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The International R.D. Laing Institute

 



Colloquia Topics Index [link]Psychotherapy  Main Page [link]




The Use of Existential Phenomenology in Psychotherapy1

RD LAING




R. D. Laing, M.D.
R. D. Laing received his M.D. from Glasgow University. Laing's name comes to mind when one
thinks of practitioners who have been most effective at challenging prevailing medical
thinking on schizophrenia. He has practiced psychotherapy for more than 35 years and has
authored 11 volumes.
Laing teaches and practices in London. Formerly he served as Chairman of The Philadelphia
Association; was associated with the Tavistock Clinic; and was a Fellow of The Foundations
Fund for Research in Psychiatry.
Laing's chapter is in two parts. Part one is descriptive: He defines terms and orients us to the
idea that praxis and process should not be confused. Part two is experiential: Laing uses
vignettes and poetic dialogues to challenge the functional fixedness in which we can
entrap ourselves.



BY "USE" I MEAN efficacy, effective action, skillful means. I might have entitled this paper the pragmatics of existential phenomenology.

At present there is no overall definition or system of phenomenology which is agreed upon by all self-styled phenome-nologists. Someone who disclaims phenomenology, such as the French historian Michael Foucault, may nevertheless be regarded as embodying much phenomenology in his theory and method.

By phenomenology I mean the science of description. In order to describe a thing, a process, an event, an action, a set, or a system of things, events or actions, one will avoid confusion if one is correct about what it is one is describing, or, more generally, if one is clear about the domain to which what one purports to be describing belongs. The description of a biochemical process is of a different order than the description of an intention. The description of intentional conduct is of a different order than the description of the unintentional movements of mindless behavior. Descriptions of intentional action, interactions, or transactions, I call praxis descriptions, using 'the word praxis to refer to the domain of intentional acts; whereas descriptions of behavior, at any level, of any kind (molecular, biologic, mechanical, or electronic), I call process descriptions.

Phenomenology thus takes us into the issue of what it is one is describing.

The discipline that addresses itself to what is this, that, anything is called ontology.

Phenomenology is a critical discipline for any science. All explanations require descriptions in order to explain.

What we take anything to be profoundly affects how we go about describing it, and how we describe something profoundly affects how we go about explaining, accounting for, or understanding what is what we are, in a sense, defining, by our description.

How do we define, how do we describe, how do we explain and/or understand ourselves? What sort of creatures do we take ourselves to be? What are we? Who are we? Why are we? How do we come to be what or who we are or take ourselves to be? How do we give an account of ourselves? How do we account for ourselves, our actions, interactions, transactions (praxis), our biologic processes? Our specific human existence?

In the light of such accounts as we give of ourselves, in our own complex and often confused ways, we account for our intentions and action, our chemistry and movements, our experience and conduct, our input, central processing and output. The critical reflective monitoring of all this is existential phenomenology; and the use of this discipline, the effective skillful means of this discipline, its pragmatics, its efficacy in the practice of psychotherapy, is what I want to address in the following pages.

The term "psychotherapy" now covers many different divergent, and some apparently antagonistic and mutually exclusive theories, techniques and practices. However, at present, in 1986, all procedures that are subsumed under the term "psychotherapy," maybe, have some elements in common.

People come to psychotherapists because they find themselves, or are found by others to be (1) experiencing themselves, others, or their circumstances or ' environment in undesired or undesirable ways, or (2) behaving towards themselves, others, or their circumstances or environment in undesired or undesirable ways.

Such patients, or clients, get "into psychotherapy" as the saying goes, with the hope and intention of changing their experience (E), and/or their behavior (B), from an undesired, undesirable starting state to a desired, more desirable end-state.

They wish this change, this transition, this transformation, to occur as quickly, as painlessly, as effectively, as lastingly, and as cheaply as possible. That is, they wish to transit from negative (undesired, undesirable) types or modes of experience (E neg, E minus, -E) to positive (desired, desirable) experience (E positive, E plus, +E); and, similarly, from undesired, undesirable types or modes of conduct or behavior (neg B, B minus, -B) to desired, desirable, types or modes of conduct or behavior (B positive, B plus, +B).

Whether we are naive or sophisticated, as psychotherapists, our procedures to facilitate such transformations and outcomes are necessarily, inevitably, based on the way we construe the problem, on what we take the trouble to be, and on our own willingness, enthusiasm, generosity, in complying with our clients' hopes and intentions, and in our skill in implementing ways and means of fulfilling their hopes and intentions.

We may not be interested in helping someone to be a more ruthless bully, torturer, terrorist, rapist, murderer, hypocrite, liar.

There is room for lengthy discussion here, but I have not the time nor space to go into such issues now. However, I must insist that there has to be a basic consenszis of intention between therapists and clients. We therapists have to regard the experience and behavior our clients hope for and desire as, basically, desirable. I, personally, am interested in practicing psychotherapy only insofar as I hope that in so doing I am making a contribution to other people, as well as to myself, becoming more fully human, more actual as persons, more real, more true, more loving, less afraid of what it is not necessary to fear, happier, more joyous, more effective, more responsible, more capable of manifesting in everyday ordinary life the desiderata of human existence, courage, faith, hope, loving-kindness in action in the world, and so forth.

In a sense, psychotherapy is applied theology, applied philosophy, applied science. Our psychotherapeutic tactics and strategies are predicated upon, and are permeated by, who and-what we take ourselves to be, how and what we wish and do not wish, want and dread, hope and despair, to be, in and through our experience and conduct.

All that is the theory and praxis of existential phenomenology in psychotherapy.

II

My focus here is to depict and describe what goes on between people's experience (E) as mediated by their behavior (B). I want to convey how I see the interconnections between personal interactions and how different ways of seeing may generate different ways of acting, and vice versa.

To this end, my presentation will presently become less orthodox. I shall mingle theoretical discourse with vignettes and verse, and "straight" talk with irony.

Perhaps you will regard it as "inappropriate" to present a paper in such an idiom. Perhaps it is. It is intended as a friendly provocation. It is evident, I hope, that I am not trying to induce you to adopt a "theoretical model." Rather, I am trying to depict a way of seeing, a way of contemplating what is going on, whether praxis or process, a destructing of destructive constructions, I shall use irony, humor, paradoxical communication, language as a sort of therapeutic rasayana, the yoga of poison as medicine, in serious play rather than in deadly seriousnes: a la Milton Erickson. Here goes!

III

The first act of a teacher is to introduce the idea that the world we think we see is only a view, a description of the world. Every effort of a teacher is geared to prove this point to his apprentice. But accepting it seems to be one of the hardest things one can do; we are complacently caught in our particular view of the world, which compels us to feel and act as if we knew everything about the world. A teacher, from the very first act he performs, aims at stopping that view. Sorcerers call it stopping the internal dialogue and they are convinced that it is the single most important technique that an apprentice can learn. (Castenada, 1974, p. 231)

Don't take it serious.It's just an experience.

A man had the following problem. He was married. Over a period of 18 months to a year, he became convinced that his wife was having an affair. He did not feel it incumbent on himself to indicate to her that he was aware of this, since she didn't feel it appropriate to mention it. They conducted themselves as if she weren't having an affair. Everything was in place just exactly as it always had been.

Then a day came to have one of those "Let's talk about it" conversations.

She: "Let's talk about us."
He: "Let's talk about Ralph as well."
She: "What are you talking about?"
He: "Well, you know."
She: "I don't know. Please tell me what you are getting at, what you are driving at."
He: "Well, you know, come on."
She: "You have to explain to me what you are talking about. I don't know what you are talking about."
He: "This affair you're having with Ralph."
She: "What affair? There is no affair, it's all in your own mind. It's all in your own imagination. You're making it up. There is no affair. Why do you think there is some affair?"

There were no gross indices that he could point to. No "proof." She absolutely insisted that he had it all wrong. He had become absolutely convinced from innumerable microevents that the picture he had constructed (she is having an affair with Ralph) was correct. He couldn't even pin it down to anything in their own intimate sexual relationship. Everything was "in place," as if nothing was going on. Indeed, he was at a loss. He wasn't sure. He could have made it all up. He consulted a psychiatrist, a friend. He put this situation to him and asked, "Am I psychotic? If I am making all this up then I must conclude that I am suffering from some sort of a paranoid thing. Maybe I am going paranoid and haven't realized it until now. Am I psychotic?" The psychiatrist replied, "Yes, you are."

This precipitated him into a state of catastrophic anxiety at the prospect that he might be paranoid. He came to see me and told me his story. As it happened, I knew that his wife was having an affair. In the social circles where his network and mine overlapped, "everyone" knew his wife was having an affair-except him. So I told him.

This precipitated him into another catastrophic reaction in which he became, not paranoid, but very depressed, for about a year. As he came out of it he said, "What really threw me? I don't think it was jealousy. I had become terribly attached to my sense of reality."

Versions of that situation arise at all levels, international, interracial, between companies, men and women, parents and children. Very often no one knows what the situation is, what is going on, what is the case, and what is not.

Phenomenology is an attempt to release our minds from the blind, uncritical attachment to any set of miserable meanings-right or wrong, true or false.

The "cure," in this case, was to see the joke. But it is not always funny.

A lady consults me. Her son of 14 was diagnosed as schizophrenic and was referred to a psychiatric unit for treatment. For some time he had not been getting on well with his father. He wouldn't do anything his father asked or ordered and was coming over with "You aren't my father anyway."

The mother's quandary was that, in fact, her husband wasn't the boy's father, but no one knew that except her. Perhaps she would tell her husband and/or her son, "Anything might happen."

Or not. If she did not, she would see her son, diagnosed as schizophrenic, an in-patient, under observation, medicated, and possibly beginning a career as a schizophrenic. She didn't want to see that happen. She eventually did tell her husband, though she was risking everything by doing so. She thought he wouldn't be able to take it. He might beat her, kill her, leave her.

The story had a happy ending, almost too good to be true. She told her husband, she told her son. Her husband was very upset, the son was very relieved. The conduct that had led him to be diagnosed as schizophrenic evaporated; and she and her husband went off for a new honeymoon.

She found the courage to take a chance on truth. Even though all through our lived experience "reality" is constructed (radical constructivism), this striving to construe our reality correctly, which may lead us to radical relative perspectivism and radical constructivism, redeems us from despair and empiricism. Truth should be thought of not as a substance, a thing, but as a praxis; grammatically not as a noun for an object, or even for a correspondence between objects or processes, but as a verb for truthful speech and action between us.

A description is a definition and a prescription.
A 14-year-old girl is brought before me by her mother because she is
suffering from anorexia, (a process description)

She declares
I am not suffering from anorexia.
I am on a hunger strike, (a praxis description)
Shall I treat her anorexia?
Shall I try to break her hunger strike?
The plain fact is
She is not eating
She does not eat
One construction is that
She is suffering from anorexia
Another construction is
She is on a hunger strike
She does not sit down
Is she suffering from
no-sitting downness?
Is she on a
not-sitting down strike?

These two ways of describing her not-eating are two ways of defining what is going on-in terms of process (suffering from a mental disorder) or in terms of praxis (intentional choice-in-action). In such descriptions and definitions, there are, already, by implication, two prescriptions, two strategies of response-in terms of process, treatment of her disorder-in terms of praxis, to treat her as a person. Her treatment is the way we treat her.

An eight-year-old boy
does not read
does not write
Is he suffering from alexia? (process description, definition, prescription, explanation)
Is he on a reading strike? (praxis-description, definition, prescription, understanding)
Is he suffering from agraphia?
Similarly, is he on a writing strike or
anorexia or refusal to eat
alexia or refusal to read
agraphia or refusal to write

These are constructions, in either case explanations of a sort, already not simple descriptions

It is useful to discriminate between
depictions
descriptions, definitions,
constructions,
explanations,
prescription,

but in much clinical terminology all these categories are confounded, all confused. (Read DSM-III, alert to these issues)

Epistemologists never tire of telling us that
the map is not the territory,
a menu is not a meal,
the score is not the music, that that painted pipe is not a pipe, Magritte.

This (1) is not a number. The radical constructivists do not let us go home, do not let us off so lightly.

Whatever I take to be the territory may be a map.

Everyone knows that
A menu is not a meal but many people eat menus.
Waves and particles are not light.
The brain is not the soul. When my heart stopped it did not attack me.
Death is perfectly safe.
The people we see as patients or clients are seldom in physical pain.
They are in mental misery,
Many are enmeshed in entangled webs of mixed meanings

An incident in couple therapy.

They are arguing.
She gets up and is walking out the door.
He shouts
Why are you walking out the door?
She replies
I am not walking out the door.
He is confused and bewildered.

Do you love me?
If you love me
believe me

Believe me
you don't love me
you don't love anyone
And no-one loves you
except me

Believe me
But
don't believe
because I say so
just look into your heart of hearts
and you will find
that everything I've told you
is true

The therapy here consists in showing the fly the way out of the bottle. It's a simple booby trap. Once you realize, make real to yourself, that it is a trap it ceases to be a trap. Once you see it is a killer, it can't kill you.

You love me
You don't love me
Believe me
Don't believe me

We learn what we see and this learning is fraught with complications, contradictions and paradoxes. Sometimes anyone's mind might boggle.

Here are two descriptions of incidents from my own family life. As I did in the book in which they were published (Laing, 1984, pp. 136-138 & p. 144).* I shall withhold the many comments I could make on them. I hope, especially in the context of these present considerations, their relevance will be evident. If you do not see their relevance, then I am sorry to say you do not see what I am trying to point out.

CORFU AFTERNOON, ON THE BEACH

Adam+ sights an unidentified object floating fairly far out to sea. He proposes a "project" with "component operations." Basically, he, Arthur, and I are to swim out to it, identify it, and if "feasible," bring it ashore.

The first "component operation" passes uneventfully. Arthur, he, and I stand on an offshore rock. Each throws his goggles and snorkle into the sea, dives in after them, retrieves them, puts them on.

Operation Two is to swim out to unidentified floating object. We set off together. Soon Adam and Arthur were drawing ahead of me, and it was not long before I had swum out further than I had done for at least 25 years. Further was too far. The object, a black shape, looked just as far away as it had done from the shore. Adam and Arthur seemed 30 or 40 feet further out. Then Arthur stopped. Adam was still for going on, but Arthur ordered him back. They swam back together to where I was and the three of us swam back to shore together.

I was grateful to feel the sand under my wobbling knees and very glad to sink back into the safe sand. Arthur looked quite relieved. Adam was livid. I've never seen him so enraged. He was hopping mad. He threw himself on the sand and squirmed and twitched around like an eel with vexation.

He blamed it all on Arthur, for turning back.

Arthur; Don't blame me! It was way off.
Adam: No it wasn't.
Jutta: (who had been watching from the shore) You were only halfway there.
Adam: No we weren't. We were almost there.
Daddy: No we were not almost there. It was still far away. Definitely too far away.
Adam: It wasn't.
Daddy: It was.
Arthur: Adam! (he wasn't listening) Adam!! Your mummy saw it from the shore.
Adam: She did not.
Daddy: It was too far.

Adam looked at us all.

Daddy: I'm telling you. It was too far.
Arthur: It was still far away.
Jutta: You weren't even halfway there.

He was completely surrounded.

Adam: You're all lying.Arthur: Look. Why should we lie to you Adam. We're all friends.
Adam said nothing.
Arthur: It was too far for me, and it was definitely too far for you.

He still said nothing.

Daddy: Look. You still can't swim further than Arthur, or me, even.
Adam: How do you know?
Daddy: Your mummy saw us from the shore. We were only halfway there.
Jutta: That's right.
Adam: She's lying.
Jutta: No I'm not. You won't listen to anyone, that's your trouble.
Adam: Well I'm not going to listen to you.
Jutta: You'd better watch it. You had better watch it.
Daddy: Do you seriously think that you know better than everyone else?

Adam said nothing.

We all took a short breather. Except Adam, who was still "at it," though he was silent.

Daddy: Anyway. It's not a defeat.
Adam: Yes it is.

And it started up again. After the third full round of the above, with minor variations, Adam's vehemence had in no way abated.

Jutta: It was an optical illusion.
Adam: A what??
Jutta: An optical illusion.
Adam: An optical illusion!? What is an "optical illusion"?
Jutta: Something that looks different from what it is.
Adam: You mean I can't believe my eyes?!
Daddy; Well. Not always. Not just like that. Not without reservations.
Adam: Reservations!?

ITEM 144

March 1977

Jutta is taken aback by coming upon Adam making grandiose magical passes with a stick at our ailing palm tree in the hall.

Jutta: Can I believe my eyes? Can I believe my eyes?
Adam: No.

Later

Jutta: I couldn't believe my ears! I can't believe my eyes!

IV

Everyone knows we are affected by our nearest and dearest. It is devilishly difficult to study the ordinariness of everyday life where most of our clients' happiness and unhappiness arise. Descartean-Gali-lean natural science does not help us here, for our theory must be explicitly designed to see the world of personal passions, intentions and actions, that is, praxis as well as process. Neils Bohr's concept of complementary may help us here.

Any cogent, coherent psychotherapy must both draw on and contribute to the pragmatic knowledge, the knowledge-inaction, of how we affect each other, personally.

There is so much that goes on between us that we can never know. But we do know that the divide between fact and feelings is a product of schizoid constructions, which is not useful in the practice of psychotherapy.

In reality, the reasons of the heart (praxis) and the physiology of the brain (process) coexist and are interdependent.

In this presentation, I tried to depict a way of seeing what is seen or not, what comes into view or not, from whatever point of view. This pragmatic reflexivity, this reflexive pragmatism is necessarily reflected in my style of depiction. It therefore may turn out that the main significance of this presentation lies in the attempt to disclose or reveal a way to look at what we see and do that enables what I describe to be seen and done.

__________________________________________

DISCUSSION BY THOMAS S. SZASZ, M.D.

Dr. Laing comes out in this presentation as someone I would characterize, among other things, as a person who fantasizes relativism. He makes a fetish out of relativism. It seems as if everything goes, which is one of the reasons why many critics have recently accused him of changing his position. Well, I don't know if he changes his position, or whether he has so many of them. But I think that this kind of relativism really only applies to the social world and only to some aspects of the social world. In point of fact, in the physical world, our knowledge of physics, chemistry, and mathematics is not nearly as relativistic as modern philosophers make it out, at least not in my opinion. Also, even in the social world it is not nearly as relativistic as it sounds if we take our point of departure somewhere else. In this respect, although some of our views are quite similar, we seem to go at it in different ways. I do not go at it from this very anecdotal, personal point of view, but I look for where the money is, the power. Then things are not so relativistic.

We talk about being teachers and teaching skepticism. But how can you teach skepticism to people until you know something? You can only be skeptical about something you understand. It seems to me, therefore, that first of all children have to have a certain fund of information. As Archimedes put it, I can move the world if I have a place to stand. When we have a place to stand, then we can begin to be skeptical. I think I know where that place is. That place is having a decent mother and father in childhood, a decent education in adolescence, and courage as a grown-up. Then, we can move things. Then we can be skeptical. Otherwise, we only talk about skepticism. Of course there is also the question that was raised that somehow we want to transcend our frame of reference. We always talk, especially nowadays, in psychotherapy and psychiatry about seeing the world differently. But words are cheap. How many people want to see the world differently? They don't want to do that. I think they want to be left hypnotized.

__________________________________________

COMMENT BY DR. WATZLAWICK

Let me try to build a bridge. I remember the day when I read Korzybski and was very taken by this famous quotation, "The map is not the territory." It occurred to me a few years ago that radical constructivism is probably right--the map is the territory. In Korzybski's view, there is a real territory for which the map is an adequate matching. In the perspective of radical constructivism, there are only maps. Of the territory we know nothing. This has important implications for the simple reason that when we talk about reality, it doesn't occur to us that we can only know the real reality, if it exists in terms of what it is not. That is our only reliable knowledge of anything that might be a real reality somewhere because we find out about it only where our reality construction breaks down. Only in the breaking down and the nonfitting of our view of reality do we realize that we are somehow seeing things in a way that is not what they appear to be. That doesn't mean that we therefore know how they are.

As von Glasersfeld says in a book I recently published, The Invented Reality (New York: W.W. Norton, 1984), there is a difference between matching and fitting. The transcendental idealist believes that he has a matching view of reality, that somehow his ideas express, contain, and embrace reality as it really is. The radical constructivist, on the other hand, realizes that he has only, at best, a view of reality that fits--just as a key fits the lock. The fitting of the key only tells us that the key fulfills the function for which it was built. It says nothing about the nature of the lock. I think that in therapy we have to deal with people whose reality constructions have broken down. What therapy can do is to help them to build a new construction or a slightly modified construction.

I would take exception to Dr. Szasz's claim that in the natural sciences we have a more reliable view of reality. I have recently spoken with theoretical physicists who have greatly shaken my view that they are any better off than we are.

As the editor and author of several books on reality, I get angry letters that have to do precisely with what Laing said about nihilism: We, the constructivists, if I may count myself among them, are coming up with a constructive worldview, something in which all values and rules are being made relative. I cannot go into detail, but if you take the idea seriously that we are the architects of our reality, there are three outcomes that seem fairly acceptable. One is that we begin to realize that we are free. If I am the architect of my own reality, it is within my power to construct it one way or the other. The second outcome is that this view makes us responsible, in the deepest ethical sense, because we no longer have the easy way out into the behavior of others or the way things are outside of our control. And the third thing I think a radical constructivist would arrive at is the idea of tolerance.


NOTES

*Reprinted with permission from Conversations with Adam and Natasha (1984), Pantheon Books, a Division of Random House, New York.

+Adam is my son, aged eight. Arthur is a friend, about forty. Jutta is my wife, Adam's mother.

REFERENCES

Castaneda, C. (1974). Tales of power. New York: Touchstone Books (Simon & Schuster).

Laing, R.D. (1984). Conversations with Adam and Natasha. Pantheon Books, a Division of Random House.



Jeffrey Zeig (editor). The Evolution of Psychotherapy 1987
Proceedings of the 1985 conference in Phoenix,
sponsored by the Milton Erickson Foundation

"The Use of Existential Phenomenology in Psychotherapy"
by RD Laing
with discussion by Thomas Szasz and comments byPaul Watslawick

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