hate has to come first

In The Divided Self chapter 10 Laing makes extensive effective reference to a paper by Hayward & Taylor (1956) called 'A schizophrenic patient [Joan] describes the action of intensive psychotherapy'. The following caught my eye:

Laing: The main agent in uniting the patient, in allowing the pieces to come together and cohere, is the physician's love, a love that recognises the patient's total being, and accepts it, with no strings attached.
Joan: Hate has to come first. The patient hates the doctor for opening the wound again and hates himself for allowing himself to be touched again. The patient is sure it will just lead to more hurt. He really wants to be dead and hidden in a place where nothing can touch him and drag him back.
The doctor has to care enough to keep after the patient until he does hate. If you hate, you don't get hurt so much as if you love, but still you can be alive again, not just cold and dead. People mean something to you again.
The doctor must keep after the patient until he does hate, that is the only way to get started. But the patient must never be made to feel guilty for hating. The doctor has to feel sure he has the right to break into the illness, just as a parent knows he has the right to walk into a baby's room, no matter what the baby feels about it. The doctor has to know he's doing the right thing.
The patient is terribly afraid of his own problems, since they have destroyed him, so he feels terribly guilty for allowing the doctor to get mixed up in the problems. The patient is convinced that the doctor will be smacked too. It's not fair for the doctor to ask permission to come in. The doctor must fight his way in; then the patient doesn't have to feel guilty. The patient can feel that he has done his best to protect the doctor. The doctor must say by his manner, "I'm coming in no matter what you feel."
It's hellish misery to see the breast being offered gladly with love, but to know that getting close to it will make you hate it as you hated your mother's. It makes you feel hellish guilt because before you can love, you have to be able to feel the hate too. The doctor has to show that he can feel the hate but can understand and not be hurt by it. It's too awful if the doctor is going to be hurt by the sickness.
What is striking about Joan's description of her state and its apt therapy is how replete it is with moral tension. Laing tells us that is the doctor's love that cures. Joan tells us all about her hate, and her need for the doctor to engage in a non-collaborative self-assured tolerant manner. The manner, i.e. the form of the relationship, a form Laing calls 'love', is all.

What today is called 'clinical psychology' can, I believe, often-enough almost be defined as an attempt to approach psychological suffering and treatment in descriptive/psychological rather than moral/evaluative terms. To the extent that it succeeds in its attempt, to that extent does it damage the patient and impede true recovery. Joan needed a therapist who could be morally assured and bold. She did not ask for a moral relationship defined merely as a collaborative willingness to do work which itself could be understood non-morally (merely epistemically, for example). Instead she asked for what she essentially needs - a transformative moral relationship, the therapist's containment and metabolism of her hate, a stance which from the standpoint of the defences amounts to intrusion, a stance which is nevertheless in the service of recognition of the patient's actual and potential humanity.

Psychologists are today so apt to disaggregate and deconstruct schizophrenia into this or that symptom which supposedly warrants treatment. Laing takes a different route - he reaggregates the symptoms into an understanding of predicament - the schizoid and schizophrenic predicament and struggle with the courage to be, to be in relation to fate and to the passing of time, and particularly the courage to be in relation to others.


Popular Posts