"KNOWING WHAT AIN'T SO": R. D.
LAING AND THOMAS SZASZ - THOMAS SZASZ- ATHENAEUM
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"KNOWING WHAT AIN'T SO":
R. D. LAING AND THOMAS SZASZ
THOMAS SZASZ
REPRINTED FROM PSYCHOANALYTIC REVIEW, 91:
331-346 (JUNE), 2004
"KNOWING WHAT AIN'T SO":
R. D. LAING AND THOMAS SZASZ.
THOMAS SZASZ
REPRINTED FROM PSYCHOANALYTIC REVIEW, 91:
331-346 (JUNE), 2004.
I
The trouble with people," observed Josh
Billings (Henry Wheeler Shaw, 1818-1885),
the great nineteenth-century American humorist,
"is not what they don? t know but that
they know so much that ain? t so."
Psychiatrists and people interested in psychiatry
"know" that Ronald D. (David) Laing
(1927-1989), the Scottish psychiatrist, and
I share the same ideas about mental illness
and involuntary mental hospitalization. We
are lumped together as the co-founders and
co-leaders of the "anti-psychiatry"
movement. My aim in this brief essay is to
show that it "ain? t so."
II
Regarding the management of mental illness,
these are some of the opinions Laing expressed
and some of the actions he engaged in:
When I certify someone insane, I am not equivocating
when I write that he is of unsound mind,
may be dangerous to himself and others, and
requires care and attention in a mental hospital
(1960, p. 27).
To say that a locked ward functioned as a
prison for non-criminal transgressors is
not to say that it should not be so. Our
society may continue to ?need? some such
prisons for unacceptable persons. As our
society functions at present such places
are indispensable. This is not the fault
of psychiatrists, nor necessarily the fault
of anyone (1985, p. 6).
It does not follow from such possibly disturbing
considerations that the exercise of such
[psychiatric] power is not desirable and
necessary, or that, by and large, psychiatrists
are not the best people to exercise it, or,
generally, that most of what does happen
in the circumstances is not the best that
can happen under the circumstances (1985,
p. 15).
In 1965, Laing and his colleagues founded
the Philadelphia Association. The Association?
s Report for 1965-1969 listed its aim as
follows (Philadelphia Association, n. d.):
"To relieve mental illness of all description,
in particular schizophrenia. To undertake,
or further research, into the causes of mental
illness, the means of its detection and prevention,
and its treatment. ... To promote and organize
training in the treatment of schizophrenia
and other forms of mental illness" (p.
3).
Supporters of Laing are likely to object
that this wording was necessary for securing
tax-exempt status for the Association as
a "charity," and was phrased this
way solely to accomplish that purpose. That
rationalization presumes that the need to
create the Philadelphia Association justified
the compromise. But cui bono? Who needed
and benefited from this Association? Its
founders. I maintain that Laing and his followers
refused to come to grips with a basic contradiction:
if schizophrenia is not a disease, then there
is nothing to "treat." Yet, Kingsley
Hall ? Laing? s "alternative asylum"
? was touted as offering a better "treatment"
for schizophrenia than that offered in the
conventional mental hospital.
In his 1979 review of three of my books in
the New Statesman, Laing went out of his
way to assert that it makes no difference
whether we accept or reject psychiatric coercion
("slavery"). He wrote: "In
these three books [The Theology of Medicine,
The Myth of Psychotherapy, and Schizophrenia],
Szasz continues, extends and deepens his
diatribe, which began in 1961 with The Myth
of Mental Illness, against what he regarded
as the abuse of the medical metaphor in our
society. ... But suppose we do drop the medical
metaphor. If the rest of us could recognise
that what Szasz is propounding are, of course,
eternal verities, then psychiatry would disappear,
and with it what he calls antipsychiatry"
(1979, p. 96).
This is not what I wrote. I wrote: "[P]sychiatry,
as we know it, would gradually disappear..."
Laing added: "... and with it what he
calls antipsychiatry." Why did Laing
add those words? Was this his way of reaffirming
his identity as a psychiatrist, his identification
with a medical specialty resting on the "medical
model of mental illness"?
After writing that "psychiatry, as we
know it, would gradually disappear,"
I continued: "Specifically, involuntary
psychiatry, like involuntary servitude, would
be abolished, and the various types of voluntary
psychiatric interventions would be reclassified
and reassessed, each according to its true
nature and actual characteristics."
Laing concluded: "It sounds as though
it would all be much the same. It makes one
wonder what he is making all the fuss about,
whether he is not making a sort of fetish
out of the medical metaphor, and a scapegoat
out of psychiatry. We miss in these books
any in-depth analysis of the structures of
power and knowledge such as we find in Foucault
and Derrida."
In a reply, Anthony Stadlen, a well-known
British existential analyst, noted that in
Sanity, Madness, and the Family, the book
Laing co-authored with Aaron Esterson, Laing
acknowledged his debt to, and agreement with,
the thesis set forth in The Myth of Mental
Illness. In the Introduction to that book,
Laing and Esterson wrote: "It is important
to recognize that the diagnosed patient is
not suffering from a disease..." and
in a footnote added: "For the development
of this argument, see, Szasz, Thomas S. The
Myth of Mental Illness)" (1964, p. 4).
Stadlen (1979) then continued:
Dr Laing? s new role as the "perfectly
decent" defender of psychiatry against
Szasz? s "insulting and abusive"
"fuss" calls for comment. Laing
is saying, unequivocally, that "it would
all be much the same" to him whether
involuntary psychiatry be retained or abolished.
He is saying "it would all be much the
same" whether voluntary interventions,
including his own, are intended as medical
treatments for illness or as interpersonal
counselling, ethical exploration, existential
analysis. He implies quite clearly that he
is one of the "rest of us" who
do use the medical metaphor (pp. 236-237).
Laing had always wanted to be seen as a psychiatrist.
His followers love the medical rhetoric of
illness-and-treatment. For example, M. Guy
Thompson (1997), an existential analyst and
admirer of Laing, entitles his essay, "The
fidelity to experience In R. D. Laing? s
treatment philosophy," and laments that
"Laing ultimately failed to conceive
a method of treatment that could be ?packaged?
for universal consumption." Thompson?
s paper is peppered with medical clichés,
such as "clinical technique," "clinical
work," and "innovative treatment
of psychiatric patients." The term "clinical"
implies illness and implies? justifies treatment;
conversely, the term "treatment"
implies illness. Laing and many of his existential
followers are among the happy warriors of
the therapeutic state (Szasz, 2001).
III
I am concerned with the consequentialist
meaning of the term "mental illness,"
that is, the legal uses and social repercussions
of psychiatry? s pseudomedical rhetoric.
Laing is more interested in the ontological-philosophical
meaning of mental illness. He interprets
"mental illness" in existential
terms: the mental patient suffers from a
life crisis, from confusion and mystification.
At one moment he appears to question the
existence of "mental illness",
the next moment he writes as if "it"
is an identifiable "condition."
He seems to think, and wants his readers
to think, that he is posing profound paradoxes
about "it," which, when "understood
dialectically," are not contradictory.
In The Politics of Experience and the Bird
of Paradise, one of his most influential
books, Laing (1967) writes: "There is
no such condition as ?schizophrenia?, but
the label is a social fact and the social
fact a political event" (p. 100). The
incarceration of persons said to be schizophrenic
and the use of this "diagnosis"
in the insanity defense are also social facts.
It is precisely because they are social facts,
not facts of nature, that we can approve
and support them or disapprove and oppose
them. Laing says nothing about the insanity
defense, but says quite a lot about psychiatric
incarceration: he does not say it? s wrong;
in the final analysis, he supports it.
The Bird of Paradise, according to Laing,
is not an expository essay at all. In his
interview with Bob Mullan, Laing talks about
his involvement with LSD. Mullan (1995) then
asks: "Can you see why people came to
the conclusion that you wrote The Bird of
Paradise on acid?" Laing replies: "It
had nothing to do with acid ... I regard
that as a prose poem of the genre of Aurélia
of Gérard de Nerval ..." (p. 225).E1
Further on, still replying to the same question,
Laing adds: "There is one page in the
Bird of Paradise that I don? t think I could
have written without the experience of mescaline,
which with some hesitation I put it and incorporated
it into that text" (p. 226). This sort
of self-contradiction characterizes all of
Laing? s writings.
Chapter 5 of The Politics of Experience and
the Bird of Paradise is titled, "The
Schizophrenic Experience." At the end
of it, Laing (1967) writes: "Perhaps
we can still retain the now old name, and
read into it its etymological meaning: Schiz
? ?broken?; Phrenos ? ?soul or heart?. The
schizophrenic in this sense is one who is
broken-hearted, and even broken hearts have
been known to mend if we have the heart to
let them" (p. 107).
Nomen est omen. (A name is an omen.) "Schizophrenia"
is a psychiatric diagnosis, the name of a
serious mental illness. Renaming "it"
a broken heart does not change its ominous
(from the root, omen) implications. As for
mending broken hearts, doing that professionally
is now called "psychotherapy";
less elegantly, "talk therapy";
in plain English, listening and speaking
to persons about their problems. As a human
service, such an enterprise is either a medical
activity or it is not a medical activity.
Laing never committed himself to either position.
He equivocated. He waffled. That was his
solution for both wanting and not wanting
to be a psychiatrist, wanting to appear as
both opponent and supporter of psychiatry.
I view the term "mental illness"
as a metaphor, scrutinize its diverse meanings
and uses as strategic rhetoric, and focus
in large part on the legal and practical
consequences of the term? s deployment: Cui
bono? Cui malo? "Mental illness"
is a concept with a vast range of variable,
imprecise, and uncertain meanings and consequences.
"It" predicates neither the human
mind nor the human body. Rather, like "love,"
the term refers to a relationship (usually
between persons, sometimes between the individual
and his inner voice). Some persons treated
as mental patients have problems in living
(as does everyone); other are the victims
of scapegoating; still others seek to occupy
the mental patient role (for many reasons,
among them to avoid an onerous duty or responsibility
for misbehavior).
Because I view mental illness as a non-disease,
I believe the psychotherapist should not
play doctor (Szasz, 1965, 2003). Laing loved
to play doctor. In the early 1960s, Laing
met Leary, lectured on LSD, and gave the
drug to his patients: "I used it in
my practice in Wimpole Street for several
years. I got into the habit of giving it
to some patients of mine or someone else
every other week. I incorporated it into
my whole work" (emphasis added) (Mullan,
1995, p. 225).
IV
Personal responsibility is another subject
on which Laing and I disagree far more than
we seemingly agree. We agree, with Sartre,
that no person can escape being a moral agent,
responsible for his actions. Agency is an
integral part of being a conscious, acting
individual. Nothing ? not disease (physical
or "mental"), not privation, not
poverty, not even duress at the point of
a gun ? deprives us of being moral agents.
We are, at all times, responsible for everything
we do. This is a powerful premise. It is
the core of what I regard as the Judeo-Christian
moral code. At the Last Judgment, insanity
is neither an excuse nor even a mitigating
circumstance. Dante took the idea seriously.
Laing didn? t. Psychiatrists don? t. I do.
Taking responsibility seriously entails taking
liberty seriously as well. That, in turn,
requires an unqualified repudiation of psychiatry?
s two paradigmatic practices: the insanity
defense and civil commitment. Laing did not
take seriously enough the premise that everyone,
regardless of his "mental state,"
is responsible for his behavior.
Daniel Burston, professor of psychology at
Duquesne University in Pittsburgh and a biographer
of Laing, agrees that there are fundamental
disagreements between Laing and me, but contends
that I overemphasize them. He acknowledges
that Laing and I are "not cut from the
same cloth" (Burston, 2004): "Szasz,
Laing, and Foucault are often lumped together
indiscriminately as ?anti-psychiatrists?
by spokesmen for the psychiatric establishment,
and indeed, by its critics as well. And like
Szasz, I confess, I am thoroughly sick and
tired of that simple-minded refrain."
Burston defends Laing against my criticism
that Laing refused to take his role-obligations
seriously. I use the term "role-obligation"
to identify the responsibilities we incur
by virtue of our roles, especially if the
role is assumed voluntarily, exemplified
by parenthood. Burston contends that I take
my role-responsibilities too seriously, specifically
for insisting that the psychotherapist who
promises to keep his patient? s communications
confidential must do so. (No one is compelled
to be a therapist and no therapist is compelled
to make such a promise; he is free to warn
the prospective patient that if he tells
the therapist he wants to kill himself or
someone else, the therapist will commit him.)
Adverting to the psychiatrist? s traditional
social mandate to protect the patient from
"dangerousness to self and others,"
Burston defends psychiatric preventive detention,
both as "suicide prevention" and
as "crime prevention": "[S]imilar
constraints prevent us from maintaining complete
confidentiality when a client? s behavior
poses a grave risk to another human being."
He implies that that was also Laing? s position
regarding psychotherapeutic confidentiality.
"Admittedly," Burston concludes,
"by valuing life above the principle
of confidentiality, we are making an ethical
judgment ? the wrong one, in Szasz? s view,
the right one, in mine." Framing the
issue this way prejudges it: the premise
entails the conclusion, namely, that the
therapist who betrays his promise to the
patient values life more highly than the
therapist who does not betray his patient.
I disagree. In my view, such a therapist
(assuming he has promised the patient complete
confidentiality) betrays a sacred trust.
That is not a sign that he values life. It
is a sign only of the fact that the therapist
is at heart a coercive paternalist, incapable
of accepting the patient as a full-fledged
person responsible for managing his own life.
To my knowledge, Laing never made it clear
what he regarded as his obligation to patients,
or anyone else. He did emphasize that he
had contracted with his own mind: "The
contract I have made with my mind is that
it is free to do anything it cares to do"
(in Evans, 1976, p. 12). Laing believed his
mind ought to be free to do anything. Did
he believe his mind had obligations? He didn?
t say. There is no entity "mind."
We use the term as a stand-in for the "I,"
as in "I have a mind to take off the
afternoon." Laing is saying that he
is free to do anything he cares to do, unrestrained
by moral obligations.
As I see it, the principle of "existential"
responsibility entails the principle of "libertarian"
liberty. If a person? s behavior constitutes
a criminal offense, he ought to be (or may
be) punished for it; under no circumstances
should he be "treated" for it.
If his behavior does not constitute a criminal
offense, he is entitled to liberty, that
is, entitled to be left unmolested by the
coercive apparatus of the state. Depriving
a legally competent adult of liberty in a
"hospital" for the purpose of protecting
him from himself implies belief in "mental
illness" and all that belief entails.
V
Claiming to profess a view only to disavow
it later is characteristic of Laing? s work
and personality. His responsibility for introducing
the foolish, self-stigmatizing label "antipsychiatry"
into psychiatric discourse is an important
case in point.
David Cooper was Laing? s friend, colleague,
and co-author. In his Introduction to The
Dialectics of Liberation, Cooper (1968) wrote:
"The organizing group [of the Congress
on the Dialectics of Liberation, held in
London in 1967] consisted of four psychiatrists
who ... counter-label[ed] their discipline
as anti-psychiatry. The four were Dr. R.
D. Laing and myself, also Dr. Joseph Berke
and Dr. Leon Redler" (p. 7). This is
a clear claim of authorship for what these
four men evidently believed was an appropriately
dramatic and shocking name for their ideology
and movement.
Who was David Cooper? In Laing? s own words,
Cooper "was a trained Communist revolutionary
... a member of the South African Communist
Party ... we cooperated on writing Reason
and Violence" (in Mullan,
1995, pp. 194-5). Laing says his relationship
to Cooper was ambivalent: "I was really
pissed off when people attributed Cooper?
s position to mine [sic]. We were almost
completely different creatures. ... Again
and again I had said to David Cooper, ?David,
it is a fucking disaster to put out this
term.? But he? d a devilish side that thought
it would just serve them all right and confuse
them. So let? s just fuck them with it. But
I didn? t like that" (pp. 194, 356).
Laing could have prevented the term "anti-psychiatry"
from being attributed to him by preventing
the publication of The Dialectics of Liberation
or by withdrawing his contribution to it
and declaring, then and there, that he objects
to the term. But he did nothing of the sort.
Instead, years later, he complained about
the term and blamed others, for example Cooper?
s literary agent and publisher, for involving
him in it: "[They] had really done me
a publishing disservice by encouraging my
alleged association with anti-psychiatry"
(Mullan 1995, p. 356).
Adrian Laing (1994), in a sympathetic biography
of his father, comments: "Ronnie made
two mistakes with David? s introduction [to
The Dialectics of Liberation]. First, he
did not insist on reading it prior to publication.
Ronnie did not consider himself an ?anti-psychiatrist?
... The damage, however, had been done. David
managed to label Ronnie an anti-psychiatrist.
Ronnie was furious at this move, but made
a more serious mistake in not taking immediate
and effective action to rectify his position"
(p. 138).
Were Laing? s inactions "mistakes"?
Or did they represent his typical way of
having his cake and eating it too, as Adrian
himself aptly puts it? Laing was alternately
autocratic-domineering and passive- helpless,
powerful and powerless, a universal genius
and a seeker after enlightenment.
His explanation for fathering an exceptionally
large number of children by several women
is illustrative. Laing biographer John Clay
(1996) writes: "With the birth of Benjamin
on 15th September, 1984, Laing now had nine
children, with one more still to come. Why
so many children, when he was an only child
himself. [A friend] asked him this once,
why he had let it happen. Laing replied,
?They seem to want it. I should have stopped
them!? It was an example of his detachment
again, as if it had nothing to do with him,
a closing-off of his feelings, as happened
with his drinking" (p. 217). What is
one to make of this self-portrayal of Laing
as a man helplessly at the mercy of his paramours?
It is an error to call this behavior an "example
of his detachment," as Clay calls it.
We can speak of "detaching" ourselves
from certain experiences, for example our
angry or erotic feelings, but we cannot properly
speak of "detaching" ourselves
from our responsibilities, especially to
the children we bring into the world. When
we do so, we are not detached, we are reprehensibly
irresponsible. As I see it, this facet of
Laing? s behavior is more plausibly viewed
as another example of his systematic refusal
to accept responsibility for his actions
and their consequences. To Mullan (1995),
Laing explained: "So I wasn? t thinking
of contraceptive devices or anything like
that, that was up to Anne [Laing? s first
wife]..." (p. 76)
VI
Laing ends his book, The Politics of Experience
(1967), with this haughty, oracular sentence:
"If I could turn you on, if I could
drive you out of your wretched mind, if I
could tell you I would let you know"
(p. 156).
Laing was an inconsistent fantasist, traits
that seem to have endeared him to some of
his admirers. He was not "rigid."
He was "flexible" about his position
on the disease status of mental illness,
the use of psychiatric drugs, the moral legitimacy
of psychiatric paternalism, and the use of
psychiatric coercion. In a 1984 interview
on Anthony Clare? s popular TV show, "Clare
had asked him what he would want from a psychiatrist
if he became ?profoundly psychomotoretarded,
profoundly depressed or suicidal,? and Laing
had replied, ?I would want whoever was taking
my case over to make sure that I hadn? t
anything rational to worry about in terms
of obligation, commitment, duties, etc.?
and then ?to transport my body to some nursing
home and if you had any drugs that you thought
would get me into a brighter state of mind
to use those.? It made riveting listening"
(in Clay, 1996, p. 234).
In effect, Clare invited Laing to write his
"psychiatric will" (Szasz, 1982),
and the will Laing wrote requested that he
be treated in accordance with the "standard
of care" of modern biological-coercive
psychiatry, the institution he ostensibly
opposed all of his professional life.
One more example of this pattern of self-contradiction
and irresponsibility should suffice. It is
an embarrassing episode which I cite as it
is already in the public domain. In 1976,
Fiona, Laing? s first-born child who is then
twenty-four years old, is rejected by her
boyfriend. Laing biographer John Clay (1996)
writes:
[S]he had "cracked up," and had
been found weeping outside a church ... near
the family home Ruskin place. She was taken
into Gartnavel Hospital. A bitter row now
broke out between Laing and his family over
her breakdown, and the reasons for it. Adrian
was involved in this, acting as mediator.
He rang his father up and asked him "in
despair and anger" what he was going
to do about it. Laing reassured him that
he would visit Fiona and "do everything
in his power" to ensure that she was
not given ECT, but when it came to the crunch,
as Adrian Laing relates, all he could say
was "Well, Ruskin Place [the home of
Laing? s ex-wife] or Gartnavel ? what? s
the difference?" Such a scathing and
deprecatory remark showed once again an avoidance
of responsibility for his first family, indefensible
since his line had been that the breakdown
of children could be attributed to parents
and families. Instead, Laing went into denial.
When he gave an interview shortly afterwards
in New Society he declared, "I enjoy
living in a family. I think the family is
still the best thing that exists biologically
as a natural thing" (p. 181).
Laing acted as if there had been only two
places where Fiona could be housed and cared
for, the mental hospital or the home of Laing?
s ex-wife. Obviously, there was another option,
namely, Laing taking Fiona home ? his home
? and caring for her by himself or with the
aid of private help. This would have cramped
his life style and cost him money. It is
an option Laing evidently did not consider
and Clay ignores.
I have long considered Laing? s moral conduct
? drinking to excess and giving LSD to associates
and patients; promiscuous flirtation with
fashionable fads, from Buddhism to "rebirthing";
pugnacity, violence, fathering 10 children
and not taking care of them ? shameful and
reprehensible.
Regarding Laing? s politics, it is surely
fair to say that he was fashionably anti-American,
a typical left-liberal statist. Andrew Collier,
a Marxist philosopher and the author of a
flattering but flawed book, R. D. Laing:
The Philosophy and Politics of Psychotherapy,
takes that for granted. In fact, he rejects
any comparison between my work and Laing?
s because, unlike Laing, I am not a socialist.
Collier (1977) writes: "I think it does
Laing an injustice to lump him together with
Szasz, even though he [Laing] sometimes invites
this treatment. ... Szasz is mainly a polemical
writer whose theoretical tools are chosen
with a view to winning his case against medical
and for moral judgments about ?mental illness.?
His work lacks the theoretical interest of
Laing? s, and incidentally contains some
very un-radical political ideas as well ?
e. g., his opposition to socialized medicine"
(pp. 146).
VII
In my book, Schizophrenia: The Sacred Symbol
of Psychiatry (1976), I showed that the idea
of schizophrenia is the "sacred symbol"
of both psychiatry and antipsychiatry; and
I documented in detail that Laing? s views
and mine are fundamentally dissimilar (pp.
45-84). Although most writers continue to
bracket Laing and me as if we were the identical
twins of "antipsychiatry," happily,
there are exceptions. Ralph Raico
(1990), a professor of history at the State
University of New York in Buffalo, emphatically
rejected the mindless linking of my views
with Laing? s. He wrote:
There is no question that, as regards psychiatry
and psychology, Szasz is the great advocate
of the principle of voluntary exchange, the
rule of law, and the open society. ... [H]e
has added a rich social- psychological dimension
to the story of the eternal conflict of Liberty
and Power. ... Szasz? s point is that respect
for personhood requires ascribing responsibility
to the individual, including the individual
who may wish to evade such responsibility
by calling upon a psychiatric "hired
gun." This alone makes it clear that
his position must not be assimilated with
that of the "left-wing" critics
of psychiatry, such as R. D. Laing. ... Against
the current of a culture that would deny
it, Szasz restores the human world of purpose
and choice, of right and wrong.
In The Confinement of the Insane: International
Perspectives, 1800-1965, edited by Roy Porter
and David Wright, both distinguished historians
of medicine, Porter (1946-2002/2003) summed
up my views as follows.
Perhaps most radically ... Thomas Szasz deemed
mental illness a mythic and monstrous beast,
and proclaimed that "mental illness"
was a fiction. ... Over the centuries, medical
men and their supporters have been involved,
argues Szasz, in a self-serving "manufacture
of madness." In this, he indicts both
the pretensions of organic psychiatry and
the psychodynamic followers of Freud, whose
notion of the "unconscious" in
effect breathed new life into the obsolete
metaphysical Cartesian dualism. For Szasz,
any expectation of finding the etiology of
mental illness in body or mind ? above all
in some mental underworld ? must be a lost
cause, a dead-end, a linguistic error, and
even an exercise in bad faith.... In promoting
such ideas, psychiatrists have either been
involved in improper cognitive imperialism
or have rather naively pictorialized the
psyche ? reifying the fictive substance behind
the substantive. Properly speaking, contends
Szasz, insanity is not a disease with origins
to be excavated, but a behavior with meanings
to be decoded ( p. 2).
Laing? s name does not appear in this book,
an omission consistent with the fact that,
when all is said and done, he contributed
nothing of value to the debate about psychiatric
slavery, that is, "the confinement of
the insane," the psychiatrically and
socially acceptable euphemism for the practice
(Szasz, 1977, 2002). For me ? and I believe
for Laing? s erstwhile friend and collaborator,
Aaron Esterson ? R. D. Laing was a disappointment.
He was intelligent, well-read, and started
his career by courageously confronting the
fundamental moral problem of psychiatry ?
"therapeutic" coercion. That problem,
which is also a solution, benefits and harms
both psychiatric "patients" and
psychiatric "healers." It is a
tough problem. If it were not tough, it would
not have plagued the profession for the better
part of three hundred years.
But after facing the problem and writing
about it, he sold out. He took a principled
stand neither for coercion as care, nor for
liberty and responsibility as more important
values than "mental health." Laing
did not sell out to conventional psychiatric
careerism or the pharmaceutical industry.
He sold out to self-indulgence and the bitch-goddess
of fleeting fame.
Not only did Laing sell out, he also deceived
himself. He knew that life is a relentless
series of choices and conflicts, compelling
us, as moral agents, to adopt one course
of action and relinquish or reject another.
Laing could not face this. Admiringly, Theodor
Itten (n. d.), an Austrian psychotherapist
and friend of Laing? s, relates: "Ronnie
Laing once dreamt of a football match where,
as he put it, ?I am both sides.? It only
ends when ?the game turns into a dance.?"
This posture places Laing squarely in the
camp of the sinners Dante (1265-1321) ? in
John Ciardi? s classic translation? calls
"opportunists" (p. 41):
I, holding my head in horror, cried: "Sweet
Spirit, what souls are these who run through
this black haze?" And he [Virgil] said
to me: "These are the nearly soulless
whose lives concluded neither blame nor praise.
They are mixed here with that despicable
corps of angels who were neither for God
nor Satan, but only for themselves. The High
Creator who scourged them from Heaven and
Hell will not receive them since the wicked
might feel glory over them ... Mercy and
Justice deny them even a name" (pp.
42-43).
Psychiatry, like religion and politics, deals,
inter alia, with how people ought to live.
I agree with Burke: "Example is the
school of mankind, and they will learn at
no other" (in Bartlett, 1992, p. 332).
Hence: "Never wholly separate in your
mind the merits of any political question
from the men who are concerned in it"
(in Jay, 1996, p. 66).
In psychiatry, too, what the person says
and writes cannot be divorced from who he
is and how he lives. Hence, what is ad hominem
is also ad rem.
I wish to thank Anthony Stadlen for help
in the preparation of this paper.
Notes
1. Laing is referring to the nineteenth-century
French poet and essayist Gérard de Nerval?
s (1808-1855) Aurélia, which the publisher
describes thus: "Aurélia is a document
of dreams, obsession, and insanity. An account
of Nerval? s unrequited passion for an actress
and subsequent descent into madness, this
book was a favorite of artist Joseph Cornell?
s, and its author was championed by both
Marcel Proust and André Breton. One of the
original self-styled ?bohemians,? Nerval
was best known in his own day for parading
a lobster on a pale blue ribbon through the
gardens of the Palais-Royal, and for his
suicide in 1855, hanging from an apron string
he called the garter of the Queen of Sheba."
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