Anarchy 70/Libertarian Psychiatry: an introduction to existential analysis
an introduction to
existential analysis
Dr. Laing has written that his main intellectual indebtedness is to “the existential tradition”—
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.
“Man cannot be sometimes slave and sometimes free; he is wholly and forever free, or he is not free at all.”
Sartre argues against the Freudian three-
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-
“In the context of our present madness that we call normality, sanity, freedom, all our frames of reference are ambiguous and equivocal.”
By far the largest group is the third—
“Many of us, for quite some time have considered that problems of punishment and repression are most acute in the context of imprisonment. But this is not so; the really intractable problem in this sphere is that of the mental hospital.”
In his account of “de-institutionalisation” (anarchy 4) Colin Ward referred to the prison as “the most sinister of institutions” and no doubt it is. But as anarchists are aware, the state can make skilful use of the “approved” concepts of crime and criminality to divert attention from its own more grandiose but identical activities: so we should be alert to the possibility that the institutions openly labelled as prisons are not the only ones serving that function. Suppose, as Roger Moody says in his article that mental hospital and prison are “different terms for the same thing”? If there is some truth in this there is consequently an additional danger in that anything called a “hospital” has automatically a protective cocoon around it as a result of its claim to provide therapy. But surely the “voluntary” presence of many of the patients in mental hospitals ensures that they cannot have a punitive character or effect? A different approach is suggested by the American sociologist Erving Goffman: “… We must see the mental hospital, in the recent historical context in which it developed, as one among a network of institutions designed to provide a residence for various categories of socially troublesome people.”[16]
As Malatesta noted in his essay “Anarchy”, “Organs and functions are inseparable terms. Take from an organ its function, and either the organ will die, or the function will reinstate itself.” The existence of the mental hospital is justified by its function of curing the mentally ill. “The patient’s presence in the hospital is taken as prima facie evidence that he is mentally ill, since the hospitalization of these persons is what the institution is for.” A very common answer to a patient who claims he is sane is the statement: “If you aren’t sick you wouldn’t be in the hospital.”[18] One consequence of this for the person initiated into a “career” as a mental patient is that his past life will be restructured in terms of a “case history”—
Because society needs lunatics to provide it with reassurance of its own sanity, so it has need of institutions to contain them. But as with prisons, the real enemy is not the material structure—
“In the popular mind the schizophrenic is the proto-typical madman—
One psycho-analytic view is that schizophrenia is the outcome of a split between a person’s “conscious” and “subconscious” forces which in the normal state are believed to work simultaneously. Another idea—
This I hope is enough to provide some basis for R. D. Laing’s and A. Esterson’s statement in the introduction to Sanity, Madness and the Family that there is no more disputed condition in the whole field of medicine. “The one thing certain about schizophrenia is that it is a diagnosis, that is a clinical label, applied by some people to others.”[24] The essentially social process which results ultimately in the fixing of this label to one person is the underlying theme of three books and a good many articles by Dr. Laing and his colleagues. I shall try to outline their account of this process subsequently, but an idea of their truly radical conclusions can be given here:
“We do not use the term ‘schizophrenia’ to denote any identifiable condition which we believe exists ‘in’ one person.”[25]
“I do not myself believe that there is any such ‘condition’ as schizophrenia. …”[26]
“Schizophrenia is not a disease in one person but rather a crazy“Schizophrenia, if it means anything, is a more or less characteristic mode of disturbed group behaviour. There are no schizophrenics.”[28]
“Over the last two decades there has been a growing dissatisfaction with any theory or study of the individual which artificially isolates him from the context of his life, interpersonal and social.”
Sartre holds that all groups are structured against an awareness of a “spectator”. This “spectator” may be an individual—
The British existentialists make use of two words, series and nexus, in differentiating between kinds of group—
Praxis and process are both terms used by Sartre. Basically, praxis is what is done by someone: “deeds done by doers”, “the acts of an individual or group”; whilst process refers to “what just happens”, activity not intended by anyone and of which no one person in a group may be aware.
The position of the person within the group will affect his idea of himself—
Dr. Laing’s second book The Self and Others deals with the way in which a person is affected by his situation in a “nexus” of others, in particular within the family. “The others either can contribute to the person’s self-fulfilment, or they can be a potent factor in his losing himself (alienation) even to the point of madness.” He asserts his belief that “fantasy is a mode of experience” and that relationships on a fantasy level are “as basic to all human relatedness as the interactions that most people most of the time are more aware of.”
What happens in the families of “schizophrenics”? It is important to emphasise that it is not the thesis of these workers that the family rather than the individual is “ill”. A group is not an organism—- “The patient was a good, normal, healthy child; until she gradually began
- “to be bad, to do or say things that caused great distress, and which were on the whole ‘put down’ to naughtiness or badness, until
- “this went beyond all tolerable limits so that she could only be regarded as completely mad.”
What was seen by the mother as her daughter’s “good” period, in infancy and early childhood, she described with such remarks as “she gave no trouble”, “she always did what she was told”. Laing comments that what to the mother were signs of goodness, were signs that the child had never been permitted to become “existentially alive”—
In Sanity, Madness and the Family (the first volume of an uncompleted study) Drs. Laing and Esterson present extracts from interviews with members of 11 families, all of which contained daughters diagnosed as “schizophrenic”. In the Introduction to this book the authors write “… we believe that we show that the experience and behaviour of schizophrenics is much more socially intelligible than has come to be supposed by most psychiatrists … we believe that the shift of point of view that these descriptions both embody and demand has an historical significance no less radical than the shift from a demonological to a clinical viewpoint 300 years ago.” Behaviour which is eventually interpreted by the family as a sign of madness is, they argue, the outward expression of a desperate attempt on the part of the “mad one” to “make sense of a senseless situation”—
These writers claim, and I think demonstrate, that armed with a knowledge of the patient’s existential situation, it is possible to make sense of what “psychiatrists still by and large regard as nonsense”. For example, Julie, the patient in “The Ghost of the Weed Garden” referred to herself whilst in her “psychotic” state as “Mrs. Taylor” and as a “tolled bell”. Dr. Laing interprets her chosen title “Mrs. Taylor” as expressing the feelings: “I’m tailor made; I’m a tailored maid; I was made, fed, clothed and tailored” and a “tolled bell” is also “the told belle” “the girl who always did what she was told”. The schizophrenic’s “delusions” of persecution are real expressions of reaction in response to real persecution and are existentially true; that is to say they are “literally true statements within the terms of reference of the individual who makes them.”††
The person is now launched on a “career” as a mental patient. He is confirmed in this role by society’s agents the psychiatrists, in collusion with the patient’s family, and by process of betrayal and degradation[34] becomes an inmate of a mental hospital, which institution embodies “a social structure which in many respects reduplicates the maddening peculiarities of the patient’s family … he finds psychiatrists, administrators, nurses who are his veritable parents, brothers, sisters, who play an interpersonal game which only too often resembles in the intricacies of its rules the game he failed in at home.”[35]
The existential analysts have asserted that a great deal of what passes for treatment in mental institutions is violence. Perhaps we can now begin to see what is meant by this. David Cooper in his article in Views, No. 8 quotes Sartre’s definition of violence: “The corrosive
THEORIES IN PRACTICE: “THE ANTI-HOSPITAL”
** An article in The Observer (4.9.66) announced the formation of “Project 70”—
*** This may be an allusion to a case which was receiving some publicity at that time. Zenya Belov, a student, was confined in a Russian mental institution around September, 1965—
† References to a letter from Brenda Jordan in Peace News (17.6.66).
†† See also Laing’s interpretation of the statements of a schizophrenic from the original account in Kraepelin’s Lectures on Clinical Psychiatry, 1905 (pp. 29-31 The Divided Self). Laing writes: “What does this patient seem to be doing? Surely he is carrying on a dialogue between his own parodied version of Kraepelin, and his own defiant rebelling self. ‘You want to know that too? I tell you who is being measured and is measured and shall be measured. I know all that, and I could tell you, but I do not want to’.” Laing comments: “This seems to be plain enough talk.”
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.
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- ↑ Robert G. Olson, An Introduction to Existentialism, New York, Dover Publications, 1962, p. 52.
- ↑ ibid., p. 105 (a reference to an episode in Being and Nothingness, p. 495).
- ↑ J.-P. Sartre, Situations III, Paris, Gallimard, 1949 (quoted by Olson, p. 121).
- ↑ Olson, op. cit., p. 119.
- ↑ Sartre J.-P. Sartre, Being and Nothingness, London, Methuen, 1956, pp. 461-2.
- ↑ ibid., pp. 471-75 (quoted by Olson, p. 121).
- ↑ The first part of R. D. Laing’s The Self and Others is a lucid argument against the basic concepts of traditional psycho-
analysis. - ↑ “Massacre of the Innocents”, Peace News, 22nd January, 1965.
- ↑ BBC “Panorama” on “Mental Health”, 6th June, 1966.
- ↑ David Cooper, “The Anti-Hospital: An Experiment in Psychiatry”, New Society, 11th March, 1965.
- ↑ David Cooper, “Violence in Psychiatry”, Views, No. 8, Summer, 1965.
- ↑ ibid.
- ↑ Part of a letter by Pierre-Joseph Brie, “Insanity and the Egg”, Peace News, 1st July, 1966.
- ↑ T. S. Szasz, “Politics and Mental Health”, American Journal of Psychiatry, No. 115 (1958) (quoted by Erving Goffman in Asylums, p. 509).
- ↑ Erving Goffman, <span data-html="true" class="plainlinks" title="Wikipedia: Asylums—
Essays on the Social Situation of Mental Patients and Other Inmates">Asylums— , New York, Anchor Books, 1961, pp. 363-4.Essays on the Social Situation of Mental Patients and Other Inmates - ↑ ibid., p. 354.
- ↑ ibid., p. 135.
- ↑ ibid., p. 380.
- ↑ For a reconstruction of a psychiatric interrogation see “The Case Conference”, Views, No. 11, Summer, 1966. <span data-html="true" class="plainlinks" title="Wikipedia: Elias Canetti<!-- 'Elia Canetti' in original -->">Elias Canetti<!-- 'Elia Canetti' in original --> has written that “questioning is a forcible intrusion. When used as an instrument of power, it is like a knife cutting into the flesh of the victim. … The most blatant tyranny is the one that asks the most questions” (Crowds and Power, Gollancz, 1962).
- ↑ A sentence of Dr. Joshua Dierer’s, speaking at the World Federation of Mental Health, 1960 (quoted by Colin Ward in “Where The Shoe Pinches”, anarchy 4).
- ↑ Goffman, op. cit., p. 384.
- ↑ An estimate made by the Swiss psychiatrist E. Bleuler, quoted by David Cooper in “The Anti-Hospital”.
- ↑ P. Rube, “Healing Process in Schizophrenia”, Journal of Nervous and Mental Diseases, 1948 (quoted by John Linsie in “Schizophrenia: A Social Disease”, anarchy 24).
- ↑ R. D. Laing, “What is Schizophrenia?”, New Left Review, No. 28.
- ↑ R. D. Laing and A. Esterson, Sanity, Madness and the Family, London, Tavistock, 1964.
- ↑ R. D. Laing, “What is Schizophrenia?”, op. cit.
- ↑ David Cooper, “The Anti-Hospital”, op. cit.
- ↑ David Cooper, Violence in Psychiatry, Views, No. 8.
- ↑ R. D. Laing, “Us and Them”, Views, No. 11.
- ↑ R. D. Laing and A. Esterson, op. cit.
- ↑ R. D. Laing, “Us and Them”, op. cit.
- ↑ David Cooper, “Two Types of Rationality”, New Left Review, No. 29.
- ↑ op. cit., p. 155.
- ↑ Erving Goffman in Asylums makes use of the term “career” to denote “the social strand” of a person’s life inaugurated at the moment of his definition as a mental patient; “betrayal funnel” to describe the circuit of figures (relatives, psychiatrists, etc.) whose interactions end with the patient’s confinement in the 374asylum, and “degradation ceremonial” for the psychiatric examination preceding the patient’s admission.
- ↑ David Cooper, “Violence in Psychiatry”, op. cit.
- ↑ ibid.