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The International R.D. Laing Institute

 



Colloquia Topics Index [link]Art & Literature Index



Laing and Psychotherapy*

by
John M. Heaton



This paper is divided into two parts. First I will give a brief account of Laing's background in psychotherapy and his position in it for those who are not familiar with his work. Then I will discuss his concept of experience which is central to his thought on psychotherapy and his critique of modern society.

His Background: Laing trained in psychiatry in Glasgow and did his National Service in the army as a psychiatrist. He became interested in severely disturbed people and practised a psychotherapy chiefly inspired by his reading in phenomenology. He admired practitioners like Harry Stack Sullivan and John Rosen who introduced direct analysis; he was impressed that they talked in ordinary language to psychotics. Then he came to London to the Institute of Psychoanalysis where he trained with the middle group, having Charles Rycroft as his analyst and Winnicott and Marion Milner as his supervisors. His analysis was "undramatic" and according to him he soon realised "the name of the game"; so presumably he conformed, perhaps rather strange in view of his childhood which, on his own account, was very disturbed. My own impression from talking to Laing was that he was disappointed with his experience at the Institute, but he certainly had a thorough grounding in psychoanalysis which influenced him deeply.

While training at the Institute, Laing was a registrar at the Tavistock for 6 years. He became very disillusioned with them, and I think they with him. He had a lot of sympathy with the argument that the Maudsley dealt with really ill people, but the Tavistock was a sort of dilettante outpost that dealt with normal middle class people. He was unhappy at not working in a hospital and only seeing people well enough to attend outpatients. However he did run groups for "border-line" patients at the Tavistock and learned a lot of the contempory work on psychotherapy. After he left the Tavistock he worked in private practice for the rest of his life.

Perhaps his main objection to the Tavistock was that the " therapists there were in the state that Kierkegaard described as: 'The despair which is ignorant of being despair, or the despairing ignorance of having a self and an eternal self' (Kierkegaard 1989 p.73). They had no concept of man as spirit. There had to be something wrong with their patients and they saw it as their job to find it. There was a spiritlessness about the Tavistock that I think drove Laing to despair. A form of despair incidently also described by Kierkegaard - the despair of wanting in despair to be oneself, a form of defiance. It is clear from his first book The Divided Self and from conversations with him that Kierkegaard's The Sickness unto Death influenced his thought about the schizoid state more than any other book. His critique of 'normality' is based on Kierkegaard and one can see this influence in much of his writing.

His Psychotherapy: Absolutely central to Laing's thought and practice is that psychotherapy involves a relationship between persons, and he was concerned all his life in working out the implications of this. Now, persons are embodied beings and not bodies plus minds; he was scathing of any psychotherapeutic theory or practice that studied minds apart from bodies or bodies apart from minds; or the pretence of uniting them by means of a hyphen: psycho-somatic. He agreed with Aristotle in his Politics (Bk 1.2) who stated that man is a political animal and that man is the only animal who has the gift of speech. And whereas mere voice is but an indication of pleasure or pain, and is therefore found in other animals, the power of speech is intended to set forth the expedient and inexpedient, and therefore likewise the just and the unjust. And it is characteristic of man that he alone has any sense of good and evil, of just and unjust, and the like, and the association of living beings who have this sense makes a family and a state.

The voice can cry out in pleasure or in pain as in infancy but human speech is articulated and has to be learned and can be written down. It is the ability to be articulate that is central to human being.

Now all this was fundamental to Laing and we can take each of Aristotle's statements and directly apply them to Laing's thought.

Persons are embodied: There are two ways that Laing developed this. He was very interested in gesture and the way our bodies communicate using the codes and classification systems of body symbolism which illustrate how political and social categories shape the decoration, perceptions and dispositions of the body. He was a friend and admirer of Ray Birdwhistell, an anthropologist who pioneered kinesics, the study of gestures and their meaning with the use of sound cameras and tape recorders. Laing would vividly describe the gestures of students, lecturers and sometimes colleagues and speculate on their meaning. The way words are spoken can be more revealing than the words themselves.

His concern with the body was also manifest in his interest in Yoga and the martial arts, and he would often recommend their practice as well as practising them himself. In no way did he think of the practice of psychotherapy as a purely mental exercise; he would, for example, advise patients who had a bad posture or some other body ailment to take up Yoga or some other body therapy.

Psychiatrists of course would rightly claim that they are very concerned about the body in that they study the brain and influence it with an increasingly powerful arsenal of drugs. But as far as psychotherapy is concerned it is the lived body that is important and this is influenced and empowered by the cultural principles that organise society as well as biological principles. For example it is very difficult for us to understand the gestures of someone from a very distant culture. Injunctions as insignificant as: 'Stand up straight' or 'Don't hold your knife in your left hand' reflect a whole political philosophy which can be largely unconscious (Bourdieu 1977 p.94).

Politics -Man is a political animal: Two of Laing's books have politics in the title: The Politics of Experience and The Politics of the Famity. Again and again he emphasised that to understand people it is no good retiring into oneself and introspecting one's mind, observing one's so called inner world. As Louis Sass (1994) has argued it is the schizophrenic who is the extreme example of one who enters within himself to try and reach a solipsistic self sufficiency. For Laing it is the relation between persons that is central in theory, and in practice (Laing 1967 p.42). He was thus critical of the Cartesian tradition; Descartes was one of the first and most influential to articulate the division of mind from body and he had his basic insight by retiring by himself into a poule or stove heated room for some days.

Laing's interest in games theory and the various strategies that people develop to cope in families is another example of the political emphasis in his thought. His belief that the behaviour of the schizophrenic is better understood as a special strategy that a person invents in order to live in an unliveable situation (Laing 1967 p.95) is another example. These are attempts to get out of the 'malfunction' perspective of much psychotherapy which tends to address and treat the individual and his/her inner world, without taking into account that we are all situated in a practical space in which we live our lives and have to develop ways of coping with the difficulties we meet. It is this insight into practical space that is the source of Laing's interest in couples, the family, groups, communities, and society at large.

What Laing was trying to do was to create a shift not in what is seen, but in the way you see it. To see people behaving in certain ways as schizophrenic is one way of seeing them. But it is not the only way, for a different way of seeing brings different things into view; a confusion of Sir Martin Roth (1986) who criticised Laing for talking as if he had never been to a psychiatric outpatients and seen people who were obviously schizophrenic. The Laingian reply was that if you have been trained to look in a certain way then you will construe things according to how you have been taught to see them. So a psychiatrist will see schizophrenics. But this is not the only way of seeing people. At one time one may have seen the same people as possessed by demons, others would see them as people suffering a great deal of mental pain, or one might just see one's old Dad in a terrible state. It all depends on one's training, what one is asked to do etc. But it is fundamental to the concept of a person that they can be seen and see in different ways, as the structure of human perception .

Another political dimension of Laing's thought was his interest in power. He studied Foucault closely and was responsible for the translation of some of his books. To both thinkers power is present in all human relations and is not good or bad as such but of course can be, and is frequently misused; they were opposed to the liberal dictum of Lord Acton that all power corrupts and absolute power corrupts absolutely. Laing was interested in demystifying power not in the absurd project of getting rid of it; he was perfectly aware and not ashamed of the fact that he had a considerable amount of power - to get his books published, to take on or reject students, for example. Demystifying power is important in psychotherapy since some people think that because one is a doctor one can have them certified and bundled off to hospital; or alternatively that one can save them from the consequences of crazy actions. To make the law clear can be very helpful to some and Laing would do this. At a more sophisticated level he argued that psychiatric and psychoanalytic knowledge is not so impersonal and value free as it is often made out to be; there are complicated political forces at work in all societies which encourage and reward some forms of knowledge and discourage others.

Psychiatry, he thought, more than any other branch of medicine, is necessarily influenced by political forces. And by politics he meant much more than the amount of money the government is prepared to spend on psychiatry. The sort of dazed protest that one gets from some psychiatrists at the changes in psychiatric practice produced by politicians is the result of them ignoring the political dimension of most psychiatry. The failure of psychiatrists to think through the political dimension of their practice has left them at the mercy of politicians. To hide one's head in the 'inner world' as many psychoanalysts do or in the mechanisms of the brain as many psychiatrists do is an avoidance of an essential dimension of the care of mental suffering.

Laing was concerned with the study of people in situations especially people in a social crisis. Crucial to this is his insight that no one in the situation knows what the situation is (Laing 1971 p.31). The situation has to be discovered (p.33). The stories people tell about the situation which includes the 'patient', parents, spouses, children, social workers, doctors; do not tell us simply and unambiguously what the situation is. These stories are a significant part of the situation but there is no a prior; reason to believe or disbelieve a story because someone tells it. The history of a situation is a sample of it, one person's way of defining it. It is vitally important for the psychiatrist not to construe the situation in terms of a few psychiatric myths, for resorting to one mythology or other is precisely what people do when confronted with a frightening and confusing situation.

To study a situation one has to enter it and try and keep a clear head, for critical situations are usually confusing to all concerned. One then finds one is involved in a process for the situation changes as soon as one has entered it. Each interpretation is an act of intervention that changes the situation, which thus invites another interpretation. So a movement of deliberation, negotiation and engagement is started which hopefully leads to a desirable conclusion for all. It is not the imposition of one person's demands on others; it is political and not managerial.

Laing was scathing of the tendency to label people schizophrenic on just a few minutes' interview in outpatients as if this label conveyed much understanding. It may be easy for an experienced person to spot various signs and symptoms but the central question to him was the nature of the social situation that the person lived in which drove the person to respond in the way they did. And of course the situation in outpatients is also a social situation for all concerned as he showed beautifully in his discussion of Kraepelin's catatonic patient at the beginning of The Divided Self (Laing 1960 p.29).

The Talking Cure: Aristotle's remarks about the difference between the mere voice and articulated speech is central to all psychotherapy which is a talking cure. Freud was perfectly clear that psychotherapy involves a movement away from being ruled by the pleasure principle to the ability to judge what is or is not expedient, the just and unjust. As Laing put it: Psychotherapy is an obstinate attempt of two people to recover the wholeness of being human through the relationship between them (Laing 1967 p.45). He emphasised that it is two human beings that are in a relationship and so language, how we address one another, patterns of communication, the good and the bad, are central. He was always concerned that justice must be seen to be done by all concerned as far as possible in the treatment of mental disorder because justice is a basic characteristic of our humanity.

Ritual: One of the ways in which Laing was far ahead of his time was his insight into the importance of ritual in psychotherapy.

Ritual is used by all societies as a powerful means of dealing with and preventing social conflicts. It is a means of integrating the society and the individual both externally and internally. It is central to culture as a means of reconciling ourselves to nature and the natural violence within human beings. Rituals themselves are a way of constructing power relations and a way of empowering some and disempowering others. Symbolic systems, such as particular ritual patterns encode, and therefore promote particular social patterns. Ritual is basic to Foucault's notion of the constitution and exercise of power because of the way in which power involves the body and strategy. The social body is the micronetwork of power relations. And by social body he means the shifting network of power relations between a man and a woman, between the members of a family, between a master and his pupil, between everyone who knows and everyone who does not (Foucault 1980 p.187).

Ritual is not necessarily seen as a form of control by its participants. Thus a devout Roman Catholic will not feel controlled by the Mass but empowered by it whereas someone trying to free themselves from Catholicism may feel it is an instrument of coercion. Revolutions such as the Russian revolution of 1917 tried to do away with ritual but it has been shown they merely substituted a new lot of rituals for the old ones.

Ritual is basic to psychotherapy and probably more basic than story telling for there is a ritualistic aspect to story telling, and in the healing rituals of many societies story telling plays a little part. Freud and most psychoanalysts overlooked the importance of ritual as they were too much under the influence of the Enlightenment, and thus understood ritual to be mere superstition and only recognised debased forms of it as obsessional rituals. In the last 50 years anthropologists have understood ritual to be a key focus in the study of culture. Few people now hold the beliefs of the Enlightenment. Ritual is not to do with truth and falsehood as is science. It is more a strategy of social action, probably basic to man and many animals, and is a way of empowering or disempowering people.

Laing was interested in all sorts of psychotherapy partly because of his interest in ritual and what makes an efficacious psychotherapeutic ritual. It is often easier to see the ritualistic aspect of therapies that one does not practise oneself. He was interested in Shamanism as numerous anthropologists have shown that it is a very effective therapy in certain types of what we would call mental disorder. I should add that he did not claim to be a Shaman himself. He was perfectly aware that psychotherapy is very culture specific for its effectiveness; at root it is a cultural therapy for a cultural disorder in contrast, for example, to surgery. Surgery has been mostly developed in Western cultures but its effectiveness is not culturally specific; a heart transplant would be perfectly effective if done by a surgeon on someone whose culture was completely foreign to him.

Man, one could say is not only a political animal or a featherless biped but is also a creature that has a natural impulse for ritual and this has an important part to play in psychotherapy and Laing was a pioneer in its study.

Experience: Laing frequently used the notion of experience and it is central to his thought. But, as is well known in philosophy, the notion of experience is a very tricky one as it has many meanings; almost every philosopher who uses it gives it his own special meaning.

To anyone brought up in the Anglo-American tradition one thinks of the standard empiricist doctrine that all knowledge originates from experience and that nothing is in the intellect that was not first in sense. This gives it an epistemological flavour as it is assumed that there is an unproblematic foundation of knowledge which is given in experience and this is usually identified with sense experience, from which all knowledge is assumed to be derived and against which all theoretical interpretations must be tested. Hence the importance of observation and experiment in science. The threat to scientific progress is then seen as undisciplined interpretations arising from rationalist intuitions or unreflective dictates of custom and tradition.

Of course the bugbear of this view of the development of knowledge is mathematics; mathematics is essential to science but depends on axioms and proofs and not sense experience. Freud, who considered himself an empiricist, completely ignored mathematics with disastrous results to psychoanalysis. For the conceptual confusions in psychoanalysis are much more like the confusions in the foundations of mathematics studied by philosophers such as Frege and Wittgenstein than confusions due to lack of knowledge in the empirical sciences which require more experiment and observation. Laing, like Lacan and Bion, was one of the few psychotherapists to have some understanding of this. Hence his interest in mapping, games, rules and metarules. But he was in this as in much else, a pioneer but also something of an amateur.

For example for a time he was much enamoured of Gregory Bateson's explanation of the double bind theory in terms of Russell's theory of types. But the theory of types had been shown to have fatal difficulties in the 1920s.

But Laing had a much more robust concept of experience than the standard empiricist one. He was a great admirer of David Hume whom he mentions several times with approval in Bob Mullan's Mad to be Normal (1995) and I often discussed Hume with him. It is easily forgotten that Laing was proud of his Scottish roots and so naturally was familiar with Hume and the Scottish Common Sense school of Thomas Reid. If people were more familiar with these Scottish roots then much of Laing's intellectual itinerary would become clearer.

Experience does not necessarily mean the sense data epistemology of modern empiricism with which Hume has been identified by many English academics. That abstract notion of experience is a barbarism of refinement to use Hume's term; it occurs when reflection becomes separated from common life, instantiating the view from nowhere; the thinker becomes radical and absolute or so he thinks.

Experience for Hume as well as for Laing is the enjoyment through conversation of the deeply established customs and conventions of a way of life, the domain of participation. To quote Hume: And indeed, what could be expected from Men who never consulted Experience in any of their reasonings, or who never search' d for that experience, where alone it is to be found, in common Life and Conversation (Hume 1996 p.2). He goes on to stress that the participation of women is essential to achieving the sort of humane self-knowledge that the conversation of common life makes possible.

Both Laing and Hume argued that the human world is understood through social participation in contrast to the world of the physical sciences which we learn about by limiting ourselves to observation and theorising. One might ask how does experience teach? We derive our judgments from experience but experience cannot direct us to derive anything from it. However, inherent in the notion of experience is the idea of multiple instances, repeatable occurences. So we can learn from experience but what we learn could have been otherwise and so experience could not teach without a context of human life with its customs and ways.

Psychoanalysis studies a particular way of participation, with its customs, rules and techniques. But to generalise this and assume that it is the best way of studying human nature and, worse still, to try and force its study into the methods of the physical sciences is to fall victim to a false philosophy. Human beings participate with one another in many different ways and so there are many different ways of getting to know and understand the human world.

I think this is one reason why Laing always retained some regret for leaving the mainstream of psychiatry. For psychiatry studies people in mental pain in all sorts of situations - inpatients, outpatients, their home and with their family, in prisons and the community not just under the constraints of consulting room psychoanalysis.

To quote Laing:

If human beings are not studied as human beings, then this once more is violence and mystification.

A little later referring to some contemporary writing on the family and the individual:

Gone is any sense of possible tragedy, of passion. Gone is any language of joy, delight, passion, sex, violence. The language is that of the boardroom. No more primal scenes, but parental coalitions; no more repression of sexual ties to parents, but the child 'rescinds' its Oedipal wishes … There is frequent reference to security, the esteem of others. What one is supposed to want, to live for, is "gainining pleasure from the esteem and affection of others". If not, one is a psychopath. (Laing 1967 p.53-4)

Hume would have liked this quote. It illustrates a central theme of his - the illusions that false philosophy can lead to. For it inverts truth by trying to base ordinary language on a ; special languages - in this case the language of the boardroom. He argues that all special languages grow from ordinary language the words we learned on our mother's knee and then talking to our brothers, sisters, and friends. Secondly it claims that all desire can be subsumed under one -in this case gaining pleasure from the esteem and affection of others. Human beings however have countless desires. If I thought that this talk would get me much esteem and affection from others surely I would be grossly deluded. There are all sorts of possible responses to it, perhaps if I am lucky one or two people might give me some esteem but I should be surprised to get much affection!

Laing's insight into the importance of common sense and the ordinary is shown in much of his writing. Most importantly in his 'treatment' of schizophrenic people in small communities where the ordinary difficulties of living together can be met and discussed rather than being dealt with by well-meaning 'carers' or blotted out with drugs. So what Blankenberg (1982 &.1991) has called 'the loss of natural self-evidence' - one of the fundamental defects found in schizophrenia - can be healed.

So what is the mystification of experience? How can we judge it? Experience as meant by Laing, Hume, and Montaigne, who Laing greatly admired, is not concerned with knowledge in the scientific sense but with meaning and this is mostly conveyed by stories, maxims, proverbs, etc. If something dramatic happened at this meeting you would probably go home and tell a story about it and you might add: "It was quite an experience".

Experience in this sense is incompatible with certainty and once an experience has become measurable and certain, it immediately loses its authority. There is no formulating a maxim nor telling a story where scientific law holds sway. A man of experience depends on imponderable evidence and this is difficult to teach as one has to learn correct judgments where no definite rules apply. Rather a teacher gives the right "tip" at the right time and his ability to do this shows his authority. Laing would often talk of the importance of being 'street wise' in psychotherapy.

The contempory way in psychotherapy, and much psychiatry, is of course the way of science and administration, and this conceals and mystifies experience. So no wonder psychiatrists complain of their loss of authority, for authority depends on experience whereas applied science depends on following the correct rules. When the authority lies in the rules and not the person of the psychiatrist and his/her judgment based on experience, then an administrator can easily check whether the rules have been followed or not. So authority passes from the psychiatrist to the administrator and experience is expropriated from both psychiatrist and patient.

Laing had great personal authority in his understanding of the infinitely varied forms that mental suffering presents. I think this is what made him into the effective and world famous therapist that he was.

__________________
REFERENCES

Aristotle Politics Trans. J. Barnes 1253a7-17.

Blankenburg, W. (1982) .A dialectical conception of anthropological proportions' in Phenomenology and Psychiatry. Ed. A.J.J. De Koning &. F.A. Jenner. London: Academic Press.

Blankenburg, W. (1991) Contribution à la Psychopathologie des schizophrénies Pauci-symptomatiques. Trans. J.M. Azorin &. Y. Totoyan. Paris: Presses Universitaires de France.

Bordieu, P. (1977) Outline of a Theory of a Practice. Trans. R. Nice. Cambridge University Press.

Foucault, M. (1980) Power/Knowledge. Ed. C. Gordon. N.Y.:Pantheon Press.

Hume, D. (1996) Selected Essays. Oxford University Press.

Kierkegaard, S. (1989) The Sickness Unto Death. Trans. A.Hannay. Penguin.

Laing, R.D. (1960) The Divided Self. Penguin.

Laing, R.D. (1967) Politics of Experience. Penguin.

Laing, R.D. (1971) The Politics of the Family. London: Tavistock.

Mullan, B. (1995) Mad to be Normal. London: Free Association Books.

Roth, M. &. Kroll, J. (1986) The Reality of Mental Illness. Cambridge University Press.

Sass, L. (1994) The Paradoxes of Delusion. Ithaca &. London: Cornell University Press


"Laing and Psychotherapy"
by
John M. Heaton

in R.D. Laing: Contemporary Perspectives, Salman Raschid, Ed.
Free Association Books, 2005


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