On Being Sane In Insane Places

In 1973 psychologist David Rosenhan set out to test the validity of psychiatric diagnosis by simulating auditory hallucinations in an attempt to gain admission to psychiatric hospital. Unbelievably, he and the other 8 pseudopatients were admitted and remained in care for an average of 19 days each (7 days shortest, 52 days longest) before the experiment and its findings were published in the journal Science under the title "On Being Sane in Insane Places."

The following is an overview of the experiment:

The eight pseudopatients were a varied group. One was a psychology graduate student in his 20’s. The remaining seven were older and “established.” Among them were three psychologists, a pediatrician, a psychiatrist, a painter, and a housewife. Three pseudopatients were women, five were men. All of them employed pseudonyms, lest their alleged diagnoses embarrass them later. Those who were in mental health professions alleged another occupation in order to avoid the special attentions that might be accorded by staff, as a matter of courtesy or caution, to ailing colleagues. With the exception myself (I was the first pseudopatient and my presence was known to the hospital administration and chief psychologist and, so far as I can tell, to them alone), the presence of pseudopatients and the nature of the research program was not known to the hospital staffs.

The settings are similarly varied. In order to generalize the findings, admission into a variety of hospitals was sought. The 12 hospitals in the sample were located in five different states on the East and West coasts. Some were old and shabby, some were quite new. Some had good staff-patient ratios, others were quite understaffed. Only one was a strict private hospital. All of the others were supported by state or federal funds or, in one instance, by university funds.

After calling the hospital for an appointment, the pseudopatient arrived at the admissions office complaining that he had been hearing voices. Asked what the voices said, he replied that they were often unclear, but as far as he could tell they said “empty,” “hollow,” and “thud.” The voices were unfamiliar and were of the same sex as the pseudopatient. The choice of these symptoms was occasioned by their apparent similarity to existential symptoms. Such symptoms are alleged to arise from painful concerns about the perceived meaninglessness of one’s life. It is as if the hallucinating person were saying, “My life is empty and hollow.” The choice of these symptoms was also determined by the absence of a single report of existential psychoses in the literature.

Beyond alleging the symptoms and falsifying name, vocation, and employment, no further alterations of person, history, or circumstances were made. The significant events of the pseudopatient’s life history were presented as they had actually occurred. Relationships with parents and siblings, with spouse and children, with people at work and in school, consistent with the aforementioned exceptions, were described as they were or had been. Frustrations and upsets were described along with joys and satisfactions. These facts are important to remember. If anything, they strongly biased the subsequent results in favor of detecting insanity, since none of their histories or current behaviors were seriously pathological in any way. - psychrights.org...

However, being released seemed to be much harder than being admitted. The only way to secure release was to admit that they were suffering from the diagnosis of the psychiatrists. So all were forced to admit to having a mental illness and agree to take antipsychotic drugs as a condition of their release.

As David Rosenhan himself stated:

"I told friends, I told my family, 'I can get out when I can get out. That's all. I'll be there for a couple of days and I'll get out.' Nobody knew I'd be there for two months … The only way out was to point out that they're [the psychiatrists] correct. They had said I was insane, 'I am insane; but I am getting better.' That was an affirmation of their view of me."

The findings sent shockwaves through the medical profession but it was going to get even worse...

After the findings were published a well known research and teaching hospital made the claim that such diagnosis errors would never occur at their institution.

So:

Rosenhan arranged with them that during a three month period, one or more pseudopatients would attempt to gain admission and the staff would rate every incoming patient as to the likelihood they were an impostor. Out of 193 patients, 41 were considered to be impostors and a further 42 were considered suspect. In reality, Rosenhan had sent no pseudopatients and all patients suspected as impostors by the hospital staff were genuine patients.

This led to a conclusion that "any diagnostic process that lends itself too readily to massive errors of this sort cannot be a very reliable one". Studies by others found similarly problematic diagnostic results. - en.wikipedia.org...

The study concluded that "It is clear that we cannot distinguish the sane from the insane in psychiatric hospitals" and also illustrated the dangers of depersonalization and labeling in psychiatric institutions. It suggested that the use of community mental health facilities which concentrated on specific problems and behaviors rather than psychiatric labels might be a solution and recommended education to make psychiatric workers more aware of the social psychology of their facilities.

This experiment highlights just how easy it is for someone to be admitted into a psychiatric institution as ‘insane’ but even more worryingly it shows how hard it is to be released once you have been labelled as such. Even the pseudopatients in Rosenhans experiment were only released with a diagnosis of schizophrenia "in remission," which Rosenhan takes as evidence that mental illness is perceived as an irreversible condition creating a lifelong stigma rather than a curable illness.

I can’t help but wonder how many perfectly sane people have been wrongly diagnosed and as a result have spent extended periods of their lives in institutions.

However it doesn’t end there.

As a result of these findings the Psychiatric establishment tried to find an objective way to measure mental illness, by using methods like computers and checklists. These new diagnostic techniques intentionally measured only surface symptoms and asked nothing about the patients life or environment. This led to the huge increase of self diagnosis. Everyday people on the street were able to test themselves according to these skewed diagnosis methods – with millions discovering that they indeed suffered from some kind of mental illness (50% of Americans). From these techniques came mental diseases that we all know today like Attention deficit disorder (ADD) and Obsessive compulsive disorder (OCD).

Suspiciously, around the same time as this, American drug companies announced they had developed a new kind of drug that would cure all of these new found symptoms - Selective serotonin reuptake inhibitors (SSRi’s) – or to me and you, antidepressants, chiefly sold under the name Prozac. Content people who just a few years earlier had thought they were perfectly normal were now diagnosing themselves with all manner of mental illnesses and then rushing to their doctors asking for this drug.

Thirty years later and we have 6 year olds on daily doses of prescription drugs, the diagnosis? ‘Depression.’

“Insanity is the only sane reaction to an insane society.”

- Thomas Szasz

Related:
www.springerlink.com...
en.wikipedia.org...
psychrights.org...
en.wikipedia.org...

The Birth of Modern Psychiatry - brilliant little overview of all discussed (Part One of Four)


[edit on 24/6/10 by LiveForever8]

Wow ! that's a fantastic resault. We have a say here :" crazy poeple are not all in the asylum",

Psychatry is not an exact science but most psychatrists still believe in absolutes.

I believe that you did a good job introducing us to the begining of something much larger. I would like to see you do a little more in depth analysis on why people so readily believe that they are suffering.

I would also like to see you present some of the other side. Kind of a refutation of some of the key arguments on behalf of psychiatry.

I hadn't heard of this study before. I appreciate you bringing it to our attention.

reply to post by LiveForever8


Wow. Thanks for that. Really top post mate.

Although not really classed as being insane, my step son was misdiagnosed with asperger syndrome.

It happened because of a lazy teacher, extremely broad list of symptoms and the need for every parent to believe their child is special.

Once diagnosed he was put into a lower stream of education and from there things got worst.

I had always believed there was nothing wrong with him, just a late bloomer and shy and withdrawn from his natural father and mother splitting up.

This is what I've battled against for the last 8 years:

1. His father and his family. Convinced that something is wrong with the kid, because people in authority said so.

2. A school that said the best he can hope for is a job on the market, bagging peoples groceries- that from a teacher.

3. A school psychologist near retirement insisting that MY step son was a fruit cake.

4. A father-in-law, also a psychologist ( my wife's step father ) blindly believing the diagnosis.

5. etc etc.

This is what they didn't count on:

1. Me, reading the original diagnosis.

2. Every penny I'd saved from mine clearance work and other work.

3. The power of two fingers to authority.


Here in the Netherlands, once you are streamed into a certain level of education, it is very difficult to climb out of it. I did not except that my step son was stupid. So, we paid for him to repeat his last year of junior school.
Twice.

Even this private school was convinced / indoctrinated.

But he started to come out of his shell. We then found the most respected child psychologist in Nederland and within 24 hrs the original diagnosis was
found to be wrong.

The OFFICIAL wording on the original diagnosis? - Patient has a little bit of Asperger Syndrome.

We had always believed you " can't be a little bit pregnant ". As it turned out we were vindicated, but we are still picking up the pieces. He's 15 now. Another 4 yrs of high school at a far better level and tonight he just got his Judo orange belt.

Bottom line: These buggers, these head doctors, don't have a bloody clue what they are doing.

Any parents reading this, who are in similar circumstances, feel free to U2U me if you'd like any more info.

It's a money making, school seat filling, self justification scam of unbelievable proportions. If you have doubts, dig in and fight them all the way.

Thanks for this thread LiveForever. Good job mate.

Edit to add: Being sane in insane places: My boy has been through this, Me and the Missus went through it and I think the whole bloody world is going through this.

[edit on 24-6-2010 by Sam Vimes]

reply to post by Sam Vimes


Have you seen the Louis Theroux documentary 'Americas Medicated Kids'?

It's a fascinating insight into a family who are all on some prescription drugs of some kind - even the dog!

Louis meets Hugh, a 10-year-old who has been diagnosed with ADHD, oppositional defiant disorder, Asperger's syndrome and bipolar disorder. Moving in with Hugh and his family, Louis learns more about his controversial diagnosis and gets to know a family where even the dog is on meds. - www.bbc.co.uk...

The suspicion was that pharmacology was standing in for basic parenting, but that's not how the parents saw it. "When she's on medication," said one mother, "she's my best friend." And off medication, she's presumably just her daughter.

It's such a hard position for a parent to be in, after all, who are they to disagree with a doctor? The reality is that doctors are not gods - they are human like the rest of us and therefore are capable of making mistakes like the rest of us.

I'm glad you seem to have sorted your step sons diagnosis out, thanks for sharing your story

Originally posted by LiveForever8
reply to post by Sam Vimes

 

Have you seen the Louis Theroux documentary 'Americas Medicated Kids'?

It's a fascinating insight into a family who are all on some prescription drugs of some kind - even the dog!

Louis meets Hugh, a 10-year-old who has been diagnosed with ADHD, oppositional defiant disorder, Asperger's syndrome and bipolar disorder. Moving in with Hugh and his family, Louis learns more about his controversial diagnosis and gets to know a family where even the dog is on meds. - www.bbc.co.uk...

The suspicion was that pharmacology was standing in for basic parenting, but that's not how the parents saw it. "When she's on medication," said one mother, "she's my best friend." And off medication, she's presumably just her daughter.

It's such a hard position for a parent to be in, after all, who are they to disagree with a doctor? The reality is that doctors are not gods - they are human like the rest of us and therefore are capable of making mistakes like the rest of us.

I'm glad you seem to have sorted your step sons diagnosis out, thanks for sharing your story

I have a childhood friend, Roberto, who's one year older than me, strong as a bull, but dumb as a rock. Or at least everybody always treated him that way, specially his parents. The main reason is because he couldn't speak well. When he opened his mouth he always sounded a bit slow.

Anyway, everybody treated him as dumb and he believed he was dumb. He was one year older than me and finished highschool 3 years later. After that, I went to college and moved to another city and didn't get a chance to meet with Roberto again for several years.

When I finally met him, I was surprised. Roberto, who had problem speaking and everyone thought to be dumb, was now a lawyer! But how can a lawyer act in his profession if he doesn't speak properly? Well, his speaking problem was gone.

Turns out Roberto WASNT DUMB!

He had a phonoaudiology problem, which his parents never suspected. Because of that condition, he couldn't speak well and because of that he was treated by everyone as being dumb, so much that he actually believed he was stupid.

Roberto found out about his problem only after becoming an adult. He doesn't even seem like the same person. He speaks well, has a sharp mind and is doing well as a lawyer.


[edit on 24-6-2010 by henriquefd]

Psych hospitals are big business, if you can't find patients who really need care they'll be happy to diagnose sane people as dangerous.

How would I know? I was incarcerated for 3 months on someone else's verbal testimony that I was a "danger to society". No court, no hearing, no trial, no jury. Off you go! Then they pump you full of drugs that destroy your personality. Once your mind has been neutered they will release you once you have agreed to "get with the program". This means of course that you MUST admit to having psychological problems and cannot deal with them without "professional" help.
I missed my senior prom, graduation and the funeral of my best friend at the time. This all happened because a teacher got alarmed at my writing assignment ( we had to write a fictional story).
Moral of the story - NEVER seek help from a "professional". talk to family and friends, the people who actually love and care about you. To the people that run these hospitals you are nothing more than a body to fill their beds.
PSYCHOLOGY IS A FRAUD

reply to post by Asktheanimals


Oh wow, really? Can you go into more detail about what happened to you? Was your experience similar to the Rosenhan experiment at all?

In what can be termed as the nation’s fastest growing drug problem, a new report from the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Centers for Disease Control and Prevention (CDC) reveals a rapid spurt in fatalities resulting from the abuse of prescription pain drugs.

According to official sources, there were two million visits to the ED in 2008 for misuse and abuse of all drugs.

These included nearly a million visits for illicit drugs like coc aine and heroin and almost the same number for non-medical use of prescription or over-the-counter drugs.

This report found that the approximate number of ED visits for nonmedical use of opioid analgesics increased 111percent during 2004--2008 (from 144,600 to 305,900 visits) and increased 29 percent during 2007—2008.

The report also found that ED visits involving misuse of anti-anxiety drugs such as Valium, Klonopin, Ativan and Xanax, increased 89 percent from 2004 to 2008 (from 143,500 to 271,700 visits) and 24 percent during 2007-2008. - www.themoneytimes.com...

I cant see how anyone would be surprised by these statistics and what makes it worse is that there are many, many more who are suffering but who do not seek medical attention.

'Try telling one of them that you are going to take some vitamin C, do some cleansing or change your diet and they roll their eyes and snicker at you like you must be from another planet.'

This is a very good point and with the implementation of Codex Alimentarius the prospect of using natural remedies is looking less likely which is going to see the prescription drug problem get worse.

reply to post by henriquefd


What a great story.

It just goes to show the effect a mis-diagnosis can have on an individual and those around them.

What treatment, if any, did your friend receive after finding what the actual problem was? Did he receive any medication prior to finding the correct diagnosis, maybe for whatever they suspected the problem was originally?