Are you Mad?
August 19, 2013
Psychiatric assessments are frequently not meaningful because psychiatrists tend to pay attention to behaviour to the exclusion of experience. Consequently, they fail to behave like medical men. A doctor does not simply observe his patients behaviour but asks their patients where it hurts to map out the nature and the extent of the illness. Psychiatrists who do not listen to their patients' experiences or who interpret these experiences symbolically instead of using them as information are not using the medical model.
The ideas of Psychiatrist R.D. Laing, fly in the face of traditional psychiatry. He developed a psychoanalytical model which sought to understand rather than to label schizophrenics and developed the idea that Schizophrenia is 'itself a natural way of healing our appalling state of alienation called normality'.
'Madness need not be all breakdown... It may also be breakthrough. It is potentially liberation and renewal as well as enslavement and existential death'.
It is not an illness to be treated but a 'voyage'. Socially, madness may be a form in which 'often through quite ordinary people, the light begins to break through the cracks in our all-too-closed minds'.
The difference between Laing and Freud appears to be that one "normalized" insanity while the other explained it and offered a model to treat it. For example Freud saw compromise as an absolute necessity for the growth of the individual. Laing equated that growth with false growth and a colluding functionalism which leaves us only the choices of withdrawal or persecution.
Mat Wilson mirrors Laing's views regarding insanity (abnormal society) and has coined the word, "psychotic dissonance" to clarify this process.
According to Laing, those of us 'outside' institutional walls are no more 'sane' than those inside, only more adept at manipulating our false-selves to provide a better defence and hence more capable of protecting ourselves.
In some respects, Laing appears to be saying that it is a more genuine state of mind to be psychotic than conflicted because the 'madman' is not a divided divided or 'masked' personality. Others have likened psychosis to a religious state of mind.
Laing's work is timeless because it dealt with the fundamental issues of human existence and his inclusive approach to analysis is illuminating because it replaces incoherence and confusion with comprehensibility.
As a psychiatrist, Laing informed us that he personally had a difficult time in detecting the 'signs and symptoms' of illness in psychotic patients because their behaviour appears to him meaningful and appropriate rather than odd and irrelevant, and he stunningly demonstrates what it means to understand patients as human beings rather than to classify them as instances of a disease. Laing demonstrated that utterances that strike some as being inconsequential ramblings can be seen as comprehensible responses to the immediate situation.
Laing's comprehensive approach is radical compared to traditional psychiatry. Treatment is not prescriptive. Instead of the degradation ceremonial of psychiatric examination, diagnosis and prognostication, we need, for those who are ready for it, 'an initiation ceremonial through which the pertson will be guided with full social encouragement and sanction into inner spavce and time, by people who have been there and back'.
The madness that we encounter in 'patients is a gross travesty, a grotesque caricature of that natural healing process of that estranged integration we call sanity. If psychiatrists really understood their patients they would see that their behaviour was a reflection of the natural healing process, a desire to explore the inner world.
Next: Is psychotic dissonance destroying your sanity.
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