Understanding Psychosis ‐ from Laing to Bentall. Personal Reflections on Changing Therapeutic Perspectives
| Date | 01 September 2004 |
| DOI | https://doi.org/10.1108/13619322200400023 |
| Published date | 01 September 2004 |
| Pages | 3-5 |
| Author | Thurstine Basset |
| Subject Matter | Health & social care |
Understanding Psychosis – from Laing
to Bentall. Personal Reflections on
Changing Therapeutic Perspectives
Thurstine Basset
Thurstine Basset Consultancy Ltd
Personal Perspective
n November 2003, I was sitting in an
almost-comfortable chair waiting to hear the third
annual Henry Hawkins lecture. This event is co-
ordinated by MACA (The Mental After Care
Association) and commemorates one of their key
founders. The speaker, whom I had not heard before,
was Richard Bentall, professor of psychology at the
University of Manchester, whose book Madness
Explained – Psychosis and Human Nature had been
published earlier in 2003. The book had already caused
quite a stir and the audience was anticipating an
interesting and challenging presentation.
It was when he was introduced that my mind
wandered back in time. Bentall’s book, we were told,
was selling very well, topping the charts for this type of
book. Indeed, Madness Explained was likely to become
as influential as a classic from another era – The Divided
Self by RD Laing, first published in 1960.
I had heard Laing speak at the Roundhouse in
London in the early 1970s. He sat on the stage, picked
out by one spotlight. The audience, a substantial one,
sat in semi-darkness. He spoke for about an hour about
‘madness’ and how he understood it. He used many
examples from his own work as a therapist. He went
off on various tangents, some of which he returned to
and some of which he left dangling in the air. At the
end there was rapturous applause. The lights came up.
We, the audience, myself included, were not sure if
what we had heard was brilliantly insightful or
hopelessly muddled. Perhaps it was a bit of both.
Of course, by the early 1970s Laing had published
all his key works and had achieved ‘guru’ status. The
political climate was very different to the present day
and Laing had moved from an initial position of ‘anti-
psychiatry’ to what would now probably be called ‘anti-
capitalism’. Although psychiatry was hardly
mainstream, with most care still being provided in
outdated and out-of-the-way large Victorian hospitals,
ILaing’s works had become mainstream in as much as
they were read widely both within and outside mental
health services. As such, people like Laing were
celebrities and were often called upon to perform. For
example, during the 1970s, a joint event featuring both
Laing and Carl Rogers took place at the London
Hilton. Laing and his colleagues wanted the event to
have some theatre and staged mock re-birthing
ceremonies throughout the audience. Rogers, on the
other hand, preferred to sit among the audience and
talk to participants about what they were hoping to get
from the occasion. I cannot imagine such an event
taking place nowadays.
In the early 1970s I was working at St. Augustine’s,
a large psychiatric hospital near Canterbury. The
hospital was a traditional institution. It had many good
individual workers, but the overall ethos for the staff
was one of containment through institutionalisation. In
common with a number of other large hospitals at that
time, it became subject to an inquiry. The explanation
of how the overall philosophy of care made itself
apparent on the wards is well described by the two
nurses whose complaints about the hospital had led to
the eventual inquiry:
‘As far as ward management was concerned, the priority
was staff. Wards were managed and run mainly for the
benefit of staff, with ward routine and tradition suiting
the staff. There was never any discussion regarding
whether it was suitable for the patients. There was an
unspoken rule that staff should have an easy time.
Patients had to conform and not disturb the routine. In
my experience the patient always came last’ (Etsello &
Ankers, 1976).
I remember spending time on the long-stay wards at
this hospital talking with patients and wondering how
different things might be if Laing had been the
medical superintendent.
Shortly after this, I had the opportunity to see
Laing’s work in practice during a placement with the
The Mental Health Review Volume 9 Issue 3 September 2004 ©Pavilion Publishing (Brighton) 2004 3
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