Expression

Ronald David Laing was a Scottish psychiatrist who wrote extensively on mental illness, in particular, the experience of psychosis. Laing’s views on the causes and treatment of serious mental dysfunction, greatly influenced by existential philosophy, ran counter to the psychiatric orthodoxy of the day by taking the expressed feelings of the individual patient or client as valid descriptions of lived experience rather than simply as symptoms of some separate or underlying disorder. Often associated with the anti-psychiatry movement, he himself rejected the label as such, as did certain others critical of conventional psychiatry at the time. He wanted to challenge the core values of a psychiatry which considers mental illness as primarily a biological phenomenon of no social, intellectual or political significance.

Laing was a critic of psychiatric diagnosis, arguing that diagnosis of a mental disorder contradicted accepted medical procedure. Diagnosis was made on the basis of behavior or conduct, and examination and ancillary tests that traditionally precede diagnosis of viable pathologies like broken bones or pneumonia occurred after the diagnosis of mental disorder. Hence, according to Laing, psychiatry was founded on a false epistemology of illness diagnosed by conduct but treated biologically.

The fact that medical doctors had annexed mental disorders did not mean they were practicing medicine. Hence, the popular term “medical model of mental illness” is oxymoronic, since, according to Laing, diagnosis of mental illness did not follow the traditional medical model. The notion that biological psychiatry is a real science or a genuine branch of medicine has been challenged by other critics as well.

He never denied the existence of mental illness, but viewed it in a radically different light from his contemporaries. For Laing, mental illness could be a transformative episode whereby the process of undergoing mental distress was compared to a shamanic journey. The traveler could return from the journey with important insights, and may have become a wiser and more grounded person as a result. This was consistent with the critique of the alleged dubious validity of “value judgements” prevalent in Western society, which was common among academics in the 1960s and 1970s.

Laing argued that the strange behavior and seemingly confused speech of people undergoing a psychotic episode were ultimately understandable as an attempt to communicate worries and concerns, often in situations where this was not possible or not permitted. Laing stressed the role of society, and particularly the family, in the development of madness. He argued that individuals can often be put in impossible situations where they are unable to conform to the conflicting expectations of their peers, leading to a “lose-lose situation” and immense mental distress for the individuals concerned. The perceived symptoms of schizophrenia were therefore an expression of this distress, and should be valued as a cathartic and transformative experience.

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