The Aspiring Psychologist Podcast - What Happened When 8 Sane People Pretended to Be Mentally Ill - Documentary - Rosenhan Experiment

Starting point is 00:00:00 Hi there, it's Marianne here. Before we dive into today's episode, I want to quickly let you know about something exciting that's happening right now. If you've ever wondered how to create income that works for you, rather than constantly trading your time for money, then you'll love the Race to Recurring Revenue Challenge with my business mentor, Lisa Johnson. This challenge is designed to help you build sustainable income streams. And whether you're an aspiring psychologist, a mental health professional, or in a completely different field,

Starting point is 00:00:32 the principles can work for you. There are also wonderful prizes to be won directly by Lisa herself. And if you join the challenge by my link, you can be in with a chance of winning a one-to-one hours coaching with me, Dr. Marianne Trent. Do you want to know more? Of course you do. Head to my link tree, Dr. Marianne Trent, or check out my social media channels, or send me a quick DM and I'll get you all the details. Right, let's get on with today's episode. How do you tell the difference between someone who is sane and someone who isn't? What

Starting point is 00:01:07 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's 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.

Starting point is 00:02:02 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 practiced. 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,

Starting point is 00:02:59 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. 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

Starting point is 00:03:46 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 seem 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're not crazy, are you?

Starting point is 00:04:31 And I'm sorry if any of the language in this video is triggering. 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 labeled with a psychiatric diagnosis, everything else they did was interpreted through that lens.

Starting point is 00:04:54 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

Starting point is 00:05:33 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. 3. Dehumanisation in psychiatric care. Many of the pseudo-patients reported feeling ignored or treated dismissively. It seemed that doctors and nurses often seemed to avoid direct interactions with the pseudo-patients, which highlighted what we call the depersonalisation that can seem to occur in institutional settings at times. The fallout and the controversy. The study's publication caused somewhat of a furore 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.

Starting point is 00:06:26 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 tale? 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. 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 too. Modern relevance, why does it matter today?

Starting point is 00:07:16 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 while 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-5. However challenges do remain particularly in recognizing the complexity of mental health and avoiding over-reliance on labels. Alternative approaches to psychiatric diagnosis, such as the Power Threat Meaning Framework

Starting point is 00:07:55 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. 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-centred 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 that stigma and that belief about

Starting point is 00:08:39 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. And our fourth point, in terms of modern psychology studies, it's also informed our ethical practices 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

Starting point is 00:09:25 Phineas Gage, the man whose brain injury involving a large spike through his brain revolutionized our understanding of personality and behavior. 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 Rosenhan experiment

Starting point is 00:09:54 wasn't just a test of psychiatric diagnosis. It was a bold challenge to the way we perceive and treat mental illness. 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 Rosenhan's study? Was it a necessary wake-up call or do you think it crossed ethical lines? Do you think you would have been able to talk yourself in or out of psychiatric hospital in the 1970s. Do let me know in the

Starting point is 00:10:26 comments below or come and chat with me on my socials where I am Dr. Marianne Trent everywhere. If this has whet 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 you're 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 behavioral therapy, reflection, interview skills, application skills, and so much more.

Starting point is 00:11:07 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. If you're looking to become a psychologist, then let this be your guide. With this podcast at your side, you'll be on your way to being qualified. It's the Aspiring Psychologist Podcast with Dr. Marianne Trent My name's Jana and I'm a trainee psychological wellbeing practitioner. I read the Clinical Psychologist Collective book.

Starting point is 00:12:02 I found it really interesting about all the different stories and how people got to become a clinical psychologist. It just amazed me how many different routes there are to get there and there's no perfect way to become one and this kind of filled me with confidence that no I'm not doing it wrong and put less pressure on myself. So if you're feeling a bit uneasy about becoming a clinical psychologist I'd definitely recommend this just to put yourself at ease and everything will be okay but trust me you will not put the book down once you start

The Aspiring Psychologist Podcast - What Happened When 8 Sane People Pretended to Be Mentally Ill - Documentary - Rosenhan Experiment

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