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Thoughts on "The Divided Self: An Existential Study in Sanity and Madness"

The Divided Self: An Existential Study in Sanity and Madness by R. D. Laing

This work represents a criticism of psychiatry. It fundamentally questions some basic premises that psychiatry has about itself and its role, as well as the "mentally disordered".

Laing starts the book first by examining different angles by which one can view a human being - a human being can be a person, and a human being can be an organism. Therefore - when a human being speaks, you can either look at the content of what they express, or you may look at it as a mechanical/biological process that manifests. According to Laing, one fundamental problem in psychiatry is that it's devoted to the latter (as a biological organism) even though the discipline itself is a study and therapy relating to personhood, something that on the surface at least does appear rather absurd.

In this work he brings the example of "hebephrenic" and "catatonic" individuals to make his point - which is:

1. There is value and meaning even in speech that is generally regarded as severely disorganized and incomprehensible at first sight (he claims this incomprehensibility can be traced to a lack of willingness to understand, on the psychiatrist's part)

2. A certain degree of symptoms that are regarded as demonstrations of a mental disorder can be directly traced to the de-humanizing treatment psychiatry offers. He provides what he considers to be the legitimate motivations people that suffer from a mental disorder have to display "symptoms" while treated - for example an agitated behavior can represent a legitimate sense in which the patient feels that they are not being viewed as persons, and protest that in a form of agitation.

Laing, among other things, claims that even delusions are the result of real existential and phenomenological concerns that simply manifest in a way that's no longer abstract, but rather as plain facts. For example, a delusion that one does not exist can be the result of someone having grown up with a severe lack of autonomy and with the feeling that they were never able to become their own person.

To the end of providing an alternative to the (also since then) increasingly medicinal approach in psychiatry that fundamentally frames 'mental disorders' as chemical imbalances and the like, he utilizes a phenomenological and existentialist lens with which to view mental hardships, in addition to psychoanalysis - thus reframing disorders that are just seen as chemical imbalances, and the resulting behavior as simply incomprehensible or irrelevant into representatives of intelligible concerns that an individual faces.

For the record, he doesn't claim a lack of connection between chemical balance and mental health - but he claims that solely focusing on that breeds a completely wrong attitude that dehumanizes the mental health patients and in fact worsens their suffering. He thinks, for example, that at least some of the recoveries from psychosis represent repression - by which a false "sane" persona is constructed but in which internally the person struggles just as much.

Whether his analysis is truly correct or not I can't say, but I do think this humane approach towards mental health is valuable and eye-opening. At the very least he provides food for thought and does bring examples that at least seem to demonstrate the limitations of the dominant attitudes in psychiatry as it currently is.

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