Thank you all for your moving comments on my modest thoughts about friendship and community. MadinAmerica is truly a community of friends and I am so grateful for this wonderful forum where we can talk to each other in this way! Love to you all . . . Report comment
Thank you all for your moving comments on my modest thoughts about friendship and community. MadinAmerica is truly a community of friends and I am so grateful for this wonderful forum where we can talk to each other in this way!
Love to you all . . .
Michael, I want to thank you for a most thoughtful and erudite article comparing Szasz with the Epicureans. I agree with your assessment of the three traditions of conceptualizing “mental illness,” and thought you summarized the similarities between Epicurus and Szasz brilliantly.
I also agree that, though Szasz has been very influential with a small number of critics of psychiatry, most of whom, I suspect, belong to MIA, his message has fallen on deaf ears in the world of psychiatry, the media, and the popular culture, despite the correctness of his message. It is a pity that some of the readers of this blog misunderstood your article as an attack on Szasz. Perhaps putting the word Szasz and failure in the same sentence was apparently too much for some of his followers to entertain?
You raise some excellent points, in an admittedly provocative way, that warrants serious consideration. I find interesting, for example, the point you raise about Szasz’s views on freedom and whether this is the same as autonomy. Szasz was a Libertarian and detested communism and anything even remotely smacking of liberal politics. This is a pity because it severely limited his influence, since it is preciely those liberals who are most invested in more humanitarian treatment of people wrongly diagnosed as mentall ill. Szasz’s notion that we are all responsible for our actions, as well as our mental states, is also problematic. Yes, we are all responsbile for who we are and the sense we make of the world, but we don’t all act in a responsible manner. Some people need help, but that was not Szazs’s strong suit. He was more invested in dismantling psychiatry than in cresting humane ways of helping people in dire straights.
That seems to me to be his greatest failing – dare I usse that word? Many of Szszs’s views about psychiatry are similar to those or R. D. Laing, with whom I worked for many years in London. Despite all of Laing’s efforts to fight the encroachment of instituional psychaitry into our lives, he also failed to accomplish what many of his followers had hoped for, a realistic alternative to psychiatry. It is a sober activity to look upone those whom we see as our champions and recognize they, too, have feet of clay, and that there are important reasons why “good” ideas sometimes “fail” – or at any rate do not succeed as quickly as we would hope.
Both Szasz and Laing went out of their way to offend people. Neither were very likable human beings. That is their right. They took no prisoners and devoted their lives to helping people who are the real victims in our society, those who are temporarily so vulnerable that they are at the mercy of the ultimate authorities in our culture, for lack of a viable alternative. The principal weakness of Szasz’s message was that he did not really offer an alternative to the system currently in place. When Italy decided to close down all their mental hospitals without an alternative to replace them with, they were suddenly confronted by thousands of people in mental distress that had nowhere to go to for help. The state ultimately set up “traveling hospitals” that went to the homes of those in acute distress and adminstered ECT to them in their homes! Hardly an improvement over what they had before.
To me this is the main reason Szasz has had little impact on mainstream society. The other reason is the one you so astutely explain, that also explains Laing’s marginal impact, that for the most part very few people want to take responsibility for their lives and prefer to blame their problems on “sufferng from mental illness,” for which they can be medicated out of their senses. To forgo medication is not a fun experience and requires weathering unvelievable anxiety until such feelings abate or can be accepted. It may also require psychotherapy, an expensive alternative. Given the choice, most people opt for psychiatric treatment. The scandal in our culture is that we don’t offer alternative, Soteria-like places for people to go to, IF that is their choice which, for most, would not be.
Thank you for your beautifully written, though-provoking article. I hope it encourages more of the same from this readership.
I agree Joanna. Steve is an old friend of mine from my days in London and is one of the loveliest human beings I have ever known.
Thanks Frank. Yes, they were ready to lock Jerome up and throw away the key.
Hear hear, Tom!
Thanks Tom. I agree, our protocols of labeling people psychotic or neurotic often make absolutely no sense at all. It may have just been Jerome’s singlminded insistence on being in his room that looked psychotic to others. Let’s not forget, however, that he would have died had we not fed him. The refusal to communicate even with those you have turned to for help is at the least extreme behavior. Is it psychotic? It’s hard to say what that even is. . .
Yes John, precisely. That’s exactly what good psychotherapy or psychoanalysis is, not trying to change people but just simply trying to understand them.
Szasz viciously attaked Laing in an article published in the mid-1970s in a British magazine where he accused Laing of being a communist because the houses he was running were “communes”! Szazs also said that anyone who advocated therapy – even a household where no therapy was taking place, but was arguably a “therapeutic” experience – was just more of the same psychiatric treatment of “illnesses” that don’t exist. The article was full of factual errors along with his diatribes against all forms of therapy. I understand that Szasz modified this position later and allowed that psychotherapy can be useful, but he never ceased his relentless attacks against Laing, his use of LSD, alcoholism, etc. I met Szazs years later at a conference in Florida and he was just as unpleasant in person as he was in print. I know he has become an icon of the alternative to psychiatry movement for his advocacy against psychiatric institutionalization, but I can’t say I admire or think very highly of him.
Thank you Alex. I really appreciate you comment.
Thanks Chrys! And sorry if I offeded you about my comment concerning the British weather. My analyst, who was also Scottish, told me that he loved the rain and only got depressed when the sun was shinning. I think he was pulling my leg, as I was yours!
I couldn’t agree more. American culture in particular is obsessed with safety and is intolerant of anything that seems strange or unfamiliar. Britain is a comparatively tolerant society that has always valued eccentricity, so it’s no accident that it was on the UK where Kingsley Hall and it’s offsprings were able to flourish. We value freedom – as long as it happens somewhere else!
Seth, where do I begin? I don’t intend to respond to all of your voluminous comments, many of which are repeated over and over, but I do want to address what appears to me to be the basic conflicts between our perspectives. I hope that in responding to you I don’t elicit another flood of commentary from you! I know you’re a writer, as am I, but I don’t believe that blogs of this nature were designed to accommodate dissertation-size commentary. Remember what E. F. Schumacher said: small is beautiful.
First I want to say that I appreciate that you and I share a high opinion of Laing and his work, and I also appreciate your comments about Szasz, and I believe we are in basic agreement about the relative merit of both Szasz and Laing’s work.
Some of the things I want to say pertain to our different outlooks and what it means to be mad or crazy; my other comments are to correct some of your assumptions about Laing’s position on these issues.
From your comments I take it that you and I come from polar opposite positions as to how we define the word crazy. You not only reject the concept of psychopathology, you also reject the concept of madness, for all intents and purposes. For you the mad person is someone embarked on a metaphysical journey, is not “psychotic” or “schizoid,” but is rather in some sort of enlightened state of becoming, what Grof calls a spiritual emergence. By this definition, no one is crazy in the conventional, psychiatric or psychoanalytic way of understanding this term. This is an amazing position to adopt and one that I propose is patently impossible to support. I know far too many crazy people who are not going through a spiritual experience and who are suffering from acute terror and fear of other people, much as Laing describes in THE DIVIDED SELF. I myself have been one of these people.
I, on the other had, believe that everyone is crazy, to varying degrees, including myself. When I’m feeling crazy I don’t experience this as something spiritual or wonderful. I am either feeling way more anxious than I feel comfortable with, or depressed, gloomy, and so on. On the other end of the spectrum, I sometimes feel very excited, impulsive, and dangerously unpredictable and my judgment is not all that reliable. I’m not feeling bad when I feel this way. On the contrary, it feels wonderful, and in the moment I don’t recognize this as a manic or hypomanic moment. Only in hindsight do I realize that I was really out there, and hopefully I didn’t do or say something that I will come to regret. Many of the people I see in therapy have the same range of psychological states, and they find therapy a very useful venue in which to gain greater self-awareness. They find the relationship as supportive and value having someone to talk to. Whether I think of them as neurotic, schizoid, paranoid, depressed, manic, or what have you, I’m not “treating” anyone for their “psychopathology.” But I do recognize those aspects of their coping style as to varying degrees “crazy”, as do they, and our hope is that their crazy responses to their anxiety and the bad judgments that sometimes arise will diminish over time.
I agree that conventional psychiatric treatment is terrible, and I have devoted my career to seeking and offering alternatives to that. I applaud your political efforts to help people avoid hospital incarceration and drug treatment. For me personally, I think I can be of more help by offering a kind of therapy, to those who want it, that is not overbearing or exploitative, but sympathetic and compassionate. I make no apologies for that.
As for Laing, I can see that you have studied his work very carefully and that he has had an important impact on your work. I have also studied his writings carefully. However, as I stated in my recent blog about antipsychopathology, my remarks were only partially based on Laing’s writings, specifically THE DIVIDED SELF. Most of my comments were based on my personal relationship with Laing and the conversations we shared together over a period of nearly twenty years. I was not only a student of Laing’s, I also worked for him as his administrator at his organization, the Philadelphia Association, and in that capacity I was his right-hand man for seven years. I served as the gatekeeper through which people were either admitted or refused permission to see him. I represented Laing to groups he did not have the time or inclination to see, and I kept him abreast of those meetings and what transpired. In effect, I was his eyes and ears to the outside world. I also lived in one of the post-Kingsley Hall therapeutic communities, Portland Road, for four years. (I intend to write another blog soon describing some of my experiences there.) I’m saying all this to impress on you that I needed to have a perfect understanding of Laing’s position in order to represent him and his ideas to others. Though that relationship ended in 1980 when I left London and returned to California, I continued to see Laing on a regular basis for the remaining nine years of his life on his many visits to California, during which he was often my house guest. During those visits we spoke about his current writing, thinking, projects, etc. He was also quite eager to know what people thought about him.
So you took this one comment in a new preface to THE DIVIDED SELF where Laing says he was speaking too much about “them” and not enough about “us” to imply that he had completely rejected what he had written in TDS and disowned it, in favor of the position represented in THE POLITICS OF EXPERIENCE. This is simply wrong, but I can see how someone might be inclined to interpret it that way if they wanted to. I can assure you that up to his death, Laing believed that TDS was by far his best book and the one that his legacy would be built on. This was the reason I focused on it in my blog. That may be hard to take in, so I will try to explain why he saw it that way.
It’s true that Laing’s ideas developed further after SELF AND OTHERS was published in 1961. During the period that he was writing the articles that would eventually be published in TPOE Laing was incorporating the work of the Palo Alto group and other American family therapists, such as Russell Lee, into his thinking. His research at the Tavistock with Aaron Esterson was also an important source of new thinking. When he put those essays together into a book in 1967 Laing had opened Kingsley Hall and was treating some of the residents there whom he was seeing in therapy with LSD. (Though this has never been published, he gave a series of talks at the William Alanson White Institute in NY about his work at Kingsley Hall that was nothing short of amazing. A colleague of mine and I are currently hoping to edit these lectures and have them published.)
Laing told me that when he wrote TPOE he was angry and that showed in the polemics of his diatribe against “the system”. The book was partly inspired by Nietzsche’s THUS SPOKE ZARATHUSTRA and Freud’s CIVILIZATION AND IT’S DISCONTENTS. Though this book was his most famous and widely read, Laing also realized that he had alienated many people in the mental health community who were offended by some of his comments, which he regretted. It was in this book that he talked about schizophrenia as not a mental illness, but a potential transcendental voyage of discovery and self healing. You have obviously been very influenced by this thesis, as was Stan Grof when he developed the Spiritual Emergency Network with his wife, Cristina.
When I arrived in London in 1973 to work with Laing, the madness-as-mystical-voyage metaphor was still in full bloom. We were all open to looking at what people were experiencing without judgment or presupposition. No one was medicated and no one was being “treated” for anything. The position was, as Laing liked to say, live and let live. The only time anyone was compelled to leave was when they tried to kill someone. I was nearly killed on three different occasions by three different people during the four years that I lived there. So you see, some crazy people can indeed be quite dangerous, just like sane people.
After some 500 people had passed through Kingsley Hall and the many subsequent houses that were operating in London, we arrived at certain conclusions about whether so-called psychotic episodes can be viewed as transcendental voyages. The so-called 14-day voyages that Laing wrote about and that I personally witnessed many times did not necessarily result in no subsequent breaks, voyages, or whatever you want to call them. Many of them came back a year later wanting to do it all over again. Though there was no formal treatment at these houses, except, perhaps, for “conversations” that the person responsible for the house – always, like Laing, a therapist – had with the members living there on regular visits, Laing believed that it was desirable to be in individual therapy while living in one of these houses. Most people did, though some chose not to. We began to realize that the 14-day voyagers were experiencing a manic episode, and when they emerged from it they were their “old self” again. We suggested this would be a good time to go into therapy and get to the bottom of what that experience had been about. Some did, but most chose not to, and many of them repeated the same yearly cycle, over and over again, with no insight into what was going on with them.
I believe that psychotic breaks are an attempt at self-healing, which is why I don’t think being medicated out of it is useful. Some people come through this more or less healed, but it has been my experience that for most people this is where their work begins, not ends, and I firmly believe that therapy with the right person can be enormously beneficial. I don’t know what to say about the spiritual aspect of this experience. The word, spiritual, is too vague for me. It can mean anything you want it to. One of the men at Portland Road who tried to kill me was convinced that Jesus Christ was commanding him to. I think some people are more spiritual than others, and some of these people have psychotic breaks. These are beautiful people who wouldn’t harm a fly, and I love them. On the other hand, some people who are in the throes of a violent manic episode believe they are having a spiritual experience, but I seriously doubt that is the case. These things are complicated.
All I want to say Seth, is that I respect your position as I hope you can respect mine. We are free to disagree about this or that and I don’t hold that against you, and I hope you don’t hold that against me. Laing was a wonderful, complicated man capable of extraordinary compassion and insight and honesty. He could also be a real prick and trouble-maker, and I loved him for that too. He was like the juvenile delinquent that all the other high school kids protected because they recognize that he is acting out their own impulses, and is willing to carry the load and pay the price for his outrageous behavior. I have never known a more courageous and fascinating human being, and I miss him terribly. I wish you could have been at the R. D. Laing Symposium that I and other former colleagues of Laing’s convened recently at Wagner College on Staten Island, NY. It was a festival of love, where some 80 people gathered to give papers and share stories about our relationships with him. It was such a success that we are planning to have more, perhaps at Esalen, in the next year or so.
I hope we can live with our differences and be friends. I think you’re a very good person doing wonderful work. Perhaps sometime we can meet and get to know each other.
All the best,
Thanks Matthew, and Michael!
Thank you, bipolarORwakingUP! I don’t mind the fall-out, these are tender subjects and not so easy to communicate with each other about them with a common language. I have finally found to time to respond to some of Seth’s comments, though, in case you’re interested.
And more blogs are on the way!