“Ronald Laing and the Rationalizing of Madness” written by Reznek assesses Laing’s

idea about schizophrenia that is against the disease model of schizophrenia. Firstly, Reznek
asserts that Laing sees the behaviours of schizophrenia as rational since schizophrenic behaviour
is explicable in terms of reasons (desire and belief). For example, a person who has a desire to
fool others and believes that by acting oddly, the desire can be achieved. Thus, acting oddly is
intentional and not caused by any diseases. However, Reznek argued that the reason may be
made up to assert that schizophrenic behaviour is rational and the rational explanation does not
imply that the behaviour (at a deeper level) is not a result of disease. A disease or physical
process may be needed to explain the formation of abnormal reasons that motivate the
schizophrenic behaviour.

Secondly, Reznek claims that Laing sees that schizophrenic behaviour as an intelligible
response to unliveable family situations. It is not a disease because the source of disturbance is
located outside the individual. In the article, Reznek argued that Laing fails to provide evidence
to show that all symptoms of schizophrenic behaviour are strategies adopted by the patient
intentionally. The fact that these responses are understandable reactions to social circumstances
does not show that they are not illnesses. If Laingians explain genetic (Kety, Rosenthal &
Wander, 1971, cited in Reznek, 1991) and anatomical differences (Brown et. al., 1985, cited in
Reznek, 1991) found in schizophrenics as reasons predispose schizophrenics to adopt such a
strategy, it means the word ‘disease’ has been simply substituted by “strategy”.

Thirdly, Reznek states that Laing postulates that schizophrenic is ‘truly’ sane and holds a
true belief about reality. However, Reznek refute Laing’s argument by pointing out that
psychiatrists do not judge one to be deluded based on the truth or falsity of a person’s belief but
whether he/she has a good reason for it. Besides, the belief adopted is delusional if it is
undesirable (hence a disease), and harmful to them. Reznek also mentions that Laing sees
schizophrenic behaviour as a result of healing process, and it brings valuable consequences. Yet,
Reznek argued that schizophrenia is undesirable (on balance) because most patients do not seem
to like their psychotic states (Wing, 1975, cited in Reznek, 1991).

In short, Reznek believes that Laing’s views of schizophrenic behaviour are

fundamentally wrong. In the argument layout, few passages from Laing that clearly represents
his ideas have been quoted, and reconstructed into conceptual premises and factual premises by
Reznek. Then, Reznek produces his own arguments to refute Laing’s premises, and thus refute
his arguments. By doing so, Reznek has examined Laing’s ideas systematically and
comprehensively because he has shown an interpretation of Laing’s ideas which are followed by
an illustration proving that Laing’s conceptual premises are false. From Laing’s passages which
have been quoted by Reznek, it shows that he has made an accurate interpretation of Laing’s
arguments.

The arguments presented in this article are trying to be persuasive though they are rather
weak. Reznek has done a good job to refute Laing’s arguments but there is no sufficient evidence
from him to justify his view of schizophrenia being a disease. In other words, without providing
a stronger alternative way of interpretating schizophrenia to replace Laing’s rationalizing of
madness, Reznek’s interpretation is incomplete. Firstly, Reznek does not provide a clear
definition of disease in the article. It is unknown to us what he believes schizophrenia is. The
concept of disease might have implied a biological approach to schizophrenia. However, it is still
questionable since due to the controversy about the nature of schizophrenia. It is arguable
whether schizophrenia is a result of disturbance in brain function (a disease) or social
construction (a label given to deviant individuals) (Thomas, 1997). The discussion of the nature
of schizophrenia seems to be avoided by Reznek and there are limited explanations supporting
that schizophrenia is a disease.

For example, he makes a point that there is a disease process that disrupts our normal
reasoning and leads to “faulty inductive logic” (p.60) which implies that schizophrenic
behaviours are “symptoms of some underlying diseases” (p.60). He also states that when one is
deluded with an irrational belief, it is a disease process. From this point, it seems that a cognitive
model of explanations is more applicable than a biological model. We will need to consider that
it is still possible for a normal person to have faulty beliefs. For example, false consensus effect
suggests that we will falsely believe people as being more alike to us than it is (Hogg &
Vaugham, 2005).. Thus, there seems to be a continuum existing between normal thoughts and
delusions(Strauss, 1969 cited in Kingdon & Turkington, 2000). Schizophrenia represents a
position at the extreme end of the continuum, known as a disease by Reznek. Can an irrational
belief that falls in the middle of two extreme ends be considered as a disease as well? In other
case, using LSD (Comer, 2003) or sleep deprivation (Oswald, 1974, cited in Kingdon &
Turkington, 2000) may produce psychosis experience like schizophrenia. Although it is caused
by organic states (e.g. drug-induced), it is not considered as a disease, apparently. Hence,
Reznek’s argument saying that a disease process exists is not well-supported here.

Besides, it is questionable that he says “being an explicable response to a social situation

does not mean it is not a depressive illness” (p.64) since it raises a question to us – Is depression
an illness? Nevertheless, Reznek further develops his argument with anorexia nervosa as an
example of illness that results from abnormal situations. In this part, it is shown that the concept
of illness, instead of disease has been used by Reznek. This suggests that Reznek does not
produce a consistent argument of schizophrenia being a disease process throughout the article. It
also shows that he does not make clear distinctions between disease and illness despite their
differences. In addition, Reznek claims that there is only a trivial difference if Laing has used
‘strategy’ to substitute ‘disease’. However, the term used is important because it may influence
the treatment approach. For example, if schizophrenia is not a disease but a strategy, it does not
need medications and hospitalization. It seems that Reznek does not notice the implications of
using the concept of disease. Moreover, Reznek uses organic disorders as an analogy to explain
schizophrenia, it raises another question – do they adequately resemble each other? For example,
when he compares TB with schizophrenia, he presumes that schizophrenia is a disease.

From my perspectives, I agree with Reznek as Laing’s ideas may not explain
schizophrenia well. Yet, I do not think that schizophrenia is a disease. Rosenhan’s study (1973,
cited in Heather, 1976) shows that pseudo-patients cannot be distinguished from genuine patients
in a hospital setting. If schizophrenia is a disease, the diagnosis should not be arbitrary.
Nonetheless, there is insufficient evidence that justifies brain abnormalities in schizophrenics
because not everyone who suffers brain abnormalities develops schizophrenia, and not every
schizophrenic shows a history of brain dysfunction (Corcoran & Malaspins, 2001; Comer, 2003).
Antipsychotic drugs only reduce positive symptoms of schizophrenia but not curing them
(Davison & Neale, 1998). In fact, the conventional antipsychotic drugs produce severe unwanted
side-effects such as a reaction called Tardive Dyskinesia with symptoms similar to Parkinson
disorder’s symptoms (Comer, 2003). Other than that, it is possible that schizophrenia is nothing
but a label given to deviant individuals by the society (Thomas, 1997). From Szasz’s point of
views (1970, cited in Heather, 1976), schizophrenia is not a disease but a label given to explain
odd behaviours, like the concept of witchcraft in the late Middle Ages.
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International Journal of Mental Health, 30(1), 17–32. Retrieved December 18, 2007
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Heather, N. (1976). Psychiatry and Anti-psychiatry. In Radical Perspectives in Psychology, pp.

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Thomas, P. (1997). The Dialectics of schizophrenia. New York: Free Association Books.