The wrong experiment that changed psychiatry

It was 1973. The American psychologist David Rosenhan published an article that shook the very foundations of psychiatry. It was titled “About Healthy Living in Crazy Places”. He summarized the results of an experiment he carried out between 1969 and 1972. Rosenhan and seven other volunteers, all healthy, presented themselves to various psychiatric hospitals. So began the wrong experiment that changed psychiatry.

In the sham experiment that changed psychiatry, healthy patients were admitted to psychiatric hospitals.
In the sham experiment that changed psychiatry, healthy patients were admitted to psychiatric hospitals.
Made up symptoms

All reported having the same symptom. They said they heard a voice saying one of three words: “hit”, “empty” or “hollow”. As Rosenhan wrote, that was enough for everyone to be hospitalized. Everyone was completely normal when they were admitted. But some of them, including him, were held for several days. They held him for 52 days. The psychologist also condemned the mistreatment and neglect he and the rest of the volunteers received.

Seven of the eight sham patients were diagnosed with schizophrenia. Rosenhan’s experiment and its rocky conclusions led to a strong questioning of psychiatry. In particular, it has questioned the ability of psychiatry to diagnose and distinguish between insanity and sanity.

Almost half a century later, Susannah Cahalan became interested in psychiatry for a very personal reason. A few years ago she was admitted to a mental hospital after she was diagnosed with schizophrenia. However, it turned out that he did not suffer from this disorder.

Track down the doctor

Her interest in psychiatric matters led her to learn about Rosenhan’s famous experiment. It interested her because it had something similar to do with what she had experienced. He decided to research and write about Rosenhan’s work.

“I’ve noticed that there are inconsistencies between what you’ve published in yours paper and what he wrote in this unpublished book. Then I found David Rosenhan’s medical records, and then the problems came up, ”he revealed.

Cahalan tried to track down the seven “pseudo-patients” who took part in the experiment, along with Rosenhan, who had died in 2012. He says it’s like “chasing ghosts”. She didn’t even hire a private investigator.

David Rosenhan became famous thanks to this experiment.
David Rosenhan became famous thanks to this experiment.

After years of searching, he finally found one: Bill Underwood, who at the time of the experiment was a PhD student at Stanford, where Rosenhan was teaching at the Department of Psychology.

Underwood shared an experience similar to Rosenhan’s. He found that there was a ninth “dummy patient” who participated in the experiment but was not included in the final results. Harry Lando had also been a PhD student at Stanford who had been recruited by Rosenhan. Like the rest of the volunteers, he was hospitalized, diagnosed with schizophrenia, and spent 19 days in a San Francisco mental hospital. Lando described it as a positive experience.

He was deeply depressed. David Rosenhan described an underworld of abuse and neglect, but Harry Lando described the experience as almost magical, ”he says. “He came out of 19 days of hospitalization a transformed person.” Apparently, his case was not taken because it did not fit David Rosenhan’s theory. He argued that mental health facilities are harmful places that should be closed.

The fake

In his book The great pretender (“The great fony”) also asks if there really were all of the other volunteers who allegedly took part in the experiment. Rosenhan himself left out important details about his hospital stay. Not only did he report auditory hallucinations, he also claimed to have committed suicide. That, says the author, justifies the decision to include him. “Dr. Bartlett wasn’t a bad doctor who made a bad decision (…). He was a good doctor who did the best that could be done, given the information received,” says Cahalan.

The wrong experiment that changed psychiatry wasn’t all bad. It helped improve the diagnosis of mental illness. “David Rosenhan’s work gave this checklist approach a boost to make it mainstream in psychiatry.”

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