The man who abolished madness

R D Laing regarded psychiatry as akin to penology, designed mainly to keep mad people out of society's way

Related Topics
Subversive yet compassionate, enduring yet marginal. This is how the work of a key figure in the 1960s, a leader of the counter-culture, the Scottish psychotherapist R D Laing, was characterised at a meeting to re-assess him which took place at the Mahatma Gandhi Hall in central London on Sunday. It was a gathering of 100 or so admirers, of people who want to carry on developing his insights.

Laing's work and writing started from the assumption that schizophrenia is not a disease with symptoms in any conventional sense. No malfunctioning of the brain has yet been detected that explains mental illness. Thomas Szasz, a contemporary of Laing, said that minds could be "sick" only in the sense that jokes were "sick" or economies are "sick".

In The Divided Self, Laing's most influential book, he wrote that it was possible to know just about everything that could be known about schizophrenia without being able to understand one single schizophrenic.

It is from this starting point that flowed both Laing's subversive intent and compassionate response. He was one of the founders of the anti-psychiatry movement which persists to this day. In this view, psychiatry is seen as akin to penology; it is primarily concerned with keeping mad people out of society's way rather than with improving their condition. Its history is a history of constraint.

We even get a glimpse of this in Boswell's life of Johnson. The great man was asked to comment on the unfortunate poet Christopher Smart, who was "confined in a mad-house". Burney had asked Johnson how does "poor Smart do?". He replied: "I do not think he ought to be shut up. His infirmities were not noxious to society. He insisted on people praying with him; and I'd as lief pray with Kit Smart as anyone else. Another charge was, that he did not love clean linen; and I have no passion for it."

One hundred years later new state institutions were set up, with locked wards, padded cells and strait-jackets. Instead of prisons, prisoners and warders, there were mental hospitals, patients and nurses. Later, from the 1930s to the 1950s (when Laing was working in a Scottish mental hospital), came the use of insulin-induced comas, lobotomy and electroshocks. Since then constraint has largely been achieved through the agency of tranquillising drugs. For Laing, the state system which he had seen from inside was worse than useless, because its methods could have perverse results.

At the heart of his analysis was the notion of a person so utterly insecure that in the ordinary circumstances of living, he or she may feel more unreal than real, more dead than alive, precariously differentiated from the rest of the world, so that his or her identity was always in question. Such people may feel more insubstantial than substantial, and they may feel their selves as partially divorced from their bodies.

In these circumstances, everyday life constitutes a continual and deadly threat. Their incomprehensible talk, their weird behaviour, their catatonic states are all to be seen as defensive strategies, designed to protect their poor tortured souls from engulfment, implosion or depersonalisation.

Schizophrenics could be understood and helped, argued Laing, only with compassion and with therapy rather than medical intervention. At the meeting on Sunday, all the talk was of the need to be with people before you could help them, to stand by attentively, of developing an "attuned" understanding of the schizophrenic's situation, of cultivating an ability "to be with". What patients needed, it was said, was an experience, not an explanation such as psychoanalysis offers. Somebody who had worked with Laing said that his patients found themselves as part of a general enterprise of understanding what it is to be human.

It follows that the appropriate setting for such work is a therapeutic community rather than a hospital. For five years in the 1960s, Laing ran such a place, Kingsley Hall in the East End of London, where it became a notorious feature of the counter-culture of the decade. It was chaotic and anarchic and a nuisance to its neighbours.

Clancy Sigal, in his obituary of Laing, wrote that "we were not looking for cures, because there was no madness ... if we stopped thinking in terms of madmen and madwomen and started participating more joyfully in the unhappiness (called "madness") of others, there was some possibility - none of us in our right minds called it more than that - that people in trouble might be helped."

Along with criticisms of conventional psychiatry, the Kingsley Hall initiative has also been developed and refined. In this country a number of small communities have been founded, often called "households" to imply the creation of a sort of family structure. The more ordinary these refuges appear, the more tranquillity they impart. In the United States, ambitious projects have been attempted. On Sunday , Loren Mosher gave an account of two houses he established in California, which operated for 12 years until their funding eventually dried up.

He set out to "de-hospitalise" madness, de-medicalise madness (ie, it is not a disease), to de-professionalise it with the use of staff without mental health qualifications whose first duty was "to be with patients", and to de-drug it. A study has subsequently shown that the outcomes were as good or better than those for patients treated in hospitals. Mr Mosher is having similar success with a much larger undertaking in Washington DC.

None the less, these initiatives and the beliefs which underpin them remain marginal. Thirty years have passed since such notions were first discussed; Laing was their leading exponent. Neither side has been able, once and for all, to vanquish the other in argument, because neither can show convincing proof of its assertions.

Laing's followers argue that therapeutic communities are cheaper to run than state facilities, but the argument does not convince and the medical establishment continues to view schizophrenia as a disease which can be ameliorated, if not cured, with sophisticated drugs.

React Now

Latest stories from i100
Have you tried new the Independent Digital Edition apps?
iJobs Job Widget
iJobs General

Sauce Recruitment: Retail Planning Manager - Home Entertainment UK

salary equal to £40K pro-rata: Sauce Recruitment: Are you available to start a...

Ashdown Group: Front-End Developer - London - up to £40,000

£35000 - £40000 per annum: Ashdown Group: Creative Front-End Developer - Claph...

Recruitment Genius: Product Quality Assurance Technologist - Hardline & Electric

£18000 - £24000 per annum: Recruitment Genius: The role in this successful eco...

Ashdown Group: QA Tester - London - £30,000

£28000 - £30000 per annum: Ashdown Group: QA Tester - London - £30,000 QA Tes...

Day In a Page

Read Next

CPAC 2015: What I learnt from the US — and what the US could learn from Ukip

Nigel Farage

If I were Prime Minister: I would create a government that actually reflects its people

Kaliya Franklin
HIV pill: Scientists hail discovery of 'game-changer' that cuts the risk of infection among gay men by 86%

Scientists hail daily pill that protects against HIV infection

Breakthrough in battle against global scourge – but will the NHS pay for it?
How we must adjust our lifestyles to nature: Welcome to the 'Anthropocene', the human epoch

Time to play God

Welcome to the 'Anthropocene', the human epoch where we may need to redefine nature itself
MacGyver returns, but with a difference: Handyman hero of classic 1980s TV series to be recast as a woman

MacGyver returns, but with a difference

Handyman hero of classic 1980s TV series to be recast as a woman
Tunnel renaissance: Why cities are hiding roads down in the ground

Tunnel renaissance

Why cities are hiding roads underground
'Backstreet Boys - Show 'Em What You're Made Of': An affectionate look at five middle-aged men

Boys to men

The Backstreet Boys might be middle-aged, married and have dodgy knees, but a heartfelt documentary reveals they’re not going gently into pop’s good night
Crufts 2015: Should foreign dogs be allowed to compete?

Crufts 2015

Should foreign dogs be allowed to compete?
10 best projectors

How to make your home cinema more cinematic: 10 best projectors

Want to recreate the big-screen experience in your sitting room? IndyBest sizes up gadgets to form your film-watching
Manchester City 1 Barcelona 2 player ratings: Luis Suarez? Lionel Messi? Joe Hart? Who was the star man?

Manchester City vs Barcelona player ratings

Luis Suarez? Lionel Messi? Joe Hart? Who was the star man at the Etihad?
Arsenal vs Monaco: Monaco - the making of Gunners' manager Arsene Wenger

Monaco: the making of Wenger

Jack Pitt-Brooke speaks to former players and learns the Frenchman’s man-management has always been one of his best skills
Cricket World Cup 2015: Chris Gayle - the West Indies' enigma lives up to his reputation

Chris Gayle: The West Indies' enigma

Some said the game's eternal rebel was washed up. As ever, he proved he writes the scripts by producing a blistering World Cup innings
In Ukraine a dark world of hybrid warfare and murky loyalties prevails

In Ukraine a dark world of hybrid warfare

This war in the shadows has been going on since the fall of Mr Yanukovych
'Birdman' and 'Bullets Over Broadway': Homage or plagiarism?

Homage or plagiarism?

'Birdman' shares much DNA with Woody Allen's 'Bullets Over Broadway'
Broadchurch ends as damp squib not even David Tennant can revive

A damp squib not even David Tennant can revive

Broadchurch, Series 2 finale, review
A Koi carp breeding pond, wall-mounted iPads and a bathroom with a 'wellness' shower: inside the mansion of Germany's 'Bishop of Bling'

Inside the mansion of Germany's 'Bishop of Bling'

A Koi carp breeding pond, wall-mounted iPads and a bathroom with a 'wellness' shower