The Crucible of Experience: R.D. Laing and the Crisis of Psychotherapy
Cambridge, Massachusetts: Harvard University Press, 2000, 168 pp.
$Cdn 41.50 cloth (0-674-00217-2)
Insanity is wisdom, the normal is obscene, the family is hell, mental illness does not exist and modern society is alienated to its very core. Familiar ideas from the radical New Left of the 1960s, and few intellectuals articulated this critique of the mental health professions and modern society as eloquently and directly as the Scottish psychiatrist and writer R.D. Laing. Few authors, moreover, have been as controversial within the mental health professions, while retaining a hold on the imagination of social critics concerned with the relationship between psyche and society. It would be easy to dismiss a book on Laing as an academic period piece for an aging Woodstock generation unwilling to let go of its intellectual icons. It is the measure of success of the intellectual historian Burstons newest book that he manages to write about Laing and his ideas in ways that illuminate rather than simply rehash debates from the sixties. Laing was a frustrating even infuriating theorist, but his ideas hit chords that will not go away for anyone committed to thinking sociologically about issues of mental health.
It is not difficult to understand why Laing has been so controversial. Burstons earlier book The Wing of Madness: The Life and Work of R.D. Laing (Harvard: 1996) outlined biographical details that must give one pause about Laings professionalism, emotional stability and judgment. Today, one can not credibility defend Laings militant opposition to biological explanations of mental illness, his often strange even irresponsible clinical practices, his irrational and blinding hunger for fame, his rather questionable personal ethics and behavior, his adherence late in his life to rebirthing therapy and his excessively shrill critique of the family and modern culture. Burston raises the level of debate about mental health in modern society by acknowledging the irresponsible even bizarre aspects of Laings legacy while insisting on the continuing relevance of his ideas in light of the inability of modern psychiatry to think sociologically and critically about the concept of normality as well as the one-sided dominance of the medical model in mental health. Burston is an intellectual historian with a sociological eye. The Crucible of Experience will be of interest to sociologists of mental health, sociological theorists, clinicians and general readers concerned with the legacy of the 1960s.
Revisiting Laing allows us to reexamine many of the core issues sociologists and intellectuals must confront when thinking critically about psyche and society. Is the contemporary family a haven of love and support in a heartless world of commercialism and individualism? Or is the family central to the reproduction of gender inequality and oppression, and a source of violence, abuse and irrational authority? Is madness a mental illness, understandable in terms of the natural sciences and curable within a medical model? Or is insanity socially and historically constructed, and best understood through the insights of art, philosophy and literature? Is being normal in modern society a desirable quality? Or is adaptation to an irrational and unjust social order a sign of reduced mental health according to criteria rooted in an understanding of human nature and psychology? Should psychotherapists take political stands in relation to the society in which they work? Is helping patients adapt to society a political stand itself? What should one make of the recent decline of psychoanalytic therapies and the rise of drug based mental health treatment? Has Freudian therapy died a natural death, a demise justified by its sect-like structure and unscientific grounding? Or is the rise of drug-based therapies a move away from the humanism of Freudian theory as well as a capitulation to the logic of insurance companies, a consequence of a modern culture concerned with quick fixes and a victory for pharmaceutical companies fixated on profits? Was the radical thought that came out of the 1960s a needed challenge to the intellectual orthodoxies of the modern European and North American middle class? Or did much of 60s radicalism lead to the rejection of all authority, the collapse of core values of Western civilization and the justification of irrational and childish behavior rationalized as radicalism? It is striking how many of these issues Laing spoke to with passion and insight, even if not always with good sense. Burston does an excellent job of reminding us of the details of Laings life and work, providing historical and philosophical resources for reexamining contemporary debates. The Crucible of Experience is a dense but well-written and very readable little book that leads to and illuminates as many important questions as it answers.
Burston does answer some smaller questions remarkably well, and the book can be recommended partly on that basis. Laing was born in the Govanhill district of Glasgow in 1927, and Burston provides us with a useful summary of Laings upbringing in a tension-filled family as well outlining the important details of his later life and career. Laing was a talented, creative, and musically and philosophically oriented young man who attained academic success with ease. By the age of 24, Laing was a captain and psychiatrist in the British army. Burston gives us a glimpse of Laings troubled relationships and marriages, his many children, his experiments with LSD, meditation and gurus, his successes and failures as a therapist and clinician, and his attaining of world wide fame with a series of best selling books that were often labeled (to Laings irritation) as part of the anti-psychiatry movement. As Burston puts it, at the height of his career, Laing was the most widely read psychiatrist in the world, reaching people across disciplinary boundaries and in all walks of life.
Burston also lays out the basic ideas of Laings important books such as The Divided Self (1960), The Politics of Experience (1967), The Politics of the Family (1971) and The Facts of Life (1976). Burston is a very careful reader, and his book gives us a detailed sense of the development, tensions and contributions of Laings theoretical writings. Laings early work was devoted to elucidating the dilemmas of the schizoid and schizophrenic patient. Drawing on Gregorys Batesons famous concept of the double-bind, Laing suggested that, in Burstons words, a patients bizarre ideas and utterances are often intelligible responses to the complex and contradictory messages, demands, and prescriptions imposed on them by others. Throughout the 1960s, Laing was one of the most articulate critics of the stance in which the clinician assumes a priori that he is a neutral scientific observer/classifier of an (irrational) patients speech and behavior. Laing would have agreed with Goffman, Burston reminds us, that much of mental health is not a collaborative search for truth but a degradation ceremonial.
Laing developed this critique at great length looking at families and schizophrenia from a phenomenological perspective. And in his most well-known book The Politics of Experience, Laing expanded this critique of normality in modern society to suggest, as Burston puts it, families, schools, and churches provide us with little more than systematic training in self-estrangement and inauthenticity a secular equivalent to the Fall. Later in life, Laing flirted with rather strange ideas about rebirthing therapy before dying of a heart attack while playing tennis at the age of sixty-two. Burston is a talented intellectual biographer, and he manages to place Laings work in the context of his troubled personal life, without reducing ideas to gossip. We live in an age of biography, but Burstons book resists turning Laing into either an intellectual hero to be worshiped or an icon to be debunked.
Burston has emerged as one of the most thoughtful, erudite and scrupulous scholars working in the area of the history of psychoanalysis and psychotherapy. Burstons first book The Legacy of Erich Fromm (1991) played an important role in creating new interest in the social theory and psychotherapy of German critical theorist Erich Fromm. This otherwise excellent book was sometimes marred, however, by its tendency to offer speculative psychological interpretations, inelegant writing and the books emphasis on biographical over sociological and historical factors in explaining the emergence and decline of Fromms theoretical contributions. Burstons writing and intellectual approach has matured, and both The Wings of Madness and The Crucible of Experience are first-rate pieces of scholarship and prose. A curious reader can get all the details one would need to know about the life and work of R.D. Laing in The Crucible of Experiences well-crafted hundred and sixty-eight pages of intellectual history placed in a thoughtful sociological context.
More importantly, Burston is theoretically and philosophically sophisticated and provides us with a useful introduction to phenomenological psychology. A Canadian trained in the Social Thought program at York University, Burston now teaches at Pittsburghs Duquesne University in a psychology department with a unique and historically important tradition in phenomenological approaches. Burstons philosophical grounding allows him to outline remarkably clear and concise overviews of the thought of Husserl, Heidegger, Buber and Sartre. The Crucible of Experience provides an enormously useful discussion of the links between the existential and phenomenological philosophical traditions and Laings existential psychology. In psychology, as in sociology, phenomenology and existentialism offer important counter-traditions to the scientific mainstream within the discipline. Stressing such themes as lived experience, intersubjectivity, contingency, fear of death, agency and meaning, the phenomenological and existentialist traditions provide a philosophical foundation for thinking about human psychology in ways that resist the excessively scientific and biological orthodoxy of contemporary psychology and the mental health professions. For theorists, sociologists and mental health professionals with limited patience for philosophical speculation, Burstons book is a compelling and mercifully concise reading of several of the leading figures in the phenomenological tradition. Burston both shows how Laings thought flowed from a dialogue with these thinkers, as well as suggests how this theoretical approach can provide tools to resist excessive quantification and scientism in the study of the human psyche and condition.
Existentialism is a diverse intellectual tradition brought together by its insistence that human beings share a basic structure of existence. At a time when difference is all the rage, existentialism reminds us that despite varied historical and cultural situations, and age, gender, class and racial distinctions, all human beings share a throwness, contingency, and the need to infuse or confer value and to impart meaning to life through action and decision, and thus take responsibility for their personal destiny. A related but distinct tradition, phenomenology emphasizes that there is a world of immediate or lived experience preceding the objectified and abstract world of natural-scientific inquiry. For phenomenologists, fidelity to the texture of human experience, through patient and painstaking description, should precede any effort at explaining the phenomenon in abstract or quantitative terms. Burston does a wonderful job of summarizing existentialism and phenomenology, laying out some of the important differences and similarities between the various thinkers in the tradition and translating the assumptions of these thinkers for philosophical amateurs like myself. Reading this book as a sociological theorist interested in micro social psychological theory, Burston illuminates why followers of Husserl and Heidegger tend to dismiss the Freudian concept of the unconscious. Burston does an excellent job of discussing the implications for psychological theory of the work of Max Scheler, Martin Buber and John Paul Sartre. We learn why Karl Jaspers is worth looking at for those interested in the links between philosophy and psychology. There are times when Burston seems more generous to these speculative philosophers than might be called for, especially given his biting critiques of scientific researchers in the mental health professions. And specialists in philosophy and phenomenological sociology will likely find much to quibble with and contest. But for this reader, at least, there is much in Burstons book that illuminates phenomenological and existentialist thought in relation to the concerns of contemporary social theory.
As useful as is Burstons biographical and philosophical guide to the thought of R.D. Laing, the central contribution of The Crucible of Experience flows from the larger questions it opens up for us. In retrospect, it would be easy to dismiss Laing as a kook and an extreme example of the irrationalism of the New Left. Events and dynamics in the world and the mental health professions today, however, suggest this conclusion would be what Burston calls a premature and smug triumphalism. Burston does not pull back from criticisms of some of Laings excesses, but he reminds us of the historical context in which anti-psychiatry emerged. Laing wrote in a period of electro-shock treatments and an unchallenged authority even authoritarianism of the mental health professions. The use and abuse of drug therapies has replaced confinement as the treatment of choice within the psychiatry, but the larger questions that Laing raises are as relevant as ever. There is a politics to therapy, and it cannot be understood simply as a technical and medical issue, despite the claims of some mental health professionals.
Within sociology, theorists such as Erving Goffman, Michel Foucault, Thomas Scheff, Dorothy Smith and various scholars of deviance have long been raising similar concerns about how definitions of mental illness can be socially, organizationally and politically constructed. Social critics and sociologists should be commended for contributing to the development of a skeptical attitude towards the power and authority of the mental health professions than existed before the 1960s. Reasonable questions can be raised about the rights and interests of individuals who do not fall within the definitions of normality laid out with such certitude in documents such as the American Psychiatric Associations Diagnostic and Statistical Manual of Mental Disorders. Laing must be understood as part of a larger tradition that has raised important questions about the social construction of sanity. The shrill anti-professional tone of Laing and other similar theorists seems outdated and was certainly unfair to the many dedicated mental health professionals who are attempting to do some good and as little harm as possible in the face of tragic psychological pain and suffering. There is no question that these theorists often went too far in their critique of the mental health professions. Contemporary historians and social analysts have raised legitimate questions about the negative consequences of these radical constructionists perspectives, but Laings work should remain an important part of these larger debates.
At the same time, social critics and social scientists need to be accountable for the consequences of theories and writings. Laing is to be commended for his courage in often taking the side of patients over psychiatrists and children over parents. But he was wrong to argue singlemindedly for the social and family causes of schizophrenia, an added cruelty and indignity to parents confronting a terrible condition. On this issue, and on others, Laing often did go off the edge. Burston is to be commended for addressing these questions so directly in his account of Laings work and influence, and sociologists should be willing to look at Goffman, Foucault and Smith with the same critical appreciation. Did Goffmans critique of the mental health professions in Asylums contribute to the de-institutionalization of mental patients, a process that some historians and social critics would argue lead to enormous suffering and social problems? Did Foucault, like Laing before him, promote an excessively negative even paranoid view of modern society that encouraged extremist politics and led to little positive social change? What if rhetorical strategies are not everything, and K really did suffer from emotional problems? I do not have the competence or the data to answer these questions, but we should follow Burstons account of Laing in considering these possibilities.
In addition, while Laings work should be placed in the larger context of these social analysts of mental health and modernity, his writings provide insights not available from Goffman, Foucault and Smith. Like Erich Fromm before him, Laing was somewhat unique in that he had extensive clinical experience while insisting on the importance of a structural, historical and cultural analysis of the societies in which the mental health professions are embedded. I would go further than Burston is willing to do in calling for a synthesis of the phenomenological approaches that Laing promoted with the more traditional social scientific methods he denounced. But Burston makes a compelling case for Laings core argument about the need for a theory and therapeutic practice that puts un-measurable qualities such as human hope, fears, evil and even spiritual well-being at the center of any psychological approach in the human sciences and helping professions. In times when institutions associated with major research universities withdraw job offers from professors who raise legitimate questions about drug treatments for mental health, a reminder of the courage and humanistic commitment of flawed but brilliant individuals like R.D. Laing provides a welcome addition to debates about the politics and sociology of mental health.