[Tavris is an American psychologist. In the following review of Wisdom, Madness and Folly, she contends that the book is an appealing account of the first part of Laing's career.]

The second sweetest set of three words in English is "I don't known," and it is to R. D. Laing's credit that he uses it often. For psychiatry really does not know much about madness. It cannot explain why an American catatonic schizophrenic, crouched in apparently mindless rigidity in front of a television set for a month, can later recite every detail of the World Series he has seen. It cannot explain why Scottish catatonic schizophrenics "come out" on New Year's Eve to smile, laugh, shake hands, and dance, only to revert to apathy the next day. "If any drug had this effect," Dr. Laing says, "for a few hours, even minutes, it would be world famous," hailed as a medico-psychiatric, biochemical, scientific breakthrough of the first order.

This appealing book is Dr. Laing's account of his first 30 years, from 1927 to 1957: his childhood, education, early training in psychiatry, the observations and decisions that led him to break from traditional psychiatry. The reader unacquainted with Dr. Laing's work and writings will have no inkling that he was the charismatic leader of the English "antipsychiatry" movement (a term he disclaims); that his 1960 book, The Divided Self, launched his fame as a counterculture rebel, mentor and mystic; or that he once celebrated schizophrenic thinking as a comprehensive, even superior, mentality. The reader acquainted with Dr. Laing will not learn here why he became disenchanted with his earlier ideas and abandoned the politics of madness, why his own methods of treating schizophrenics failed, or what he now believes about mental illness.

"I am not trying to justify myself, or prove that I am right," Dr. Laing begins, and, mirabile dictu for an autobiography, this is absolutely true. Only once does he defend himself against charges that he idealizes mental suffering, romanticizes despair, or denies the existence of painful emotional disorder. He understands, he says, that society must do something with people who are too disruptive or too crazy. "If a violinist in an orchestra is out of tune and does not hear it, and does not believe it, and will not retire, and insists on taking his seat and playing at all rehearsals and concerts and ruining the music, what can be done?"

In trying to answer that question, Dr. Laing came to three realizations: first, that much of the unalleviated misery he saw in his patients was manufactured by psychiatry itself; second, that he would not like to be treated the way his own patients were treated; and third, that no one had the foggiest idea of how to treat people who were severely disturbed. "What does one do, when one does not know what to do?" Dr. Laing asks. The answer must weigh the patient's pain against the psychiatrist's power. "I am still more frightened by the fearless power in the eyes of my fellow psychiatrists," he writes, "than by the powerless fear in the eyes of their patients."

These observations about psychiatry and the power of psychiatrists are not new, nor are they limited to Britain. (Jonas Robitscher's brilliant analysis of the American system, The Powers of Psychiatry, made the same points several years ago.) Some of the treatments that horrified Dr. Laing—insulin-induced convulsions and coma, lobotomies, electroconvulsive shock, straitjackets—were supplanted by drugs in the late 50's. Yet the issues of treatment, control and care of patients remain exactly the same. The "snake pit" is not ancient history in some hospitals. Drugs have not been universally helpful (indeed, that is one reason why modified electroshock treatments have returned). The war between somatic and psychological interpretations of mental disorder rages as noisily as ever, with each side making tragic errors of diagnosis and treatment.

Moreover, then as now, many psychiatrists fail to talk to patients, much less listen to them. A patient of Dr. Laing's complained of deafness and pain in his ear, although no neurological damage could be found. No one had asked the man, until Dr. Laing, whether he had any idea what was causing the pain in his ear, which led Dr. Laing to a psychological answer. Another ward patient in a British Army hospital had the same "delusion" of being dragged out of bed at night and beaten up by men in army uniforms. A second patient had the same delusion. So did a third and fourth. Dr. Laing listened, and the result was a court-martial of two men responsible for abusing patients. Does this seem unusual? A psychiatrist told me recently that at a recent conference members of his panel and the audience debated endlessly about possible physical and chemical interventions in treating a chronically depressed man. "No one," he said, "had thought to ask the man what he was depressed about."

Dr. Laing's account of his upbringing and family life consists of impressionistic dabs on a canvas; the reader must construct the picture. Some dabs convey aloof, punitive parents—the kind of mother who burned a 3-year-old's toy horse because he was becoming too fond of it, the kind of father who slapped him for using "the wrong tone of voice." Particularly subtle dabs suggest a bizarre story of his mother's manipulations to break the friendship between her husband and his female piano accompanist, a story told as vaguely as it must have seemed to a little boy. "'Ronald [she would have said], we never talk about that sort of thing.' Hence I became fascinated by all those sorts of things we don't talk about."

Sometimes Dr. Laing offers his own connections between experiences. Asthma, he suggests, was the price he paid for his sense of suffocation and his policy of keeping out of trouble for the sake of a quiet life. "I just had to live with the most unpleasant queasy sense of corruption," he writes. "It is terrible to feel you have to pretend you love someone when you do not."

Other experiences do not connect. Dr. Laing grew up in a world of pervasive anti-Semitism, hearing that Jews have different germs from us and what was happening to Jews in Germany was their own fault. Yet he and a friend were the only medical students in a class of 200 to feel sickened and outraged by "training" films of Nazi experiments on Jews, and later he found a "spiritual father" as well as a medical and intellectual mentor in a Jewish neurosurgeon, Joe Schorstein. Did he lose his anti-Semitism easily, like baby teeth, or did it have to be extracted, like an impacted molar? Or did the remarkable empathy he was later to bring to talking with patients prevent him from sharing his family's anti-Semitism in the first place? He doesn't say.

Dr. Laing's doubts about psychiatry began early. "It looked the same as the rest of medicine, but it was different," he recalls. "I was puzzled, and uneasy. Hardly any of my psychiatric colleagues seemed puzzled or uneasy. This made me even more puzzled and uneasy." Fortunately for psychiatry and for his patients, Dr. Laing has retained his uneasiness. It is a good quality to have in approaching the "breakthroughs" that appear every so often in the treatment of mental disorder. A few years later, after some successes and many failures, excitement subsides; Dr. Laing's own method had the same fate. But this book reminds us of what psychiatry, ultimately, is for. "How can we entice these ghosts to life, across their oceanic abyss, across our rivers of fear?" I don't know, he says, but I'll try.