined deviant behavior with medical means and in the name of health (Conrad 1

et al., 1981) . The power of the label and its devastating effects on schizophrenics results in sometimes one single solution, that comes in form of a chemical or electric shock in dehumanizing, prison like hospitals (Bentall et. al., 2004). One of the key elements in Laing `s approach is combining a critique of psychiatric power with a social interpretation of schizophrenia, offering an alternative to biomedical reductionism and biological determinism (Scott et al., 2006). He believes that human behavior and experience is socially meaningful, and every behavior and thought pattern of a schizophrenic can be understood and interpreted by analyzing the social context of the individual. Stripped of its context, no behavior makes sense (Ingleby, 1981). Laing argues that the psychiatric interview and assessment evaluates the individual paying little attention to his social world, pulling him out of the context of his interpersonal relations in the family, this resulting in labeling the individual `s behavior as incomprehensible, deviant. To look and to listen to a patient and to see signs of schizophrenia (as a disease) and to look and to listen to him simply as a human being are to see and to hear in as radically different ways (Laing, 1960). As claimed in the Preface of Sanity, Madness and the Family, the behavior and experience of a schizophrenic are more socially intelligible than has come to be supposed by psychiatrists, and so, the psychiatrist must try to learn to interpret the patient `s language in order to decode and understand the hidden meaning behind it. Ingleby (1981) comes to defend this statement from criticism that suggested Laing is not entitled to talk about schizophrenics if he is questioning the very nature and existence of the illness by giving an ordinary example, saying we are allowed today to talk about witches even if we do not believe in the Devil. According to Laing, in order to understand a schizophrenic, one must realize that no-one has schizophrenia, that one is schizophrenic, as schizophrenia is a way of experiencing the world. In Laing `s view, one of the triggers that lies at the core of a schizophrenic `s behavior is not just one `s unique way of experiencing the world, as explained by others, but the clash between realizing oneself as an independent, autonomous human individual and the demands and expectations of the others (family, society). The socialization and internalization of control being an immensely complex process, it consists of a double bind between the institutionalized expectations of the development of autonomy and the

permanent countervailing demands of the social, cultural contexts. The conflict is taken from the intra-psychic to the interpersonal level, the whole inner individual experience of the world becoming mediated by social relationships. As described in The Divided Self, in an attempt to preserve the autonomy and integrity of the self, the individual can engage in good faith behaviors that could be discredited and misinterpreted as bizarre, self destructive, as the mind does not operate in a social vacuum and so, the mutual misperceptions of self and others have a crucial effect on the way these inner conflicts will be resolved (Scott et al., 2006). As we cannot experience other than our own perception of reality, we must rely upon what we think others think about their experience, from the signals they convey. According to Goffman (1959), there is a huge difference between the impressions people consciously give through their actions and the ones they unwittingly give off through nonverbal gestures, sometimes contradicting the initial intended message. This specific pattern of disturbed communication is what lies, in Laing`s view, at the heart of the illness, as it can be detected in the pathological families of the schizophrenics. Laing questioned the very existence of an actual illness, arguing that it can be viewed as nothing more than a communication disorder of the whole family, with terms as diagnosis and treatment masking the web of familial connections which is the real truth of the matter (Sedgwick et al., 1972). He identifies two family patterns: serial and nexial. The serial types allow each member to have a greater sense of individuality, but lack real personal concern for one another. They display excessive concern for each other only in the likes of social approval or scandal. The members consider themselves as a family unit but their actions, goals are not dependent on one another. The nexial family constellation fosters greater interdependence between the relationships, bounded together by fear, anxiety, enforced guilt and in which weaker and more insecure members may begin to internalize personality traits of stronger members . With his famous ontological insecurity term, Laing underlines the profound uncertainty of one `s boundaries between self and the world : The capacity to experience oneself as autonomous means that one has really come to realize that one is a separate person from everyone else. () A lack of sense of autonomy implies that one feels one`s being to be bound up in the other, or that the other is bound up in oneself, in a sense that transgresses

the actual possibilities within the structure of human relatedness. (Laing, 1960, 52-53). He describes how the individual hides his true self away in a desperate attempt to protect and preserve its autonomy, and displays to the outside world a false self, more compliant to the demands of the social norms and expectations. The slip into madness occurs when these two drift apart even further so the false self becomes alien even to its creator (Scott et al., 2006). Psychosis is thus a particular way of being where all the interactions take the form of splitssplits between the real and the false self, between the real self and the body which becomes part of the false self, between the false self and others. (Kotowicz, 2005, p.19). Laing identifies three sources of anxiety that parasite the life of the ontologically insecure individual: engulfment, implosion and petrification and depersonalization. These can be described as fears of being consumed by others, loose all sense of self autonomy (engulfment) , world collapsing around oneself (implosion) or fears of being frozen, turned into stone (petrification and depersonalization). The Divided Self is considered to be, by most critics, Laing `s masterpiece, a classic in psychiatric literature with a exceptional quality of exposition. In Sanity, Madness and the Family, Laing and Esterson (1970) present a series of portraits of schizophrenics families that can be understood and interpreted in the light of Laing`s theory. Illustrating nothing more than fragments of clinical interviews, without trying to explain the events in a theoretical frame, the reader is left to draw his own conclusions on the presented cases. Examples of distorted patterns of communication, attempts by the parents to undermine the child `s struggle in becoming a person and developing autonomous thought, dismissing or invalidating his own memories, competing with each other for the child `s attention yet forming a strong alliance against him, all these can be found through the book. The rejection of formal parental obedience and attempt to develop an autonomous, independent self is interpreted by the parents, in one of the cases presented, as a descent into madness, progressing through three stages from good to bad to mad (Scott et al., 2006). As we analyze one of the case studies presented in the book, we can easily notice the parents strategies in controlling the child: invalidating her own views of the events as being silly or untrue, being convinced that she could read their minds, developing a secret non-verbal language through signs and gestures, perceiving her

attempts on gaining independence (such as finding a job, trying to leave home) as if something wrong is happening to their daughter. These behavioral patterns can help the reader understand Laing`s view of placing madness, not in the mind of the patients but in the very dynamics of the family which they are trying to escape. The psychiatric label is seen as merely helping sustain the family `s dominance and control by reinforcing their views and officially scapegoating the deviant member of the group. As a result, it is argued by Laing that those in power to label and classify the individual as being normal or deviant, are the ones who create the entity of mental illness and create the rules and expectations linked to this role. According to Becker`s (1963, p.9) labeling theory, social groups create deviance by making the rules whose infraction constitutes deviance, and by applying these rules to particular people and labeling them as outsiders. One of the main critiques addressed to this book was made by Peter Sedgwick (1975) in a volume of essays Laing and Anti Psychiatry. His main objection was referring to the absence of the very symptoms of illness of the patients. Although the book ` s main goal was to make the schizophrenic experience intelligible in the context of family, there are no actual symptoms of schizophrenia shown, no word salad, the replies of the patients are perfectly coherent and comprehensible, leaving us wondering what was actually wrong with these supposedly schizophrenic women (Kotowicz, 2005). A counter reply to this criticism (that the patients in the book might not be really schizophrenic) is given by Ingleby (1981) who claims that this statement rebounds damagingly on the critics because if eleven out of eleven randomly selected diagnosis of schizophrenia are incorrect, the overall rating of misdiagnosis would be 100 per cent. Another criticism mentioned by Ingleby (1981) was the disappointing fact that Laing never took his analysis of relationship dynamics between an individual and its family to the next level, excluding society as a whole, therefore never went beyond the level of family in linking madness to its social context. In his book, The philosophical Defence of Psychiatry, Lawrie Reznek (2005) is assessing Laing`s views on schizophrenia. As a first criticism, he questions the idea of seeing the behavior of schizophrenia as rational as it is goal oriented (explicable in terms of reasons). He argues that even if the schizophrenic is as rational as the rest of us, that does not mean schizophrenia is not a disease because a disease process is needed to explain the

schizophrenic `s abnormal experiences and reasons that motivate their behavior (Reznek, 2005). Also, referring to the disordered speech and behavior of a schizophrenic, he claims that as it deteriorates, it would be more plausible to link it to a form of underlying disease rather than a product of intelligible motives. Regarding Laing`s thesis on family dynamics, Reznek (2005) argues that the author fails to prove how schizophrenic behavior is a strategy purposely adopted to escape the pressure and demands of the oppressing family and not just a consequence of this social context. He continues stating that even if there would be such proof that the schizophrenic behavior is a rational strategy that helps the individual cope with the stressful environment, and it is motivated by a desire and belief (survival), it does not mean that the process whereby such a desire and belief are acquired is not a disease process. Even if we discover that schizophrenic behavior is caused by certain abnormal family situations, this does not mean that we cannot say that such abnormal family situations cause the disease of schizophrenia. To think otherwise is to commit the essentialist fallacy. (Reznek, 2005, p.65). Reznek (2005) also questions Laing `s idea of madness seen as a healing and transforming process, with valuable consequences. In order to dismiss this assumption, he claims that schizophrenia is an undesirable process, as most patients are distressed and do not like their psychotic states (Wing 1975, cited in Reznek, 2005). Apart from the criticism referring to his work, controversy was raised surrounding Laing`s personal life and influence upon his own family members. As eccentric as his academic work and thesis, Laing`s lifestyle was much criticized and sadly, cast a shadow of doubt upon his own abilities to follow through his ideas and walk the talk. Despite his great interest in studying family dynamics and the impact the interpersonal relationships have on the individual experience of a human being, Laing failed to manage his own family, and was heavily criticized for drug and alcohol abuse, causing his ideas to be rejected along with his outrageous behavior. After the famous Kingsley Hall experiment ended, the therapeutic communities remained the most tangible legacy of Laing. As Kotowicz (2005) states, apart from these communities, virtually none of his ideas survived the filter of official thinking in psychotherapy or psychiatry. Scott et. al, (2006) suggests that that Laing`s work should still be of contemporary interest, as social changes since the 1960s did not influence his core assumptions that schizophrenia

can be understood in terms of socially meaningful action. According to Giddens (1984, 1991) the concept of ontological insecurity is still a key element in understanding the contemporary lifeworld. In the era of rapid change and instability, it is difficult to answer existential questions about our own place in the world. Giddens is expanding this concept from an individual scale to a generalized social condition that affects us all. Even though he debated so much on topics like individual perception, socially meaningful experience, group bonding and interpersonal relationship dynamics, family life, Laing changed his position often and avoided finalizing his work in a comprehensive and complete theory of a science of persons. It could be argued that his own emotions and experiences influenced the way in which he viewed his thesis and revised them. Although he stated that his theory is not trying to explain the cause of schizophrenia, the reasons for drifting into madness, but just to describe the context in which they appear, Laing is often remembered as the one that placed the blame for a child ` s deviance on the parents and the family as a whole (Kotowicz, 2005). This was fairly criticised as only aggravating the schizophrenic `s family situation, adding unnecessary pressure and guilt to the already desperate members. Even so, Laing `s work can be interpreted as a critical theory of psychiatry, at the core of which lies the clash between medical power and the agents of over-socialization. One of the key elements in his theory is the concern around the notion of power and dominance that penetrate human relationships. The power is located, not in the abstract social structure such as statistical or class stratification, but in the everyday events of life. As Scott et al., (2006) suggest, his thesis could have the potential to help clarify debates within sociology, given his strong critique against the medicalization of human interpersonal and social problems that can be applied in everyday situations, not just to people and families under pathological distress. In Mad to be normal, Mullan (1995) claims that the accusation of idealizing mental misery has fallen heavily on Laing`s shoulders, replying that he has never idealized mental suffering or romanticized despair nor stated that parents and society caused mental misery, rejecting the label of anti psychiatrist he has been given. As stated by Roberts (2006), for the lost souls of the world, Laings voice was an island, a beacon, and carried a resonance beyond his critique of the heartlessness of modern medicine. In my opinion, even though much of his ideas are now rejected by what we call

modern psychiatry, Laing left us a most valuable gift. His efforts in trying to switch the focus, from understanding the illness, its symptoms and process to understanding the human being that is experiencing it, his inner torment, emotions and strategy of coping with unlivable situations, that is a great lesson that should be acknowledged and taught to future generations. In an attempt to break the standards that created a social barrier between normal and mad, he made efforts in decoding the psychotic language instead of simply rejecting it as being incoherent and incomprehensible, in order to finding meaning and sense behind the deluded surface. The main fact of life for me is love or its absence. Whether life is worth living depends for me on whether there is love in life. Without a sense of it, or even the memory of an hallucination of it, I think I would lose heart completely. R.D. Laing, The Facts of Life (1976)

References: Becker, H.S. (1963) Outsiders : Studies in the Sociology of Deviance, New York: Free Press. Burston, D. (1996) The wing of madness: The life and work of R. D. Laing, USA: Harvard University Press Goffman, E. (1959) The Presentation of Self in Everyday Life, Harmondsworth: Penguin Giddens, A. (1984) The Constitution of Society : Outline of the Theory of Structuration, Cambridge: Polity Press. Giddens, A. (1991) Modernity and Self Idenitity, Cambridge: Polity Press. Ingleby, D., Conrad, P. (1981) Critical Psychiatry: The politics of mental health. Middlesex: Penguin Books Itten, T., Roberts, R. (2006) Laing and Szasz: Anti-Psychiatry, Capitalism and Therapy [online] Available from World Wide Web: http://www.scribd.com [accessed on 10 March, 2012] Kotowicz, Z. (2005) R. D. Laing and the Paths of Anti-Psychiatry [online] Available from World Wide Web: http://www.scribd.com [accessed on 28 February, 2012] Laing, R. D. (1960) The Divided Self, London: Penguin Books Laing, R. D. (1976) The facts of life, New York: Pantheon

Laing, R. D., Esterson, A. (1970) Sanity, Madness and the Family, 2nd edition, London: Penguin Books Mullan, B. (1995) Mad to be normal: Conversations with R. D. Laing, London: Free education books Read, J., Mosher, L. R., Bentall, R. P. (2004) Models of Madness: Psychological, Social and biological approaches to schizophrenia, Hove: Brunner- Routledge Reznek, L. (2005) The philosophical defence of psychiatry [online] Available from World Wide Web: http://books.google.co.uk [accessed on 3 March, 2012] Scott, S., Thrope, C. (2006) The Sociological Imagination of R. D. Laing [online] Available from World Wide Web: http://onlinelibrary.wiley.com [accessed on 5 March, 2012] Sedwick, P. (1975) R. D. Laing: self, symptom and society, 3rd edition,Middlesex: Penguin Education

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