In many ways this is a delightful book and quite unlike the majority which have been written about Laing. Though brief and succinct, the chapters are enjoyable and provocative. The treatment of sociological accounts of deviance and self presentation (Goffman, Scheff) which challenge the assumed reality of mental illness and their relationships with aspects of Laing’s work are interesting and illuminating. Parallels between these and Szasz’s work are also drawn which highlight important weaknesses in Szasz’s right wing libertarian position, without discarding what is of value in his work. Miller’s exposition of the body of work which Laing left behind focuses on three main themes, drawn from his earlier work; ontological insecurity, the true/false self dichotomy and the social intelligibility of the experiences and behaviour of people deemed by the psychiatric profession to be mad. Miller is keen to contrast the value inherent in these ideas with the sterility afforded by arguments derived from the theory and practice of biological psychiatry. What is perhaps of greatest interest for the reader however is the middle section of the book in which Miller situates Laing’s work in the context of Scottish intellectual and cultural life, finding a tradition of philosophical scepticism toward both orthodox psychoanalysis and mainstream medical views of mental illness itself.
The concluding section of the book dealing with critical psychiatry is perhaps the weakest. It is not uninformative, but rather misnamed - discussing contributions by psychologists such as Mary Boyle and Dorothy Rowe alongside the activities of the Hearing Voices Network. No connections are made here between the critiques emerging from such work and the wider critical post modernist movement emerging in psychology and the social sciences. Genuinely critical voices within psychiatry itself, remain regretfully rare. I think it is also unfortunate that Miller repeats the view of others that Laing romanticised the notion of mental illness via popularising the idea of psychosis as a healing route back to sanity. Laing dealt satisfactorily with this criticism in his conversations with Bob Mullan. Nowhere did he advocate that the psychotic journey was always the road back to sanity, and given the bulk of his writings into ‘human misery’ as he put it - his discussions of this possibility occupied a minor space. We would indeed be wrong to dismiss outright the possibility that for some, a passage into madness, given the right support may be a viable way back to sanity.
A consistent theme running through all sections of the book is the contrast between understanding and explanation as stances towards those suffering psychological distress. The current domination of mental health care by institutional biological psychiatry means that mental health system workers face substantial obstacles if they wish to understand those in their care. As Miller argues eloquently, Laing’s efforts to combat that dominance has left us with much that is of enduring value - intellectually and spiritually. This is a welcome book which I hope will contribute to keeping human values and Laing’s ideas alive in the field of mental health.