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Customer Review

on 20 May 2008
... only for those with schizotypal personality disorder the mask ceases to be a defence, it corrodes the fragile self of the sufferer, turns against its wearer and can ultimately lead to full schizophrenic psychoses.

I get the impression on reading this book that RD Laing was responsible for injecting some much needed humanity into mental health treatment back in the sixties. As a support worker in mental health today I find much of Laing's emphasis on the subjective experience of the sufferer as relevant and important, yes, but at the same time quite obvious. Anyone reading Thomas Paine's Rights of Man will have much the same reaction, that after so long and so much change much of the book's radical feel has been lost. But skip back to four or five decades before the term person-centred-care was thought up, back to a time when anything ostensibly incoherent from a patient was written off as merely the `symptom of a disease', then we can begin to feel thankful that at least someone in fifties Glasgow was paying attention to what Heidegger and Sartre were up to.

The book is split into three parts. The first defines the idea of ontological insecurity (the dread of implosion, engulfment or petrifaction a person's identity) and ways of approaching the patient as a person and not as clinical material. The second explores Laing's version of the false-self system, a fatal defence mechanism whereby a person will remove themselves to the bell jar in order to protect but ultimately starve what they consider their inner `true' selves; we find here examples of people who, though clearly disturbed, have not as yet lost their capacity for coherent action in the world. The third part attempts to reveal what it means when that coherency does break down.

Laing's position, that objectivity in this field is not only pointless but impossible, and his insistence on a therapeutic engagement with distressed people on their own terms, allows him to provide a persuasive narrative for the descent into schizophrenia. He shows that people do not simply `go mad', but that each patient contains a history detailing their own slow and involuntary self-destruction. The book reads as a descent by-proxy from the relatively minor condition of a man who can only enjoy imagining having sex with his wife (just to be clear, yes, he is getting some), to the final condition of the `dilapidated hebephrenic', in her own words "born under a black sun", who must be found out between her other fragment selves after nine years of abandoned consignment to the agitation wards of a psychiatric hospital. Laing has written as much a tragedy here as a psychology book, as much worth reading for its emotional impact as for the clarity of his theory. Definitely recommend it.
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