Review of Madness Explained: Psychosis and Human Nature by Richard Bentall. Allen Lane, an imprint of Penguin Books: London, 2003
Penguin Books was RD Laing's publisher. It rescued Laing's first book The Divided Self, which was originally published by Tavistock Press, to create a bestseller. Other publications, particularly The Politics of Experience and The Bird of Paradise, promoted the phenomenon of "anti-psychiatry". The appeal of anti-psychiatry may not have been dependent on Penguin Books, but the popularity and eminence of the publishers may have helped to create celebrity status for Laing.
The same success may be anticipated and desired for Madness Explained by Richard Bentall. The book sets out with a similar aim to Laing to make madness more understandable. Rather than base this awareness in existentialism as did Laing, it has modernised the approach in recent empirical psychological research.
The book is a tome of 640 pages. It is well written, so its wordiness arises not from verbosity but its monumental aim to create a new synthesis. Here Laing differs. Although Laing may have thought that he was creating a new social phenomenological understanding, he never actually wrote such a grandiose work. As is widely known, his ambition instead was drowned in drunkenness. Any failure on the part of Bentall to create a new understanding of madness arises not from his lack of effort but the difficult, if not impossible, nature of the task in itself.
Part of the attraction of Laing came from his controversial attack on mainstream psychiatric practice. Bentall has the same radical streak, and sees his work as a ground-breaking way of thinking about madness and its treatment. However, his critique of the biomedical model, represented by Emil Kraepelin, and its more recent revival in the neo-Kraepelinian approach to make psychiatric diagnoses more reliable, is overshadowed by his wholesale acceptance of cognitive science. In an interview for New Scientist, when asked how he differed from the anti-psychiatrists, he answered that he was a scientist and that on the contrary Laing did not know when his ideas were inconsistent.
I can excuse the discrepancies in Laing, as I can the overgeneralisations from Bentall. However, my disappointment with Bentall is greater, and it takes longer to get there because of the length of the book. I kept hoping he would eventually deal with practicalities. He seems to appreciate the uncertainties of mental health practice, but then seeks to fix them in a symptom-orientated approach. I am not convinced that this really creates more understanding of mental illness. We might still be waiting for the definitive critique.
D B Double
Consultant Psychiatrist, Norfolk Mental Health Care NHS Trust