Monday, January 11, 2010

Sometimes the Centre Cannot Hold 5

Searching for the Elusive Centre:
I return again to R.D. Laing's little classic The Divided Self. What impresses me is Laing's sheer humanity and impressive humility. In commenting in some detail on one of Kraepelin's descriptions of one of his patients (a young man) way back in 1905, he mentions the fact that very little has changed really with respect to doctor-patient interviews. Notice the humanity and humaneness of Laing's commentary in the following:
One may see his behaviour as 'signs' of a 'disease'; one may see his behaviour as expressive of his existence. The existential-phenomenological construction is an inference about the way the other is feeling acting. What is the boy's experience of Kraepelin? He seems to be tormented and desperate. What is he about in speaking and acting in this way? He is objecting to being measured and tested. He wants to be heard. (Op.cit., p. 31)
Bring your attention to the last two sentences because they are at the heart of what Laing as an existential therapist is all about - listening to the patient in the concreteness of his existence, listening to his pain and torment, not attempting to measure or test, but being a trained and empathetic ear.

The Therapist as Interpreter:
Laing bows his knee to the founder of psychoanalysis - Dr Sigmund Freud - at this point in the text. According to Laing the great man used the metaphor of the expositor or reader of hieroglyphics as a rough approximation of what the therapist or analyst seeks to do - to interpret what the patient said OR says. He also mentions the metaphor of the interpretation of historical texts as expounded by Dilthey (see ibid., pp. 31-32) While commending this interpretative approach, Laing does issue a timely warning:
To look and to listen to a patient and to see signs of schizophrenia (as a 'disease')and to look and to listen to him simply as a human being are to see and to hear in as radically different ways as when one sees, first the vase, then the faces in the ambiguous picture. [Laing is here referring to the traditional visual perception puzzle where one can see faces looking at one another on one glance or a vase or candle stick when looked at with another glance.] (Ibid., p. 33)
Then, Dr Laing, quotes Dr Harry Stack Sullivan's important remark, on the surface of it very obvious, that the psychotic patient is, after all, 'simply human.' In this way, the therapist can understand the patient's existential position. He then loses no time to disabuse the reader's mind of a narrow cognitive understanding of what is meant by 'understanding.' By this term, he tells us, he means something akin to 'love' which he admits is a very debased and over-used term. Then he expresses by a real example what he means by 'understanding' or 'love.'
No one has schizophrenia, like having a cold. The patient has not got schizophrenia. He is schizophrenic. The schizophrenic has got to be known without being destroyed... the therapist's hate as well as his love is, therefore, in the highest degree relevant. (Ibid., p. 34)
Insights into Schizophrenia:
I was quite taken with Ronald Laing's use of the glass metaphor with respect to schizophrenia. I had also come across the use of this image by a woman with whom I had a short relationship. She described her schizophrenia as similar to being in a glasshouse. Our sense of our own privacy is very important to each of us and it is the very basis of genuine relationships. However, schizophrenics often see themselves as totally transparent to others. Here are the words of Ronald Laing once again:
... but the person whom we call schizoid feels both more exposed, more vulnerable to others than we do, and more isolated. Thus a schizophrenic may say that he is made of glass, of such transparency and fragility that a look directed at him splinters him to bits and penetrates right through him.. We may suppose that precisely as such he experiences himself. (Ibid., p. 37)

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