As author, I must respond to those comments of Adrian Laing's in his review of my book that are most urgently called for, since, as a psychiatrist, I see them as potentially giving rise to harm to patients.
He accepts as credible my account of my experience (15 months after his father left) that 1950's Glasgow Royal Mental Hospital (Gartnavel) was caring and supportive of patients though it was without adequate funding centrally to provide for decent accommodation for some. His father, R. D. Laing, wrote of it as 'not a bad refuge', (Mezan.1972, p.168).
Nevertheless, though not then yet born, Adrian insists it was 'barbarous', his only evidence being facets of treatment adopted by psychiatrists of many years before, in the Victorian age, after whom ideas had moved on. The offending aspect of their practice was unknown to 1950's Gartnavel psychiatrists, who would have regretted and deplored it, but unlike Adrian would also have recognised their many beneficent activities.
Worse still, Adrian, cannot conceive of the problems of maintaining a safe refuge for the gentle insane mental hospital majority if emotionally unstable patients are aggressively terrorizing them and there are inadequate trained staff. He blackens the name of Sir D.K. Henderson who was in that situation in the difficult times of 1915 during the First World War. Henderson's settled principle was to calm the disturbed by assigning trained nurses to listen and talk with them; but there were few trained nurses who had not left for war work. The only known remaining protection for others was then to calm those manically active by restraint, perhaps also cooling the over-heated, or isolating them in a strong room; each method undesirable but unavoidable in these circumstances. Patients might, on return of sanity, have been glad to have been stopped. Every incident was recorded for the Board of Control. Henderson was then the only psychiatrist for over 500 in-patients along with the Superintendent. Useful drug treatments of later years had not yet been discovered.
Adrian forgets that against his principles his own father's anxiety about behavior of one resident of the 10 or 11 patients in his Kingsley Hall led him to force a drug injection on that man in concert with other `anti-psychiatrists'. (John Clay "RD Laing - A Divided Self" page 136).
Henderson inspired Maxwell Jones, the pioneering psychiatrist who, from the 1940s, evolved therapeutic community treatment in an open-door unit for people with personality problems. Key features of his work were absence of physical treatment, permissiveness, promotion of listening to patients and of insight, giving patients' responsible roles, and democratizing the doctor/patient relationship. When this unit attained the status of an independent hospital, Max christened it `Henderson Hospital', before going on to treat the mad and other patients in Dingleton, an unlocked hospital. Both R.D. Laing personally and his staff in Kingsley Hall thought it worthwhile to make efforts to learn from what Max was doing.
Today Henderson Hospital, a unique NHS resource for this effective psychological treatment, is under threat of closure due to financial stringency occasioned by other wars. This urgently needs challenging. It seems to me the kind of psychiatry of which Adrian could see father approving.
Adrian compares his father's generalized furious rhetoric against psychiatrists with the fury of Jimmy Boyle who had experienced incarceration in a Glasgow goal and wrote in fury about the penal system. He overlooks that Jimmy had the highest regard for the psychiatrists at the prison who created a therapeutic community through which he managed to outgrow the orientation of a Glasgow gangster which had brought him there and become kindly and creative, artist, sculptor and writer. Adrian also overlooks that in contrast to the conventional penal system the attitude of the Superintendent which percolated 1950's Gartnavel was that punishment played little part in reform. Adrians father said he had found these furious criticisms had been ineffective with fellow psychiatists (Mad To Be Normal page 378) and the historian psychiatrist linked that with the heat of his delivery. (Historian/psychiatrist Tantam). It was when he approached another psychiatrist respectfully and reasoned his case he was successful (Raschid page 60).