Oisín Wall. The British Anti-Psychiatrists: From Institutional Psychiatry to the Counter-Culture, 1960-1971. Routledge Studies in Cultural History Series. New York: Routledge, 2017. xiv + 212 pp. $155.00 (cloth), ISBN 978-1-138-04856-0.
Reviewed by Allan Beveridge (University of Edinburgh)
Published on H-Disability (February, 2020)
Commissioned by Iain C. Hutchison (University of Glasgow)
Over the decades, the anti-psychiatry movement of the 1960s has attracted a lot of attention. Its story has been recounted in memoirs, biographies, and oral histories; has received scholarly scrutiny; has been examined in newspaper articles and documentaries; has been portrayed in films, novels, and plays; and has been the subject of a great deal of mythologizing. Its legacy has been fiercely contested. For some, it represents a period when orthodox psychiatry was finally exposed as an authoritarian and repressive tool of the state: further, by confronting mainstream psychiatry, the anti-psychiatrists, in this view, were also revealing the hypocrisies and iniquities of Western society. For others, the anti-psychiatrist movement was a short-lived and ineffectual protest, and very much of its time. Its advocates espoused a highly romanticized view of madness, which, from this opposing viewpoint, left the mentally ill untreated, a stance both morally and clinically indefensible. In recent years, scholars have sought to provide a more balanced picture that takes account of both the idealism of the movement and its shortcomings. The era, however, is still a difficult one to portray: does one focus on key individuals or on wider social trends? Does one concentrate on particular geographical locations or does one encompass the main global theaters where anti-psychiatry was enacted: the United States, the Netherlands, Italy, and the United Kingdom? Does the anti-psychiatric movement represent a radical rupture in the approach to the mentally ill, or are there continuities with the past? And, indeed, what does the term “anti-psychiatry” mean, and did all the leading players associated with the movement accept the label?
Into this field comes Oisín Wall whose new book is based on his PhD thesis. He chooses to focus on a particular geographical location, the United Kingdom, or more specifically, London, and on a particular period, 1960 to 1971. He also chooses to take in wider social and cultural developments, rather than just focusing exclusively on individual practitioners, although he does spend time examining the careers of R. D. Laing and David Cooper in particular.
Wall begins his book by examining the state of psychiatry before the advent of anti-psychiatry in the 1960s. He points out, as Nick Crossley, Catherine Fussinger, Mathew Thomson, and others have before him, that many of the so-called radical ideas of the anti-psychiatrists had their roots in the mainstream psychiatry of the mid-twentieth century, most notably the notion of the “therapeutic community.”[1] He looks at the therapeutic community projects at Mill Hill in London run by Maxwell Jones and Northfield Hospital in Birmingham run by psychoanalysts, including Wilfred Bion and Sigmund Foulkes. These ventures introduced a degree of democratic decision-making, looser staff-patient distinctions, educational programs, and a focus on the interactions of the group as a way of forging a therapeutic community. Wall observes that these same practices became guiding principles in the anti-psychiatric communities.
Wall then considers Cooper’s attempt to run a therapeutic community at Villa 21 at Shenley Hospital in Hertfordshire. Cooper went further than the earlier proponents of the therapeutic community: in Villa 21, the staff did not wear uniforms and they ate from the same plates as the patients. Wall has been resourceful, and indeed fortunate, in tracing two former residents of Villa 21 whom he calls “Adam” and “Ben.” Their testimony helps to bring alive the day-to-day reality of Villa 21. Interestingly, they have opposing views of the place. Adam found Dr. Cooper caring and thought his stay had improved his mental health, whereas Ben felt he survived his time in Villa 21 in spite of his treatment, rather than because of it. Both agreed that patients were expected to “perform” madness, especially if there were visitors to the unit. Indeed, Adam became a “star” patient. As Wall astutely observes: “In many ways this left the residents in a classic double-bind position: on the one hand they were at the hall to work through their madness, with the intention of emerging on the far side; but on the other hand they had been granted access to this exciting community by virtue of their overt craziness and there was the constant threat that they might, in Clancy Sigal’s words, ‘go down and come up straight’” (p. 81). (Sigal was an American writer who gave a comic account of his experiences as a resident in Kingsley Hall in his 1976 novel, Zone of the Interior.)
Wall goes on to consider the aforementioned Kingsley Hall, which was another therapeutic community, located in East London and presided over by Cooper’s colleague, Laing. He judges that it differed from Villa 21 in that it did not have such direct anti-institutional aspirations and did not threaten or confront mainstream psychiatry. He writes: “It did not directly challenge any pre-existing institution. Indeed, in some ways the hall served the exact opposite purpose to Villa 21” (p. 82). However, one could argue that the very existence of Kingsley Hall provided an example of how the mentally ill could be cared for in a different way to that of the standard psychiatric hospital, and, in that sense, it represented a challenge to orthodox psychiatry.
Wall then examines the counterculture of the 1960s. Drawing on his own archival research and the work of such commentators as Jeff Nuttall and Barry Miles, who were involved in the counterculture scene at the time, he evokes the heady atmosphere of the period, which combined radicalism, internationalism, hedonism, and just plain silliness. He also shows how anti-psychiatrists became involved with the counterculture, and how this contributed to their increasingly extravagant and apocalyptic claims. Where once they concentrated on the individual psychiatric patient, they now moved on to what they saw as the repressive role of the family and the evils of the West. They maintained that Western intervention in the third world was a function of the mapping of repressed sexual and murderous desires on to entire peoples, transforming them into the “other.” They declared that the Nazi concentration camps were a model for the methods employed by modern-day institutions, such as mental hospitals and schools, to dehumanize its population.
The anti-psychiatrists believed that institutions behaved like families in order to exercise power over people. Wall devotes a whole chapter to the anti-psychiatrists’ view of the family. They claimed that it was only through liberation on a micro-political level—at the level of the family—that society could be changed on a macro-political level. By escaping the oppressive power of social institutions, one became truly “authentic.” Wall discusses Cooper’s 1971 book, The Death of the Family, which he judges brought the different strands of the anti-psychiatric view of the family together and has been unjustly neglected and underrated.
Wall contends that the decline and fall of anti-psychiatry was intricately linked to the demise of the counterculture. As he writes: “By the mid-1970s, the novelty of the synthesis between the counter-culture and psychiatry, which had once attracted attention on all sides, was wearing off. For psychiatrists, the anti-psychiatrists’ theories and practices were no longer seen as sufficiently therapeutically focused, and for the counter-culture their politics either did not go far enough or were not developed enough” (p. 180). Elsewhere, he lays responsibility for the demise of anti-psychiatry at the door of Laing and Cooper, whom he considers were charismatic but also manipulative and abusive. This caused problems in sustaining the support and cooperation of others. David Ingleby had made this point some years before in Critical Psychiatry: The Politics of Mental Health (1980).
One of the difficulties of the book is the author’s decision to talk about the “British anti-psychiatrists,” rather than considering each one individually. While there were similarities in approach—Laing and Cooper wrote Reason and Violence (1964) together, and Laing also jointly researched Sanity, Madness and the Family (1964) with Aaron Esterston—there were significant differences between them. Further, Joseph Berke, whom Wall awards a key role in the development of anti-psychiatry, was, of course, American, while Cooper was South African. Such a strategy of grouping these diverse individuals under the umbrella of “the British anti-psychiatrists” gives the impression that there was more unity among the anti-psychiatrists than was actually the case. It is also confusing for the reader to disentangle which views were unanimously accepted and which were the expression of an individual anti-psychiatrist. A better title might have been, “Anti-Psychiatrists Working in Britain.” The term “anti-psychiatry” is itself contested. Laing is on record as rejecting the term as applied to himself. Wall does consider Laing’s claim and argues that Laing only made this claim in later years but that he seemed to accept it at the height of anti-psychiatry’s popularity. This is an interesting observation and may well be true given Laing’s penchant for self-mythologizing.
Wall gives insufficient credit to the work of previous scholars. Fussinger has written about the continuities between the approach of anti-psychiatrists and the postwar psychiatric experiments with therapeutic communities. David Abrahamson has compared Laing’s involvement with the “Rumpus Room” experiment at Gartnavel Royal Hospital in Glasgow to his later work at Kingsley Hall. Thomson identified that the roots of British anti-psychiatry lay in mid-twentieth-century psychiatry. None of them gets cited. Crossley has explored the influence of the counterculture and the New Left on anti-psychiatry. He does earn a citation, but there is no extended engagement with his work.[2] In my Portrait of the Psychiatrist as a Young Man (2011), I detail the early influences on Laing, which included his clinical years in Glasgow. Laing was to describe himself as a “conservative revolutionary,” by which he meant he was carrying on the tradition of the older Glasgow psychiatrists, such as Angus MacNiven, the superintendent of Gartnavel Royal Hospital, who were skeptical of the new physical treatments, such as psychosurgery and medication, and who saw their role as protecting their patients from harm.
Despite these reservations, Wall has produced a readable account of a much-discussed subject and has also provided original research and observations in the process.
Notes
[1]. Nick Crossley, “R. D. Laing and the British Anti-Psychiatry Movement: A Socio-Historical Analysis,” Social Science and Medicine 47 (1998): 877-89; Catherine Fussinger, “‘Therapeutic Community’, Psychiatry’s Reformers and Antipsychiatrists: Reconsidering Changes in the Field of Psychiatry after Word War II,” History of Psychiatry 22 (2011): 146-63; and Mathew Thomson, “Before Anti-Psychiatry: ‘Mental Health’ in Wartime Britain,” in Cultures of Psychiatry and Mental Health Care in Postwar Britain and the Netherlands, ed. Marijke Gijswijt-Hofstra and Roy Porter (Amsterdam: Rodopi, 1998), 43-60.
[2]. Fussinger, “‘Therapeutic Community’”; David Abrahamson, “R. D. Laing and Long-Stay Patients: Discrepant Accounts of the Refractory Ward and ‘Rumpus Room’ at Gartnavel Royal Hospital,” History of Psychiatry 18 (2007): 203-15; Thomson, “Before Anti-Psychiatry”; and Crossley, “R. D. Laing and the British Anti-Psychiatry Movement.
If there is additional discussion of this review, you may access it through the network, at: https://networks.h-net.org/h-disability.
Citation:
Allan Beveridge. Review of Wall, Oisín, The British Anti-Psychiatrists: From Institutional Psychiatry to the Counter-Culture, 1960-1971.
H-Disability, H-Net Reviews.
February, 2020.
URL: http://www.h-net.org/reviews/showrev.php?id=54633
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 United States License. |