Abstract
Matt Oakes extends the discussion of DSM-type diagnostics to argue that as we now stand within a time of alarming mental health incidence, the urgency to reconsider our approach to this contemporary epidemic has never been more vital. His chapter returns to the theory of R.D. Laing to confront this issue, examining it from a psychosocial perspective that emphasises its social sources and commitment. R.D. Laing offered a unique and refreshingly human-focused insight into the phenomenology of schizophrenia. Immersing himself fully within this bleak and ostracised world, Laing explored the often-tortured inner landscapes and from within this space communicated experiences of psychic suffering to which all could relate. This chapter re-examines these communications and asks how they might be revived for current times.
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Notes
- 1.
Talking therapies are the preferred treatment choice of patients, clearly advocated in the NHS, 2016, Five Year Forward View for Mental Health (England.nhs.uk). However, demand is so great that this is unlikely to be a realistic achievement (Rose 2019).
- 2.
Rose (2019) states that drugs, in some cases, may have some benefit in the short-term, but the prolonged use that dominates current treatment strategies is of little benefit.
- 3.
Lithium was the drug that propelled this change. The medicinal impact of lithium gained attention during the 1940s and following research, was introduced to the NHS in the 1950s (Gitlin 1990).
- 4.
Although the NHS (nhs.uk. 2012) state ‘clinicians in the UK predominantly use the ICD-10 system to diagnose mental disorders, while the DSM classification system is mostly used for research purposes,’ the conspicuous use of the term ‘predominantly’ is an important caveat. As reported by Tryer (2014), the global influence of the DSM imbues it with perceived authority and as such creates a ‘general belief that it is in some way “more accurate”.’
- 5.
A slight reduction in categories is present in DSM-V compared to DSM-IV with several categories being amalgamated.
- 6.
Dementias (Alzheimer, Parkinson diseases) are an exception showing diagnostic consistency with neuroscience results (Rose 2019).
- 7.
There is evidence of patients resisting this power dynamic however this remains unusual and is even less possible at the immediate point of contact with psychiatric services (see Morrison 2005).
- 8.
Agreeing with Laing that schizophrenia was not a disease or illness but retaining ‘psychiatric words’ for what appears to be ease of understanding, the American critic of psychiatry Theodore Lidz (1972) stated that what we call schizophrenia is the ‘essential mental disorder’ (p. 154), an experience that exists at the absolute extreme. Its understanding would therefore facilitate insight into all other experiences of psychic suffering.
- 9.
Lidz was also an advocate of social conditions in the development of schizophrenia, emphasising the role of the family with his research, beginning in the 1940s. The intelligibility of the sufferer’s language was not an overt consideration for him until after reviewing Laing’s work (see Lidz and Lidz 1949; Lidz 1972 for this changing dynamic).
- 10.
As per the radical propositions of Timimi (2013): a current advocate, vocal within the Campaign to Abolish Psychiatric Diagnosis Systems such as ICD and DSM (CAPSID).
- 11.
‘We have an already shattered Humpty Dumpty who cannot be put back together again by any number of hyphenated or compound words: psycho-physical, psycho-somatic, psycho-biological, psycho-pathological psycho-social etc., etc’ (Laing 1960, p. 23).
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Oakes, M. (2019). Laing in the Twenty-First Century: Psychic Suffering in the Neoliberal Landscape. In: Frosh, S. (eds) New Voices in Psychosocial Studies. Studies in the Psychosocial. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-030-32758-3_10
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