Anarchy 70/Libertarian Psychiatry: an introduction to existential analysis

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Libertarian Psychiatry:
an introduction to
existential analysis

PETER FORD

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This art­icle aims to draw at­ten­tion to the work of a group of British psy­chi­atrists of whom the best known are R. D. Laing and David Cooper. They have achieved some no­tori­ety in this country because of the ex­tent of their di­ver­gence, both in theory and prac­tice, from cur­rent psy­chi­atric ortho­doxy—and par­tic­u­larly as a con­sequence of their refer­ences to the pre­val­ent “treat­ment” of the men­tally ill as “viol­ence”. As a teacher, I am not qual­ified to at­tempt more than an out­line of their ideas as under­stood by me, after read­ing their books and art­icles and some related studies. But the im­plica­tions of the work of the British ex­ist­en­tial­ist group ex­tend beyond the limits of psy­chi­atry—and the very gener­ality of their as­ser­tions in­vites a re­sponse from the layman. Writing of the pro­cess which in their view results in the ul­ti­mate in­val­id­a­tion of persons through the label­ling of them as “mad”, Laing asks: “… what func­tion does this pro­ced­ure serve for the civic order? These ques­tions are only begin­ning to be asked, much less answered. … So­cially, this work must now move to further under­stand­ing … of the mean­ing of all this within the larger con­text of the civic order of so­ciety—that is, of the polit­ical order, of the ways persons exer­cise control and power over one an­other.” (New Left Review, No. 28.) Anarch­ism is about just this, and any theory, from what­ever dis­cipline, which leads to a ques­tion­ing of the polit­ical order of so­ciety should have rel­ev­ance for us—and we should know some­thing about it.

  Dr. Laing has written that his main intel­lec­tual in­debt­ed­ness is to “the ex­ist­en­tial tradi­tion”—Kierke­gaard, Jaspers, Heideg­ger, Bins­wanger, Tillich and Sartre—and of these there is no doubt that Sartre’s in­flu­ence has been the great­est. The British ana­lysts have clearly worked out their own the­or­et­ical basis and in many in­stan­ces have de­veloped Sartre’s ideas rather than merely adopted them as they stand. I am not cer­tain, for ex­ample how com­pletely Laing and Cooper share Sartre’s total re­jec­tion of the con­cept of “the un­con­scious”. However, their book Reason and Viol­ence: A Decade of Sartre’s Philo­sophy 1950-1960 (Tavistock, 1964) opens with a com­pli­ment­ary pre­fat­ory note from the French philo­sopher—I believe this is an un­usual honour for a book about his ideas—and this im­prim­atur sug­gests that what­ever their diver­gen­cies, they can­not be basic.

  In anarchy 44 J.-P. Sartre is re­ferred to as “one of the fore­most anarch­ist moral­ists” (Ian Vine: “The Moral­ity of Anarch­ism”). This de­scrip­tion com­pares in­triguingly with an­other, made by the so­cial­ist Alasdair MacIntyre, re­view­ing Sartre’s book The Prob­lem of Method in Peace News. He re­fers to Sartre as a newly found “spokes­man of genius” for “ersatz bolshev­iks” and “im­it­a­tion anarch­ists”. Not know­ing MacIntyre’s idea of the genu­ine art­icle, this does not ex­actly rule the French­man out and I believe his work may well just­ify a place on an anarch­ist’s book list. Writing with par­tic­u­lar refer­ence to Sartre’s recent work, MacIntyre notes that Sartre can offer no bonds, other than re­cip­roc­ally threat­ened viol­ence and terror, of suf­fi­cient strength to main­tain the co­he­sion of human groups in a world of “im­pos­sibly indi­vidual­ist indi­viduals”. Per­haps a spokes­man for Stirner­ites? Never­the­less, the poten­ti­alit­ies of Sartre’s philo­sophy as a basis for anarch­ism are in­cid­ental to my pur­pose here.

  The first of four epis­odes of this essay are in­tended to create a set­ting against which ex­ist­en­tial ana­lysis may be viewed.

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EXISTENTIAL FREEDOM

  “Man can­not be some­times slave and some­times free; he is wholly and forever free, or he is not free at all.”

Sartre: Being and No­thing­ness

  The con­cept of free­dom at the core of ex­ist­en­tial­ism is very dif­fer­ent from what I take to be the com­mon under­stand­ing of the term. In gen­eral usage, a man is free in as much as he can achieve his chosen ends with a min­imum of effort. Simil­arly, a man’s free­dom is re­duced as the ob­stacles between his de­sires and chosen ends are in­creased. Free­dom is re­garded as a measur­able quant­ity; one may have a lot or a little of it, and it can be taken away—or even “given”. The anarch­ist’s hypo­thet­ical destin­a­tion, the “free” so­ciety, may often be thought of in the sense of an har­mo­ni­ous envir­on­ment in which all re­mov­able ob­stacles between man’s de­sires and their ful­fil­ment have been elim­in­ated. But for Sartre, man is totally free by reason of his very being as man, and ob­stacles between de­sires and chosen ends are of no rel­ev­ance. To use a favoured ex­ist­en­tial­ist phrase, man is free by onto­lo­gical neces­sity. But his free­dom rests, within this con­cept, in his total re­spons­ibil­ity in the face of un­deter­mined choice and in his recog­ni­tion of the in­escap­able ob­lig­a­tion to choose. An intuit­ive aware­ness of this re­spons­ib­il­ity—per­haps pro­voked by some sort of “ex­treme situ­a­tion”—gives rise to what Sartre calls “the anguish of free­dom”. It is our fate to be free. “… One must always de­cide for one­self and efforts to shift the burden of re­spons­ib­il­ity upon others are neces­sar­ily self-de­feat­ing. Not to choose is also to choose, for even if we de­liver our power of de­ci­sion to others, we are still re­spons­ible for having done so. It is always the indi­vidual who de­cides that others will choose for him.” In so far as we are free in our choices, we “create” the ob­stacles that lie between our pro­ject and its ful­fil­ment: “an in­sig­ni­fic­ant public of­fi­cial in Mont-de-Marsan without means may not have the op­por­tun­ity to go to New York if that be his ambi­tion. But the ob­stacles which stand in his way would not exist as ob­stacles were it not for his free choice and values: in this case, his desire to go

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to New York.” Even though human free­dom, in his view, is total, Sartre ad­mits of a sense in which it may be spoken of in terms of degree. A man may be said to become “more free” as his con­scious­ness of total free­dom and re­spons­ib­il­ity in­creases; and cer­tain situ­a­tions in life can crystal­lize this aware­ness. In an ap­par­ently cryptic para­graph in Being and No­thing­ness Sartre de­scribes the German Oc­cupa­tion of France during the last war as such a situ­a­tion. “… the choice that each of us made of his life and his being was an au­then­tic choice because it was made face to face with death, because it could always have been ex­pressed in these terms: ‘Rather death than …’.” But the issue is not just one of an in­creased sense of re­spons­ib­il­ity for our day-to-day options—for in­stance in de­cid­ing upon a change in oc­cu­pa­tion, or merely which book to read next; most sig­ni­fic­antly we choose our­selves, and our day-to-day de­ci­sions neces­sarily re­flect this primary choice we have made. We are what we have chosen to be. All our sub­sequent modes of action are re­lated to this original “project-of-being”, “Freely chosen at the moment one wrenches one­self away from the in-itself to create one’s own world” (the in-itself: the world of things). This event I take to be com­par­able with what R. D. Laing calls “ex­ist­en­tial birth” which, he sug­gests, is as essen­tial for a fully human ex­ist­ence as the bio­lo­gical birth which it nor­mally follows.^* It is only in rela­tion to this funda­mental choice, the indi­vidual’s original “pro­ject-of-being” that his later beha­viour can be fully under­stood. The plaus­ibil­ity of this basic idea is not in­creased by Sartre’s denial of the divi­sion of the self into con­scious and un­con­scious modes; the idea of a tooth­less infant con­sciously de­termin­ing its future life­style and pur­pose is at first thought ab­surd. But whilst ex­pli­citly deny­ing valid­ity to the “un­con­scious” Sartre does separ­ate con­scious­ness into “re­flect­ive” and “non-re­flect­ive” levels, and it is at the non-re­flect­ive level that this funda­mental choice is made. He stresses that this original choice is in no way de­liber­ate: “This is not because it would be less con­scious or less ex­plicit than a de­liber­a­tion but, on the con­trary, because it is the found­a­tion of all de­liber­a­tion and because … a de­liber­a­tion re­quires an inter­pret­a­tion in terms of an original choice.” The con­cepts of “au­then­ti­city” and its ap­proxim­ate op­po­site “bad-faith” are in a sense under­stand­able as judge­ments (al­though Sartre claims only to use these terms de­script­ively) upon the degree of con­cord­ance between the choices of our re­flect­ive con­scious­ness and our original pro­ject-of-being. In a pas­sage which bears di­rectly upon ex­ist­en­tial ana­lysis he writes that a man “can make vol­un­tary de­ci­sions which are op­posed to the funda­mental ends which he has chosen. These de­ci­sions can be only vol­un­tary—that is, re­flect­ive. … Thus, for ex­ample, I can de­cide to cure myself of stutter­ing. I can even

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suc­ceed in it. … In fact I can ob­tain a result by using merely tech­nical methods. … But these re­sults will only dis­place the in­firm­ity from which I suf­fer; an­other will arise in its place and will in its own way ex­press the total end which I pur­sue. … It is the same with these cures as it is with the cure of hys­teria by elec­tric shock treat­ment. We know that this ther­apy can effect the dis­ap­pear­ance of an hys­terical con­trac­tion of the leg, but as one will see some time later the con­trac­tion will ap­pear in the arm. This is because the hys­teria can be cured only as a total­ity, for it is a total pro­ject of the for-itself” (the for-itself: the world of con­scious­ness and in­ten­tion).

  Sartre argues against the Freud­ian three-way split of the per­sonal­ity into id, ego and super-ego and the Psycho-ana­lytic dictum of con­scious beha­viour as de­term­ined by drives, in­stincts and de­sires al­legedly eman­at­ing from the id. As Sartre’s argu­ments hinge upon his stated belief in man’s on­to­lo­gical free­dom, Freud’s pro­ject of “de­term­ina­tion by the un­con­scious” is met with similar ob­jec­tions to those made against other de­term­in­ist theories and I need not at­tempt to sum­mar­ise them here. The only valid form of ther­apy is one aimed at dis­cover­ing an indi­vidual’s funda­mental pro­ject-of-being—and this is the pur­pose of ex­ist­en­tial ana­lysis (or psycho-ana­lysis; the pre­fix seems to be op­tional). “The prin­ciple of this psycho-ana­lysis is that man is a total­ity and not a col­lec­tion; he there­fore ex­presses him­self in his total­ity in the most in­sig­ni­fic­ant and the most super­fi­cial as­pects of his con­duct” (Being and No­thing­ness). Through the use of a tech­nique or method based on such as­sump­tions the ini­tially “crazy” actions of the in­sane may be made com­pre­hens­ible—and may even ap­pear “reason­able” if a picture of the world in which the pa­tient lives can be as­sembled.

  R. D. Laing has written that “only by the most out­rage­ous viol­a­tion of our­selves have we achieved our cap­ac­ity to live in relat­ive ad­just­ment to a civil­isa­tion ap­par­ently driven to its own de­struc­tion” and has de­scribed the “normal” person in the present age as “a half-crazed creature, more or less ad­justed to a mad world”. What is the norm that gives the gen­erally ac­cepted mean­ing to such relat­ive de­scrip­tions as “mad”, “insane”, “mal­ad­justed”? And what is the sig­ni­fic­ance of what is done to the people that are dis­qual­i­fied when meas­ured against this cri­terion; the people that the mad offi­cials label as “offi­cially mad”?

THE INSANE IN A MAD WORLD

  “In the con­text of our present mad­ness that we call normal­ity, san­ity, free­dom, all our frames of refer­ence are am­bigu­ous and equi­vocal.”

R. D. Laing: The Divided Self.

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*See The Divided Self, pp. 41-42. For an ac­count of the con­sequences of the ob­struc­tion of this oc­cur­rence: “an ex­ist­en­tially dead child” see p. 183. In Views, No. 8, David Cooper writes: “… the begin­ning of per­sonal de­velop­ment is never pure passiv­ity. … From the first moment of mother-child inter­action, where each is an­other to the other, the child is in the posi­tion of having to ini­ti­ate the pro­ject to become who­ever he is to be, and this is in prin­ciple a free choice, his free crea­tion of his essen­tial nature.”

NOTES

<references>

Relev­ant Books and Art­icles not men­tioned in Refer­ences:

R. D. Laing, “Series and Nexus in the Family”, New Left Review, No. 15.

David Cooper, “Sartre on Genet”, New Left Review, No. 25.

R. D. Laing, The Polit­ics of Ex­peri­ence and the Bird of Para­dise, Penguin Books, Autumn, 1966.

R. D. Laing, H. Phillip­son, A. R. Lee, Inter­per­sonal Per­cep­tion: A Theory and a Method, London, Tavistock, 1966.

T. S. Szasz, The Myth of Mental Ill­ness, London, Seeker and Warburg, 1962.

Carl R. Rogers, On Becoming a Person, London, Constable & Co., 1961.