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On being sane in insane places
Article in the journal Science published in the January 1973 edition, Vol. 179 (250-258) on the Rosenhan experiment.
16 pages, Unknown Binding
First published January 1, 1973
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Displaying 1 - 12 of 12 reviews
December 9, 2016
"we cannot distinguish sanity from insanity."
Journal article about experiment where 'sane' ordinary people gained admittance to a variety of psychiatric hospitals by telling one lie "I heard voices" but no longer do and otherwise behaving as ordinarily. All were admitted and diagnosed as insane. Their 'normal' behaviors were interpreted in medical notes through the lenses of the diagnosis not directly from their behavior. Humorous if it were not for the fact that 'mental illness' is still not seen as a form of 'physical illness' despite the latest research.
"Medical illnesses, while unfortunate, are not commonly pejorative. Psychiatric diagnoses, on the contrary, carry with them personal, legal, and social stigmas."
One of the more hilarious things recorded by one of the 'patients':
"One psychiatrist pointed to a group of patients who were sitting outside the cafeteria entrance half an hour before lunchtime. To a group of young residents he indicated that such behavior was characteristic of the oral-acquisitive nature of the syndrome. It seemed not to occur to him that there were very few things to anticipate in a psychiatric hospital besides eating."
http://psychrights.org/articles/rosen...
Journal article about experiment where 'sane' ordinary people gained admittance to a variety of psychiatric hospitals by telling one lie "I heard voices" but no longer do and otherwise behaving as ordinarily. All were admitted and diagnosed as insane. Their 'normal' behaviors were interpreted in medical notes through the lenses of the diagnosis not directly from their behavior. Humorous if it were not for the fact that 'mental illness' is still not seen as a form of 'physical illness' despite the latest research.
"Medical illnesses, while unfortunate, are not commonly pejorative. Psychiatric diagnoses, on the contrary, carry with them personal, legal, and social stigmas."
One of the more hilarious things recorded by one of the 'patients':
"One psychiatrist pointed to a group of patients who were sitting outside the cafeteria entrance half an hour before lunchtime. To a group of young residents he indicated that such behavior was characteristic of the oral-acquisitive nature of the syndrome. It seemed not to occur to him that there were very few things to anticipate in a psychiatric hospital besides eating."
http://psychrights.org/articles/rosen...
June 5, 2026
An interesting article that shows that real psychiatric patients have better insight into people faking mental illness than psychiatrists do!
Psychiatry and psychology are notorious for their inexact methodologies and this is perfectly highlighted here.
Basically mental health services are winging it! Happy days!
I read this article for free here :-
https://www.weber.edu/wsuimages/psych...
Psychiatry and psychology are notorious for their inexact methodologies and this is perfectly highlighted here.
Basically mental health services are winging it! Happy days!
I read this article for free here :-
https://www.weber.edu/wsuimages/psych...
Read
September 12, 2024slay
May 27, 2020
I picked this research paper up after reading "The Great Pretense."
I wanted to read the way Rosenhan thinks, regardless of the debate around this paper's reliability and validity, let alone its potentially fraudulent nature. I read it as an essay, whose impact on the practice of psychology as well as the wave of deinstitutionalization has been undeniable. I took it in for its observational arguments, rather than the alleged scientific facts.
"On the stickiness of psychodiagnostic labels" is the segment that stands out for me. Rosenhan argues that once tagged, there's nothing a patient, well, a person can do to overcome it. I find this observation to be accurate based on my personal experience of bulimia nervosa. A condition that is assumed to become synonymous with who you are, much like alcoholism.
Initially, admitting the clinical label I was assigned helped me understand its mechanics. I learned how others suffer from it. I was able to compare and contrast how similar yet different my own condition was. Overall, the label helped me see what I had as an illness to be treated. However, past the treatment stage, carrying the label around like a tattoo, being in perpetualremission, the idea that I will never be fully cured helped me next to none. Only when I began to forget about my diagnosis, when I moved to a new city, when I acquired new friends, when I adopted a dog, and grew up a little, I was able to permanently erase the label from my mind.
I don't argue that the prescription to cure acute psychological disorders is to pretend they never happened and that they'll go away. But I find myself agreeing with Rosenhan that the symptoms of these disorders overshadow everything else so intensely that in treatment, root causes may go amiss, and the much-needed motivation required for the patient to help herself may be attacked by the strength of the labels.
In my psychological history, the tag still stands as a scarlet letter, as a red flag to watch out for. Like Rosenhan notes, the perception of my circumstances may be shaped entirely by the diagnosis. Unlike other physical illnesses, the flu, or a broken leg I healed from.
-----
It seems to me that Rosenhan wanted to tap into the cinematic fascination the society has for the mentally ill. He wanted to flip the script on the idea that the insane induce fear and hostility. For that, he wanted to prove how lines are blurred between sanity and insanity.
Under the influence of Cahalan's big investigative work, as well as the current political climate and power mechanisms that gravitate far from the grounding power of morals, my instinct is to look at this whole "essay"s negative film print. Each segment of the paper- labeling, powerlessness, hospitalization, depersonalization, and their consequences raise vital questions about the state of our society when their context is flipped over.
What about our treatment of the insane who roam undiagnosed and untreated in sane places?
What if in our deinstitutionalized world, our society's economic aspirations, new generations' imaginations are driven by a strange resonance with insanity? Artistry, courage, pioneership, ability to reach states of the mind on the peripheries of human imagination may very well be attributed to symptoms of mental disorders. What if we are handing out labels of achievement, what if we are idolizing, empowering, and identifying with the mentally ill yet powerful few? What if we are letting our society's normalcy being shaped by them?
Those are the questions bugging my mind that Rosenhan's paper, with its content and its context, left me with.
I wanted to read the way Rosenhan thinks, regardless of the debate around this paper's reliability and validity, let alone its potentially fraudulent nature. I read it as an essay, whose impact on the practice of psychology as well as the wave of deinstitutionalization has been undeniable. I took it in for its observational arguments, rather than the alleged scientific facts.
"On the stickiness of psychodiagnostic labels" is the segment that stands out for me. Rosenhan argues that once tagged, there's nothing a patient, well, a person can do to overcome it. I find this observation to be accurate based on my personal experience of bulimia nervosa. A condition that is assumed to become synonymous with who you are, much like alcoholism.
Initially, admitting the clinical label I was assigned helped me understand its mechanics. I learned how others suffer from it. I was able to compare and contrast how similar yet different my own condition was. Overall, the label helped me see what I had as an illness to be treated. However, past the treatment stage, carrying the label around like a tattoo, being in perpetualremission, the idea that I will never be fully cured helped me next to none. Only when I began to forget about my diagnosis, when I moved to a new city, when I acquired new friends, when I adopted a dog, and grew up a little, I was able to permanently erase the label from my mind.
I don't argue that the prescription to cure acute psychological disorders is to pretend they never happened and that they'll go away. But I find myself agreeing with Rosenhan that the symptoms of these disorders overshadow everything else so intensely that in treatment, root causes may go amiss, and the much-needed motivation required for the patient to help herself may be attacked by the strength of the labels.
In my psychological history, the tag still stands as a scarlet letter, as a red flag to watch out for. Like Rosenhan notes, the perception of my circumstances may be shaped entirely by the diagnosis. Unlike other physical illnesses, the flu, or a broken leg I healed from.
-----
It seems to me that Rosenhan wanted to tap into the cinematic fascination the society has for the mentally ill. He wanted to flip the script on the idea that the insane induce fear and hostility. For that, he wanted to prove how lines are blurred between sanity and insanity.
Under the influence of Cahalan's big investigative work, as well as the current political climate and power mechanisms that gravitate far from the grounding power of morals, my instinct is to look at this whole "essay"s negative film print. Each segment of the paper- labeling, powerlessness, hospitalization, depersonalization, and their consequences raise vital questions about the state of our society when their context is flipped over.
What about our treatment of the insane who roam undiagnosed and untreated in sane places?
What if in our deinstitutionalized world, our society's economic aspirations, new generations' imaginations are driven by a strange resonance with insanity? Artistry, courage, pioneership, ability to reach states of the mind on the peripheries of human imagination may very well be attributed to symptoms of mental disorders. What if we are handing out labels of achievement, what if we are idolizing, empowering, and identifying with the mentally ill yet powerful few? What if we are letting our society's normalcy being shaped by them?
Those are the questions bugging my mind that Rosenhan's paper, with its content and its context, left me with.
November 26, 2020
This was a disturbing article to read (though not very surprising) and reminded me of a quote,
"Health consists of having the same diseases as one’s neighbors." - Quentin Crisp
It also made me want to finish reading a book called Weekends at Bellevue (https://www.goodreads.com/book/show/6...).
"Health consists of having the same diseases as one’s neighbors." - Quentin Crisp
It also made me want to finish reading a book called Weekends at Bellevue (https://www.goodreads.com/book/show/6...).
June 30, 2016
A very interesting experiment that shows how preconceptions can alter the perception of a person and how difficult it can be to overcome these.
A very groundbreaking experiment that must have stirred up the psychology world in its time and that is still discussed today
A very groundbreaking experiment that must have stirred up the psychology world in its time and that is still discussed today
April 22, 2022
I read this paper after watching a video on pseudopatients by crash course and I must say we have made a big leap from the time this was written but we still have a long way to go in the treatment and care of mental diseases.
September 23, 2020
In his essay, On Being Sane in Insane Places, D. L. Rosenhan discusses a series of experiments that he participated in involving psychiatric institutions and the effect of misdiagnoses of psychological disorders on the patients admitted to the hospitals. Rosenhan’s research shows us that the labels associated with mental illness (particularly schizophrenia) have a significant impact on the way patients are treated.
it raise questions regarding normality and abnormality is in no way to question the fact that some behaviors are deviant or odd. Murder is deviant. So, too, are hallucinations. Nor does raising such questions deny the existence of the personal anguish that is often associated with "mental illness." Anxiety and depression exist. Psychological suffering exists. But normality and abnormality, sanity and insanity, and the diagnoses that flow from them may be less substantive than many believe them to be. At its heart, the question of whether the sane can be distinguished from the insane (and whether degrees of insanity can be distinguished from each other) is a simple matter: do the salient characteristics that lead to diagnoses reside in the patients themselves or in the environments and contexts in which observers find them? From Bleuler, through Kretchmer, through the formulators of the recently revised Diagnostic and Statistical Manual of the American Psychiatric Association, the belief has been strong that patients present symptoms, that those symptoms can be categorized, and, implicitly, that the sane are distinguishable from the insane. More recently, however, this belief has been questioned. Based in part on theoretical and anthropological considerations, but also on philosophical, legal, and therapeutic ones, the view has grown that psychological categorization of mental illness is useless at best and downright harmful, misleading, and pejorative at worst.
David Rosenhan sought to challenge common psychiatric diagnoses, using a controlled experiment to test whether the sane can be distinguished from the insane—wanting to shed light on a problem of type 2 error and misdiagnosis that often has serious social and psychological consequences (1973). The experiment placed eight “pseudopatients,” or normal, clinically sane individuals, in various mental hospitals throughout the country under the pretense that they had heard voices (and once admitted, ceased displaying any symptoms). The reactions and diagnoses of these pseudopatients were used to verify misdiagnoses, and Rosenhan ultimately concluded that psychiatric professionals have a bias for diagnosing the sane as “insane,” and use this determination to interpret behavior as a product of that diagnostic label. This paper will review this theory and experiment using the evaluation criteria set out by Akers and Sellers (2012), in order to determine its validity in a methodological, scientific fashion (p. 1-15). While Rosenhan points out from the very beginning that the concepts “sane” and “insane” are problematic—due to cultural differences and interpretations—he nonetheless adheres to a simplified understanding of deviant and non-deviant behavior. In this way, the terms “sane” and “insane” do not necessarily have to be defined—as they can be measured in perceived sanity or insanity, through diagnosis. In this way, the experiment is turned to perceived illness as compared to whether the behaviors associated to that illness are acted out. He claims that normality (and therefore abnormality) “is distinct enough that it can be recognized wherever it occurs.
it raise questions regarding normality and abnormality is in no way to question the fact that some behaviors are deviant or odd. Murder is deviant. So, too, are hallucinations. Nor does raising such questions deny the existence of the personal anguish that is often associated with "mental illness." Anxiety and depression exist. Psychological suffering exists. But normality and abnormality, sanity and insanity, and the diagnoses that flow from them may be less substantive than many believe them to be. At its heart, the question of whether the sane can be distinguished from the insane (and whether degrees of insanity can be distinguished from each other) is a simple matter: do the salient characteristics that lead to diagnoses reside in the patients themselves or in the environments and contexts in which observers find them? From Bleuler, through Kretchmer, through the formulators of the recently revised Diagnostic and Statistical Manual of the American Psychiatric Association, the belief has been strong that patients present symptoms, that those symptoms can be categorized, and, implicitly, that the sane are distinguishable from the insane. More recently, however, this belief has been questioned. Based in part on theoretical and anthropological considerations, but also on philosophical, legal, and therapeutic ones, the view has grown that psychological categorization of mental illness is useless at best and downright harmful, misleading, and pejorative at worst.
David Rosenhan sought to challenge common psychiatric diagnoses, using a controlled experiment to test whether the sane can be distinguished from the insane—wanting to shed light on a problem of type 2 error and misdiagnosis that often has serious social and psychological consequences (1973). The experiment placed eight “pseudopatients,” or normal, clinically sane individuals, in various mental hospitals throughout the country under the pretense that they had heard voices (and once admitted, ceased displaying any symptoms). The reactions and diagnoses of these pseudopatients were used to verify misdiagnoses, and Rosenhan ultimately concluded that psychiatric professionals have a bias for diagnosing the sane as “insane,” and use this determination to interpret behavior as a product of that diagnostic label. This paper will review this theory and experiment using the evaluation criteria set out by Akers and Sellers (2012), in order to determine its validity in a methodological, scientific fashion (p. 1-15). While Rosenhan points out from the very beginning that the concepts “sane” and “insane” are problematic—due to cultural differences and interpretations—he nonetheless adheres to a simplified understanding of deviant and non-deviant behavior. In this way, the terms “sane” and “insane” do not necessarily have to be defined—as they can be measured in perceived sanity or insanity, through diagnosis. In this way, the experiment is turned to perceived illness as compared to whether the behaviors associated to that illness are acted out. He claims that normality (and therefore abnormality) “is distinct enough that it can be recognized wherever it occurs.
This entire review has been hidden because of spoilers.
May 24, 2026
"The sane are not always sane...lose tempers...occasionally depressed or anxious...(all) for no good reason... Similarly, the insane are not always insane... If it makes no sense to label ourselves permanently depressed on the basis of occassional depression, then it takes evidence that is presently available to label all patients insane or schizophrenic on the basis of bizarre behaviors or cognitions... seems more useful to limit our discussions to behaviors, the stimuli that PROVOKE them, and their correlates."
In other words, sometimes the sane can be thought to be insane just by a temporary behavior, because the observer already has a preconceived notion that the sane person is insane and neglects to look at the WHY the person is exhibiting such a behavior and that maybe it's merely a reaction to a stimuli (like a person) that is harmful to them or also behavinging insanely at the time (or even always.)
It's a real shame, because I really strive to look at an individual and sympathize or try to understand why they are the way they are, but so many people are not like that and these devestating things happen. Though I would like to think things have improved since this article and experiment was conducted, there are still people with the old fashioned ignorant way of thinking, and also, just the human nature of trying to conform socially and rely on the typical assumptions, rather than look at individuals. I also wish it wasn't so easy for society to jump on negative things and instead, try to make things better and more positive by IMPROVING situations rather than just complaining or badtalking, hence making them worse...
But again, I'd like to hope that things have changed for the better and are continuing in that direction. Great read!
In other words, sometimes the sane can be thought to be insane just by a temporary behavior, because the observer already has a preconceived notion that the sane person is insane and neglects to look at the WHY the person is exhibiting such a behavior and that maybe it's merely a reaction to a stimuli (like a person) that is harmful to them or also behavinging insanely at the time (or even always.)
It's a real shame, because I really strive to look at an individual and sympathize or try to understand why they are the way they are, but so many people are not like that and these devestating things happen. Though I would like to think things have improved since this article and experiment was conducted, there are still people with the old fashioned ignorant way of thinking, and also, just the human nature of trying to conform socially and rely on the typical assumptions, rather than look at individuals. I also wish it wasn't so easy for society to jump on negative things and instead, try to make things better and more positive by IMPROVING situations rather than just complaining or badtalking, hence making them worse...
But again, I'd like to hope that things have changed for the better and are continuing in that direction. Great read!
May 19, 2024
The politics and nuance behind diagnoses lead me to constantly switch my stance the value of a diagnosis in modern life. Rosenhan points to the harm a diagnosis can have, and that is certainly true today, but many others are denied diagnoses and are harmed because of this gatekeeping. I wish this research could be conducted (ethically) today. 70s psychiatric institutions, like the ones described here, are reminiscent of modern prisons. If this research could be done today, I believe we would find that modern psychiatric institutions, which are still pretty garbage, reflect the current ideas for prison reform.
September 26, 2019
Quick but interesting read about a study of the internal workings of psychiatric facilities, and how the treatment of patients impacts medical staffs ability to see when someone does or doesn't need care. Interesting investigation of a generalized lack of care in mental health facilities, and suggestions about what to do going forward.
April 2, 2023
“…normality and abnormality, sanity and insanity, and the diagnoses that flow from them may be less substantive than many believe them to be.”
”Whenever the ratio of what is known to what needs to be known approaches zero, we tend to invent "knowledge" and assume that we understand more than we actually. We seem unable to acknowledge that we simply don't know.”
“We now know that we cannot distinguish insanity from sanity. It is depressing to consider how that information will be used.”
”Whenever the ratio of what is known to what needs to be known approaches zero, we tend to invent "knowledge" and assume that we understand more than we actually. We seem unable to acknowledge that we simply don't know.”
“We now know that we cannot distinguish insanity from sanity. It is depressing to consider how that information will be used.”
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