What Happened When 8 Sane People Pretended to Be Mentally Ill - Documentary - Rosenhan Experiment

Dr Marianne Trent (: 00:00

How do you tell the difference between someone who is sane and someone who isn't? What if the system itself can't even tell? In the 1970s, a daring experiment put mental health institutions to the test and the results shook the psychiatric world. Today we are exploring what's known as the Rosenhan experiment and uncovering what it taught us then and now about perception, diagnosis, and mental health. Hi, I'm Dr. Marianne Trent, a qualified clinical psychologist. Welcome along. In today's episode, we are diving into one of the most iconic and controversial studies in psychology. That is David Rosenhan on being sane in insane places. And honestly, since I first learned about this study when I was in my A Levels, that name has stuck with me. It really is iconic, and that's because this experiment challenged the very foundations of psychiatric diagnosis and revealed somewhat uncomfortable truths at times about how mental health care was being practised.

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We are going to be breaking down what happened, what it means, and how it's still relevant today. Let's dive in the experiment. What happened? So it was 1973 and David Rosenhan, who's a psychologist and professor, set out to answer a bold question, can mental health professionals reliably distinguish between what he was calling sanity and insanity? To test this, Rosenhan recruited eight pseudo patients, which incidentally did actually include himself. These people were from various professions, including psychologists, even a psychiatrist, a housewife, a painter. And what they were tasked with was to all pretend to experience one symptom. In this case, he asked them to report that they were hearing voices and that these voices said thud, empty or hollow. Rosenhan specifically chose those words because he thought they didn't align with any known psychiatric symptoms at that time, they weren't commonly reported words for any diagnosis.

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So what happened? What were the results? Well, all eight were admitted to inpatient hospitals and most of them were diagnosed with schizophrenia. The study really began though when they had managed to get themselves admitted to those psychiatric hospitals. Thereafter, the patients, the pseudo patients I should say, were asked to behave completely normally. They didn't report any additional symptoms. They answered all questions that were asked to them, and they seemed to have stopped experiencing those auditory hallucinations. So how long were they in there for? Well, the average length of stay was 19 days, but with one person even staying for 52 days, despite acting sane inside the hospitals, none of the staff identified them as imposters. But interestingly, many of the real patients did suspect that they weren't truly ill. They would say things to them like, you are not crazy, are you? And I'm sorry if any of the language in this video is triggering.

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It's the language that was used in the 1970s at the time. Psychological insights. What did we learn? One, the power of labels. Once the pseudo patients were labelled with a psychiatric diagnosis, everything else they did was interpreted through that lens. For example, they were asked to record their notes of what was going on in the hospital. That that note taking, that just writing things down in a journal in a diary, was described as pathological writing behaviour. That's like you writing notes in a meeting or in a supervision or writing a diary or a journal. But these normal actions that many of us still do, even to this day, were reframed to fit the diagnosis. They saw what they wanted to see and interpreted it accordingly. Two, confirmation bias staff members expectations influenced how they perceived the pseudo patients. They saw what they expected to see, which is symptoms of mental illness, and dismissed any evidence that seemed to contradict their assumptions or their beliefs.

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Three Dehumanisation. In psychiatric care, many of the pseudo patients reported feeling ignored or treated dismissively. It seemed that doctors and nurses often seem to avoid direct interactions with the pseudo patients, which highlighted what we call the depersonalization. That can seem to occur in institutional settings at times, the fallout and the controversy, the study's publication caused somewhat of a ferrare in the psychiatric community. It seemed to reveal cracks in the reliability of psychiatric diagnoses and raised questions about how patients were being treated at that time. Following on from the study, one hospital actually challenged Rosenhan to send more pseudo patients claiming that they could identify them over a period of weeks. The staff flagged 41. Yes, 41 individuals as imposters. The twist in the tail rosenhan hadn't sent anyone. Whilst the study was groundbreaking, it wasn't without criticism. Some argued that the lack of transparency in the methodology used made the results hard to replicate.

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Others believed the study unfairly undermined trust in psychiatric professionals who were doing their best with the knowledge and tools available at the time. I think an additional consideration would be the waste of psychiatric professionals, time, money, and resources to modern relevance. Why it does it matter today? Firstly, it gives us food for thought about diagnosis terms, and really the ethics of diagnosis as a standalone way of understanding people and the difficulties that they experience. So of course, whilst psychiatric diagnosis has come a long way since the 1970s, we've got more refined criteria and tools like the ICD 11 and the DSM five. However, challenges do remain particularly in recognising the complexity of mental health and avoiding over reliance on labels. Alternative approaches to psychiatric diagnosis such as the power threat, meaning framework by Lucy Johnston and Mary Boyle have also been posited. And if you'd like to learn more about the power threat meaning framework, please do check out episode 21 of the Aspiring Psychologist Podcast where I chat with Lucy herself.

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I will link that in the show notes for this episode. Secondly, we've got stigma and misdiagnosis. The study reminds us of the stigma that can come with mental health labels. It also highlights the importance of second opinions and patient-centered care to reduce the risk of misdiagnosis. Of course, what we know in modern psychiatric care is it can be very hard to get labels and diagnoses overturned at a later stage. And that stigma and that belief about you can follow you around perhaps throughout your life. Thirdly, we have the implications beyond mental health. The insights from this study beyond psychiatry are that they apply to any field where labels and first impressions influence decisions. This is around in education, in criminal justice or employment, maybe even social groups and families too. It really is a call for us to approach every situation with empathy and critical thinking.

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And our fourth point in terms of modern psychology studies, it's also informed our ethical practises and our procedures and gives us food for thought about the generalizability of research too. Before we wrap up, if you are enjoying this episode, you might also love my recent deep dive into the story of Phineas Gauge, the man whose brain injury involving a large spike through his brain revolutionised our understanding of personality and behaviour. I also recently covered the Milgram experiment where people administered massive electric shocks to people because they were told to. So don't miss that one either, and I would love it if you would let me know which topics you'd like me to cover in future. Do let me know in the comments conclusion, what can we take away? Well, the Rosen Harn experiment wasn't just a test of diagnosis. It was a bold challenge to the way we perceive and treat mental illness.

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It reminds us that labels can shape reality and that empathy and understanding should always guide our approach to mental health care. So what do you think of Rosen? Ha's study? Was it a necessary wake up call or do you think it crossed ethical lines? Do you think you would've been able to talk yourself in or out of psychiatric hospital in the 1970s? Do let me know in the comments below or come and chat with me on my socials where I'm Dr. Marianne Trent, everywhere. If this has worked your appetite for psychology, please do check out the Clinical Psychologist collective book, the Aspiring Psychologist Collective book. Come and join my free Facebook group for aspiring psychologists, the Aspiring Psychologist community with Dr. Marianne Trent. And if it's your time and your ready for the next step in your mental health career, please do check out the Aspiring Psychologist membership where we are doing wonderful things, looking at research, cognitive behavioural therapy, reflection, interview skills, application skills, and so much more. If you found this episode interesting, don't forget to like, subscribe, share it with others who also love diving into the iconic psychology studies and learning more about the way that we understand the world today and how we've understood it in the past.

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