The X Process: Anti-Psychiatry and Its Hopes

The X ProcessAnti-Psychiatry and Its Hopes Rob White (bio) The famous "Escape" or "run away from it all" is an excursion in a trap even if the trap includes the south seas, which are only for those who want to paint them or sail them. —F. Scott Fitzgerald R.d. Laing started his medical career at Gartnavel Hospital in Glasgow, Scotland, as an enthusiastic innovator. When he came to work in the female refractory ward, nobody treated patients with respect. He asked nurses to instead be friendly with the twelve most hopeless cases, and found that these changes had an immediate effect. The patients who had been dayroom automatons now "hopped and skipped and twiddled around," delighted by the attention.1 After eighteen months of the new regimen, the twelve of them were discharged. It was, Laing said, one of the most gratifying experiences of his life, and proof that traditional psychiatry could be reformed. Within a year, however, all the women were back in the hospital. (As a patient elsewhere put it, "I did tryto start out again in life a couple of years ago and really started to get down to it; but there it is, I got this trouble again."2) Eventually Laing decided that people couldn't be helped in asylums, no matter how many enlightened initiatives were attempted. In 1972 he told Franco Basaglia, who successfully led a campaign to shutter Italian asylums, "I had a choice either to stay in the system and try to accomplish what I wanted, without succeeding, or to get out. I got out."3 What he wanted was an alternative to traditional mental hospitals and orthodox doctors—an anti-psychiatry. Though he came to dislike the name, coined by his friend David Cooper in 1967, it summed up the project well enough. Anti-psychiatry was born out of anger at the mistreatment of patients who were labeled crazy when what really afflicted them was despair. (Laing said that etymologically "schizophrenia" meant being broken-hearted.) For a few years Laing's fame and anti-psychiatry's affinity with the defiant mood of the late [End Page 170] sixties forced the medical profession to reform. Then Laing turned to mysticism while Cooper grew provocatively militant, and anti-psychiatry's opponents seized the opportunity to discredit the whole project. In 1976 the well-known Irish psychiatrist Anthony Clare spoke for many when he disparaged Laing's recent work: "It has nothing to offer those to whom Laing appeared to make so many promises, hold out so many hopes."4 Ungenerous though he was, Clare had a point. The anti-psychiatrists got carried away by the search for solutions to the plight which Laing in particular had a gift for describing, and their interest in suffering faded. For this reason, the problem of hope was more complicated than Clare suggested. There was too much reassurance in Laing's later work, not too little. Optimism eclipsed the initial pity and dismay. Looking back in a time when the stigma of psychiatric diagnosis has evolved into a badge of social adaptability, or even an identity in itself, it almost seems tragic to have lost anti-psychiatry's sense of what it is to feel maddeningly cast adrift from other people. Laing had always been interested in the self's solitariness and vulnerability, and "alienation" was a watchword in his early work, which was influenced by pessimistic European philosophy and psychoanalysis. Though he admired the influential sociologist Erving Goffman, their views about personal identity differed. Goffman's Asylums (1961), with its feel for society's clampdown mechanisms, pictured the self as a war-torn city. "In the hospital," Goffman wrote, "the inmate can learn that the self is not a fortress, but rather a small open city," sometimes patrolled by hostile troops and at others by friendly forces.5 Patients discovered how flimsy they were in themselves through the disturbing experience of being invaded by the institution. By contrast Laing believed that many people on wards were remote because they continued to have strong defenses. The "outward behaviour" of the incommunicado patient "is a defensive system analogous to innumerable openings...