In his short life the Scottish psychiatrist Ronald (“Ronnie”) Laing progressed from iconoclast to guru and mystic. The Divided Self was written at the beginning of this journey, when he was only 30. He went on to write other books in which he expressed some of the main tenets of the anti-psychiatry movement, including the belief that madness can be a useful interpersonal strategy or even a healing process rather than an illness—but this first book, published in 1960, is probably his best.
In it he describes with empathy some of his patients and concludes that those who developed schizophrenia did so because of disturbed family relationships. Although he followed Freud in regarding schizophrenia as a disorder of ego identity, his book made schizophrenic symptoms—often regarded as incomprehensible—seem understandable for the first time within the family context. Some people who read The Divided Self became psychiatrists as a result, and the book had a considerable influence on the culture of the 1960s and 1970s (think of One Flew Over the Cuckoo's Nest, for example).
The contents of The Divided Self can be summarised briefly. Abnormal family relationships can in some cases result in the development in the child of “ontological insecurity,” a schizoid personality, and, eventually, frank psychosis, usually in adolescence or later. The “self” of the child cuts itself off from other people and starts to relate only to itself so that it can maintain its identity and protect itself from external danger. The self comes to hate the world but also feels guilty because it thinks it does not deserve to be alive. The self may then attempt to destroy itself—or may split and then relate only to its false self (the self that complies emptily with the world). In psychosis the self can disintegrate into several parts or subsystems, which persecute what is left of the real self. In the end the self may no longer exist at all, but only what one patient poetically described as “the ghost of the weed garden.”
This theory raises a number of questions. Firstly, is the very concept of a self that is divided in the way that Laing describes even conceptually possible? Secondly, is the speech of schizophrenic patients really as intelligible as Laing suggests? Laing interprets much of what his patients said as the consequence of disturbed family relationships or as a concealed attempt to retain some of their identity, but it remains unclear whether schizophrenic speech disorders can be explained in this way. Thirdly, the few case histories Laing gives us could never constitute anything like adequate scientific evidence for his theory, even if his theory turned out to be true. Laing did not even consider the possibility that for some patients living with a family might actually have a protective effect. We still do not know what causes schizophrenia or indeed whether what we call schizophrenia is a single disease entity. Since Laing wrote his book we have evidence of genetic factors, structural brain damage, and intellectual dysfunction in schizophrenia, which any adequate theory about the cause or causes of schizophrenia would have to explain. This does not, of course, exclude the possibility that social factors, including the influence of the family, could play a part in such an explanation.
Probably the real value of The Divided Self is ethical rather than scientific. Laing treated his patients with great respect, and trying hard to understand them was part of this. In his autobiography, Wisdom, Madness and Folly, he recalls a senior psychiatric social worker who reproached him at a meeting: “Dr Laing, I am told that you allow your schizophrenic patients to talk to you.” Psychiatric patients are still stigmatised today, even by medical and psychiatric staff, who could learn something fundamentally important from this book.