R. D. Laing (1927–1989)

R.D. Laing has acquired kind of a cult status within psychiatry, not least due to his understanding of schizophrenia and his revolutionary approach towards patients. But is such reputation warranted?

His views are obviously rooted in the zeitgeist of his time that is, the counter-culture of the 1960s which was so critical of the establishment (as it was back then) that it was willing to look for explanations to individual disorders beyond, said, purely 'systemic' approach (for lack of a show more better term). I personally have nothing against that; and, in fact, I tend to agree with him in seeing schizophrenia as being, potentially, a defence mechanism resulting from trauma and/ or threats or perceived threats, whereas 'the self' withdraw and/ or is being alienated in favour of a 'false-self', with all the consequences this can have (from dissociation to feeling of persecution etc.). My problem with such view, though, is that it is, itself, reductionist. Psychosis and psychotic behaviours can be caused by a wide range of different reasons, of which a threatening, traumatic experience occurring in someone's life is only one. What about genetics? What about biology? What about the effects of some substances in triggering psychotic disorders?

Now, of course, the issue, here, is certainly not Laing himself! It's, merely, the paradigm within which he was working. After all, neurosciences were nowhere quite where we are now in our understanding of the human brain, and so he, of course, had no way to work based on what we now know. Nevertheless, here's not the only aspect where he showed himself reductionist. For example, the cases that he used to illustrate his view are all of people who grew up in dysfunctional families (more or less), and so his understanding tends to focus only upon the family environments of the persons concerned. But are dysfunctional families the only, potentially triggering cause?

Give him that: unlike some of his colleagues at the time, he was not blaming mothers only for children/ later adults developing schizoid symptoms. He, on the contrary, urged us to look at the whole family dynamics as 'a constellation' (his word). This approach is relevant too, but one must not forget that other alienating environments can, also, act as trigger, something which seems, here, to have eluded him (e.g. enough has been written, for instance, about why, in the Western world, Black people would be more likely to be diagnosed with schizophrenia than their White counterparts....). But then again: his was quite a new understanding, and so he could not but have been limited, himself, in his own frame of thinking.

Something which cannot be taken away from him, though, is his deep, heartfelt compassion and empathy for people otherwise dismissed as 'mad', and so (supposedly) uncapable of making sense when being psychotic, hence easy to ignore. He, on the contrary, was of the opinion that no matter how deluded a patient could be, under their 'schizophrenese' that is, their psychotic/ deluded language (I don't know if he coined the term, but I admit to liking it...) there is indeed 'a self' creeping out of 'the false self', and so that we ought to listen -attentively. He, then, was putting the patient at the centre of our understanding, something which has come to become working practice within the mental health and care sector since, yet which remains extremely difficult to do when handling psychotic people (I work with schizophrenic, and, yes, such ability to truly 'listen' is everything but easy!).

My rating is harsh. I gave it 2 stars only while, by any reckoning, it surely deserves a 3 stars at least. The thing is: I struggled to read it. The issue, here, was not the ideas of the author per se (no matter how limited, even within his own frame of thinking e.g. schizophrenia as being a result of 'alienation'). The issue was his heavy reliance on psychoanalysis, a field which I find loaded with jargon and, quite frankly, more prone to subjectivity than proper science. Again: it's not his fault either. He was merely looking up at Freud and his heritage the way people my generation are, perhaps, looking up at neurosciences and their heritage. Psycho-analytic mumbling asides, I would still recommend reading Laing for, at least, and again, his heartfelt empathy for schizophrenic individuals, and his insistence upon 'listening', truly listening to what they communicate beyond their (seemingly) nonsensical 'schizophrenese'. show less

This book blew my world open. Yes, people become schizophrenic due to their environment. Yes, people can be driven to madness by their families, when they are told their pain is their fault, or not real, and they are isolated, and are forced to accept a reality that is not true to their experience. It is clear in each of these families how the individuals went crazy, and in their own way, are the sanest people in their families, and have moments of connected clarity about their family life show more and dynamics that the rest of the family is denying the reality of. This is an important book, that when taken seriously, is perhaps the truest and most accurate account of how a person becomes 'crazy'. Please read it. show less

Laing still has his followers and his own work moved on somewhat from this 'classic' early text but, as the introduction to this edition by neuropsychiatrist Anthony David suggests, his 'insights' of the late 1950s into the causes of schizophrenia have not stood the professional test of time.

This does not mean that he was wrong since we should always be wary of expert claims (they may be overturned a decade or more later) but only that the book is not likely to be useful to working show more psychologists rather than cultural historians and those 'searching for meaning'.

The book should be seen as a humanist tract coming out of two intellectual trends - existentialist philosophy and psychotherapy. It still has value as insight into the trajectory of thought as our culture moved into the 'sixties'. It is still provocative in its working model of our own condition.

The basic thesis is outlined with all the complex language of these two traditions, creating the paradox that an appeal to direct engagement with the problem of 'madness' beyond objectivity is couched in a rather sclerotic and often derivative language of 'given discourses'.

Critics might also point out to Laing's well known personal instabilities and his inability to maintain his own family despite the costs that his own writings might have implied as far as his children were concerned. I am not going to go down that route.

What is clear is that Laing is as divided as his objects of study in simultaneously trying to maintain some degree of scientific objectivity (while chafing against the theory) and 'sympathy' for the sufferers of mental breakdown. Sometimes it feels as if this book is his own psychotherapy.

The best chapters (whatever the scientific validity) are the last two which give us evidence of one schizophrenic's [Joan] own assessment of their situation (helping Laing's thesis along the way) and a dreadful account of extreme suffering [Julie].

The book ends with no resolution, no suggestion of a cure or a treatment, just a description of a state of being with the barest suggestion of some hope that is barely justified by what has gone before. The book becomes, in the end, an intellectual exercise.

To get to that point, Laing puts forward a theory of the dynamic between the 'false self' and the 'inner self' that is too complicated to summarise here but depends greatly on existentialism and phenomenology to carry its weight.

I am not qualified to judge the validity of his work in relation to treatment matters. Perhaps there are insights that are being ignored by modern experts. However, I was not as a lay person persuaded that Laing had honestly been more than suggestive. He provides 'insufficient data'.

The book becomes useful not because it tells us very much about schizophrenia that is useful (other than to confirm that it exists and is horrible) but because Laing is capturing (through the philosophy rather than his profession of psychiatry) some dark truths about our general condition.

What I found useful was the existentialist 'mythology' that he develops out of a combination of his own discomfort, study. professional practice and the observed tragedy of people whose minds completely break down for whatever reason.

What seems psychologically (at least as a means to treatment and cure) inadequate seems quite the opposite as a popularisation of the grim insights of the existentialist philosophers which have always struck me as both intrinsically true and socially unpalatable.

This does not mean that it is a great work in any way because the great work in this area is to be found in the philosophers themselves - Kierkegaard, Heidegger and Sartre amongst others. The book is more in the tradition of Colin Wilson's 'The Outsider' as exposition of an 'ideology'.

This is not to say that it is not an important historical text precisely because a tormented professional, faced by the horrors of madness, is attempting to find an answer and offers the last late flowering of existentialist thought as part of his tool kit (at least in this book).

Having said that, the humanist aspects of his analysis are still valuable and they ring true. Laing has found something very askew in the way our consciousness can work, how families can twist things into crisis and minds can collapse in onto themselves like black holes.

There is a lot of philosophy surrounding consciousness and a separate (continental) philosophy of our relation to being but less is done on the historical evolution and contingency of consciousness not just in individual human development but within humanity over time.

Of course, the problem is that the data is often not there and what is there is skewed to extreme cases and literate elites (who mask their inner selves in any case as part of their means of retaining power).

My intuition (no more) is that Laing was looking at a set of general truths about consciousness (which existential phenomenology provides) but then taking the contingent conditions of the nuclear family in the mid-twentieth century and over-egging his pudding as a result.

Nevertheless, as I read the book, periodically I would find an insight that raised the potential fragility of my own sanity (and those around me) and how the process he describes could spin any of us under certain conditions (but there is surely a genetic issue of predisposition) into the abyss.

Most of us, if we think about it, know that our inner self and our socialised self (centred initially on the family and its treatment of our autonomy) have some type of dynamic relationship that may not be unstable for everyone but could become very unstable and may result in miserable 'fixes'.

From this perspective the book is still worth reading for its ability to 'shake up' our complacent beliefs that we have achieved reliable stability on the one hand or must accept our miserable 'fixes' or neuroses (designed to hold us together) as both given and inevitable on the other.

Laing's description of minds becoming increasingly trapped in some sort of 'death in life' where a whole series of paradoxes, contradictions, failures of communications, ignorances and misunderstanding conspire to send someone into hell remains coherent and plausible.

The book does not really answer why some people and not others, why some 'fixes' are creative, beneficial and part of personality (he alludes to William Blake suggestively) and some are disastrous and what can be done about it all. The book is not 'helpful' in that respect.

Indeed, I think some people might be rather disturbed by the book in a way that is not at all helpful though I doubt if it would send anyone mad on its own. It is not Act II of 'The King in Yellow'. All in all, worth reading but less as psychology and more as thoughtful popular philosophy. show less

As an early and historic example of thinking about the 'insane' or 'mental illness' in a different (not medicalised) way, Laing has done the world a great service in bringing ideas about the nature of human being from the world of existential philosophy together with his experience of 'schizophrenic' individuals in the context of their families.

If you work as a therapist, I would suggest this is a must-read, even if you take issue with Laing's ideas about schizophrenia. Psychiatrists, on show more the other hand, shouldn't read it, because it will upset them if they don't credit his viewpoint, and upset them even more if they do.

Among its flaws, it does get a little too caught up still with psychiatric concepts and speculation that aren't rooted in phenomenology, but he makes a very good attempt to bring the latter to bear on his case material. And in places he's a somewhat repetitive writer - but that also helps to solidify the ideas he's trying to get across.

Overall, in this book he sounds like someone you'd like to have at your side if your mind really took a wander off the beaten track - with his apparent capacity for patient and careful listening and fearless compassion. I imagine very few psychiatrists of his day would have had the time, courage or skills for that, and even less so nowadays in their hyper-pharmacological paradigm of trying to quickly anaesthetise mental and existential distress with pills. show less