The Woodstock of Psychotherapy
Yet in 1985 there were still pockets of therapists dispersed throughout the country who believed that the therapy profession was on the eve of a revolution, a transition to a more humanistic, less traditional, less pharmaceutically oriented model. Approximately seven thousand of these therapists (including me) converged on Phoenix, Arizona, in 1985 for a conference sponsored by the Milton H. Erickson Foundation. Virtually all of the major innovators in the profession were gathered there--mostly but not exclusively those who had rejected the idea of mental illness and who advocated for reforms in the mental health system--including R. D. Laing, Thomas Szasz, Salvador Minuchin and Jay Haley. The conference attendees, who were mostly under forty years old, were told on a number of occasions by the speakers that the future of therapy lay in their hands.
R.D. Laing was in good form. It had been arranged for Laing to interview a bona fide "paranoid schizophrenic"--whom he had never met before--in a private room, while an audience of several thousand therapists watched on a video screen in a conference hall downstairs. (Needless to say the young woman was informed in advance of the arrangement.) Despite the fact that the woman, Christy, knew she was being watched, she readily opened up to Laing and shared with him the unusual ideas (e.g., there was a conspiracy out to "get her") that evidently had earned her the label of chronic psychotic. Laing did not attempt to talk her out of this idea (although he disagreed with her on occasion)--in fact, he agreed. He stated, "I mean this whole setup is an enormous conspiracy, and you're right in the middle of the conspiracy just now." "So," he added with a chuckle, "if you came here to get away from the conspiracy; you haven't done very well." When she asked him what kind of conspiracy he was talking about, he said he thought it was a benign conspiracy, a sign that the universal mind (the term she had used earlier in the conversation) was "waking up." The conversation concluded with a lively discussion of the Bible.
After her twenty-two minute talk with Dr. Laing, she asked if she could accompany him downstairs to watch while he answered questions from the other therapists, a request that seemed to surprise even Laing himself. During the question period Laing responded caustically to one of the questioners who stated that nothing of value had occurred in Laing's interaction with Christy:
This young woman sitting beside me is supposed to be an absolute paranoid schizophrenic on medication. [She had been withdrawn from medication at Laing's request a day or two before their dialogue.] She’s sitting here just now perfectly compos mentus, perfectly clear, facing this most intimidating situation from the stage, not exhibiting any symptoms of schizophrenic disorder. If you knew of any medication that could do that in twenty minutes, from there to here, would you say you wouldn't give that to a patient? You would have to spend the rest of your life being a biochemist to understand what the chemical effect of that sort of thing is supposed to be in the central nervous system. So you don't know anything about this sort of process. Have the humility to admit that, and keep your place!
After a number of questions, some curious, some appreciative, some critical, the young woman asked to make a few remarks in conclusion. "I don’t go around like a paranoid schizophrenic all the time. I know how to keep my cool, and I think this guy [Laing] would be a great psychotherapist, because he does that... because he knows how to tap into other people’s minds... not by just asking questions and trying to figure things out like some doctors."
At this point Salvador Minuchin emerged from the audience to express his own appreciation of Laing and Christy's interaction and to reprimand the audience for what he took to be their failure to grasp the implications of what had occurred.
I think you should learn something from Ronald. Because I don't think you did. You see, what we have experienced here is a communion of love. What I was observing, and I felt entranced, I felt in love with this young person, and she was able to elicit from Ronald, and so did he from her--that kind of experience. It was experience not at the level of words, but there was an element of joining, that was expressed in their hands, in their legs, they were moving exactly in the same place, and I loved it. And I think it's important that you should know that. I am talking to the physician that talks about drugs. Because the drug that existed there is very, very powerful.
Minuchin was underscoring the point that what had occurred between Laing and Christy challenged one of the primary dogmas we had all been taught to believe in graduate school: that "schizophrenics" are not capable of forming relationships, that they are not amenable to therapy and that the most therapists can do is to help them to function on a very low level by maintaining them on "medication." Yet Laing had managed to win Christy's trust in a very short period of time, and his acceptance of her enabled her to manifest her own intelligence and charm. Although Laing and Minuchin had different theoretical orientations, both of them were iconoclasts who were critical of the ways in which the dogmas of the mental health profession limited the individual's capacity to grow and to change. Both were critical of the profession's reliance upon psychiatric drugs.
Laing's dialogue with Christy was in stark contrast to a dialogue he reproduced in his book written in 1982, The Voice of Experience,
between one of the most highly regarded psychoanalysts in the century; Wilfred Bion, and his schizophrenic patient. Bion advocated that interpretations should be "simple," "exact" and "mature." What follows is an excerpt from Bion’s session with his patient:
PATIENT: I picked a tiny piece of my skin from my face and feel quite empty.
ANALYST: The tiny piece of skin is your penis, which you have torn out, and all your insides have come with it.
PATIENT: I do not understand... penis... only syllables and now it has no meaning.
ANALYST: You have split my word "penis" into syllables and now it has no meaning.
In the next session the exchange went as follows:
PATIENT: I cannot find any interesting food. I do not feel able to buy any new clothes and my socks are a mass of holes.
ANALYST: By picking out the tiny piece of skin yesterday you injured yourself so badly you can not even buy clothes; you're empty and have nothing to buy them with.
PATIENT: Although they are full of holes, they constrict my foot.
ANALYST: Not only did you tear out your own penis, but also mine. So today there is no interesting food--only a hole, a sock. But even the sock is made of a mass of holes, all of which you made and which have joined together to constrict, or swallow and injure, your foot.
Evidently this and subsequent sessions proved to Bion that the patient was so delusional that he believed he had literally eaten Bion's penis, leaving a persecuting hole the patient felt a need to fill up. Ten days later Bion reported, "A tear came from his [the patient's] eye and he said with a mixture of despair and reproach, 'Tears come from my ears now.'"
Laing remarks wryly that it is no wonder tears were coming from his ears after having to listen to Bion's absurd interpretations day after day, week after week, month after month, year after year. (This psychoanalysis went on for years, we are told, which is not unusual.) While Bion's statements are entirely fantastic, the patient’s statements seem to convey simply and exactly (albeit metaphorically) that what Bion is saying makes abso1ute1y no sense to the patient. Laing remarks that "it is difficult to fathom the difference between Bion's psychoanalytic fantasies and what is usually called a psychotic delusional system." It is in fact the analyst here, the "expert," who seems more "out of contact" with reality than the patient.
Although Laing says that the two individuals are "equally crazy" he goes on to make the point that the patient is in fact making a profound communication when he states that tears were coming from his ears. If Laing were seeing such a patient, he says he can imagine a sigh. "I might be caught by his talent to say so much in so little... I could not help but feel that the tears in his ears might betoken a sense on his part, which I can not help but share, of something sad, maybe even pathetic, about our relationship. There is truly an abyss between these two men."
If Laing had conversed with Bion's patient, one imagines that the patient would have felt understood, as Christy did. But Bion as a psychoanalyst was more interested in fitting the patient into the procrustean bed of his own theories than in communicating with him as a fellow human being. It is no wonder that psychoanalysts reach the conclusion that schizophrenics are unable to form relationships with therapists....
Taken from Unholy Madness by Seth Farber. © 1999 by Seth Farber. Used by permission of InterVarsity Press, P.O. Box 1400, Downers Grove, IL 60515. All rights reserved. No part of this material may be reproduced in any form without written permission from InterVarsity Press.