The Divided Self: R.D. Laing and the Challenge to Psychiatry

1. Scope and evidence

This card concerns an idea and its author, so it carries two verdicts. That Laing originated and popularised the existential, person-centred critique of psychiatry set out in The Divided Self and later books is Established: the publications, dates and his role are fully documented. Whether his account of the causes of schizophrenia was correct is a separate question, and the answer is that it is Disputed and, in its strong form, not supported by subsequent research. The claim that Laing was an "anti-psychiatrist" is a mislabelling he himself rejected. Stories about his early ward experiments and quotations circulating under his name are marked Legend/Disputed where the record does not support them. The broad claim that he influenced humane, patient-centred care is treated as Shared: the influence is real and acknowledged by those who built on it, but it ran alongside many other reformers and cannot be credited to him alone.

2. A Glasgow upbringing

Ronald David Laing was born on 7 October 1927 in Govanhill, on Glasgow's South Side, the only child of David Laing, an electrical engineer, and his wife Amelia. He described his childhood as strict, anxious and emotionally guarded, and later critics have noted how closely his theories about families echo his own account of growing up. He was a gifted pupil at Hutchesons' Grammar School, a strong classical scholar and an accomplished pianist, and he read widely in philosophy as a teenager, including Kierkegaard, Nietzsche and Marx.

He went on to study medicine at the University of Glasgow. He was not a model student. He failed his finals at the first attempt and qualified as a doctor in 1951 after passing the resits. Glasgow mattered to the rest of his career in two ways: it trained him, and it gave him his first direct experience of the large, crowded psychiatric wards of the mid-20th century.

3. Army psychiatry and the insulin-coma wards

After qualifying, Laing was conscripted into the Royal Army Medical Corps and spent around two years as an army psychiatrist at Netley in Hampshire. There he worked on wards where patients were treated with insulin-coma therapy, a now-abandoned procedure in which patients were repeatedly put into hypoglycaemic comas. He later said that what struck him was not the treatment itself but how rarely anyone sat down and talked to the patients as people. That observation became the starting point for everything he wrote.

4. Gartnavel and the "Rumpus Room" (1954–55)

Back in Glasgow in 1953, Laing joined the staff of Gartnavel Royal Hospital. On its refractory ward, women with long-term diagnoses of schizophrenia spent most of the day in a bare dayroom with almost nothing to do. Working with the psychiatrists John Cameron and Andrew McGhie, Laing helped set up a separate, furnished room where a small group of these patients spent the day with the same two nurses, with materials for cooking, sewing and other activities.

The results were written up in The Lancet in 1955 as "Patient and nurse: effects of environmental changes in the care of chronic schizophrenics" (Cameron, Laing and McGhie). The patients became more sociable, took more care over their appearance and began to engage with activities and other parts of the hospital. The experiment is often cited as an early demonstration that the ward environment and human relationships shape how psychiatric patients behave.

Two cautions apply. First, it was a team project, published under Cameron's name first, not Laing's solo work. Second, Laing's own later account, in his memoir Wisdom, Madness and Folly (1985), that all the women were discharged within a year and then readmitted within another, does not match the published record. Historians who have examined the episode conclude that his retelling contains discrepancies, while still crediting the compassion behind the experiment.

5. London and The Divided Self

In October 1956 Laing left Glasgow for London to train in psychoanalysis at the Tavistock Clinic, where he worked until 1964. There he wrote the book that made him famous.

The Divided Self: An Existential Study in Sanity and Madness (1960) set out to make psychosis understandable. Drawing on existential philosophy (Kierkegaard, Heidegger, Sartre) and on his clinical notes, Laing described what he called "ontological insecurity": a person who does not feel securely real and whole may protect themselves by splitting off a hidden "true self" from a compliant "false self" they show to the world. In his account, the strange speech and behaviour of someone diagnosed with schizophrenia could be read as an intelligible, if desperate, way of coping with that split, rather than as meaningless noise produced by disease.

This was a sharp break with the psychiatry of the day. The German psychiatrist Karl Jaspers had argued in 1913 that many psychotic experiences, especially delusions, were fundamentally "un-understandable." Laing's whole project was to say the opposite: that with enough patience, a clinician could understand them. The book sold slowly at first, then very widely once Laing became famous in the 1960s, and it remains in print.

6. Families, politics and The Politics of Experience

Laing's next books moved from the individual to the family and then to society. Sanity, Madness and the Family (1964), written with Aaron Esterson, presented case studies of eleven families in which a daughter had been diagnosed with schizophrenia. The authors argued that, once you saw the family's patterns of communication, the daughter's behaviour made far more sense.

His ideas drew on the American "double bind" theory of Gregory Bateson, Don Jackson, Jay Haley and John Weakland (1956), which proposed that contradictory messages within families could contribute to schizophrenia. Laing developed his own related idea of the "knot," later turned into a book of poem-like dialogues, Knots (1970). He did not originate the double-bind theory, though it is often attributed to him.

By The Politics of Experience and The Bird of Paradise (1967), Laing's tone had become openly political and visionary. He wrote that the experience and behaviour labelled schizophrenic was "a special strategy that a person invents in order to live in an unlivable situation," and he suggested that a psychotic episode might, in some cases, be a kind of journey that could end in healing if it were not interrupted. These claims made him a counter-cultural celebrity. They also became the most contested part of his work.

7. Kingsley Hall (1965–70)

In 1965 Laing and colleagues founded the Philadelphia Association, a charity to explore alternative approaches to mental distress. Its best-known project was Kingsley Hall in Bromley-by-Bow, East London, a community where people in severe distress lived alongside therapists, without locked doors, uniforms or routine medication.

The most famous resident was Mary Barnes, a former nurse whose regression and recovery at Kingsley Hall were described in Mary Barnes: Two Accounts of a Journey Through Madness (1971), written with the psychiatrist Joseph Berke. She became a painter and is often presented as proof that the approach worked.

The wider picture is less clear. Kingsley Hall kept no systematic outcome records, life inside was at times chaotic, and relations with neighbours were poor. The community closed when its lease ended in 1970. It is best understood as an influential experiment, not as evidence that the model was effective.

8. "Anti-psychiatry": a label he refused

In 1967 Laing's colleague David Cooper published Psychiatry and Anti-Psychiatry, which gave a name to a loose set of critics of mainstream psychiatry. The press and many textbooks have applied the label to Laing ever since. Laing rejected it. He criticised the coercion, institutional routines and heavy use of physical treatments common in the psychiatry of his time, but he did not deny that people in mental distress suffer, or that they need help. He continued to describe himself as a psychiatrist.

He is also often grouped with the Hungarian-American psychiatrist Thomas Szasz, author of The Myth of Mental Illness (1961). The grouping is misleading: Szasz argued from a libertarian position that mental illness was not a medical category at all, and he was openly critical of Laing and of Kingsley Hall.

9. What the evidence has shown since

Laing's strongest claims about causation have not held up.

Families do not cause schizophrenia. Research since the 1970s, including twin, adoption and genetic studies, has shown a substantial inherited contribution to the risk of schizophrenia, alongside developmental and environmental factors such as early-life adversity, migration, urban upbringing and cannabis use. The 1960s idea that parents' communication patterns cause the condition has not been supported. It also caused real harm, adding blame to families already coping with a relative's illness.

Psychosis is not reliably a healing journey. Untreated psychosis is associated with worse long-term outcomes, and antipsychotic medication remains an evidence-based treatment for many people, used alongside psychological and social support.

None of this is advice about any individual's care. It is the reason this card treats Laing's causal theories as Disputed.

10. The legacy that lasted

What survived is Laing's insistence that patients are people whose experiences mean something. That idea has become part of mainstream care, even among psychiatrists who reject his theories.

Soteria. The American psychiatrist Loren Mosher spent a sabbatical in London, got to know Kingsley Hall, and on his return set up the Soteria project in California (1970–1992), a small, homely residence for people in a first episode of psychosis. Unlike Kingsley Hall, Soteria was formally evaluated, and its approach has been revived in several countries.

Therapeutic communities. The Philadelphia Association still runs community households and a psychotherapy training in London.

Patient voice. Laing is widely cited as one forerunner of the service-user and survivor movements, and of approaches that put listening at the centre of care. This influence is real but diffuse; those movements had many sources.

11. Later life

From the 1970s Laing's reputation declined as his work became more mystical and his personal life more troubled. He travelled to Sri Lanka and India in 1971–72 to study meditation, ran "rebirthing" workshops later in the decade, and wrote poetry and memoir. He spoke openly about episodes of heavy drinking and depression. Those admissions formed part of a case brought by the General Medical Council, and on 20 May 1987 he voluntarily withdrew his name from the Medical Register. He died of a heart attack while playing tennis in Saint-Tropez on 23 August 1989, aged 61.

12. Why Scotland?

Laing's ideas were formed in London and became famous internationally, but their roots are Scottish. He was shaped by a Glasgow Presbyterian upbringing and by Glasgow's university, and his first clinical work was on Glasgow's wards. His papers are held by the University of Glasgow Library.