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The International R.D. Laing Institute



Bibliography Main Page [link]
Politics & Other Works



Sanity, Madness and the Family
with Aaron Esterson

Tavistock 1964
Pelican Books 1970
Penguin 1971

Contents
ABE


· Commentary ·

Sanity, Madness, and the Family was published in 1964, and co-authored with Aaron Esterson. Like Laing, Esterson was a Glaswegian psychiatrist who was deeply versed in existentialism, whom Laing had befriended at University. With the help and encouragement of John Bowlby, Director of the Tavistock Clinic, Laing and Esterson began studying over one hundred families in which one member was diagnosed with schizophrenia in London's East End. Twenty-five families were eventually selected, and hundreds of hours of interviews took place, most of them in the family's own homes. The interviews were taped and the recordings were transcribed and analyzed with the help of social worker Sydney Briskin. This process took five years, from 1958 to 1963, when the original group of 25 families were finally whittled down to 11 for brevity's sake.

In conversation with Daniel Burston in July of 1992, John Bowlby allowed that Sanity, Madness and the Family may be "the most important book on families written in the 20th century". This is great praise, even when you consider that Bowlby himself never cited Sanity, Madness and the Family in print. But it was not well received by the rest of the psychiatric profession, who believed that Laing and Esterson were blaming the family members of mental patients for their misery and confusion. This is a common misreading. In fact, Laing and Esterson were not offering a new theory on the etiology of schizophrenia, since they doubted its existence in the first place. Instead, Laing said, "Our question is: are the experience and behavior that psychiatrists take as symptoms of schizophrenia more socially intelligible than has come to be supposed?" For example, why does a patient vehemently insist that her mother murdered her a decade ago, and vent her anger at mother for that alleged offense at almost every opportunity?

Another common misreading of Laing and Esterson's work is that they said regarded mental patients as being "rational". But as Laing and Esterson admitted, there is nothing rational about a woman who accuses her mother of murdering her. The charge is so plainly at variance with the facts that, taken at face value, it is easily dismissed. However, the fact that the accusation is not rational does not mean that it is meaningless. And the meaning of delusions, they said, can be established by placing them in the (public and private) contexts in which the mother and daughter interacted historically. Unfortunately, said Laing and Esterson, psychiatrists who employ the medical model lack the time, the training and the incentive to discern the social intelligibility of their patients' symptoms, and usually end up collude with parents and siblings who want to invalidate the patient's ranting completely.

To view the strange ideas, utterances and experiences of mental patients through fresh, unbiased eyes, Laing and Esterson devised a method called "social phenomenology" that brackets 1) all medical model preconceptions about schizophrenia as a neurobiological disorder, and 2) all psychoanalytic theories about unconscious motivation, but nevertheless 3) attends faithfully to the conscious thoughts, feelings and experiences of the various family members, paying close attention to the points of convergence and divergence in their accounts of their shared history. Sometimes the differences in perspective between various family members are so dramatic they are difficult to believe, much less comprehend, and remain somewhat mysterious until the researchers can pinpoint the patterns of mystification, denial, and occasionally, frank deception (or self-deception) that gave rise to them. Then low and behold, in case after case, ideas and utterances deemed bizarre (by family members and psychiatrists alike) became readily intelligible in light of a shared history and "family dynamics" that are disowned or denied by the "sane" ones.

Whereas The Divided Self and Self and Others used case history material to illumine Laing's theoretical positions, Sanity, Madness and Family said relatively very about theory, and let the case history material speak for itself. The eleven case histories that Laing and Esterson presenting are riveting, but also profoundly disturbing, and apt to polarize readers, who are left to draw their own conclusions.

 

· Contents ·

Preface
Preface to the Second Edition
Introduction

FAMILIES

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
The Abbots
The Blairs
The Churches
The Danzigs
The Edens
The Fields
The Golds
The Heads
The Irwins
The Kings
The Lawsons

Appendix
Index


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