Book Review: Dialogues on Madness and Wisdom: In Conversation with R. D. Laing

Having recently read the first eight books written or co-written by R.D. Laing, I was not sure I would get much out of reading this Vincenzo Caretti interview, Dialogues on Madness and Wisdom: In Conversation with R.D. Laing, but, in fact, this little eighty-one-page interview had a lot to give. There were, for me, new ideas to stimulate me and a reworking of some of his older ideas. One does not expect new books to appear from a great master long after they have died, so for me it had the air of excitement of the album released after Tupac's death! It felt like Laing was speaking from beyond the grave!

The interview happened in English in 1978 and was translated into Italian at the time, readily available to Italian speakers but never been distributed in English. The English original no longer existed, so Danilo Serra had to translate it back into English from the Italian, finally enabling it to be available to an English-speaking audience.

Unlike the previous books I have read, this interview gave me a better feel for Laing as a person. In his books it has felt to me that he has been very careful to maintain a professional front, but this 'front' (or to use Laing's language, 'false self') was less prevalent in Dialogues, and I felt I was getting to know the man behind the mask. However, there were moments when Laing moved into impression management over such topics as his LSD use and his role as a father. When the interview took place, Caretti was a young man, at the beginning of his career, whilst Laing was in his fifties, so maybe Laing didn't feel the need to prove himself quite so much to this young protégé, resulting in a relaxed and informal interview. Caretti asked some very clever and insightful questions, to which Laing gave very full and detailed answers, although Laing did on occasion go off on a tangent and not really answer the original question.

In the interview, Laing appears to concede less influence from Sartre and existentialism, and more influence from Jung, psychoanalysis and Buddhist teachings, but this may reflect the interests of his interviewer and the questions asked. There are, however, comments that I felt echoed Sartre, such as when he argues, "I may need to destroy some of [the world] to make room for myself" (p9). In 1978, it seems Laing was blending psychodynamic and Buddhist principles, and was sending his patients off to Japanese Zen masters to practice meditation.

The contents of Dialogues includes whole chapters on Freud and Jung, plus he discusses the impact on him of Buddhist and Zen teachings, as well as talking about his early philosophical and phenomenological influences. Laing argues that psychology starts with phenomenology; he talks about LSD; natural childbirth; rebirthing; faith; music; woman in patriarchal society; young people; historical materialism; science; empathy; bereavement; interpretations; Oedipal complex; threat of castration; dream analysis; therapist intuition; language; and time, as well as the expected topics of schizophrenia and the family. In other words, I think there is something for everyone.

I will focus on a few of the things that I found particularly interesting. For example, there is a really interesting section in which Laing talks about the different psychoanalytic schools, and argues that there is not a single factor that all the different schools agree on. I had always assumed, without really ever thinking about it, that all the schools would agree on some factors, but Laing argues that there isn't a single factor that is not controversial for one of the schools. For example, the interpersonal psychoanalysts, such as Sullivan, reject object relations theory; phenomenologists, such as Medard Boss, see the notion of the unconscious as problematic; and "even Freud changed his opinion several times on several important questions and vacillated on others" (p20). Laing sees psychoanalysis "as a stroke of genius" (p20), but argues that if a group of analysts from different schools analysed the same client they would come up with diverse formulations, "and the dividing lines between all the different schools…would emerge" (p22). Likewise, with dream interpretation, one analyst may interpret a dream as reflecting an intra-psychic state, whereas Laing may interpret it as reflecting an issue in the relationship between therapist and client. To resolve the issue, one could ask the client to confirm or deny their therapist's interpretation but the client may either pseudo-agree to please the therapist or accept the interpretation because the analyst has said it is so. On the other hand, if the client disagrees, the therapist may decide that this refusal reflects resistance. Either way the therapist can conclude they are correct even when they are not. Laing worries about therapists relying too much on their intuition about a situation, as the therapist's intuition may not correspond to the reality.

There is a wonderful discussion of love, where Laing differentiates between two types of love. Firstly, love where one sees "the essence of the other as the other is" (p40), where one really knows the person that one loves. Secondly, a type of love that is about desire, wanting and utility, where "I have no particular interest in the person I desire, since what matters to me is the satisfaction of my desire" (p40) or the utility of the love object. However, he goes on to argue that "if love and desire merge with complete reciprocity…then the concrete possibility of a perfect marriage is created" (p41) and later talks about how a couple "can become one" and that this "is Paradise, or at least one of the closest experiences to Paradise that I can imagine being possible" (p74). This belief in perfection, becoming one, and a sexual relationship as Paradise on Earth, may explain why Laing struggled to maintain his relationships with women, as this, to me, suggests he was clearly trying to obtain the unobtainable.

Laing's stance on the Oedipal schema was new to me. Laing stated that he agreed with Deleuze & Guattari's (1971) conclusion that this schema "does not represent the way our spirit acts when it is uncorrupted and unafraid", and further, Laing argues that he is "convinced that what Freud proposed as a canonical schema, as a normative model, is in fact a special case of a perverse relationship" (p47). Laing takes a similar view of Freud's theory on the fear of castration, arguing that a fear of castration "is a particular example of a set of possible transformations that have to do with the limitations of our power" (p48), and says that, "We should construct a multi-dimensional diagram capable of highlighting all the different possibilities of the theme of castration" (p49).

For me, Laing's greatest life-time achievement was the way that he took a leading role in the movement that changed forever the care of the mentally ill. The demise of the old Victorian mental institutions would not have happened nearly so quickly without Laing, nor would the move away from lobotomy and electric shock treatment. It was completely revolutionary to consider that the behaviour of someone with schizophrenia make perfect sense as a response to their social context and experience, and I would urge anyone who is interested in the role of the social context in schizophrenia to read Sanity, Madness and the Family (2017 [1964]) by R.D. Laing and Aaron Esterson. In the Sixties, Laing emphasised this role of social context, in particular invalidation and the double bind, as significant in the development of schizophrenia in both Sanity, Madness and the Family and The Divided Self (1969 [1960]). However, in the Caretti interview, Laing reverses what I took him to have implied in these earlier writings, that is that schizophrenia could be caused by a response to the family milieu. In Dialogues, he emphasises the role of organic pathological processes. Laing states, "I have always been keen to emphasise that I have never put forward the hypothesis that the family or perhaps society, causes schizophrenia", rather schizophrenia is "a medical diagnosis that makes its appearance only when a doctor in the role of psychiatrist looks at another person and sees in his conduct…the manifestations of some organic pathological process" (pp42-43). Yet, in Dialogues, Laing also maintains that the diagnosis of schizophrenia is a hypothesis, as the existence of the organic pathological process has not been proven, but that "the medical diagnosis of schizophrenia coincides with the hypothesis that such a process is there waiting to be discovered" (p43). In contradiction to the biological basis of schizophrenia, Laing continues to maintain in Dialogues the intelligibility of the supposedly unintelligible behaviour of schizophrenics.

"And that once one begins to understand, the fact that such intelligibility is not noticed seems increasingly strange. One is then led to think that either psychiatrists deny what they see, or they look in a particular way that precludes them from seeing" (p44).

Laing also continues to argue that a change in the organic state can be due to social factors: "A social situation can therefore affect my physical being, my organism, my chemistry and the functioning of my nervous system" (p43). The family, of course, plays a key role in the social context. To me, it seems that there are inconsistencies in Laing's arguments and that it could be argued that Laing himself is putting forward a 'double bind', that is, stating two things that are incompatible; on the one hand, he firmly says that the family does not cause schizophrenia but rather it is an organic pathological process; but on the other hand, he continues to argue that schizophrenic behaviour is determined by the context and that social factors can change the organic state. Laing concludes, "Considering the context in which they live, that confusion [of mental ill health] is an internalisation of that context and a response to it" (p44). In The Politics of Experience (1967: 118), Laing states: "The madness of our patients is an artefact of the destruction wreaked on them by us, and by them on themselves."

I think there is a second historical reversal, this time in relation to Laing's personal history. In the interview with Caretti, Laing makes much out to be a great father: "My view of families is that they are, as the family system, the best social group known to me. I detest the idea of the dissolution of the family system of couples" (p38) and "I retain…the sense of a family ideal and try to make it operative in my own family life. Personally, I have not turned my back on the family" (p39), and he complains about the fact that "Parents seem to be losing the sense of connection between themselves and their children, and I find this very sad" (p38).

For me, Laing's statements have more in common with narcissistic idealism than with the reality of Laing's life. In R.D. Laing: A Life (2006: xxi), his son Adrian makes it clear that Laing was not a good father at all. In fact, Adrian even goes as far as to say, "my relationship with Ronnie has greatly improved since his death". Adrian reports that Laing chose not to see his children for two years after his parent's separation, and hardly at all for the rest of his childhood. Sue Stinkel (1997: 213), the mother of Laing's ninth child has stated: 'Ronnie said to me 'Mothers are there in space, fathers in time', a very existentialist comment falling on very tired ears (ears that had been up all hours of the night and day with a small baby.)'

Despite these two areas of apparent reversal of reality, I would wholly recommend Dialogues on Madness and Wisdom to both the Laing novice and the serious scholar. Laing is always interesting and challenging; he makes one think, so embrace what is inspiring and helpful, and reject what is not, which for each of us will be unique.

Claire Phoenix

References

Deleuze, G. & Guattari, F. (1971). Anti-Oedipus: Capitalism and Schizophrenia. Minneapolis: University of Minnesota Press.

Laing, A. (2006). R.D. Laing: A Life. Gloucestershire: Sutton.

Laing, R.D. (1969 [1960]). The Divided Self: An existential study in sanity and madness. London: Tavistock Publications.

Laing, R.D. & Esterson, A. (2017 [1964]). Sanity, Madness and the Family. London: Routledge.

Laing, R.D. (1990 [1967]). The Politics of Experience and The Bird of Paradise. London: Penguin Books.

Stinkel, S. (1997). In Mullan, B. (ed.) R.D. Laing: Creative Destroyer. London: Cassell.