In psychology, a family nexus is a common viewpoint held and reinforced by the majority of family members regarding events in the family and relationships with the world. The term was coined by R. D. Laing, who believed that this nexus "exists only in so far as each person incarnates the nexus...maintaining his interiorization of the group unchanged". [1]
The concept is similar to the "family psychic apparatus (FPA)...an unconscious psychic basis, common to members of the family group, inducing a specific experience of belonging". [2]
Laing was particularly interested in schizophrenia, which he believed could be understood if seen from the viewpoint of the person concerned. He saw how a powerful family nexus could victimise one member, usually a child, who found themselves in the position of not being able to speak or even think the truth without being chastised by the group, who often had vested interests in perpetuating the family myth and excluding reality. In Laing's opinion, "what is called a psychotic episode in one person, can often be understood as a crisis of a peculiar kind in the inter-experience of the nexus." [3]
Often described as part of the "antipsychiatry" movement, Laing strived to see things in terms of existentialism, emphasising the difference between "being" or "being in this world" and being alive. "An issue essential to an existential analysis of action is to what extent and in what ways the agent is disclosed or concealed...in and through action." [4] Being in the existentialist sense means being an object for others, and having others as objects, in other words carrying a model in our heads of all the significant others in our lives. [5] This model provided the motivation for many of our thoughts and actions, and without it we "cease to be" in a very real sense.
It is this need for others, in order to "be", which makes us afraid to contradict a family nexus, risking family exclusion. However "to a number of people the phantasy system of the nexus is a lousy hell, not an enchanting spell, and they want out...But within the phantasy of the nexus, to leave is an act of ingratitude, or cruelty, or suicide, or murder...Herein is the risk of defeat and madness." [6] The distortion involved in not going against the nexus can force wrong thinking - leading to "not being in reality", which Laing saw as the essence of schizophrenia; and for Laing "one of the most important questions, therefore, is whether such mistrust of her 'feelings' and the testimony of others arises from persistent inconsistencies within an original nexus." [7]
Laing and his colleagues suggested that a family nexus included both immediate family, and extra-familial people closely associated with the family and its world-view. [8] Laing argued that a closed nexus would use its energy so as to unconsciously block out any threats to its identity, keeping all interchanges at a boring, repetitive level. [9] Building on Kleinian accounts of social phantasy systems, and the sense of unquestioned reality they can generate, Laing argued that within such systems patterns of communication were multi-layered and deceptive. [10]
He also used W. R. Bion's account of how a group's basic assumptions could radiate "long silences, sighs of boredom, movements of discomfort...the hostility of the individuals was being contributed to the group anonymously". [11] As his associate Joseph Berke put it, in such a nexus "a unique pattern of communication could be made out. People did not talk to each other, but at each other, and tangentially, not directly....what people said was often contradicted by the way they said it (tone of voice and/or facial and bodily movements)." [12]
Further light was shed on such interactions by Gregory Bateson's concept of the double bind - "a situation in which contradictory demands are being put upon a child (or patient) in such a way that there is no avenue of escape or challenge". [13] Laing considered that the concept allowed a completely new understanding of what a familial environment could entail: [14] "this paradigm of an insoluble 'can't win' situation, specifically destructive of self-identity" greatly illuminated the way the subject's "disturbed pattern of communication...[was] a reflection of, and reaction to, the disturbed and disturbing pattern characterizing his or her family of origin." [15] In such a light, he considered that "mental illness" might be the outcome of a problematic configuration of a family nexus more than a necessary result of the nexus itself: in the words of Charles Rycroft, the psychotic is "the overt casualty of a deeply concealed family tragedy...the end-result of complex and skew[ed] interactions within his family." [16]
As Laing was careful to point out, however, it was not "a matter of laying the blame at anyone's door. The untenable position, the 'can't win' double-bind, the situation of checkmate, is by definition not obvious to the protagonists...The man at the bottom of the heap may be being crushed and suffocated to death without anyone noticing, much less intending it". [17]
Andrew Collier has commented on Laing's dilemma, which Laing himself seemed never to properly identify. [18] In much of his writing Laing assumed an uncorrupted natural state for the human mind, and tended to condemn society for causing mental illness, in rather (early) Marxist terms. He saw schizophrenia as a possible healing process, a way of working through things, back to normality. Collier suggests that there is no uncorrupted state, no normality; rather that as social animals we all need to incorporate others into a nexus in order to "be". We must all perhaps be "mad" to some extent if we are to function in society, rather than as loners, but we must be uniformly mad. The nature of the madman's "must", however, remains unestablished.
Psychotherapy today comes in many forms, following different schools of thought. Psychoanalysis emphasises childhood experience, and left-over feelings, though Freud did point to the role of society in his later works like Civilization and its Discontents. Family therapy concentrates on bringing families together and encouraging them to work out their interactions, but it might (depending on its theoretical orientation) offer little or no support to the victim of family nexus, who may then be punished for anything he dares to reveal or hint at, and (lacking a support network) submit to silent intimidation in family therapy, rather than risk exclusion and the "ceasing to be" that follows.
The alert family therapist will however "avoid taking the family's side...Or the scapegoat's. You mustn't take anyone's side because then you'd be joining in the blaming...You've got to treat the family as a system, without blaming anyone...you need to make them all feel supported." [19]
In psychology, fantasy is a broad range of mental experiences, mediated by the faculty of imagination in the human brain, and marked by an expression of certain desires through vivid mental imagery. Fantasies are generally associated with scenarios that are impossible or unlikely to happen.
Anti-psychiatry, sometimes spelled antipsychiatry, is a movement based on the view that psychiatric treatment is often more damaging than helpful to patients, highlighting controversies about psychiatry. Objections include the reliability of psychiatric diagnosis, the questionable effectiveness and harm associated with psychiatric medications, the failure of psychiatry to demonstrate any disease treatment mechanism for psychiatric medication effects, and legal concerns about equal human rights and civil freedom being nullified by the presence of diagnosis. Historically critiques of psychiatry came to light after focus on the extreme harms associated with electroconvulsive treatment or insulin shock therapy. The term "anti-psychiatry" is in dispute and often used to dismiss all critics of psychiatry, many of whom agree that a specialized role of helper for people in emotional distress may at times be appropriate, and allow for individual choice around treatment decisions.
Wilfred Ruprecht Bion DSO was an influential English psychoanalyst, who became president of the British Psychoanalytical Society from 1962 to 1965.
Ideas of reference and delusions of reference describe the phenomenon of an individual experiencing innocuous events or mere coincidences and believing they have strong personal significance. It is "the notion that everything one perceives in the world relates to one's own destiny", usually in a negative and hostile manner.
Ronald David Laing, usually cited as R. D. Laing, was a Scottish psychiatrist who wrote extensively on mental illness—in particular, psychosis and schizophrenia. Laing's views on the causes and treatment of psychopathological phenomena were influenced by his study of existential philosophy and ran counter to the chemical and electroshock methods that had become psychiatric orthodoxy. Laing took the expressed feelings of the individual patient or client as valid descriptions of personal experience rather than simply as symptoms of mental illness. Though associated in the public mind with the anti-psychiatry movement, he rejected the label. Laing regarded schizophrenia as the normal psychological adjustment to a dysfunctional social context, although later in life he revised his views.
David Graham Cooper was a South African-born psychiatrist and theorist who was prominent in the anti-psychiatry movement.
Object relations theory is a school of thought in psychoanalytic theory and psychoanalysis centered around theories of stages of ego development. Its concerns include the relation of the psyche to others in childhood and the exploration of relationships between external people, as well as internal images and the relations found in them. Thinkers of the school maintain that the infant's relationship with the mother primarily determines the formation of its personality in adult life. Particularly, attachment is the bedrock of the development of the self or the psychic organization that creates the sense of identity.
A double bind is a dilemma in communication in which an individual receives two or more reciprocally conflicting messages. In some scenarios this can be emotionally distressing, creating a situation in which a successful response to one message results in a failed response to the other, such that the person responding will automatically be perceived as in the wrong, no matter how they respond. This double bind prevents the person from either resolving the underlying dilemma or opting out of the situation.
Aaron Esterson was a British psychiatrist, practising in Glasgow.
Projective identification is a term introduced by Melanie Klein and then widely adopted in psychoanalytic psychotherapy. Projective identification may be used as a type of defense, a means of communicating, a primitive form of relationship, or a route to psychological change; used for ridding the self of unwanted parts or for controlling the other's body and mind.
Mary Edith Barnes was an English artist and writer with schizophrenia and became a successful painter. She is particularly known for her documentation of her experience at R. D. Laing's experimental therapeutic community at Kingsley Hall, London. She is referenced in the book The Psychopath Test by Jon Ronson and Thomas Szasz's Schizophrenia.
Theodore Lidz was an American psychiatrist best known for his articles and books on the causes of schizophrenia and on psychotherapy with patients with schizophrenia. An advocate of research into environmental causes of mental illness, Lidz was a notable critic of what he saw as a disproportionate focus on biological psychiatry. Lidz was a Sterling Professor of Psychiatry at Yale University. In his lifetime, he did a great amount of research on interpersonal causes of schizophrenia.
The trauma model of mental disorders, or trauma model of psychopathology, emphasises the effects of physical, sexual and psychological trauma as key causal factors in the development of psychiatric disorders, including depression and anxiety as well as psychosis, whether the trauma is experienced in childhood or adulthood. It conceptualises people as having understandable reactions to traumatic events rather than suffering from mental illness.
Joseph H. Berke, M.D., was an American–born psychotherapist, author and lecturer. He studied at Columbia College of Columbia University and graduated from the Albert Einstein College of Medicine in New York. Berke moved to London in 1965 where he worked with R. D. Laing in the 1960s when the Philadelphia Association was being established. Berke was a resident at Kingsley Hall, where he helped Mary Barnes, a nurse who had been diagnosed with schizophrenia, emerge from madness. Barnes later became an artist and writer. A stage play based on the book that Berke and Barnes wrote together was adapted as a stage play by David Edgar. A film adaptation of the book is currently under consideration. Berke collaborated on a number of projects with Laing, including the Dialectics of Liberation international conference in London, July 15–30, 1967, where he was the principal organizer. Berke worked as a psychoanalytic psychotherapist for individuals and families. He was the co-founder of the Arbours Association in London in 1970, and the founder and director of the Arbours Crisis Centre (1973-2010) in London. He was the author of many articles and books on psychological, social, and religious themes. Berke died in London on January 11, 2021. A great part of Joseph Berke's estate is held at the PET Archives and Collections: Personal papers of Dr Joseph Berke including materials relating to the Institute of Phenomenological Studies, Research Committee on Cannabis, Fire Magazine and Arbours Association. Alongside these materials are the professional papers of Berke including notes for two publications 'Paranoia and Persecution' and 'Beyond Madness'. Within the collection is a series of correspondence regarding the Dialectics of Liberation Congress 1967.
The Critical Psychiatry Network (CPN) is a psychiatric organization based in the United Kingdom. It was created by a group of British psychiatrists who met in Bradford, England in January 1999 in response to proposals by the British government to amend the Mental Health Act 1983. They expressed concern about the implications of the proposed changes for human rights and the civil liberties of people with mental health illness. Most people associated with the group are practicing consultant psychiatrists in the United Kingdom's National Health Service (NHS), among them Dr Joanna Moncrieff. A number of non-consultant grade and trainee psychiatrists are also involved in the network.
Identified patient (IP) is a clinical term often used in family therapy discussion. It describes one family member in a dysfunctional family who is used as an expression of the family's authentic inner conflicts. As a family system is dynamic, the overt symptoms of an identified patient draw attention away from the "elephants in the living room no one can talk about" which need to be discussed. If covert abuse occurs between family members, the overt symptoms can draw attention away from the perpetrators.
The Politics of Experience and The Bird of Paradise is a 1967 book by the Scottish psychiatrist R. D. Laing. The book comprises two parts - the first a collection of seven articles previously published between 1962 and 1965; the second a free-flowing quasi-autobiographical piece of poetry and prose.
Role suction is a term introduced in the United States by Fritz Redl in the mid-20th century to describe the power of a social group to allocate roles to its members.
Self and Others is a psychological study by R. D. Laing, first published in 1961. It was re-issued in a second edition (1969), which was “extensively revised, without being changed in any fundamental way”.
"In Two Minds" is a television play by David Mercer commissioned for The Wednesday Play anthology drama series. First transmitted on 1 March 1967, it was directed by Ken Loach and produced by Tony Garnett and features Anna Cropper in the lead role.