R. D. Laing and Aaron Esterson
Sanity, Madness and the Family:
Families of Schizophrenics
(April 1964)
Sixtieth anniversary reflections
A third subseries (fifteen seminars) on Laing and Esterson’s eleven families
Historically researched by Anthony Stadlen
Explored in film by Yaara Sumeruk
In memoriam Hilary Mantel:
‘The simple words the people speak’
2. Mystification: Double Bind: Praxis and Process
Further exploration of why this book is still not understood
Anthony Stadlen Yaara Sumeruk
conduct by Zoom
Inner Circle Seminar No. 291
Sunday 21 July 2024
10 a.m. to 5 p.m.
Jean-Paul Sartre 21 June 1905 – 15 April 1980 |
Thomas Szasz 15 April 1920 – 8 September 2012 |
R. D. Laing 7 October 1927 – 23 August 1989 |
Aaron Esterson 23 September 1923 – 15 April 1999 |
This is the second in a new subseries of fifteen Inner Circle Seminars to mark the sixtieth anniversary of the publication in April 1964 of Sanity, Madness and the Family, Volume 1: Families of Schizophrenics by R. D. Laing and Aaron Esterson.
As in our two previous subseries devoted to this book and these families, starting respectively twenty and ten years ago, in 2004 and 2014, the heart of the subseries will be eleven seminars, each devoted to one of the eleven families in the book. Anthony Stadlen will again guide discussion in detail of the family conversations in the late 1950s and early 1960s reported in the book as well of his own interviews in the present century with members of the families and, when they were still alive, the daughters labelled ‘schizophrenic’. In the second of our two subseries, starting in 2014, all but one of the twelve seminars were introduced by the great novelist Dame Hilary Mantel, who shone the light of her genius on each family in turn. In the present subseries, we are honoured by the participation of the pioneering film director Yaara Sumeruk, who has developed a simple but profound way of bringing the family conversations in the book to life in a faithful and accurate cinema film that, as seminar members have confirmed, makes the predicament of the ‘schizophrenic’ daughters more strikingly and dramatically intelligible.
But in the present, third, subseries we are devoting the first two seminars (of which today’s is the second) not to individual families of the eleven but to the general question why for sixty years readers have so spectacularly failed to understand this book. It should be emphasised that this does not mean they think they fail to understand it. On the contrary, almost all readers seem to think there is no problem in understanding what the book is about: obviously, they explain, in this book Laing and Esterson are claiming that ‘families cause schizophrenia’. Such readers will usually go on to say that this claim has long been discredited by the advance of scientific biological psychiatry, though some will say the claim was correct. It seems to make no difference whether the readers are ordinary unprofessional people, psychotherapy students, or eminent psychiatrists. But the truth is that Laing and Esterson explicitly insisted that they were making no such claim.
For example, the British psychiatrist Julian Leff (1938-2021), internationally renowned and honoured as an authority on ‘schizophrenia’, and his co-worker Christine Vaughn, wrote in their book Expressed Emotion in Families (1985, p. 1) that Laing and Esterson’s work was ‘supported by little or no scientific evidence’. Leff and Vaughn clearly supposed that what needed support by scientific evidence was, as they put it, a ‘theory of the family’s role in the origin of schizophrenia’. It is just such a supposed ‘theory of the family’s role in the origin of schizophrenia’ that Leff and Vaughn mistakenly supposed that Laing and Esterson were advocating. But Laing and Esterson repeatedly emphasised they were not advocating any such theory. Indeed, they said they disbelieved in ‘schizophrenia’.
Leff and Vaughn either failed to read what Laing and Esterson wrote; or, if they read it, they failed to understand it; or, if they understood it, they failed to believe it.
What did Laing and Esterson write? They reiterate in the Preface to the second edition (1970):
In our view it is an assumption, a theory, a hypothesis, but not a fact, that anyone suffers from a condition called ‘schizophrenia’. No one can deny us the right to disbelieve in the fact of schizophrenia. We did not say, even, that we do not believe in schizophrenia.
This does not mean Laing and Esterson are not making any claim that can be tested and shown to be true or false. They are indeed making such a claim. But the claim they are making is not the claim Leff and Vaughn imagine they are making. The claim Laing and Esterson are making is not a medical or natural-scientific claim. It is what their colleague Peter Lomas, who participated in the research for some time, would have called an ordinarily human claim. It is by ordinarily human, common-sense means that it must be tested.
Leff and Vaughn, like almost all readers, before considering what claim Laing and Esterson might be making, themselves make an assumption which is itself an implicit claim: namely, that the eleven women in the book are ‘ill’; and that the ‘disease’ from which they are ‘suffering’ is ‘schizophrenia’.
Leff and Vaughn assume, apparently unquestioningly, that Laing and Esterson are making the same assumption, the same implicit claim. They then make the further assumption that Laing and Esterson are making a further claim: namely, that the interactions in the women’s families are causing, or at least contributing to, the women’s supposed or alleged ‘illness’, ‘schizophrenia’.
This claim, if Laing and Esterson had been making it, which they were not, could only have been tested, verified, confirmed, substantiated, or refuted by comparing a statistically significant number of families of supposed ‘schizophrenics’ with a control group of the same number of families of supposed non-‘schizophrenics’ to test their supposed claim (which, of course, they were not making) of a supposed correlation between the family interactions and the supposed ‘schizophrenia’.
However, in reality, Laing and Esterson were claiming something much simpler, namely, that the way the eleven women related to their eleven respective families made ordinary social sense: that it was ‘intelligible’ or ‘comprehensible’ in Jean-Paul Sartre’s terms; or, as the authors cautiously phrased it in the Preface to the second edition of their book, ‘more socially intelligible than has come to be supposed’. It was, they claimed, an ordinarily human response to how their families related to them. To establish this required no control group.
Laing and Esterson made no assumption that the eleven women had ‘schizophrenia’. They made no assumption that the women were ‘ill’. They made no assumption that the women were ‘mad’. They made no assumption that the women had ‘split minds’. They made no assumption that the women were of ‘unsound mind’. They made no assumption that the women had anything medically ‘wrong’ with them. They made no assumption that the women had anything non-medically ‘wrong’ with them. Nor, come to that, did they assume that the negative of any of these assumptions was the case.
Nor did they make any assumption that the families, or ‘society’, were, for example, ‘schizophrenic’, ‘ill’, ‘sick’, ‘mad’, ‘split’, ‘dysfunctional’, ‘pathological’, etc.
The radical misunderstandings based on such false assumptions were the subject of the first seminar in the new subseries, Inner Circle Seminar No. 290, which took place on 16 June 2024. Such misunderstandings are primarily due to people’s failure to read what Laing and Esterson say, in plain English, they are doing in the book. We may suppose that readers do not expect the authors to say what they are in fact saying; and so, even if they begin to notice what the authors are in fact saying, they will dismiss the possibility that the authors might really be saying it; or that, if they are for some reason really saying it, they could actually mean it. See:
https://anthonystadlen.blogspot.com/2023/01/60-years-since-laing-esterson-sanity.html
In March 1964, a month before the publication of Sanity, Madness and the Family, the book Reason and Violence: A Decade of Sartre’s Philosophy, 1950-1960, by Laing and David Cooper, was published. It expounded Sartre’s Question de méthode and Saint Genet, and contained Laing’s translation-précis of Sartre’s recently published, as yet untranslated, Critique de la raison dialectique, Tome 1 (1960), of which Sartre in an enthusiastic Foreword to Reason and Violence praised Laing’s ‘parfaite intelligence’. Sartre also commended Laing’s studies of the family as ‘series’ and ‘group’ (technical terms for different kinds of human collectivity analysed in the Critique); presumably Laing had sent him his little known but important paper ‘Series and Nexus in the Family’ (New Left Review, May 1962: 1-15). Sartre wrote that he looked forward to a time when psychiatry would become ‘humaine’.
The next month, April 1964, saw the publication of Sanity, Madness and the Family. This book referred the reader to the theoretical background given in Laing’s The Self and Others (1961) and in Reason and Violence. In 1970 Esterson’s The Leaves of Spring: A Study in the Dialectics of Madness was published. It developed to book-length one of the eleven family studies (Chapter 4, The Danzigs) from Sanity, Madness and the Family; referred to the same theoretical background; and acknowledged indebtedness to ‘the philosophic tradition of dialectical investigation, particularly as it is embodied in the work of Hegel, Marx, and Sartre, though it is not a direct application of any of these’.
Key terms which Laing and Esterson use are mystification (from Karl Marx) and praxis and process (from Sartre). Laing also discusses the double bind (from Gregory Bateson), although Sanity, Madness and the Family gives only one alleged instance of it (p. 167). We shall briefly discuss these terms, and Laing and Esterson’s use of them, in what follows.1. Mystification
Because Marx by experiencing estrangement [Entfremdung, alienation] attains an essential dimension of history, the Marxist view of history is superior to that of other historical accounts.
Martin Heidegger, ‘Letter on “Humanism”’ (1949)
Laing and Esterson, in these books and elsewhere, employ the term ‘mystification’ and its cognates. The first instance appears to be in the first edition of Laing’s The Self and Others (1961: 135-6) where he writes that a person placed in an ‘untenable position’ is ‘totally mystified and alienated’. The association of mystification with alienation recalls Marx’s linking these words, but Marx is not mentioned. The phrase is removed from the much revised second edition, Self and Others (1969), but a phrase ‘the most intense conflicts’ (1961: 76) in the first edition is replaced in the second edition by the phrase ‘mystification, confusion, and conflict’ (1969: 71): a clear allusion, though still without mention of Marx, to Laing’s paper ‘Mystification, confusion, and conflict’ (1965), where he does explicitly acknowledge indebtedness to Marx. However, Laing explains Marx’s concept of mystification as ‘representing forms of exploitation as forms of benevolence’, which states only vaguely what Marx’s concept of mystification actually was.
On the other hand, Laing and Esterson’s first allusion to mystification in Sanity, Madness and the Family (1964: 8) is a good example, as we shall see below, of what Marx did mean by mystification, though they do not explain or mention this, or indeed mention Marx anywhere in their book:
‘Phenomenologically, a group can feel to its members to be an organism; to those outside it, it can appear to act like one. But to go beyond this, and to maintain that, ontologically, it is an organism, is to become completely mystified.’
In Laing’s 1965 paper ‘Mystification, confusion, and conflict’ he applies the word ‘mystification’ to the study of family interactions, comparing and contrasting it with Bateson’s (1956) concept of the ‘double bind’. Laing gives, among other examples, some that do indeed correspond precisely to Marx’s concept of mystification, and some that do not, both in family interactions and in the theories of family researchers and therapists about family interactions; but he still does not explain which examples correspond to Marx’s concept of mystification – or even to Laing’s concept of Marx’s concept of mystification – and which do not.
Laing also has a chapter ‘The mystification of experience’ in The Politics of Experience (1967). He writes: ‘Marx described mystification and showed its function in his day.’ But he still does not say what Marx actually said.
What Marx meant by mystification may be seen in the following quotations from Marx’s Das Kapital.
(1 and 2 do not contain the word ‘mystification’ but point to what Marx meant by it. In 3, 4, and 5 he uses the word ‘mystification’ to refer to the mystifying misdescription of the relationship between capitalist and labourer, or landlord and tenant. In 6 he makes his famous accusation that Hegel alludes to the dialectical nature of human relationships but mystifies it by ‘standing it on its head’ as a relationship of abstractions rather than human beings.)
1. ‘... das bestimmte gesellschaftliche Verhältnis der Menschen selbst, welches hier für sie die phantasmagorische Form eines Verhältnisses von Dingen annimmt’
[‘... the specific social relationship of the human beings themselves, which here assumes for them the phantasmagoric form of a relationship between things (Dingen).’]
Karl Marx, Das Kapital, Volume 1, Chapter 1
2. ‘... daB das Kapital nicht eine Sache ist, sondern ein durch Sachen vermitteltes gesellschaftliches Verhältnis zwischen Personen.’
[‘... that capital is not a thing (Sache), but a societal relationship between persons mediated by things (Sachen).’]
Karl Marx, Das Kapital, Volume 1, Chapter 33
3. ‘Das gesellschaftliche Verhälltnis ist vollendet als Verhälltnis eines Dings, des Geldes, zu sich selbst. ... Es wird ganz so Eigenschaft des Geldes, Werth zu schaffen, Zins abzuwerfen, wie die eines Birnbaums Birnen zu tragen. ... die Kapitalmystifikation in der grellsten Form.’
[‘The social relationship is consummated as relationship of a thing (Ding), of money, to itself. ... It becomes just as much a property of money to create value, to yield interest, as of a pear-tree to bear pears. ... capital-mystification in the most glaring form.’]
Karl Marx, Das Kapital, Volume 3, Chapter 24
4. ‘Die Vorstellung vom Kapital als sich selbst reproduzierendem und in der Reproduktion vermehrendem Wert ... hat zu den fabelhaften Einfällen des Dr. Price geleitet, die bei weitem die Phantasien der Alchimisten hinter sich lassen ... Pitt nimmt die Mystifikation des Dr. Price ganz ernst.’
[‘The conception of capital as self-reproducing and in the reproduction increasing value ... has led to the fabulous notions of Dr Price, which leave the fantasies of the alchemists far behind them; ... Pitt takes Dr Price’s mystification in all earnest.’]
Karl Marx, Das Kapital, Volume 3, Chapter 24
5. ‘... die Mystifikation der kapitalistischen Produktionsweise, die Verdinglichung der gesellschaftlichen Verhältnisse ... die verzauberte, verkehrte und auf den Kopf gestellte Welt, wo Monsieur le Capital und Madame la Terre als soziale Charaktere und zugleich unmittelbar als bloße Dinge ihren Spuk treiben.’
[‘... the mystification of the capitalist mode of production, the reification of social relationships ... the enchanted, back-to-front and stood-on-its-head world where Monsieur le Capital and Madame la Terre are up to their spookery as social characters and at the same time directly as mere things (Dinge).’]
Karl Marx, Das Kapital, Volume 3, Chapter 48
6. ‘Die mystifizierende Seite der hegelschen Dialektik habe ich vor beinah 30 Jarhen, zu einer Zeit kritiziert, wo sie noch Tagesmode war. [...] Die Mystifikation, welche die Dialektik in Hegels Händen erleidet, verhindert in keiner Weise, daß er ihre allgemeinen Bewegungsformen zuerst in umfassender und bewußter Weise dargestellt hat. Sie steht bei ihm auf dem Kopf. Man muß sie umstülpen, um den rationellen Kern in der mystischen Hülle zu entdecken. [...] In ihrer mystifizierten Form war s die Dialektik deutsch Mode, weil sie das Bestehende zu verklären schien.’
[‘The mystifying side of the Hegelian dialectic I criticised nearly thirty years ago, at a time when it was still the fashion of the day. [...] The mystification which dialectic suffers in Hegel’s hands in no way precludes him from being the first to represent its general forms of movement in a comprehensive and conscious way. With him it stands on its head. One must turn it the right way up, to discover the rational kernel in the mystical shell. [...] In its mystified form the dialectic became German fashion, because it seemed to transfigure what exists.’]
Karl Marx, Das Kapital, Afterword to second German edition
Translations by A. Stadlen
Sartre in his Critique implies that the theory of Marx and Friedrich Engels, and subsequent ‘Marxism’, while indeed a demystification up to a point, was itself also a mystification. For Marx writes, for example:
7. ‘Die Gestalten von Kapitalist und Grundeigentümer zeichne ich keineswegs in rosigem Licht. Aber ... [w]eniger als jeder andere kann mein Standpunkt, der die Entwicklung der ökonomischen Gesellschaftsformation als einen naturgeschichtlichen Prozeß auffaßt, den einzelnen verantwortlichmach en für Verhältnisse, deren Geschöpf er sozial bleibt, sosehr er sich auch subjektiv über sie erheben mag.’
[‘I draw the figures of the capitalist and landlord in no way in a rosy light. But ... my standpoint, which conceives the development of the economic formation of society as a natural-historical process [sic, emphasis added], can less than any other make the individual responsible for relationships whose creature he remains socially, however much he may subjectively raise himself above them.’]
Karl Marx, Das Kapital, Preface to first German edition
Translation by A. Stadlen
Similarly, Sartre sees Heidegger’s praise (above) for Marx’s account of history as itself a mystification and reification, because, in Sartre’s view, Heidegger’s philosophy is ‘existential idealism’ which ‘subordinates the human to Being other than man’, as Laing puts it in Reason and Violence (1964: 116).
Laing and Esterson give many specific occurrences of what they call mystification by family members in the family interviews in Sanity, Madness and the Family. But they appear to have missed an opportunity to state their central hypothesis specifically in terms of mystification in Marx’s sense (or Sartre’s development of it). For their hypothesis is that the very concept of ‘schizophrenia’ is a mystification precisely in that sense, as that concept misrepresents a ‘human’ relation between persons (primarily in the family) as a ‘natural’ relation between things (the ‘illness’ of one daughter, the ‘imbalance’ between ‘things’ in her ‘mind’ or ‘brain’). Esterson is clearer about this in The Leaves of Spring.2. Double Bind
Laing and Esterson could also have reasonably argued that the central mystification they studied in Sanity, Madness and the Family, that the ‘schizophrenic’ women were alleged to be ‘ill’, was, precisely, a ‘double bind’. It may be that the readers who do not understand the point of the book are caught in this mystification which is also a double bind.Laing discusses the double bind in The Self and Others (1961) and its (much revised) second edition Self and Others (1969). The double bind is mentioned on the dust covers of the two hard-back editions of Sanity, Madness and the Family (1964, 1970) but only once in the text (ibid., p. 167), although there are instances in the family interactions where it could have been applied with accuracy. It is often used erroneously (though not by Laing or Esterson) to mean any kind of mixed message or contradictory attribution or injunction; but it has a precise meaning defined by Bateson and his colleagues (1956), with six complex ‘necessary ingredients’, in terms of Bertrand Russell’s theory of Logical Types expounded in his and Alfred North Whitehead’s Principia Mathematica, Volume 1, Chapter 2 (1910). The crux is that the contradictory communications are, as Bateson conceived them, of different logical type: a communication and a metacommunication about the primary communication.
Laing wrote in The Self and Others (1961: 141) and Self and Others (1969: 129) that the 1956 work of Bateson and his colleagues on the double bind had ‘revolutionized the concept of what is meant by environment’. Laing did express doubt as to whether ‘the Logical Type theory, which arises in the course of the construction of a calculus of propositions, can be applied directly to communication’ (1969: 129). He also claimed that ‘in real life there probably will be at least three persons involved’ (1969: 128); but a two-person double bind can surely arise, for instance, between a single mother and her only child.
The theory of the double bind prepared the ground for Laing and Esterson’s work. For this reason, and because it has been generally banalised and misunderstood, though not by them, we shall examine it today.
3. Praxis and Process
Both Laing and Esterson also place great stress on the terms ‘praxis’ and ‘process’. They claim they are using them as Sartre does in Critique de la Raison Dialectique. They define and use Sartre’s term ‘praxis’ correctly, but they (jointly and separately) define and use the term ‘process’ in two, contradictory, senses, only one of which correctly conveys Sartre’s term ‘processus’.
Sartre in the Critique uses both ‘praxis’ and ‘processus’ to refer to human (not natural) events. ‘Praxis’ simply means human, freely chosen action. ‘Processus’ is a human, usually group, happening or development or procedure that merely looks like a natural, supposedly mechanistically determined event or fact.
Sartre states explicitly (1960: 542; English translation 1976: 549) that neither praxis nor processus is deterministic. This is what one would expect, since both describe human rather than natural events. Laing made an excellent English précis of this section in Reason and Violence (1964: 153-4), of exemplary clarity; but he seems subsequently at least sometimes to have forgotten or ignored it.
Laing and Esterson (1964: 8) define the term ‘process’, misleadingly, to mean ‘a continuous series of operations that have no agent as their author’. In other words they wrongly define it as if it were really a natural, mechanistically determined event. But they use it, in practice, confusingly: sometimes incorrectly to mean simply natural events; and sometimes correctly to mean what Sartre actually does mean by ‘processus’, namely, as explained above, human (usually group) events which only appear to be natural events having no author, but which it is the purpose of his book to demonstrate can be revealed by dialectical reason to be not natural, not deterministic, but socially intelligible as deriving from human praxis.
Esterson in The Leaves of Spring (1970: xii) explicitly, but wrongly, defines ‘process’ as referring simply to natural events, even giving an allegedly defining example of ‘process’ which he asserts is ‘deterministic’, clearly without realising that this contradicts Sartre’s definition:
I am using the terms praxis and process after Sartre. Praxis refers to events that are the deeds of doers or groups of doers, or to the intended outcome of such deeds. It refers to the acts of an agent. Process refers to events or a pattern of events of which no doer or agent is the author. Thus, praxis expresses the intentions of a person or group of persons, while process does not. Process in a system may be initiated by praxis, e.g. a blow to the head,; but the pattern of events that follows the blow, the pattern of trauma or physiological change within the organism, is determined mechanistically. This pattern of change is one of process.
The ordinary medical concept of illness is a concept of process. It refers to the events occurring within the person, and affecting his organism according to the laws of natural science.
This is a lucid definition, but it is simply wrong as a statement of what Sartre meant by ‘process’. It would have been simpler if Sartre had defined ‘process’ in this way, but he simply did not.
Laing similarly misdefines ‘process’ in this way in his paper ‘Mystification, confusion, and conflict’ (1965: 350) and in his much later confused presentation in 1985 to the first Evolution of Psychotherapy conference (1987: 203-4) when Szasz was a justifiably exasperated respondent on other grounds (1987: 210).
The whole purpose of Sartre’s Critique is to demonstrate that ‘processus’, while not a natural event, merely appears to be one, and is in fact socially intelligible by dialectical reason as the outcome of human praxis. Sartre’s project is to make history itself socially intelligible.
The error of Laing and Esterson is, on occasion, to treat Sartre’s ‘process’ as if it actually referred to nature, rather than merely appearing to refer to nature but actually being socially intelligible as human praxis. In other words, their error is precisely to mystify, in the Marx-Sartre-Szasz sense, Sartre’s concept of process.
It might have been clearer if Sartre had defined ‘processus’ as natural and deterministic, and coined another term, such as ‘pseudo-processus’ or ‘praxis-processus’, to mean what only looks natural and deterministic; but he did not. Sometimes, indeed, he does use ‘praxis-processus’, but it appears to mean for him exactly the same as ‘processus’, or rather, it appears to mean for him ‘processus’ demystified by being shown as socially intelligible in terms of praxis, whereas it would not be intelligible in this way if he had defined ‘processus’ as simply natural and deterministic.
Sartre sometimes refers to processus as inertia or the practico-inert. It is metaphorical inertia; just as ‘mental illness’ is, as Szasz insisted, metaphorical illness. To confuse or identify Sartre’s ‘inertia’ with Isaac Newton’s ‘inertia’ is, in Laing and Esterson’s words (above), ‘to become completely mystified’.
It is also important to recognise that distinguishing between the human and the natural does not have to entail a cartesian dualism. Sartre insists in the Critique that his concept of the human and the natural is not dualistic. (And, since processus only appears to be naturally determined, the question of a dualism of praxis and processsus does not arise.)
Heidegger observes that tears cannot be understood by natural science although their physical properties can be. Szasz observes that a wedding ring cannot be understood by natural science although its physical properties can be. Heidegger and Szasz are making the same point, and Laing made it too.
It is not dualistic. The two ways of seeing tears or a wedding ring, the personal and the physical, are like the two ways of seeing a human being, as person or as organism, which Laing discusses in The Divided Self: An Existential Study in Sanity and Madness (1960), published a few months before The Myth of Mental Illness. As Laing puts it, in the language of existential phenomenology, each of the two ways of seeing is a different ‘initial intentional act’. Laing writes:
It is crucial not to lose sight of Laing and Esterson’s simple, unassuming question as they restate it in the Preface to the second edition of Sanity, Madness and the Family (1970: viii):
Are the experience and behaviour that psychiatrists take as symptoms and signs of schizophrenia more socially intelligible than has come to be supposed? [Emphasis added.]
But most readers persist in misreading this simple question as if the seven words emphasised were simply not there.
The greatness of these books transcends these errors; but it may well be that the errors have contributed to the almost universal misunderstanding of Sanity, Madness and the Family and, on the rare occasions it is noticed, The Leaves of Spring. We shall try to remedy this a little today, with the help of extracts which Yaara Sumeruk will show us from her uniquely clarifying film-in-progress.
Then, in the next eleven seminars in this subseries, we shall focus on each of the eleven families in turn, in the hope that we shall understand better the words Laing and Esterson used to describe them, but perhaps also find our own.
Your questions and contributions will be warmly welcomed.
For further information on seminars, visit: http://anthonystadlen.blogspot.com/
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