Family, Phenomenology and Schizophrenia in R.D. Laing¹
DANIEL BURSTON

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For an illustration of this thesis, look at chapter nine of The Divided Self, published in 1960. There we find a brief account of a hitherto "normal" man in his fifties who, for sake of convenience, we will call Henry. One summer afternoon, Henry was picnicking with his wife and children. After the meal, in full view of passersby, he stripped naked, waded into the nearby river and doused himself repeatedly, saying he was baptizing himself for his sins. When asked what sins he was atoning for, Henry declared that he had never really loved his wife and children. Moreover, he refused to come out of the river until he was "cleansed", and was eventually dragged out by the police, and hospitalized immediately thereafter (Laing, 1960, p. 148).

Admittedly, Henry was behaving in an odd, tactless and obstinate manner. But why is the presumption in such circumstances that he was losing his mind, rather than finding it? And why is the presumption that there is something wrong with Henry's brain, rather than a tumult in his soul? Admittedly, Henry's symbolic gestures were silly, desperate, and a little histrionic. Even so, his claim that he never really loved his wife and children, far from being delusional, just might be true. As catastrophic as this realization may be for all concerned, it is better to acknowledge a bitter truth and cope with its consequences than to live a lie -- or so Henry felt, apparently.

The odds are that his wife felt otherwise. Indeed, the odds are that she was horrified at this disclosure, and felt that this raving fool was not the man she married. Any effort to uncover the real truth of the matter , by patiently sifting fact from fantasy, truth from fiction, all the way back to their courtship (and beyond, if necessary), would inevitably expose Henry's wife to raw feelings of anger, inadequacy, shame, and betrayal as she got to know the man behind the mask -- arguably, for the very first time. And even if she were up to the challenge, there is no guarantee that Henry would be restored to health -- or more precisely, to his "pre-morbid condition", which is probably what she would want. So psychotherapy is out of the question. Some somatic intervention is called for to put poor Henry in his "right" mind again.

Laing does not say what Henry's diagnosis was. But being British, Henry stood half the chance of being diagnosed schizophrenic as he did in the United States circa 1955. The contrast between profligate Americans and their parsimonious British (and European) counterparts generated much controversy in the ensuing decades; controversy which focused on how quickly and how carefully clinicians diagnose, and what criteria they use to determine the nature of a patient's disorder. But in the midst of this spirited debate, few clinicians doubted openly that patients like Henry actually suffered from a medical illness, although from 1955 and 1975, when Laing rose to prominence, the physical evidence on behalf of the medical model was still quite flimsy. Laing was quite justified in treating the rigid insistence on the organic etiology of schizophrenia as a stubborn and irrational article of faith.

Since the mid 1970's, however, evidence has accumulated which buttresses the medical model. But many questions remain. While there are high correlations between certain brain defects and certain schizophrenic symptoms, not all people who have these defects are symptomatic. And conversely, not all patients who are symptomatic have these brain defects. Moreover, some of the defects in question are not specific to schizophrenia, but are found in other severe disorders as well (Sass, 1992, appendix). And at the end of day, not one variety of schizophrenia has a clear cut etiology as yet, so none of this work is definitive.

Still, it would be naive to deny that psychiatry may discover organic problems whose prevention or remediation will eliminate or dramatically reduce symptoms, or that the newer drugs have fewer iatrogenic effects than earlier treatments had. This marks a substantial improvement on the previous state of affairs, and raises some complex and delicate questions about the relevance of Laing's critique to 21st century psychiatry.

Unfortunately, most psychiatrists are inclined to think that there is nothing complicated or delicate about it. They say that recent developments vindicate the medical model, and invalidate Laing's paranoid ravings once and for all. Another, smaller group have sufficient realism and generosity to concede that Laing's scepticism was warranted once, but suggest that in the current climate he is irrelevant, a casuality of scientific progress.

Sadly, Laing invited this kind of posthumous dismissal. Moreover, the controversies he ignited, and the uniqueness of his approach, have effectively prevented others from following in his footsteps. For unlike most of his critics, who employ standard empirical methodologies, Laing's work was rooted in phenomenology, a philosophical perspective which stresses the existence of a world of immediate or "lived" experience that precedes the objectified and abstract world of natural-scientific inquiry. The purpose of phenomenological inquiry is to illumine the most intimate interstices of experience in a descriptive fashion, rather than to explain it in causal or naturalistic terms. This emphasis on painstaking fidelity to experience is not an irrationalist exercise, a sweeping subjectivism, or an undignified surrender to the arbitrary whims and parochial perspectives of particular observers. On the contrary, claim phenomenologists, rigorous phenomenological research can clear away all that rubbish, and yield surprisingly robust results (Husserl, 1934; Husserl, 1938).

Laing was the not the first to study schizophrenia phenomenologically. He was merely the first -- along with Aaron Esterson -- to study the families of people with this diagnosis in this way. But Laing's approach was different from his predecessors'. According to Karl Jaspers, Ludwig Binswanger and their followers, mainstream psychiatric methods for classifying varieties of mental disorder can be revised, re-interpreted and deepened through phenomenological inquiry into psycho-pathological states and processes (Jaspers, 1913; Binswanger, 1963). Laing's position was much more radical. According to Laing, any system of psychopathology (and its accompanying taxonomy of mental disorders) entails a host of normative and theoretical preconceptions which becloud the clarity and immediacy of experience that phenomenology is intended to achieve (Laing, 1960; Laing, 1964a). For the sake of clarity and consistency, then, Laing advocated recourse to Husserl's epoche -- the bracketing of all beliefs and preconceptions embedded in the "natural" or "scientific" attitudes -- when dealing with deeply disturbed patients. And like Dilthey, he sought to understand their behavior in light of their experience and intentions toward the world (Dilthey, 1989), without assuming beforehand that their ideas or experiences are the result of pathological agents or anatomical lesions or deformations, and without imputing the existence of unconscious mechanisms, e.g. projection, denial, regression, etc., to account for their experience or behavior.

Unfortunately, Husserlian phenomenology is monadological, and only designed to elucidate the operations of one consciousness at a time. This was not problematic at first, since most of the clinical material Laing used in his first book, The Divided Self, was derived from individual psychotherapy cases. However, in the final chapter of The Divided Self -- the case of "Julie" -- Laing was already chafing against the constraints of this individualistic approach. Accordingly, he leapt outside this individual framework to study the relationships between Julie, her mother and sister in vivo . To elucidate the context in which Julie's delusions become intelligible -- i.e. why she claimed her mother was trying to murder her, or indeed, already had -- Laing could no longer treat significant others as imagos or intentional correlates of the patients mental operations. Laing had to study the family's experience of Julie, as well as her experience of them. More precisely, Laing had to describe the experiential substrate which prompted the shifting characterizations of Julie as "good", as "bad" and as "mad" that eventually landed her in hospital, (terms employed by Gregory Bateson et al.) As a result, this chapter reads like a preliminary sketch for Sanity, Madness and the Family -- and a brilliant sketch it is.

In short, by 1960, Laing already realized that he required a method that is transpersonal or inter-experiential, and had to search beyond Husserl and Dilthey for a firm theoretical foundation. Laing took two steps in this direction in his next book, Self and Others, where he borrowed an algebraic notation developed by Martin Buber to map the curious counterpoint of experience, fantasy and communication between two people in conversation (Laing, 1961). And toward the end of this same book, in chapter nine, Laing took Bateson's "double bind" hypothesis on board, albeit with several important modifications.

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"Families, Phenomenology & Schizophrenia in
R.D.Laing", Nov. 3, 1998.
Center for the Philosophy of Science
817 Cathedral of Learning, University of Pittsburgh


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