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Gavin Miller
University of Edinburgh

The psychiatrist R.D. Laing was born in Glasgow, on 7 October 1927. He died, aged 61, on 23 August 1989, while playing tennis in St Tropez. Memorial services were held in London, New York, and other cities across the world. In the course of his troubled life, Ronald Laing moved from the forefront of humanist psychiatry to a position of notoriety. Latterly, he was alcoholic, professionally unlicensed, and as disturbed, at times, as anyone he had ever treated. His work also descended into near-madness - he declared, for example, that his problems could be traced to the hostility of his mother's uterus, eight days after he was conceived. It is hard to forget such a figure; but it is easy to overlook the enormous influence upon psychiatry of his early work and ideas.

Much attention has been paid to the psycho-biographical aspects of Laing's life. There can be little doubt that an upbringing such as Laing's would create either an outright madman, or an excellent psychotherapist. He seems to have been raised in the kind of family he would later come to analyse as amongst the causes of schizophrenia. He was an unwanted child whose mother concealed her own pregnancy, cut him off from friends and family, and required that her obvious dislike for the fact of her son's existence be regarded as maternal solicitude. But if this upbringing gave Laing a motive and material for his theories, it did not give him the intellectual skills to analyse his own experience.

To find the ideas which helped to create The Divided Self we must look beyond the personal context of Laing's life, and investigate instead the fertile intellectual milieu which fostered his talent. Much has been made of Laing's induction into the group associated with the neurosurgeon Joe Schorstein and the psychotherapist Karl Abenheimer. There can be little doubt of the consequent influence of European existential thought upon Laing: indeed, were it not for his national service, Laing would himself have moved to the continent to study under a colleague of the existential psychotherapist, Karl Jaspers. The existential school of psychiatry undoubtedly contributes to the ideas behind Laing's most important work, The Divided Self (1959). Laing himself insists that 'this book attempts an existential-phenomenological account of some schizoid and schizophrenic persons.' His basic argument is that psychiatry tends to see the patient 'as a complex physical-chemical system, perhaps with its own idiosyncrasies but chemical none the less for that; seen in this way, you are no longer a person but an organism.' It takes 'the language of existential phenomenology' says Laing, to appreciate that a person may be seen 'as a person or [...] as an organism' accordingly as he or she is 'the object of different intentional acts.' When a man is treated as an organism, 'there is no place for his desires, fears, hope or despair as such. The ultimates of our explanations are not his intentions to his world but quanta of energy in an energy system.'

Oddly, though, Laing's most explicit acknowledgement with regard to this distinction is not to an existential psychoanalyst, but to the Scottish philosopher, John Macmurray. As Laing puts it, Macmurray's philosophy attempts 'to think of the individual man as well as to experience him neither as a thing nor as an organism but as a person.' In works such as The Self as Agent and Persons in Relation, Macmurray sets out to explain philosophically why human life cannot be thought of under objective categories, and why, indeed, the world of things is derivative of a world that is primarily active and interpersonal. Laing differs from Macmurray, though, in one significant area. In Persons in Relation, Macmurray argues that a psychiatrist must approach his patient with an objective attitude:

The behaviour of the neurotic is compulsive [...] The motives of his behaviour are no longer under intentional control, and function as 'causes' which determine his activity by themselves. This, at least, is the assumption underlying the change of attitude [by the therapist], the assumption that human behaviour is abnormal or irrational when it can only be understood as the effect of a cause, and not by reference to the intention of an agent.

Laing, however, would see this a failure on Macmurray's part to consider the possibility that seemingly insane behaviour may, in fact, be intelligible, intentional agency.

Laing's psychiatry is unified by the idea that psychiatrists habitually preclude an understanding of their clients as intentional beings. Indeed, so ingrained is objectification in the name of 'objectivity' that our automatic temptation is to say that 'psychiatry' cannot understand its 'patients'. In fact, there is no psychiatry beyond the intentionality of practising psychiatrists; and 'patients' are not in fact patients, they are agents. In so far as psychiatrists do not see themselves as engaged in what Laing calls a 'study of human beings that begins from a relationship with the other as person,' then, a priori, they turn troubled persons in malfunctioning things. The behaviour of the client is now a matter of structural or chemical causes in the brain. The possibility that the client may be engaging in some kind of comprehensible intentional behaviour is automatically excluded.

Laing therefore argues that many of the seemingly incomprehensible utterances of the mad can be understood by a sufficiently sympathetic listener:

It is not uncommon for depersonalized patients [...] to speak of having murdered their selves and also of having lost or been robbed of their selves.
Such statements are usually called delusions, but if they are delusions, they are delusions which contain existential truth.

For Laing, these declarations express the despair of an individual who has never been able to realise her own spontaneous and autonomous life in relation to others. As a consequence, she has withdrawn from social being; her 'true' self is an inner, mental existence, concealed (for a while) behind a 'false' exterior self of compliant, embodied life. What seem to be bizarre utterances which could only be 'caused' not 'meant,' are attempts to express the loss of a vital relation to the social world.

Laing's argument may be generalised to more familiar examples of mental illness. Consider for example the distinction made between reactive and endogenous depression. The former is regarded as having some kind of external 'cause' - the death of a loved one, say - while the latter, in the absence of such an event, is regarded as due to some internal pathology. This distinction is, of course, facile. The difference is really between misery for which the doctor can find an intelligible reason, and that for which he cannot. The latter kind is regarded as 'malignant,' as 'pathological,' as if these were inherent qualities, rather than an admission of a failure of comprehension. There is indeed depressed behaviour which is wholly without reason - but this danger is in complacency over this distinction. Not so long ago, a woman who was miserable because she was a housewife with two children to look after might have been regarded as pathologically depressed - particularly if she was unable to explain why she should be so unhappy in her role. Who knows what other seemingly secure attributions of endogenous mental disorder may rest upon a similar insensitivity?

To Laing, the uncritically objective attitude to the madman is really a very ancient form of social exclusion. He discusses in his autobiography, Wisdom, Madness and Folly (1985), an incident in which the psychiatric staff with whom he works are offered by buns baked by patients. The majority refuse. Laing remarks: 'Excommunication runs deep. A companion means, literally, one with whom one shares bread. Companionship between staff and patients had broken down.' There is no rational ground for the refusal to eat the buns; merely an irrational revulsion at the social meaning of this everyday ritual of communion. To eat the buns would be to break bread with the mad: but the mad, to the staff, are not kin with the sane; by virtue of their supposed neurological malfunctions, they are not acknowledged as fully human, intentional agents. This archaic social distinction is one familiar from a tradition of Scottish thought which predates Laing. In his Lectures on the Religion of the Semites (1894), the Victorian social anthropologist, William Robertson Smith, discusses the rituals which establish group life. Pre-eminent amongst these is the communion meal:

Among the Arabs every stranger whom one meets in the desert is a natural enemy, and has no protection against violence except his own strong hand or the fear that his tribe will avenge him if his blood be spilt. But if I have eaten the smallest morsel of food with a man, I have nothing further to fear from him; 'there is salt between us,' and he is bound not only to do me no harm, but to help and defend me as if I were his brother.

Those who are outside of such communion are aliens: they are subhuman; they are animals who resemble people. The psychiatric distinction between the sane and the mad, in its unthinking exclusion of intentionality from the disturbed, is a modern echo of an archaic distinction.

This a priori exclusion of the mad from recognition as intentional agents is central to most mainstream psychiatry. Every week offers some new discovery of the causes of mental illness. Scientists, the papers tell us, are confident of a certain genetic cause, or of the imbalance of certain chemicals in the brain. And yet, the fundamental objection remains: any human trait, or behaviour, can be given a strictly biological description. Schizophrenics may indeed, as studies have suggested, be born with an especially small amygdala-hippocampal complex. Yet that such a structure should be viewed as abnormal is entirely derivative of the abnormality encountered in contact with a schizophrenic. Without this primary experience of incomprehensibility, the correlative structure of the brain is merely an entirely neutral fact that is not, in itself, a disorder. If, however, a schizophrenic's behaviour is comprehensible then the search for a physical causality would, in all senses of the word, be impertinent.

The primary objectification of the mentally ill, which lies behind all natural-scientific investigation of madness, is the main object of attack for those who have followed (however unconsciously) in Laing's footsteps. For example, until 1973, the 'bible' of American psychiatry, the Diagnostic and Statistical Manual of Mental Disorders, classified homosexuality as a mental illness. This classification was discontinued due to social and political pressures from outside psychiatry. No scientist suddenly stumbled upon the unreality of this particular 'psychopathology.' Rather, as a result of political activism, a group whose behaviour had lead them to be excluded from society were now let back in. Their homosexual intentions were recognised, and no longer reduced to defective genetics, hormonal malfunctions, or wrongly conditioned reflexes. Now, even if today's genetics and neuroscience should discover a cast-iron distinction between homosexuals and heterosexuals, we should merely have an irrelevant fact. Similar political movements are now afoot to demand recognition of those who are excluded by a psychiatric diagnosis because, for example, they hear voices, or engage in some other behaviour incomprehensible to North American physicians. One can only hope that a new category of mental illness is not created in order to account for such defiant opposition to mainstream psychiatry.

This year sees the 75th anniversary of Laing's birth. It is a peculiar fact that, had Laing been a more successful human being, he would probably now be a more neglected figure. Students of Scottish culture tend to neglect the achievements of quietly respectable thinkers. Laing's later life of notoriety, though, cannot be smothered by the usual cultural amnesia. Those who care to look into Laing's work will find insight and candour; and beyond that, an unfamiliar context of psychiatric and philosophical ideas developed by Dr Jekylls who had no Mr Hydes to ensure their lasting memory.

"R.D. Laing" by Gavin Miller
Edinburgh Review
"Scotland 1802-2002: figures, ideas, formations"
Issue 110. (2002) Edinburgh University Press

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