Chapter 4 Laing and existential phenomenology Introduction Ina famous set-piece in The Divided Self, Laing contrasts the standard psychiatric interview technique as exemplified by Emil Kraepelin with what he calls the ‘existential- phenomenological construction’.! He quotes Kraepelin’s account of his interview with a patient before a class of students. Kraepelin begins: ‘The patient I will show you today has almost to be carried into the room, as he walks in a straddling fashion on the outside of his feet. On coming in, he throws offhis slippers, sings a hymn loudly, and then cries twice (in English), “My father, my real father!’. .. The patient sits with his eyes shut, and pays no attention to his surroundings. He does not look up even when he is spoken to, but he answers in a low voice, and gradually screaming louder and louder. When asked where he is, he says, ‘You want to know that too? I tell you who is being measured and is measured and shall be measured...’ When asked his name, he screams, ‘What is your name?’ Kraepelin considers that the patient is ‘inaccessible’. He concludes that the patient, had not provided a single piece of useful information and that his talk bears no rela tion to the context of the interview. Laing objects to this construction of the exchange and maintains that the patient is making a meaningful comment on his situation, albeit in a coded manner. Laing suggests that the patient is actually protesting about being paraded before students and that he is parodying the inquisitorial style of Kraepelin with his need for ‘measurement’. Laing contends that the patient's behaviour can be seen in two opposing ways: either as ‘signs’ of disease, or as ‘expressive of his existence’, Ifwe see the patient's behaviour as signs of disease, then he is the passive victim of a pathological process. However, if we sec him from Laing’s existential perspective, then he is fully autonomous: he possesses agency for his actions. This is a key concept in Laing’s existentialist approach. Individuals are held to be fully responsible for their behaviour and for their mode of being in the world, When this existential principle is applied to mental illness, individuals are considered to make choices as to how they behave and talk. While Laing grants the patient full control over their self, the price is that there can be no mitigating factors, such as biology or heredity, to absolve the patient of responsibility. Laing, RD. (1960). The Divided Self. Tavistock, London, pp. 29-31102 AING AND EXISTENTIAL PHENOMENOLOGY From Laing’s point of view, Kraepelin makes no attempt to understand the patient, as an individual with his own unique perspective on the situation. Where Kraepelin sees only nonsense in the patient’s utterances and behaviour, Laing secks to find meaning. Again, from an existential perspective, itis held that all the actions ofhuman beings are potentially meaningful. Laing’s imaginative ‘construction’ of what is hap- pening in the interview has a certain plausibility. He has also framed the discussion in dramatic terms so that the two approaches are seen to be in direct conflict. The reader is more likely to identify with Laing’s seemingly more humane approach than that of Professor Kraepelin, who, at least in Laing’s account, seems deaf to what his patient is trying to communicate. But does Laing’s version represent the ‘truth’ of the matter? Is an approach that tries to combine the disease model with the existential one more profitable? Anthony Clare has suggested that Kraepelin was attending to the form of the patient's disorder, while Laing was focusing on the content Both aspects are necessary, in Clare’s view, to properly understand the patient, Whatever one concludes, Laing has certainly alerted us to the fact that the patient has a point of view and that he cannot be dismissed as merely a collection of symptoms and signs. The origins of exis- tential psychiatry grew out of the engagement of a number of European clinicians with the philosophical movements known as existentialism and phenomenology. Existentialism Writing in 1958, the American psychotherapist, Rollo May, who was later to beftiend Laing, wrote about the definition of existentialism: The word is bandied about to mean everything—from the posturing defiant dilettantism of some members of the avante garde on the left bank in Paris, to a philosophy of despair advocating suicide, to a system of anti-rationalist German thought written in a language so esoteric as to exasperate any empirically minded reader? Rollo May was pointing to contemporary perceptions of existentialism, and during this period it enjoyed great cultural prominence. It emerged from the Academy and permeated popular culture. As May indicates, the popular perception of existentialism was shaped by the high profile of French writers such as Sartre, Camus, and de Beauvoir, who, as well as writing philosophical treatises, also wrote novels and plays, which brought existential ideas to a wider audience. May refers to Camus’s essay, The Myth of Sisyphus, which examined whether suicide was the most appropriate reaction to an absurd world, Finally, he alludes to German philosophy and more specifically to Heidegger, whose writings have certainly ‘exasperated’ many. This passage illustrates that existentialism was both a popular movement and a serious discipline for profes- sional philosophers. Laing was influenced by the popular and the professional streams of existentialism. As a young man growing up in the mid-twentieth century, he was naturally exposed to the cultural currents of his time, but he also read deeply in 2 Clare, A. (1980), Psychiatry in Dissent, Controversial Issues in Thought and Practice (second edition), Tavistock, London, > May, R., Angel, E. and Ellenberger, HLP. (eds) (1958), Existence. A New Dimension in Psychiatry ‘and Psychology. Basic Books, New York, pp. 10-11EXISTENTIALISM Continental philosophy and, as we have seen, he met and conversed with the European émigrés Joe Schorstein and Karl Abenheimer who had personal acquaintance with some of the leading existential thinkers such Heidegger, Jaspers, and Buber. Laing’s own book, The Divided Self, which dealt with the seemingly narrow subject of phenomenology as applied to mental illness, was to appeal to a wide lay public. ‘The period from the mid-1940s to the 1960s was the popular heyday of existentialism. Although its philosophical origins were considerably earlier, the popular preoccupa- tion with existentialism grew out of the carnage of the Second World War and the horrors of the Holocaust. There was a questioning of authority and a need to find meaning in an apparently meaningless world. Victor Frankl, a psychiatrist who survived the concentration camps, wrote Man's Search for Meaning, in which he put forward his thesis that the most pressing question for human beings was finding a purpose to their life, For many people, existential ideas about the importance of the individual, the absurdity of existence, and the striving for ‘authenticity’ struck a chord. Many creative writers were judged to offer a broadly existential message—Dostoyevsky, Kafka, and Samuel Beckett—all of whom Laing read and cited in his published work. Les Tempes Modernes in France and Horizon in Britain provided a platform for existential writers and we know that Laing was familiar with both these publications. ‘The English writer Colin Wilson published The Outsider in 1956, which was a popular success. It offered an existential account of the predicament of modern man and took in such writers as Dostoyevsky, Kierkegaard, Nietzsche, Sartre, and Hermann Hesse, It was a book that Laing was apparently very disconcerted to sec in print, presumably because it covered the same intellectual terrain he was hoping to occupy. Overview Existentialism is a philosophy that takes as its starting point the individual's exist- ence. It begins with the ‘individual’ rather than the ‘universal’, and does not aim to arrive at general truths. It holds that self and existence can have no fixed definition: each individual is unique and thus escapes categorization. Kierkegaard introduced the idea of ‘authenticity’ and contended that there was public pressure to conform to society, which led to ‘inauthenticity’. Anxiety in the face of death is considered to reveal the banality and absurdity of life, but it can also reveal that the true nature of our lives is based on the choices we make. Warnock emphasizes that existentialists are primarily interested in human freedom.$ Man has unique power to choose his course of action. What his freedom of choice amounts to and how it is to be described are central concerns of existentialists. Accepting responsibility for the exercise of freedom is the path to authenticity. Existentialists tend to share an opposition to rationalism and empiricism. Unlike most other philosophies, existential ideas are often expressed through novels and plays, as in the work of Sartre, Camus, and de Beauvoir, while Nietasche and Kierkegaard had a literary rather than a dry technical style of writing, 4 Earnshaw, S. (2006). Existentialism. Continuum, London; Dreyfus, H.L. and Wrathall, M.A. (eds) (2009). A Companion to Phenomenology and Existentialism. Wiley-Blackwell, Oxford. 5 Warnock, M, (1970). Existentialism. Oxford University Press, Oxford. © Dreyfus and Wrathall, A Companion to Phenomenology and Existentialism, p. 4 103