18Chapter 15. Antipsychiatry: Laing, Basaglia, and the Limits of the Movement

On a summer evening in 1967, a strange scene unfolded in a large, dilapidated house called Kingsley Hall in London’s East End. A young woman named Mary Barnes lay on the floor, wrapped in a blanket, surrounded by several men and women of varying ages. Mary, a former nurse, had sought help with a diagnosis of paranoid schizophrenia. Now, she was undergoing what her caretaker called a “rebirthing.” She was experiencing her illness as a regression to infancy—defecating on the walls and smearing feces. There was no force, no chlorpromazine injections, no being dragged to the shower or scolded. She was allowed to go through it until she herself decided to return.

Remember this name: Ronald David Laing. 1927–1989. Possibly the most famous and controversial psychiatrist of the second half of the 20th century. A Scotsman. University of Glasgow. Service in the British Army. And—the Tavistock Clinic in London. The heart of the British psychiatric machine through which he passed. What did he carry away from there? Immense charm. A razor-sharp intellect. And a book. The Divided Self, 1960. One work. One text. And—an explosion. It became one of the best-selling psychiatric texts of the 20th century. But how could one text also become one of the most debated?

Laing approached schizophrenia with a fresh perspective. Before him, the prevailing view—inherited from Kraepelin—held that schizophrenia was a brain disease leading to deterioration, something inscrutable requiring pharmaceutical control. The patient was an object, their symptoms meaningless, and the doctor’s role was to suppress the manifestations of illness.

Laing proposed something else. He said: let’s suppose that the schizophrenic is a person telling us something meaningful, if only we learn how to listen. Their delusion is not chaos but a defensive strategy against ontological insecurity — a deep, unbearable sense that the very fact of your existence is under threat. Their symptoms are an attempt to hold on to some semblance of a “self” in a world where the “self” is falling apart.

In The Divided Self, Laing exposes the mechanism. A person, cornered by the threat to their ontological security, enacts a split. They create an external “false self”—a compliant mask that meets society’s demands—while hiding the “true self” deep within, in impenetrable darkness: naked, vulnerable, defenseless. The rift widens. The gap becomes an abyss. Then the “false self” seizes power. What happens next? A psychotic break. The patient plunges headlong into delusion. Why? Because delusion is not disintegration—it is the final shield, desperately protecting the remnants of the true self.

This formulation was incredibly popular in the 1960s. Thousands of young people of that era recognized themselves in it. The Divided Self became a book of a cultural movement — alongside Herbert Marcuse’s One-Dimensional Man, Michel Foucault’s Madness and Civilization, and the novels of Ken Kesey. It was a time when the very idea of “normality” seemed to be a repressive construct imposed by bourgeois society to suppress freedom.

But Laing went further. In his works of the early and mid-1960s—with Aaron Esterson in Sanity, Madness and the Family (1964), and with David Cooper, who actually coined the term “antipsychiatry”—Laing began to argue that schizophrenia does not exist as an illness. It is a label that society—above all, the family—attaches to those who do not fit in. It is a rational response to an irrational world. Going mad in a mad world may, perhaps, be a sign of health.

1965. London. A word that means nothing to ninety-nine percent of passersby. Philadelphia. Not the American city. The Greek one. “Brotherly love.” Laing and his colleagues take this word and make it the foundation of an association—the Philadelphia Association, with no connection to the Philadelphia across the ocean. A strange choice? Only at first glance. It all comes down to translation. Next—the address. Kingsley Hall. The association’s first establishment in London. Not a clinic. Not a hospital. A home. Here, everyone lives together. Patients. Therapists. As equals. No diagnoses. No medication. No forced treatment. Not a single label in a file. Not a single pill in hand. Not a single locked door. A patient is free to endure their psychosis—as a “journey inward.” And there’s always someone from the staff nearby. Not to stop them. Not to fix them. To accompany them.

Kingsley Hall operated for five years. Dozens of people passed through its doors. Some, like Mary Barnes, even went on to write books about their experiences. According to reviews, certain individuals emerged in better condition, while others left worse off. No statistics were kept. The experiment was shut down in 1970 under pressure from neighbors and authorities. All that remains of the building itself are photographs and a legend.

However, Laing was not the only figure, and perhaps not even the most significant, in this movement.

Northeast Italy. The tiny border town of Gorizia, adjacent to Yugoslavia. 1961. Franco Basaglia was appointed the new director of the psychiatric hospital. A war veteran. A member of the Italian Communist Party. A professor at the University of Milan. 1924–1980. What awaited him behind the institution’s walls? The same thing any young psychiatrist in postwar Europe had witnessed before him. But there’s a difference between hearing about it and stepping into that reality yourself. Basaglia entered the hospital. And froze. Cages. Bars. Straitjackets binding unfamiliar bodies. Portable electroshock machines ready to sear through brains. And storerooms. Sealed storerooms where personal belongings lay in dusty darkness—the belongings of patients long forgotten. Those whom no one had ever come for. Who were these people? Patients or prisoners? Where was the line between treatment and violence? Basaglia looked at the bars—and already knew the answer. The system had been laid bare. And it was monstrous.

Basaglia took a simple step. He stopped tying patients to their beds. He abolished isolation. He removed the cages. He told the staff: the patient is a person. We work with them, not against them.

In 1964, at a congress in London, Basaglia delivered a speech titled “The Destruction of the Mental Hospital as a Place of Institutionalization.” The idea was simple and radical: psychiatric hospitals are themselves pathogenic. They make people sick. They turn suffering into a chronic condition. They must be closed.

Basaglia became the leader of the movement. In Italy, it was dubbed “democratic psychiatry.” Doctors, patients, their families, trade unions, political parties—they all eventually stood side by side. By the late 1970s, it was no longer just a brotherhood—it was a massive political force, unstoppable as an avalanche. May 13, 1978. Rome. The Italian Parliament passes Law 180. A law that would forever go down in history as the “Basaglia Law.” What did this document achieve? A reckoning. For the first time in the nation’s history, the law decreed: psychiatric hospitals in Italy must be closed. Admitting new patients to these institutions was prohibited. Constructing new ones—also banned. No more stone prisons. From then on, help would flow through a different channel—a living network of mental health centers within the community itself. Centri di Salute Mentale.

Italy became the first country in the world to shut down its asylums.

It was a triumph for the antipsychiatry movement. But history, as is so often the case, proved more complicated than its authors had anticipated.

Basaglia himself died in 1980, just two years after the law was passed. He was fifty-six. He did not live to see what would become of his reform.

And then, the law collided with reality. Passing a law to close down psychiatric hospitals was one thing. Building a functioning network of community care centers was entirely another. In many regions of Italy, there wasn’t enough funding for these centers. Staff were underqualified. Coordination was a mess. Thousands of patients discharged from former asylums ended up on the streets. In prisons. In questionable private facilities. Relatives, suddenly responsible for their severely ill loved ones again, often had no idea what to do with them. And so, a phenomenon emerged—what Italians called il rito della porta girevole—“the revolving door ritual.” A patient lands in the emergency ward. They’re discharged. Returned to their family. A crisis hits. Back to the emergency ward. Discharged again. Back to the family. Another crisis. The door keeps revolving.

In 2020, the European Journal of Public Health published a quasi-experimental study demonstrating that the implementation of Law 180 was associated with a statistically significant increase in s••••••••• levels in Italy in subsequent years. This doesn’t prove the law was a mistake, but it reveals that its real-world consequences fell far short of the idealized expectations of its architects.

The lesson is clear: shutting down something bad doesn’t automatically create something good. Dismantling an institution doesn’t guarantee a more humane alternative. Where the state had the will and resources to build actual community-based care networks—as in Trieste, where Basaglia spent his final years—the reform worked. Where it didn’t, patients were simply discharged from one institution into oblivion. Today, psychiatrists worldwide study the Italian experiment—both as inspiration and as cautionary tale.

And what happened to Laing?

Laing is perhaps one of the most tragic figures in this book.

By the late 1960s, he was a superstar. He lectured globally, sold millions of books, befriended rock stars, actors, and philosophers, experimented with psychedelics, and drank heavily. Clinical work faded as he cultivated his public persona—a voice, an aesthetic, a cultural force.

By the mid-1970s, everything crumbled. Friends and colleagues withdrew one by one. His marriage disintegrated. His son Adrian later exposed the wound in a memoir detailing a childhood shattered by Laing’s cruelty. Alcohol flowed endlessly. In 1987, a new nightmare: his medical license was revoked, the board ruling his mental state unfit for practice. Depression tightened its grip. Then—1989, southern France, a tennis court. Laing collapsed. A heart attack. He was sixty-one.

His legacy is a minefield. On one end: The Divided Self, a book that tore through the 20th century by daring to declare—the inner world of a schizophrenic isn’t chaos. Not nonsense. It means something. This was revolutionary, the foundation of a new clinical ethos. Then—the fracture. He declared schizophrenia a fiction: just a label, a tool of family and social control. Hallucinations? Delusions? Not symptoms but “soul journeys.” They shouldn’t be interrupted; they must unfold. Wait—what? Neuroscience. Genetics. Neuroimaging. Three fields. Three independent lines of evidence. Terabytes of data. All converge: schizophrenia has biological roots. Denying this isn’t radical—it’s denying reality. His later claims were wrong then. They remain wrong now.

Most agonizing are the individual lives wrecked by Laing’s ideas. Parents in the 1970s read his books, rejected psychiatry, refused medications like chlorpromazine, let their children “work through it” as he advised. Some survived psychosis and recovered. Some didn’t. Some died by suicide. Others spent decades trapped in chronic illness—conditions preventable with timely treatment.

So what should we take from antipsychiatry, and what should we reject?

Here’s what we’ll need to take.

First: unconditional respect for the patient as a human being. Their symptoms are not nonsense — they carry meaning. You have to talk with them, you have to hear them, you have to acknowledge their suffering. This principle of Laing’s, which took shape after his encounter with Bateson in Palo Alto, changed clinical culture forever, and for the better.

Second, paying attention to social and familial context. Patients don’t exist in a vacuum. How their family treats them, how society perceives them, how institutions handle their care—all these factors influence the course of their illness. Basaglia demonstrated that institutions themselves can be pathogenic—an irrefutable lesson.

Third. The patient’s right to dignity. Basaglia’s Law restored to Italian patients the civil rights they had been stripped of for decades. This is an irreversible moral achievement. Today the same rights are enshrined in the UN Convention on the Rights of Persons with Disabilities (2006) and in the legislation of most developed countries.

Rejecting the unnecessary is just as essential.

First. The assertion that schizophrenia doesn’t exist. This is an ideological position that crumbles under empirical scrutiny. Schizophrenia is real. It has a biological basis. It requires specific treatment. Denying its existence harms patients rather than helping them.

Second. The romanticization of psychosis. Psychosis is not a “journey of the soul.” It is suffering. Agonizing. Destructive. At times—dangerous. To deny a person an antipsychotic in the acute phase because “it’s their spiritual path” is a form of violence against their suffering.

Third. The condemnation of drug therapy as such. Modern antipsychotics are far from an ideal treatment: they have many side effects, they don’t always work, and they are powerless against many symptoms. But for most patients in the acute phase of psychosis, they save lives — literally. To reject them on ideological grounds is a crime against the patient.

And here is another important thought for this entire book.

Antipsychiatry, for all its mistakes, was a scientific movement. Its authors read, wrote, published, argued, erred, and corrected themselves. Toward the end of his life, Laing admitted that much of what he had said in his youth was exaggerated. Basaglia never stopped emphasizing that his reform was not an end but the beginning of a long road. This belongs within scientific debate.

When today’s Scientologist or theta healer lifts these ideas out of context, yanks out a few quotations — “there is no schizophrenia,” “psychiatry creates patients,” “medication is poison” — and releases them onto social media, he is doing two things at once. He is falsifying the arguments of Laing and Basaglia, turning nuanced scientific disputes into slogans. And he is trading on the authority of those names to sell his own services for money.

Laing did not sell “Laingian constellation facilitator” certificates. Basaglia did not charge for “deinstitutionalization training.” They were doctors. They made mistakes, but they were searching. They lived their work and often destroyed themselves with it. That is what sets them apart from today’s “spiritual teachers,” who invoke their names for their own profit.

Antipsychiatry is part of the history of scientific psychiatry. Today’s “healers” who borrow its language are not its continuation but its parody.