Reviewing Laing’s ‘Asylum’ in the Age of Neuroscience

| by | Categories: Commentary, Research

R. D. Laing and the anti-psychiatry movement have been undergoing a quiet revival in recent years. It began with Luke Fowler’s Turner Prize-winning film All Divided Selves (2011), which used lost footage of Laing and his therapeutic communities to create a poetic meditation on the mind’s potential for fragmentation. Last summer, Peter Robinson’s 1972 documentary film about Laing’s ‘clinic’ in Archway, London, Asylum, was released for the first time on DVD in the UK; this November, a play about Laing and his colleague, Marxist psychiatrist David Cooper, opened at the Arcola Theatre in London; and in 2016 we are promised a major biopic of Laing, starring David Tennant as a very different kind of doctor. Historians of psychiatry might ask what we should make of Laing’s rehabilitation (albeit one with a potential for caricature), following the steep decline in his personal and professional reputation during the last thirty years. Is the counter-culture of the 1960s and ’70s, within which Laing became something of a celebrity, now sufficiently remote, and politically exotic, to receive fresh treatment? Or is this reappraisal the product of disillusionment with neuro-chemical accounts of mental illness and their prescriptions? The recent debate about mental illness in the UK has focused on stigma in the workplace (implicitly equating mental health with economic productivity); are we now rediscovering the more challenging aspects of this earlier debate, where ‘madness’ is celebrated as social and political transgression? Reviewing Asylum, in the context of Laing’s radical psychiatric model and alongside a new commentary by participants in the film, sheds some light on why Laing is once again an object of our intellectual fascination.

 

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Laing’s interest in the type of schizophrenic community documented in Asylum had its roots in an early disillusionment with psychiatric incarceration. In 1953 Laing was the youngest psychiatric consultant in the country, administering conventional psychiatric therapies – insulin injections, electroshock and lobotomy – to schizophrenic patients at Glasgow’s Gartnavel Royal Mental Hospital. Interestingly, he was mentored there by David Henderson, who also taught Ewan Cameron, infamous for his later participation in the CIA’s MK-ULTRA mind control experiments from his base in a psychiatric hospital in Canada. Both Laing and Cameron emerged from a vibrant Scottish psychiatric research culture that was preoccupied with the aetiology and treatment of psychotic experience, and took diametrically opposed approaches to this problem, and its political applications, in their subsequent careers.

Laing, prodigiously gifted in music, literature and theology, had made an unusual and erratic medical student. After graduating, he grudgingly completed a two-year stint as a psychiatrist in the British Army, where he grew increasingly troubled by both the use of somatic therapies and his patients’ social isolation. Once employed at Gartnavel, and placed in charge of a ward of catatonic female schizophrenics, he created a ‘rumpus room’ – the seedbed for the later experiments in therapeutic community we see in Asylum. The rumpus room was a space in which patients were able to cook, knit, paint and converse freely with the nurses and doctors, where, as Laing conceived it, they ceased to be objects of physical, chemical or classificatory control. The benefits conferred on patients by this convivial environment later inspired Laing to create a completely new and unstructured model of therapeutic space. As former Archway residents make clear in the commentary on the recently issued DVD, by joining the household they entered into a utopian and anti-scientistic experiment in radical freedom. The residents freely contributed the raw biographical or experiential material, and the therapeutic and social outcomes – unmediated by psychiatric expertise – were highly unpredictable. Throughout the 1960s and ’70s, the anti-psychiatric movement struggled with the transition from a critique of conventional psychiatry to a praxis that combined liberty and self-expression with the need for therapeutic enclaves run by committed and compassionate personnel.

David Cooper coined the term ‘anti-psychiatry’ in 1967, although Laing always resisted the wholesale rejection of his profession that it implied. The British radical psychiatry movement, as we might alternatively describe it, revolved around Laing and owed much to the impact of his early work The Divided Self (1960). In this book, itself steeped in existential philosophy, particularly Sartre’s concept of ‘ontological insecurity’, Laing revealed himself to be something unique for his time: a philologist of schizophrenic discourse and a narrator of psychotic mindscapes. He went on to create controversial accounts of schizophregenic relationships in Self and Others (1961) and Sanity, Madness and the Family (1965). He recorded, and celebrated, one patient’s enlightening journey of madness in The Politics of Experience (1967). The title of this latter book expressed the essence of anti-psychiatric thinking: the parameters of psychological experience are defined by familial, social and political structures, then ratified and enforced by the psychiatric profession.

 

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The narrative power of The Divided Self, much like that of Asylum, lies in a central ambiguity. On the one hand Laing suggests a contiguity between ordinary “existential angst” , the ‘schizoid’ self and psychotic experience. On the other, he captures with unique lyricism the radical solitude, bizarrity of expression and perpetual sense of emergency inherent in psychosis. In The Divided Self, we also find Laing’s first suggestions that ‘sanity’ might be de-naturalized. In this context, Laing refers directly to the concept of mind control: “Psychiatry can so easily be a technique of brainwashing, of inducing behaviour that is adjusted by (preferably) non-injurious torture.” However, Laing’s primary interest lay in the ‘conditioning’ that occurred prior to the entry of the psychiatrist. The mental coercion that occurs in the interstices of personal relationships and family groups was his lifelong preoccupation, and in this sense he differed from other anti-psychiatric writers and practitioners, such as Goffman, Foucault and Basaglia, who focused on institutional structures of control. Laing’s own extraordinary receptiveness and ‘plasticity’, to use Gavin Miller’s phrase, in his encounters with patients, was also the essence of his therapeutics. He advocated attendance to, and where possible immersion in, the mental world of the ‘mad’ stranger, particularly his forms of verbal expression.

In 1965 Laing formed the Philadelphia Association with Cooper, Aaron Esterson and other radical psychiatrists. Their first therapeutic community for the mentally ill was based at Kingsley Hall in the East End; others, including the Archway House, soon followed. Their approach sought to be non-prescriptive, non-hierarchical and non-interventionist. Therapists and patients endeavoured to live together as equals, acknowledging their shared potential both for suffering and for therapeutic insight. In Laing’s words, these were true asylums, places of safety in which the aim was for schizophrenics in particular to be able to explore psychosis without fear of censure.

It was in this period, when Laing seemed at the peak of his intellectual, creative and professional influence that Asylum was made. In 1970, Peter Robinson filmed several short interviews with Laing in his home, and there gained permission to film life in the Archway House, on the condition that all residents agreed to the camera’s presence. After brief negotiations with several reluctant individuals, the film crew were encouraged to live within the community for six weeks and attempted to document, in cameraman Richard Adams’ words, “a world of magical ambiguity”. The dialectical relationship that emerged between filmmakers and residents is explored by Kenneth Robinson (Peter’s son), Francis and Wendy (former residents), Richard Adams and sound-man William Steele in their fascinating audio commentary. According to Wendy, residents remained sufficiently natural in front of the camera because “the house was already a laboratory, and the filming became a logical extension of that”. Some residents were openly hostile to the filming; others, like Francis, tried to make the film ‘happen’ by exaggerating their own idiosyncrasies. This raises the question of what we hope or expect to witness (transgression, degradation?), or to experience at an affective level (disgust, catharsis, compassion?) when faced with images of mental illness.

 

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It is uncertain whether the film simply captures a contingent, albeit compelling, group dynamic, or itself generates the performance of madness. The very notion of a complex ‘behavioural field’ which might be altered by the presence of a camera, family members or psychiatric ‘experts’, was central to Laing’s understanding of mental illness. Certainly director Ken Loach was impressed enough by this particular configuration of residents that he hired them as ‘authentic’ extras in his 1972 film Family Life, based loosely on Sanity, Madness and the Family. According to William Steele, the editing process also contributed to a clearer understanding of schizophrenic David Bells’s confusing speech patterns – through repeated viewings it became obvious to him that David was translating daily events into the history of the embattled Iceni tribe of Roman Britain (to take one example of David’s meta-narratives). This is also a reminder that, from the time of the celebrated nineteenth-century Parisian neurologist Jean-Martin Charcot onwards, the camera has been an important interpretive tool for many ‘psy’ professionals.

Asylum opens at dawn on an ordinary residential street in North London. We see the milkman and the postman – from this historical distance, benign agents of the post-war state – going about their business. Behind the front door of number 43, the camera pans along the hallway and stairwell, daubed with slogans and monologues. The kitchen wall has been knocked through with a hammer. A discussion is in progress about the entry of a new resident and Robinson closely observes the overlapping arcs of these various lives: how their psychic disintegration or quests for insight are often determined by group dynamics. The film crew themselves engage in the therapeutics of ‘attendance’, Robinson spoon-feeds one resident when she regresses to early infancy. We witness moments of support, conflict and desire, the unconditional affection of animals, conversations with neighbouring children, endless smoking. Meals are eaten standing up, out of tins, or in a circle around a great communal stew. There is very little furniture, for furniture defines the day’s activities too closely. This is a voluntary, ersatz domesticity, opposing itself to both the impersonality of the mental hospital and the strictures of the nuclear family. Biological family members make jarring appearances at several points, and in the course of the film, the family as institution is often dismissed as peripheral and sclerotic.

Perhaps it says something about what we demand from the ‘performance’ of madness that Archway’s apparently most unwell residents, Julia and David, are the most compelling participants in the film. Julia emerges from crisis into a kind of stunned lucidity, whereas David’s discourse remains urgent, intricate and illogical. His former life as an engineer manifests itself as a preoccupation with contraptions, structures and solutions to incomprehensible problems. In an example of how this film works as social and psychiatric history, MAD (Mutually Assured Destruction) often impinges on the madness of Julia and David. During psychotic episodes, both believe themselves to be pregnant with the atom bomb.

 

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Like Erving Goffman’s sociological study Asylums (1959), to which the film’s title nods, and Frederick Wiseman’s documentary about life in a US state psychiatric hospital, Titicut Follies (1967), Asylum promises at first to unpick the structures of madness and sanity. In Wiseman’s film the inmates, and those who detain them, occupy a range of seemingly arbitrary positions – rage, appeal, resignation – within an unyielding hierarchy of classification and control. In Asylum, we experience the very opposite phenomenon: classifications present themselves to the viewer in spite of the levelling of pathologies and power that have taken place. We are presented with a qualitative break between the culturally curious and the deeply unhappy on the one hand, and David’s impenetrable private world on the other. When David becomes physically aggressive towards other residents, it is clear that it is with him that the success of the community stands or falls. If psychosis can precipitate ‘deviance’, then psychosis also precludes the possibility of a community which can embrace all. Ultimately the group survives because it contains enough ‘sane’ ballast, represented by the therapists and the merely neurotic, embodied in a shared language. During a group meeting one resident, Lee, admits sadly that “it is possible to get lost here”. It is this refusal of hierarchy and expertise, this wilful getting-lost in what might be a hall of distorting mirrors, that remains a moot virtue throughout the film.

As to the film’s relevance to the current debate on mental health, several themes emerge. One thread in particular seems relevant to understanding the new-found fascination with Laing’s work. In the commentary, Wendy, now a therapist herself, remarks that we no longer attribute madness to familial or social dysfunction, as Laing did in 1972, because “we now have brain imaging”. In other words, because we can now observe synchronous changes in brain activity, visualizing the mad person’s ‘stigmata’ and attaching social meanings to them, no longer preoccupies us. Have we therefore replaced one form of picturing madness with another, more technocratic and arguably more impoverished, vision? The commentary concludes with a discussion of the concept of ‘attendance’ or ‘presence’ that is so central to Asylum‘s therapeutics – the capacity to be open, even in interpretive silence, to the mental sufferings of a stranger. The contrast between the nuances of therapeutic attention and the seemingly determinate meanings of brain imaging further sharpens my question: as a result of our somatic approach to mental illness and the rapid technological colonization of private space, are we losing this capacity for openness towards the heterogeneity of psychological experience? The logic of neuroscience, expressed in the functional imaging of the brain, suggests that all minds are equally readable by machine, and that the complexities of minds in social interaction are not as salient to understanding mental behaviour as the mechanisms of electrical current, chemical reaction and blood flow.

This is an age of both increasing social atomization – itself leading to an increase in psychiatric interventions – and psychological homogeneity, underpinned not only by the mediating presence of digital technology, but also by the affective flattening which is a well-documented side-effect of mood-stabilizing medications. Meanwhile, the politics of the ‘behavioural field’ have largely retreated from view. It is precisely what Asylum reveals about madness’s hidden relationship with social forms – as cause, construction or utopia – that gives us pause, and makes the film such a provoking historical document.

 

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