‘Comrade Doctor’ – On David Cooper and ‘Anti-Psychiatry’

“Madness haunts the working and sleeping hours of even the most ‘healthy’ and ‘normal’ as society loses even the appearance of rationality.”

– Russell Jacoby ¹

Picking up on Christoph Fringeli’s review of a reissue of Peter Sedgwick’s Psycho-Politics in Datacide 15, it struck me as to why my experience of reading Sedgwick’s book had been both curiously deflating and – in the chapters covering R.D. Laing – unsettling in the way it often has the tone of a personalised vendetta. Only on reading the review did this become a little clearer. Perhaps it was Sedgwick’s position as a lecturer in politics proper, as an upholder, when pushed by some of Laing’s poetic and mystical flights, of the “scientific-rationalist tradition of the Enlightenment”. Piqued by the memory of these little digs, I consulted a long essay by Sedgwick entitled ‘R.D. Laing: Self, Symptom and Society’ which was published ten years before Psycho-Politics ². Here, from the opening line, it is announced that Sedgwick is going to survey Laing’s ‘intellectual history’ and whilst pointing to the difficulty in this (e.g. Laing collaborated with others so, it is maybe implied, a ‘pure’ Laing may be hard to isolate), he still maintains, with a kind of individuating moralism, that Laing must “bear responsibility” for his writings. Throughout this essay, which seems like a pre-run for Psycho-Politics, this kind of judgment, a judgment based on a readerly reading of written texts and in only very minimally exploring the responsibilities of Laing’s therapeutic praxis, seems above all to be about bringing a counter-cultural ‘guru’ down a peg or too, writing-off existential psychotherapy and uncritically defending the NHS. So, in his review of Ken Loach’s film Family Life which is loosely based on ‘anti-psychiatric’ themes as these effect a distressed young woman, we are subject to a kind of pawky sarcasm from Sedgwick: “At first the poor girl gets some sympathetic psychiatric help in a ward run by a Laingian doctor, who is called Mike by his subordinates and conducts therapy-sessions through earnest discussion about relationships.”³

Whilst this journalistic flippancy may be directed at a social-realist reconstruction of ‘reality’, to describe the therapeutic as an ‘earnest discussion about relationships’, is almost as absurdly dismissive as the way that Sedgwick ends his review of the film: “Dr R.D. Laing is not even a Bolshevik. It is to be hoped that those who thought that he was a ‘doctor comrade’ will have some serious second thoughts.” In some ways, then, Sedgwick, in this essay, reduces ‘anti-psychiatry’ to one individual, and undermines what may have been a very real struggle for him, back then, within strictly Socialist circles, to have the ‘seriousness of mental and emotional disturbances’, as he succinctly calls it, taken as politicising factors. It is this effort, this ‘politicization of madness’ which gained a momentum from the late 50s and put more firmly into the public domain social questions of ‘madness’ and ‘sanity’; and it was ‘anti-psychiatrists’ such as Laing and David Cooper who led this push in the realm of ideas (drawing initially upon Sartre’s Critique of Dialectical Reason) and practice (starting out from bringing a therapeutical accent to psychiatric ‘care’). True, by the time of Psycho-Politics, Sedgwick has expanded his reach to include Goffman, Foucault and Szasz, but as Christoph mentions, “he is not so concerned with the wider anti-psychiatry movement”, many of whom may well have fallen over laughing at the subtitle of his book ‘the future of mass psychiatry.’ That we are living in that future may well be indisputable when you look at the prescription rates for anti-depressants and the recent entry of ‘opposition defiant disorder’ into the DSM-IV manual, but as Christoph seems to be suggesting, there is something potentially misleading in Psycho-Politics if, being deemed vital enough for a re-edition, it is to be then taken as a definitive historical statement by an author who, in replying with realpolitik to comments on his review of Family Life offered: “There also seems to have been some objection to my endorsement of shock therapy when properly administered.” That said, much is missing from the history of anti-psychiatry, even now, and one wonders, whether, amidst the missing are the testimonies of the missing-in-action and those others who survived to form ‘patient initiatives’ such as the Mental Patient Union and Group Information Asiles that had been founded by the mid-1970s.⁴ Such opposition to psychiatric violence was covered by loosely anti-psychiatric English language journals such as Humpty Dumpty (Nottingham, UK), The Radical Therapist (Somerville, USA) and Madness Network News (San Francisco Bay Area, USA). Sedgwick references and indeed cites these journals, as well as European developments in Part Two of Psycho-Politics but, reading back through the book, it becomes noticeable that there is, at times, an almost mutually-exclusive tension between a broadly responsible social psychiatry and an hyperbolic anti-psychiatry, as well as between a policy-centric socialism and an irrealist left-libertarianism.

However, returning to Christoph’s review, we get an inkling here that Sedgwick, in his push towards intellectual polemic in the Anglo-Saxon world has neglected to fully engage with European ‘anti-psychiatric’ initiatives such as the ‘democratic psychiatry’ of Franco and Franca Basaglia, the Socialist Patients Collective in Germany and the institutional psychotherapy of François Tosquelles, Jean Oury and Félix Guattari that arose in France in the 1950s (Frantz Fanon underwent a residency with Tosquelles at St Alban before applying his ‘social therapy’ approach at Blida-Joinville hospital in Algeria⁵) Whilst not quite in the domain of ‘antipsychiatry’, but most surely in the realm of ‘psycho-politics’, one could also mention the influence that Wilhelm Reich and Sexpol had upon ventures to ‘politicise madness’ (for which he was expelled from both the German Communist Party and the Freudian International Psychoanalytical Movement) as well as the developments made by the Women’s Liberation Movement in the zone of sexual politics and beyond. Sedgwick appears not to have mentioned Reich once in Psycho-Politics and the pressure of articulating the multifarious positions of the WLM falls upon Phyllis Chesler and her book Women and Madness as well as a footnoted Juliet Mitchell. However, whilst it’s easy for me to make such digs after 40 years – which, unsavoury as they may be, are perhaps still impelled by the niggly tone of Sedgwick’s media-accepting characterisations of Laing as ‘prophet-in-chief’, ‘ideological celebrity’ etc. – it is to one who gets only a brief mention by Sedgwick that I’d like to turn to here. Maybe it is because of his having ‘actual left wing credentials’, as well as the non-too flattering accounts of his therapeutic practice that have floated about⁶, that are making sure that David Cooper’s thought and practice as it developed from the 60s to the early 80s, is slowly receding from ‘anti-psychiatry historiographies despite his having named it such and having been a collaborant in the Philadelphia Association’s Kingsley Hall community (following his much maligned initiative at Villa 21, Shenley Hospital). In a not disconnected manner it could be that, as Cooper spent at least the last ten years of his life in France, he fell off the Anglo-Academic radar whilst at the same time that he came to critique the term ‘anti-psychiatry’ and outline what he called ‘non-psychiatry’. Yet, as the author of several key books on ‘anti-psychiatry’ it is a mystery as to why David Cooper was more or less omitted from Psycho-Politics.⁷

It may well be that Cooper was grateful about Sedgwick’s oversight in that, having later reassessed ‘anti-psychiatry’ (“that wretched and infinitely distorted term”) he was maybe already contributing to his own invisibility in relation to the catch-all phrase he had coined. Just as with his ideas about non-exigent communication and the role of silence and somatic gesture in his therapeutic practice, he seems to be already urging not just his own disappearance, but also the ‘dépassement’ (supercession) of psychiatry itself. That said, Sedgwick’s neglect of Cooper’s five book contribution to the topic, as well as the excessive focus upon R.D. Laing (by many more authors than just Sedgwick), may itself be contributing to Cooper (and others) becoming less visible. Here, then, rather than chart Cooper’s overall trajectory I would like to pick up from Christoph Fringeli’s review and draw upon Cooper’s last book, The Language of Madness⁸, as this, ending with an open letter to the International Network of Alternatives to Psychiatry, illustrates that Cooper may well have disappeared into a more anonymous and collective form of engagement: “The only point in writing I can see now is to infect the world with the cells of its own madness. As the madness is its own madness there should be no phenomenon of rejection. But who can tell?”

So, as Christoph mentions, The Language of Madness, published four years before Psycho-Politics, is ‘far-out’ to the degree that it not only describes Cooper’s own struggle with the ‘de-structuring/re-structuring’ experience of ‘madness’ and thus becomes more than just “out and out solidarity with psychotic experience” (for which Sedgwick berates Laing), it is also ‘far out’ in its concentrated anger and passionate willingness to politicize madness as a “common social property”, inhering in us all and a means, among others, of aiming towards “a less alienated way of being.” Throughout this book, Cooper is at pains to replace the romanticization of madness as a voyage and to use his own experiences to examine the social alienation that is a key component of ‘mental illness’. This romanticism may, however, have returned in the form of Cooper’s notion of “madmen as political dissidents”⁹, but, in distancing himself from the ‘mystical voyage’ aspect of anti-psychiatry that so galls Sedgwick, we may see this latter move as a polemical device to get across to his readers the way that, as subjects of the reciprocal selfishness of capitalist social relations, we share in mental and social alienation and how our encounters with ‘madness’ places us before both the inoperability of exigent communications that always hinge on what Sedgwick honours as “publically accessible data” as well as making us aware of the limits of ideologised notions of individual freedom as these are capitalised upon by conventional psychiatry to de-socialise the political problems that ‘madness’ poses.

To some degree, for Cooper, one element of appraising and becoming less threatened by the ‘madness’ (in ourselves and in others and in the institutions we pass through) is that for Cooper it permits an extended critique of capitalist social relations in all their forms (from the geo-political to the micro-social) and enables, in gaining a consciousness of oppression, tendencies towards ‘autonomy’ from such relations to come into collective being. By “disordering alienated existence”, by coming to articulate an often unconscious challenge to the surrounding normopathy with its “concealed injunctives” and imposed means of communication, ‘madness’ compels an urgent (and often non-verbal) response to its suffering which calls upon the human attributes of patience and non-judgementalism as well as an ability to suspend our ‘alienated’ responses that often take the form of a protective ‘self-ness.’ In challenging the limits of acceptability, experiences of ‘madness’ occasion a test of social relations and bonds of sincerity, and often finds the social efficacy of these bonds as insufficient (indeed, in relation to the psychiatric violence that anti-psychiatrists and others drew attention to it is more the case that these ‘bonds’ are more of the bondage type.) For Cooper, then, ‘madness’ may well be an ontological crisis precipitated by the place of the ‘social within the ‘self’ (and all the pressurised warping this dualism implies), that is one means of responding to the contradictions and double binds that capitalist society institutes. In the words of Cooper this society is one of ‘Total Property’ and ‘Permanent Mystification’ and as such, with property relations isomorphic to the ego-ideal and mystification entailing the ways in which we suffer “imputed desires”, Cooper’s fondness for the word ‘autonomy’ in his last book, is linked both to his ideas of ‘radical need’ and the attempt to find forms for a non-guilt inducing collective responsibility.

So, The Language of Madness, with its comets of ‘far out’ concepts like “cosmic womb”, “aeonic memory” and “molecular alteration” is just as much a book rooted in the revolution of everyday life as it the outcome of a psychedelic hangover. Indeed, some of Cooper’s wilder musings are not that far removed from his desire to make madness a political matter and point towards libertarian-left notions of autonomy. Many of his verbal comets concern notions of the ‘non-self’ that just as they may well sooth the suffering in their locked-in despair they also, as the “non-substantiality of self”, point towards a solidarity of transindividuation. In this Cooper is not so much referring to the politics of autonomia as to an autonomy from the alienated existence of capitalist social relations. Whilst it can be suggested, and Cooper does so, that we cannot individually free ourselves from the alienated relations as they exist within and between us¹⁰, there is a sense that the experiences of ‘madness’ that Cooper is trying to write-through are ‘outside’ that society. From incarceration to the ‘liquid cosh’, the ‘mad’ are those for whom society has no use (they have long formed an element of the ‘surplus population’) and to a degree ‘madness’ is to ‘opt-out’ from the pressures to conform to alienating values and monetary measures of worth. True, it’s also a deeply painful and complex situation of mental suffering, an experience of ‘non-self’ and ‘hyper-self’, of catatonic disappearance and sociopathic disregard, but in such cases there is all the more reason for society to ‘remove’ those who pose such existential, and by extension, political questions from the tracks of a fitting-room society. For Cooper, then, this ‘outside’, however metaphoric it is when placed against the backdrop of a pervasive value-form, cannot disguise feelings of being alienated from society and it is from and through these feelings, I think, that Cooper attempts to politicise madness as pertaining to an ‘autonomy’ which undermines normopathy and the psychically oppressive cost of maintaining it¹¹.

The production of the subject as a ‘normopath’ is deeply historically complex. For Cooper it extends from the imposition of valorisable values (the family-school-work triad of homo economicus) to a kind of auto-censorship that restricts both the sayable and the imaginable (the mutually reinforcing adherence to ontological parameters that the media loop is well funded to induce). In relation to the latter, Cooper, in the essay that titles his book, muses on how those deemed ‘mad’ use and play with language and its limits. This use, notes Cooper, is often in counter-response to the implicit urge of psychiatry to identify an ‘intelligible being’ on the other side of the desk. Maybe many of us have had such encounters be they in the classroom or the police interview room or psychiatrists office when ‘watching what you say’ becomes extremely urgent. For those who don’t watch what they say but ‘enact it’ (“acting a word when the word conventionally should be said” offers Cooper), the stakes are even higher in that loosing the shared reliance upon language (by ‘acting out’ or ‘poeticising’) is one of the first means by which normopathic logic becomes to feel threatened¹². The threat to ‘realize language’ – which can be simply to uphold a promise, to remove the usual ideological disjuncture between what is said and what is done and, surely, too, its creolization – is, for Cooper, the language of madness: “an incestuous union of language and action” which introduces a necessary “vivifying political insertion of unreason, which has its own rationality, into the […] manipulative discourse of the normal ones.” The same effect (of alienating the alienists) is garnered by the manic spillage of verviosity, by the fragmented and de-gestelling shards of autobiography, by the foamenting rage at being the subject of deception but, also and crucially by a silence which Cooper (maybe weary of too many ‘talking cures’) upholds as an offer of ‘communion’ rather than communication.

What increasingly takes shape across Cooper’s book is a whole bundle of what he calls ‘radical needs’; needs that are too unprofitable to be met by capitalist society in any form and which challenge this society on many levels whilst at the same time becoming reasons and motivations for the solidarities of a ‘psycho-politics’ that Cooper (as well as Laing) was involved in. We can offer, then, that even if we restrict ourselves to ‘mad discourse’ of the previous paragraph we can glean some of these radical needs: the need to maintain and experiment with transitional states wherein, coming to expression, we can “be the being of change” as Cooper puts it and, in this processual state, be identifiable as having different rationalities and not all subject to a standardised Rationality. Such a singular rationality would be one that Cooper, often reluctant to use the Freudian notion of the unconscious, would term “a pre-reflective consciousness.” When such a consciousness expresses itself it is obviously not by means of standard forms of communication. Rather it could be in the form of ‘mad discourse’ in that transition or process is often difficult to communicate in language and even more so if the interlocutor is one, invested in the sureties of his or her own arrived-at consciousness, that is blinded to another’s process. For Cooper what would follow on from this is that a ‘pre-reflective consciousness’ would be distinct from “consciousness of consciousness” which latter he sees as the “base of knowledge”. Here we could interpret Cooper as pointing towards other forms that ‘knowledge’ can take: singular knowledges to which we are our own ‘expert’! The tight confines of language, then, disavow another need: the need, from the standpoint of counter-rationalities, to engage in identity-defying absurdities, for ‘relaxing from language’ to the extent that, at a minimum, we can ‘de-face’ language and play with its shibboleths (perhaps, as with ‘mad discourse’, to bring a ‘wide span of identities’ into expression). And, of course, there is the radical need for silence which in much anti-psychiatric practice took the form of therapy being practiced as “attentive non-interference” or, much the same thing, abandoning one-to-one therapy sessions (as did Basaglia at Gorizia) to open up a sociality of meetings to plan a role-disbanding and non-hierarchical commonality of work¹³.

It could be objected that issues of food and shelter for the world’s exploited populations are the most radical of (revolutionary) needs, but yet I read Cooper’s take on radical needs as one that suggests that if we don’t take these aforementioned needs as radical, as components of a communism, then the very foundations of our solidarities and coming together will continue to be difficult to sustain. It is in light of the word ‘solidarity’ that Cooper’s use of ‘communion’ is best viewed. I’d like to suggest that it may well be that solidarity is one thing, often the mutually-supporting maintenance of commitment to a just cause, but, such a solidarity, that can often be an aspect of the ‘consciousness of a consciousness’, also needs a sense of communion to bring into play the expression of ‘pre-reflective’ and ‘singularly rational’ radical needs that, outside knowledge as such, are difficult to express and share. A sense of communion (and this is tangibly visible in the film Asylum set in one of the Philadelphia Association’s shared houses) makes it possible both to express singular rationality, our unthought knowns, as well as to encourage the unsayable (by its nature fluid, unresolved and easily misunderstood) to be said without fear of an overtly rational and self-proprietorial reprisal. Perhaps what Cooper is up to by outlining these radical needs (and he does, through recourse to Agnes Heller’s take on Marx, speak of the manufactured needs – “artificial needs” – of capitalist valorisation) is to approach the ‘politics of desire’ as, for him as well for Deleuze & Guattari in Anti Oedipus, the political mobilization of “non-imputed desires.”¹⁴

This may well be another of the approaches Cooper takes in ‘politicising madness’, for what these non-imputed desires can be, is to some degree, still to be discovered, but they could be understood, in the form of ‘radical needs’, to suggest themselves as all combining into what Cooper means by autonomy. In a diagram included in the book, Cooper refers to autonomy as “the radical need to express oneself – in the creation of values against imposed values.” Imposed values and imputed desires are, it could be said, two of the means by which psychic control and normopathy is instilled in all of us. These can add up, for the majority, to be principle means by which people fear to be expressed (saying the ‘wrong’ thing, being taken too literally, being stereotyped, being ‘unoriginal’ etc.) Yet the experience of ‘madness’ shows us (in however often a distorted and painful form) a will to expression as what Cooper calls an “acting-to-be-different.” Such an ‘acting’ is seen as suspect for not only does it step outside the norms of social relational consensus – either as an embarrassing exacerbation of individualism or an unnerving silent negation of sociality – it signals “a desperate expression of a radical need for autonomising change.” Something is gravely wrong if some people can cry out their pain in the street or be reduced to a passive mound in the corner of a hospital and it may very well test the limits of socialism as to whether those who suffer are psychiatrised and legislated-for or respected as people with a singular rationality that can be communed with. Autonomy, then, for Cooper, is this search for less alienated ways to live, it is an autonomy-from, which, taking cognizance of the intertwining of social and psychical alienation, can surely only be practiced in “lived through” spaces where the social and the self become ascertainable as a continuum.

We are maybe still a long way from such politicizing spaces and it is this that makes Cooper’s efforts all the more compelling. When he comes round to describing ‘non-psychiatry’ at the end of the book he focuses more upon the individualizing drawbacks of the ‘alternative therapies’ than he does the often hidden tyrannies of group life: “the ideology of personal salvation presents highly effective strategies of de-politicisation.” In this Cooper echoes Sedgwick and he likewise gives voice to the suspicions of those with ‘leftist credentials’ to the whole zone and practice of therapy as nothing more than ‘navel gazing’ and ‘earnest discussion’. Cooper has it that “there are no personal problems, only political problems,” but his version of the ‘political’, as I hope we’ve seen, is one that encompasses the “deployment of power” throughout society: from an awareness that the vast majority of those interned in hospital are working class through to his assertion that medical power is embodied, firstly, in the labeling diagnosis, Cooper reflects how his original coining of the term ‘anti-psychiatry’ was a means of struggling within the state-institutions of psychiatry. At best, these institutions pacified, ignored and anonymised their recipients as personifications of simplifying categories. So, throughout Cooper’s book there is the tension of the need for collective responses outside of state institutions and, at the same time, the need for autonomous expression. Cooper sometimes vigorously upholds either side of the separation in extremis, but with ‘non-psychiatry’ (or the de-psychiatrization of society as Basaglia refers to it¹⁵) he seeks, when he outlines contemporaneous initiatives, to promote a collective space in which to transform these dichotomies into a dialectical process.

The collective space in which he places his faith is the International Network of Alternatives to Psychiatry, which as its title suggests, is no longer solely concerned with a struggle within the state institutions, but is resolutely exploring autonomous or ‘self-instituted’ spaces which have an in-built suspicion of those professionally trained in the medical model¹⁶. Cooper, surely speaking of the Network without naming it quite yet, says, “in those years we were all isolated in the national context of our work. Now there are thousands of us who begin to recognize a dialectic in our struggle.”¹⁷ The Network, then, revivifies anti-psychiatry in that it overcomes, for Cooper, the latters “lack of a collective consciousness of the necessity of political involvement.” This is similar to the tenor of Sedgwick’s criticisms of Laing and Laingians (of whom Cooper was one?), but for Cooper, the politics do not lie in lobbying for policy change, but in a view of ‘political involvement’ as an autonomising political power, or force, that can “make possible a praxis that expresses a desire.” This making possible of a praxis is precisely what our institutions hold back (through red-tape, through ‘expert’-led meritocracy, through preservation of the ‘group illusion’ etc.) and it is this ‘making possible’ that Cooper seems to suggest as a key facet in any ‘politics of autonomy’; politics that can tolerate the subjectivities of an ‘acting-to-be-different’ and which can establish forms of organization through which a continuum between ‘social’ and ‘self’ can be taken as the base ground rather than any parachuted-in ideology (be it anti-psychiatric or socialist). Cooper’s experiences in Italy (with the experiments of not just Basaglia, but Giovanni Jervis in Reggio Emilia and Mario Tommasini in Parma) seem to have inspired him and further propelled his ideas about a de-medicalised and de-institutionalised non-psychiatry. These lead him to have no need to think of ‘cures’ or ‘statistics’ but, inspired by milieus which make praxis possible, that enable a dépassment of ‘self’ and a variant of communion, he is led to suggest that non-psychiatry is “the social recuperation-regaining of madness as part of the people’s culture, as part of a more total subversion of the bourgeois spirit.”

Such a conjoining with ‘madness’, a kind of ‘mad pride’, may well have its romanticisations and I can hear Sedgwick in my ear bemoaning Cooper’s indulgence in the face of suffering, but Sedgwick too, mentions how different cultures have different relationships and means of attending-to and learning-from madness. Frantz Fanon is described as doing all he could to study and understand Algerian ‘folk culture’ and djinn practices in order, not to enforce a secularist import of western psychiatry, but to appreciate, in terms used here, the ‘singular rationalities’ of the people (often injured combatants) he treated.¹⁸ Cooper, in urging us to ‘regain madness’, is, I think, urging us toward the collective discovery, the co-creation, of ‘non imputed desires’ as radical needs. Just as such desires need to be discovered and can only be alighted-at and materialized through others, so it is that singular rationalities¹⁹ can be the driver of a revolutionary process in which there are no experts or professionals, no right or wrong way, no anonymising nor narcissistic factions, but, the arousal of a means of autonomous praxis, with its drawing upon the private madness of a ‘wide span of identities’, that is dear not just to Cooper but to the post-war pioneers of group psychotherapy. This takes us back to the beginning of Cooper’s book, to the frontspiece, in which he dedicates his book to “The first revolutionary. In each of us.” Such a dedication perhaps points us to an understanding that Cooper’s last book is as much a work of political theory as it is a pro-plausible contribution to ‘mental health policy’. There is the further implication that ‘madness’, its means of expression, its singular rationality and its search for ‘non imputed desires’, is not only a spur to revolution as it is already understood, but also constitutes an arrival at revolution by means of extreme discomfort at the hands of normopathy. As a ‘psychiatrised’ participant at the third meeting of the International Network put it: “There will always be an alternative to the alternative. The conviction that strengthens us is that the struggle is not a drama, that our suffering constitutes a political itinerary…”²⁰

Howard Slater
July 2016

Endnotes