Rosenhan- Being Sane In Insane Places

Summary

In the late 19th century, journalist Nellie Bly feigned insanity to expose asylum conditions, while in the 1970s, psychologist David Rosenhan's 'On Being Sane in Insane Places' study challenged the reliability of psychiatric diagnosis. Rosenhan and his colleagues, posing as patients, were admitted to 12 hospitals with a fabricated symptom. Despite behaving normally post-admission, none were detected as sane by staff, raising questions about the validity of psychiatric practices and the treatment of mental health patients.

Takeaways

• 🏥 In the 19th century, madness started being seen as a disease managed by psychiatrists, leading to the establishment of asylums.
• 🔍 Journalist Nellie Bly feigned insanity in 1887 to expose the ease of misdiagnosis and the poor conditions within asylums.
• 📚 Nellie Bly's book '10 Days in a Mad-House' detailed her experiences and critiqued the psychiatric practices of her time.
• 🤔 The 1960s and 1970s were periods of significant questioning of established ideas, including psychiatry, leading to the rise of anti-psychiatry.
• 🧠 Thomas Szasz and other anti-psychiatrists argued that mental illness was a myth and that psychiatry was a pseudoscience.
• 👨‍⚕️ David Rosenhan's experiment in the 1970s aimed to test the reliability of psychiatric diagnoses by having healthy individuals pretend to be patients.
• 🗣️ Rosenhan's 'pseudopatients' only faked one symptom, saying they heard a voice saying 'empty,' to test diagnostic accuracy.
• 🏥 All pseudopatients were admitted to hospitals with a diagnosis of insanity, despite not exhibiting any other symptoms.
• 🕵️‍♂️ Once admitted, pseudopatients behaved normally but were never recognized as sane by hospital staff.
• 📉 Rosenhan's study highlighted the potential flaws in psychiatric diagnosis and the experience of being a patient in a mental hospital.

Q & A

What was the main purpose of Nelly Bly's undercover investigation at the asylum?

Nelly Bly's main purpose was to test the reliability of psychiatric diagnosis and to expose the terrible conditions inside the asylum.

How did Nelly Bly manage to get admitted to the women's lunatic asylum in New York?

Nelly Bly feigned insanity by pulling strange faces, tugging her hair out, and claiming everyone around her was crazy, which led to her being admitted by two doctors.

What was the significance of the symptom the pseudo-patients used in David Rosenhan's experiment?

The pseudo-patients used the symptom of hearing a voice saying 'Hollow, empty, thud' which did not represent any known schizophrenic disorder, allowing Rosenhan to test whether doctors would diagnose them as insane despite the lack of typical symptoms.

What were the two aims of David Rosenhan's study on psychiatric diagnosis?

The two aims were to investigate whether psychiatric labels would be used inappropriately in the absence of symptoms, and to observe the experience of being a patient in a psychiatric hospital.

How many of the pseudo-patients in Rosenhan's experiment were detected as sane by the hospital staff?

None of the pseudo-patients were ever detected as sane by the hospital staff during their stay.

What was the role of the anti-psychiatry movement in the 1960s and 70s?

The anti-psychiatry movement questioned the medical model of mental illness, suggesting that it was a pseudo-science and that the concept of mental illness was a myth.

What did Thomas Szasz argue about the nature of psychiatry and mental illness?

Thomas Szasz argued that psychiatry was a pseudo-science and that the very idea of mental illness was a myth.

How did Irving Goffman suggest that mental hospitals could contribute to insanity?

Irving Goffman suggested that the mere presence in a mental hospital could be enough to drive people insane due to the dehumanizing and stigmatizing environment.

What was the title of David Rosenhan's study, and what does it signify?

The title of the study was 'On Being Sane in Insane Places', signifying the experiment's focus on the experience and perception of sanity within psychiatric institutions.

What was the reaction of the hospital staff when the pseudo-patients claimed their symptoms had disappeared?

Despite the pseudo-patients claiming their symptoms had disappeared and expressing a desire to be released, the hospital staff did not detect their sanity and continued to treat them as patients.

How long did it take for one of the pseudo-patients to be released from the hospital?

One of the pseudo-patients was not released until two months after their admission, despite behaving normally and claiming their symptom had disappeared.

Outlines

00:00

🏥 The Birth of Psychiatry and Nelly Bly's Asylum Expose

This paragraph delves into the historical context of psychiatry, highlighting the 19th-century shift in perception of madness as a disease. It discusses the establishment of asylums and the emergence of psychiatrists as experts in managing mental health. The narrative pivots to Nelly Bly, a journalist who, in 1887, feigned insanity to expose the flaws in psychiatric diagnosis and the deplorable conditions within asylums. Her experiences, documented in '10 Days in a Mad-House,' underscored the ease with which one could be misdiagnosed and the urgent need for reform in mental health care.

05:00

🔍 Rosenhan's Experiment: Challenging the Reliability of Psychiatric Diagnosis

The second paragraph continues the theme of questioning psychiatric practices, this time through David Rosenhan's groundbreaking experiment in the 1970s. Rosenhan and his colleagues, posing as patients, aimed to test the reliability of psychiatric diagnosis by attempting to get admitted to hospitals with a fabricated symptom. Once admitted, they ceased faking any symptoms and behaved normally. Despite this, none of the pseudo-patients were detected as sane by the hospital staff, leading to the publication of their findings under the title 'Sane in Insane Places.' The experiment raised profound questions about the validity of psychiatric labels and the experience of being a patient in a psychiatric ward, drawing parallels to Nelly Bly's earlier work and further highlighting the need for a reevaluation of mental health practices.

Keywords

💡Psychiatry

Psychiatry is the medical specialty devoted to the diagnosis, prevention, and treatment of mental disorders. In the video, it is portrayed as a field that was being challenged for its methods and the reliability of its diagnoses during the 19th and 20th centuries. The script highlights how psychiatry was seen as having a significant impact on the lives of those deemed 'insane,' with the establishment of asylums and the power to label individuals.

💡Asylums

Asylums, historically, were institutions for the care of people with mental disorders. The script discusses the establishment of asylums in the 19th century and how they were seen as places that marked a clear boundary between the sane and the insane. It also contrasts the conditions within these asylums with the experiences of individuals like Nelly Bly, who exposed the harsh realities within them.

💡Nelly Bly

Nelly Bly, the pen name of Elizabeth Cochran, was an investigative journalist who famously feigned mental illness to expose the conditions within a women's asylum in New York. Her experiences, as described in the script, were used to critique the practices of psychiatry and the asylum system, showing how easily one could be labeled as 'insane' and the dire conditions within such institutions.

💡Anti-psychiatry movement

The anti-psychiatry movement was a social movement and intellectual current in the 1960s and 1970s that questioned the validity of psychiatric diagnoses and the authority of the psychiatric profession. The script mentions figures like Thomas Szasz and R.D. Laing, who were part of this movement, arguing that mental illness was a myth and that the institutions themselves could be harmful.

💡David Rosenhan

David Rosenhan was a clinical psychologist who conducted a famous experiment in the 1970s to test the reliability of psychiatric diagnosis. As detailed in the script, he and his colleagues faked a symptom to get admitted to psychiatric hospitals and then behaved normally to see if they would be detected. The experiment, known as the Rosenhan experiment, had a profound impact on the field of psychiatry, questioning the accuracy of its diagnostic practices.

💡Pseudopatients

Pseudopatients are individuals who pretend to have a disease or disorder for research purposes. In the context of the video, Rosenhan's experiment involved pseudopatients who feigned hearing voices to gain admission to psychiatric hospitals. The script describes how these individuals continued to behave normally after admission, challenging the ability of the staff to distinguish between genuine and feigned symptoms.

💡Diagnostic labels

Diagnostic labels refer to the terms used to categorize and identify mental disorders. The script discusses how these labels were used in situations where they might not have been appropriate, as part of Rosenhan's experiment. The study aimed to investigate whether psychiatric labels could be misused or misapplied, which was a significant concern within the anti-psychiatry movement.

💡Mental hospital

A mental hospital is a facility for the treatment of patients with mental disorders. The script contrasts the experiences of patients in mental hospitals in the 1970s with those in asylums in the 19th century. It also explores the conditions and treatment within these hospitals, as part of Rosenhan's covert participant observation study.

💡Schizophrenia

Schizophrenia is a chronic mental disorder characterized by abnormal social behavior and failure to recognize what is real. In the script, the pseudopatients in Rosenhan's experiment faked a symptom that did not represent any known symptom of schizophrenia, which was a deliberate choice to test the doctors' ability to diagnose accurately.

💡Covert participant observation

Covert participant observation is a research method where the researcher participates in a setting without revealing their true purpose. The script describes how Rosenhan and his colleagues used this method to study the experience of being hospitalized in a psychiatric ward, observing and documenting the conditions and interactions without the knowledge of the hospital staff.

💡Sane in insane places

This phrase is the title of Rosenhan's study and reflects the central theme of the video. It refers to the idea that even those who are sane can be perceived as insane in certain environments, particularly within psychiatric institutions. The script uses this concept to highlight the flaws in psychiatric diagnosis and the potential for mislabeling individuals.

Highlights

Madness was not considered a disease until the 19th century.

Psychiatrists emerged as experts to manage madness in the 19th century.

Journalist Elizabeth Cochran, aka Nelly Bly, tested psychiatry by feigning madness in 1887.

Nelly Bly's book '10 Days in a Mad-House' exposed the ease of deceiving doctors and asylum conditions.

David Rosenhan's experiment aimed to test the reliability of psychiatric diagnosis.

The 1960s and 70s were periods of questioning established ideas, including psychiatry.

Anti-psychiatrists like Thomas Szasz and R.D. Laing criticized the medical model of mental illness.

Irving Goffman suggested that mental hospitals could drive people insane.

David Rosenhan's experiment involved 'pseudo patients' getting admitted to hospitals.

Pseudo patients faked a single symptom to get admitted.

The symptom 'hearing a voice saying "Hollow empty thud"' was chosen for its uniqueness.

All pseudo patients were admitted to the hospital despite behaving normally.

The study had two aims: investigating psychiatric labels and the experience of being hospitalized.

None of the pseudo patients were detected as sane by hospital staff.

The experiment showed that mental hospitals of the 1970s were not much different from the asylums of the 1890s.

The experiment had a significant impact on the field of psychiatry.

Transcripts

[Music]

there's always been Madness but it

wasn't until the 19th century that it

came to be seen as a disease to be

managed by a new group of experts

psychiatrists new asylums were built

their walls and bars marking the

supposedly clear-cut boundary between

the sane and the insane but in 1887 an

enterprising journalist called Elizabeth

Cochran who wrote Under the name of

Nelly blly challenged

this Nelly Blye was on a mission to test

out Psychiatry so what she did she

checked into a boarding house and she

started pulling strange faces and

tugging her hair out and saying everyone

around her was crazy and sure enough it

wasn't long before two doctors had her

shipped off to the woman's lunatic

asylum in New

York once inside she behaved perfectly

normally but it made no difference as

she later wrote the saner I acted the

crazier they thought I was her articles

in her book 10 days in a mad house

showed just how easy it had been to fool

the doctors and just how terrible

conditions were inside the Asylum 85

years later a clinical psychologist

called David rosenhan would do much the

same

[Music]

thing the 1960s was a time of Social and

Cultural Revolution established ideas

institutions and professions were

questioned and one of them was

Psychiatry the 1970s were a very

turbulent period for Psychiatry

um at the time there were a group of

psychiatrists well in the 1960s anyway

and going through to the 70s there a

group of psychiatrists who actually

badged themselves as anti psychiatrists

the medical model saying that this is a

a largely physical thing that people

have become mentally ill and the anti

Psychiatry movement was saying that

perhaps we should we should see this in

a different way Thomas SATs argued that

Psychiatry was a pseudo science and the

Very idea of mental illness was a myth

Irving gothman suggested that just being

in a mental hospital was enough to drive

people insane and RD Lang claimed that

what Psychiatry said was mental illness

was just a rational response to an

insane world what bound them together

was objection a horror at the way that

psch was being practiced in those days

people were Lely just incarcerated in

big hospitals I mean we used to call

them Looney bins and in a way although

it's a

pejorative it is like it was like a dust

bin for people really it was horrible a

space where you can meet with her where

she's not going to be frightened that R

Lang was the most famous of these anti

psychiatrists it was while listening to

One of Lang's lectures that David

rosenhan wondered if there might be a

way of actually testing the reliability

of psychiatric

diagnosis can we really tell the sane

from the

insane so one evening he called some

friends and students and asked them if

they'd like to take part in an

experiment his idea was to see if they

could get themselves admitted to

hospitals as psychiatric patients and

surprisingly seven of them three women

and four men agreed one of them Martin

Seligman now himself a world famous

psychologist later explained that

rosenhan could be very persuasive and he

had to be because this was a tough

assignment I think it' been very

frightening for the pseudo patients when

they turn up these

institutions very intimidating they have

a certain smell to them however much you

see pictures of them it's nothing like

walking in it's it's a physical

experience of the there's you really

can't put into words to smell the

experience the feeling of the place it's

intimidating there would be patience

none of whom had any history of

psychiatric disorder practiced their

roles including how to avoid swallowing

the mass of tablets that'd be sure to be

given they stopped shaving showering and

brushing their teeth and 5 days later

they set off and so began one of the

most notorious experiments ever

conducted in Psychology an experiment

from which Psychiatry never quite

recovered

[Music]

rosenhan and his Confederates traveled

to 12 hospitals in five different states

in the US to try to get a more

representative sample some of the

hospitals were old some new some were

short staffed others well

staffed after calling for an appointment

the wouldbe patients presented

themselves at the hospitals they didn't

act crazy like Nelly BL had done they

just faked a single symptom

yes when the Pudo patients turn up at

the hospital they would just say I'm

hearing a voice and it's saying to me

Hollow empty thud and the significance

of this uh is that it doesn't represent

any known symptom of a schizophrenic

disorder uh so it's quite unique it's

made up no one would have accounted

anything like this before so rosenhan

was giving the doctors a chance here and

apart from saying they heard the voice

and giving a false ID everything else

the pseudo patient said was true

significant events in their life were

described exactly as they had been and

then what happened they were all

diagnosed as

insan and admitted to the

hospital all of them all of them once

admitted the pseudo patients stopped

faking the symptom and behaved in the

way they usually did hence the title of

the study being sane in insane places

when asked by staff how they were

feeling they said they were fine the

symptom had disappeared and could they

please be

released so what was rosenhan trying to

do here there were two aims to the study

the first one principally was to

investigate psychiatric labels as to

whether these would be used in

situations where they weren't

appropriate so this was first of all a

field experiment independent variable

being the lack of symptoms in the pseudo

patients once admitted and the dependent

variable the responses of the staff but

this wasn't all and the second aim of

the study was to get some data on what

it's actually like to be a patient in a

psychiatric hospital being sane in

insane places then was also a covert

participant observation study of the

experience of being hospitalized in a

psychiatric

ward so what did rosenan and his

Confederates find how long would it take

for their sanity to be detected by the

staff and what would they find out about

on the

inside how different were the Mental

Hospitals of the

1970s from the mad house of the 1890s

described by Nelly

[Music]

BL despite the fact that the hospitals

chosen were not particularly bad ones

and the pseudo patients behav quite

normally throughout their stay none of

them were ever detected by any member of

the hospital staff and this surprised

even rosenhan but I told friends I told

my family I get out when it's when I can

get out that's all be there for a couple

days and I I get out nobody knew I'd be

there for two months