CÉLPONT ALAPÍTVÁNY
The man who made fool of psychiatrists
An experiment that that enraged the psychiatric world
An article by Lauren Slater, In The Week, 7 February, 2004, p. 40-41
(1) In 1972, David Rosenhan, a young psychologist, called eight friends and said something like, “Are you busy next month? Would you have time to fake your way into mental hospital and see if they can tell you’re really sane?” All eight – three psychologists, one graduate student, a paediatrician, a psychiatrist, a painter, and a housewife – agreed to take the time to try this trick, along with Rosenhan himself. The goal: to see whether the psychiatrists’ judgements would be adequate or based on presumptions; that is, if the patient is here, labelled a patient, then he must be crazy.
(2) First, there was training. Rosenhan instructed his friends very, very carefully. For five days prior to the appointed date, they were to stop showering, shaving and brushing their teeth. Rosenhan gave his friends a lesson in managing medication, how to slip it under the tongue so it could later be get rid of in the toilet. They were to present themselves at various psychiatric emergency rooms, with words along these lines: “I’m hearing a voice.” Upon further questioning, the eight “patients” were to answer completely honestly, save for name and occupation. They were to feign no other symptoms. Once on the ward, if they admitted, they were to immediately say that the voice had disappeared and now they felt fine.
(3) The day Rosenhan departed for one of Pennsylvania’s state hospitals was brilliant with lots of sunshine and crystal clear sky. Once in the admissions unit, Rosenhan was led to a small white room. “What is the problem?” a psychiatrist asked. “I’m hearing a voice,” Rosenhan said. Rosenhan was led down a long hallway. He was taken to a room and told to undress. Someone inserted a thermometer into his mouth, checked his blood pressure, pulse: normal, normal, normal. Everything was normal, but no one seemed to see. He said, “You know, the voice isn’t bothering me anymore,” and the doctors just smiled. It didn’t matter that he was totally sane. He was diagnosed with paranoid schizophrenia and kept for many days.
(4) Rosenhan “took” his pills three times a day and then rushed to the bathroom to spit them out. In the article he later wrote, he told how all the other patients were doing this too, and how no one much cared so long as they were well behaved. Mental patients are “invisible…unworthy of account”, Rosenhan wrote. He described a nurse coming into the dayroom, unbuttoning her shirt, and fixing her bra. “She didn’t notice us.” He saw patients being beaten. He described how one patient was severely punished because he said to a nurse, “I like you.”
(5) Rosenhan and his friends were given therapy, and when they told of the joys and disappointments of ordinary life – remember, they were making nothing up save the original complaint about hearing voices – all of them found that their pasts were rephrased to fit the diagnosis. Rosenhan busily took notes while in hospital, which the staff labelled as “writing behaviour” and saw as a part of his paranoid schizophrenic diagnosis.
(6) The strange thing was, the other patients seemed to know Rosenhan was normal, even while the doctors did not. The insane could detect the sane better than the doctors could. One young man said coming up to Rosenhan in the dayroom, “You’re not crazy. You’re a journalist or a professor.” Another said, “You’re checking up on the hospital.”
(7) And then one day, he was discharged. He had learned something serious: that psychiatry was psychiatrically sick. He wondered: in how many hospitals all across America were people being similarly misdiagnosed, medicated, and held against their wills? The doctors in Rosenhan’s experiment were genuine MDs who had made dumb mistakes. Rosenhan found that the average hospital stay was 19 days, with the longest being 52 and the shortest seven. All were released with their essential sanity undetected. Their present sanity was determined as temporary.
(8) The experiment was challenged. “All right,” said one hospital. “You think we don’t know what we’re doing? Here’s a dare. Send as many fake patients as you like to our emergency room, and we’ll detect them. Go ahead.” Rosenhan liked a fight. So he said sure: in the next three months he would send an undisclosed number of fake patients to this hospital, and the staff were to judge not who was insane, but who was sane. At the end of three months the hospital staff reported to Rosenhan that they had detected 41 sane people sent by Rosenhan. He had, in fact, sent none. Case closed. Game over. Psychiatry hung its head.
(9) The experiment was greeted with outrage and Rosenhan’s study is still hated in the field, even after forty years. Yet, there are some essential truths in his findings. Labels do determine how we view what we view. Psychiatry is a relatively new science, if science at all, because to this day it lacks firm knowledge and foundation. Psychiatrists do jump to judgement – not all, but a lot of them – and they can be stuck-up, probably because they’re insecure. Rosenhan’s study did nothing to help this insecurity.
1. Finish the sentences according to the information given in the text.
Rosenhan’s preparation included…
The purpose of Rosenhan’s study was to determine…
The only made-up symptom was that…
The insane detected better…
Mental patients were considered…
The doctors purposefully misinterpreted…
In reply to a challenge, Rosenhan…
Psychiatrists tend to…
2. Choose the correct alternative.
Rosenhan wanted to know…
(a) …if assumptions cloud doctor’s thinking and form their opinion.
(b) …if doctorsjudgemental patients by appropriate diagnoses.
(c) …if psychiatrists mistreat mental patients and misinterpret their symptoms.
The symptoms they came up with
(a)…included hearing voices and some past experiences such as disappointments.
(b)…resembled schizophrenia and thus misled doctors.
(c)…were misinterpreted and selfishly adjusted.
The study…
(a)…did not make much noise and was received neutrally.
(b)…made the field doubt its validity and existence.
(c)…was generally frown upon by the profession.
Mental patients were…
(a)…generally ignored and treated inhumanly.
(b)…given thorough and appropriate therapy and plenty of medication.
(b)…were continuously being seduced by nurses.
When they were released…
(a)…they were still considered mental cases.
(b)…the doctors were convinced that they recovered owing to medication.
(c)…the doctors thought they will remain sane in the future.
3. Choose which title below goes with which paragraph.
(b) Gearing up
(a) The accomplices
(c) Failure to prove wrong
(d) Doctor’s instructions
(e) Difficult admission
(f)Detested but sadly accurate
(g) Released but still insane
(h) Reconfigured to fit
(i) The crazy proves the sanest
(j)A busy month
(k)Open doors await
(l) Malpractice
4. Fill in the table!
VERB / NOUNrecover
judgment
admit
behave
punish
complaint
presence
determine
find
secure
experiment
detect / (3ps)
appoint
5. What does the author mean by the statements below?
Psychiatry hung its head:
Labels do determine how we view what we view:
Psychiatrists do jump to judgment:
Here’s a dare:
They were to answer honestly save for name and occupation:
6. Guess theword from the text.
to try to persuade someone to do something dangerous or embarrassing as a way of proving that they are brave: d - - -
an expression used to describe information which is not given to the public: u ------
informal for stupid: d - - -
doctor who deals with children: p ------
to pretend to have a particular feeling or to be ill: f - - - -
to officially allow someone to leave somewhere: d ------
make someone angry: e - - - - -
snobbish, pompous, self-important: s ------
something that you think is true because it is very likely: p------
7. “Correct” the sentences. Put them in a more common and/or grammatically more correct form.
I’m hearing a voice.
You think we don’t know what we’re doing?
The staff were to judge who was sane.
The strange thing was, the other patients seemed to know Rosenhan was normal.
The following 2 tasks help you to increase your knowledge of certain new elements of the text. Therefore these are the most important tasks! The point of the tasks is to make you revise it and use the expressions you learnt again and again. PLEASE DO NO SKIP THESE TASKS.
8. Let’s play with the text!
A) Gather all medical words and expressions from the text.
B) Underline all the adjectives in the text.
C) Ask at least two questions about each paragraph.
D) Try to summarise each paragraph in one sentence. It can be a long one.
E) Gather the most difficult words and expressions, and look up example sentences with them in a good English-English dictionary.
9. Composition assignment. Write a report about the text using the standard report format. This task could come handy at work because reports are rather commonly used documents.
TERMS OF REFERENCE
(in relation to what you write the report; a short summary of the subject) 1-2 sentences
PROCEEDINGS
(an introduction to the report, what happened prior to writing the report, how did you gather data and so on – 2-4 sentences; in this particular case how the experiment was prepared)
FINDINGS
(the main points of the report carefully organised into subheadings/paragraphs – 4-5 sentences)
CONCLUSIONS
(what are the main consequences, what is to be learnt – 2-3 sentences)
RECOMMENDATIONS
(what is to be done on the findings and the conclusions to the report, plan for future actions – 2-3 sentences; in this particular case: how mental institutions should change)
Signature
Date
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