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PART 1
Structures: Psychiatrists, Institutions, Treatments
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1
‘I am no more mad than you are; make the trial of it in any constant question’1
R. D. Laing and the Figure of the Psychiatrist
In the opening act of Joe Penhall’s 2000 play Blue/Orange, two psychiatrists, Bruce and Robert, are debating the most appropriate response to, and treatment of, their patient, Christopher:
Robert: The human species is the only species which is innately insane. ‘Sanity is a conditioned response to environmental …
Bruce: I don’t believe you’re saying this …
Robert: … stimulae.’ Maybe – just maybe it’s true.
Bruce: Maybe it’s utter horseshit (Beat). I’m sorry. Doctor Smith. But. Which, which existential novelist said that? I mean, um, you’ll be quoting R. D. Laing next.
Robert: That was R. D. Laing.
Bruce: R. D. Laing was a madman. They don’t come any fruitier.
Robert: I think there’s something in it … 2
Bruce continues, with incredulity, noting that this is not what he was taught at medical school, and soon they will be donning tights and speculating about Hamlet’s various diagnoses if they persist with this line of thinking. Theatre is here tacitly cast as the frivolous emotional side-show in the real arena of hard, empirical science. There is also an implied swipe at psychoanalysis in general, and Freud in particular, owing to his (and others) engagement with canonical literature as creative case studies. The anti-intellectualism of Bruce’s voice here superciliously hums with the false bifurcation of the humanities and the sciences that will become a recurrent note of contention throughout this book. However, several ideas for this chapter are nested within this ‘fruity’ moment of Penhall’s perspicacious play: firstly, the ancient debate as to the origins and thresholds of the kingdom of madness; secondly, the long-standing joke that psychiatrists are often madder than their patients; thirdly, that R. D. Laing is a ‘crackpot’ relic of a bygone period in psychiatric history, best left to the arts students and their many tights. Penhall’s theatrical study of contemporary psychiatric discourses and practices also, in the course of its unfolding, raises the question as to precisely what a psychiatrist is and does. It is telling then that the play twice glances back to the twentieth century’s most controversial psychiatrist, Ronald D. Laing. Indeed, later an audience hears Bruce describe Robert’s work as ‘R. D. Laing in a gorilla suit.’ 3
Psychiatrists have long been objects of admiration and derision. They are simultaneously the guardians of the soul and peddlers of mesmeric claptrap, men of science and trick cyclists, carers and quacks. As Glen and Krin Gabbard write: ‘Their perceived omniscience is envied and feared, so mental health professionals must be continually ridiculed and put in their place to neutralise these negative feelings.’ 4 Nikolas Rose expounds upon such figures further, observing how notions of freedom and autonomy have become organising principles for the forging of modern personhood. Therapies thus offer strategies to help us become better at being ourselves: ‘Freedom, that is to say, is enacted only at the price of relying upon experts of the soul.’ 5 Frank Furedi likewise charts the ‘phenomenal expansion of psychological labels and therapeutic terms’ whose ‘main legacy so far is the cultivation of a unique sense of vulnerability.’ 6 Furedi here critiques notions including self-fulfilment and self-actualisation as forms of therapeutic governance, arguing that such a ‘therapy culture’ ‘posits the self in distinctly fragile and feeble form and insists that the management of life requires the continuous intervention of therapeutic expertise.’ 7 In these ways, some of our fundamental anxieties about what it means to be a worthwhile human huddle – needy but hopeful – around the compromised figure of the mind doctor. Think, for example, of the oft-encountered anxious jokes that abound when an individual discloses to a group that they are a psychiatrist or a psychologist. Feelings of admiration and suspicion mingle with dynamics of exposure and concealment. A medical Eye of Providence is thus apparently conferred to such figures (though notably not to their nursing counterparts, even though these actors in psy contexts very often see a great deal more and in different ways than the authoritative eyes). The mind doctor (in his plural guises) is thus a figure, culturally, of desire and dread. 8 What might be at stake, then, in our cultural remembrances of Laing? If the psychiatrist is a fiercely contested social, medical, political, and cultural figure at the best of times, what might we glean about ourselves and our attitudes to madness from examining a deeply divisive figure like Laing? This chapter will examine key artistic works about the late R. D. Laing in order to consider what they illuminate about his ideas and legacies. The chapter advances from a keen sense that we still have much to learn from this psychiatric ‘maverick’, for good and ill, and that close engagement with artistic practice offers a particularly apt strategy for this endeavour.
Knots
Adrian Laing describes the polarising nature of his father: ‘There tends to be very few neutral [opinions].’ 9 Indeed, for every declaration that ‘He was probably the most unethical person I have ever met,’ 10 one also uncovers unabashed adoration: a booking form from 1978 for his lecture at the Roundhouse bellows from the archive: ‘THE MAN HIMSELF IN PERSON!’ 11 Alongside this are the innumerable accounts by patients like Mary Barnes whose lifelong tune became a song of praise for ‘Ronnie’. 12 Moreover, Laing himself was a mesh of paradox and contradiction. As Daniel Burston narrates in his astute biography of Laing: ‘There is surely no one else in the history of ideas who has embodied the sceptical and the visionary modes of thought with equal zeal.’ 13 Certainly manifold tensions abound in the vast materials by and about Laing with respect to his theories versus his practices. Further, here is a man who both courts and abhors power, a man who clamours for professional respect and yet razes such structures of legitimacy to the ground. Yet, while he is a man fretted with flaws, he is also a radical and important voice in the field of madness and psychiatry. Burston proposes that ‘Freud and Jung continue to hold a firm place in posterity … Laing’s contribution to psychology and psychiatry – though different, of course, and distinctively his own – is possibly of the same order of magnitude as theirs.’ 14 I here concur with Burston and offer this chapter as a contribution to the burgeoning reassessment of Laing as a pivotal voice in twentieth-century psychiatry and mad politics.
Laing’s enduring legitimacy is somehow, however, less secure than the great grandfathers of psychoanalysis. This is perhaps in part owing to the obscuring impact of his lively personal biography as well as his later moves towards mysticism and intrauterine experience. Indeed, the personal lives of psychiatrists are often subject to marked scrutiny: and in seeking paragons of virtue, we don’t necessarily frequently find either gods or monsters. Laing’s precariousness as an important figure is also, without question, in part owing to the juggernaut second wave of biological psychiatry that throttles such alternative voices by force of its din. As we will see in later chapters, after DSM III (though not straightforwardly because of it) in 1980, the biomedical model of psychiatry and its ally psychopharmacology bulldoze the landscape of non-normative psychological experiences. Throughout the 1980s, 1990s, and 2000s in both Britain and North America, brain chemistry, drugs, and faulty cognition wholesale displace the ‘soft’ practices of talking, occupation, and community. This bio-domination is celebrated by figures such as Edward Shorter who proclaim that: ‘If there is one central intellectual reality at the end of the twentieth century, it is that the biological approach to psychiatry … has been a smashing success.’ 15 Indeed, Shorter lambasts ‘zealot researchers’ who have ‘seized the history of psychiatry to illustrate how their pet bugaboos – be they capitalism, patriarchy, or psychiatry itself – have converted protest into illness.’ 16 However, as Allan Beveridge has noted there has been a resurgence of interest in Laing in recent years after a period in the ...
