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Speaker 1: Welcome to stuff to Blow your Mind from house stop

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Speaker 1: works dot com. Hey, who wasn't disposed to blow your mind?

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Speaker 1: My name is Robert Lamb and I'm Joe McCormick. So, Robert,

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Speaker 1: I've got a scenario for you. Throw it at me.

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Speaker 1: Imagine you are on a jury. Okay, so you have

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Speaker 1: been picked. You're not one of the people who got

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Speaker 1: sent home early and normally get out of it. Yeah,

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Speaker 1: but you're there on the jury and you're hearing the

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Speaker 1: trial of a man who ran a muck in a

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Speaker 1: bowling alley and so he went nuts. He took his

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Speaker 1: bowling shoes off, he started throwing bowling balls at people,

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Speaker 1: and fortunately no one was killed, but several people were

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Speaker 1: seriously injured. And now this man is standing trial for

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Speaker 1: his bowling ball rampage. And at trial, the man's attorney

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Speaker 1: attempts to mount a defense based on the insanity plea,

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Speaker 1: the claim that the accused did commit the acts in question,

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Speaker 1: but is not responsible for his actions because his mental

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Speaker 1: state prevents him from understanding them. Uh. And then the

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Speaker 1: prosecution brings out an expert witness who is a highly

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Speaker 1: respected and very confident sounding forensic psychiatrist who testifies that

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Speaker 1: he has interviewed the defendant and found that the defendant

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Speaker 1: shows all the normal signs of a person in perfect

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Speaker 1: command of his actions. But then the defense brings forth

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Speaker 1: another highly respected and confident sounding forensic psychiatrist who testifies

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Speaker 1: exactly the opposite, that the defendant symptoms are consistent with

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Speaker 1: those of a person who is disconnected from reality and

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Speaker 1: cannot tell right from wrong. If you have no psychiatric

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Speaker 1: expertise yourself, how are you supposed to tell which one

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Speaker 1: of these expert witnesses is correct. This is the problem

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Speaker 1: that one encounters with a number of these trials, right,

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Speaker 1: because it ultimately comes down to a who can either

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Speaker 1: who can make the better case for insanity or insanity,

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Speaker 1: or if they both kind of make equally pressing cases,

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Speaker 1: then it comes down to something as simple as a

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Speaker 1: as a character judgment on the part on your part

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Speaker 1: of the accused. Yeah, now, I might say that it's

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Speaker 1: possibly true that this scenario I've come up with it's

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Speaker 1: kind of contrived. It might be worth saying that apparently

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Speaker 1: less than one percent of defendants in US cases plead insanity,

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Speaker 1: and then for those that do enter such a plea,

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Speaker 1: the rates of success are low, so pleading insanity typically

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Speaker 1: doesn't get you very far in the US legal system.

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Speaker 1: But the example does raise a few questions about how

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Speaker 1: we deal with concepts of mental uh, let's say, mental

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Speaker 1: normality and mental abnormality, as as the lay public understands them.

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Speaker 1: Throughout this episode, we're gonna be using the words sane

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Speaker 1: and insane to give a sense of the way that

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Speaker 1: they're used in the milieu of the experiment we're going

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Speaker 1: to talk ab out in this episode. But every time

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Speaker 1: you hear those words, you should imagine that we're putting

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Speaker 1: some huge, big finger quotes around them, because, as we

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Speaker 1: discussed at the end, these are probably not the most

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Speaker 1: useful terms or concepts for describing or helping people in

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Speaker 1: the real world, but they still are salient concepts too

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Speaker 1: many people. Like if you take the average person and

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Speaker 1: ask them if they think the difference between sane and

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Speaker 1: insane is a real, actual thing and they can tell

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Speaker 1: the difference, they'll say, yeah, right, yeah, I mean, we

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Speaker 1: we encountered this all the time, right The just the

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Speaker 1: basic idea that I'm here on this side of the wall,

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Speaker 1: and then there are people inside the hospital, there are

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Speaker 1: people receiving care, there are people that are incarcerated. That's

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Speaker 1: the insane side of the wall, and there's a bearer

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Speaker 1: between us. It's kind of a Sneeches and star Belt.

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Speaker 1: He'd sneeches approach to mental health. You can easily divide

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Speaker 1: everybody into one of two categories. Either those that have

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Speaker 1: it all thegether and are seeing everything straight and have

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Speaker 1: an acceptable understanding of reality, and in those who do not. Yeah,

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Speaker 1: And so today we want to talk about a landmark

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Speaker 1: experiment in the history of psychology, one that's been written

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Speaker 1: about and talked about a lot for years, often celebrated.

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Speaker 1: It's highly cited, and it concerns the question of how

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Speaker 1: do we know precisely what constitutes normality or mental illness?

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Speaker 1: And if there is a difference between sanity and insanity,

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Speaker 1: can anybody tell the difference? Even professionals, Yeah, especially professionals

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Speaker 1: that because this uh, I mean, that's what this whole

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Speaker 1: experiment hinges on is is how do our professionals, how

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Speaker 1: do our mental health professionals judge uh and and evaluate

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Speaker 1: individuals that are entering the system. Yeah. So the experiment

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Speaker 1: in question was carried out by the Stanford professor and

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Speaker 1: psychologist David Rosenhan, who lived from nineteen twenty nine to

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Speaker 1: two thousand twelve, And I found this in an obituary

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Speaker 1: of him, that his education path seemed to be interestingly varied.

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Speaker 1: So he got a BA in mathematics in nineteen fifty

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Speaker 1: one from Yeshiva College, and then and then a master's

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Speaker 1: in economics, and then a PhD in psychology from Colombia,

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Speaker 1: and then he went on to sort of branch into

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Speaker 1: two different fields and work on unifying concepts between them.

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Speaker 1: So he's a professor of law and of psychology. And

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Speaker 1: according to his Stanford obituary which I read, he he

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Speaker 1: was sort of known for applying psychology to legal practices

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Speaker 1: like jury selection and jury consultation. And he held various

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Speaker 1: honors during his lifetime, like being the head of the

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Speaker 1: A p A and and stuff like that. So he

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Speaker 1: was very respected psychologist and jurist, one might say. But

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Speaker 1: in nineteen seventy three, rosen Hand published in the journal

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Speaker 1: Science a piece that was old on being sane in

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Speaker 1: insane places. And it begins with this question that we

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Speaker 1: talked about a minute ago. If sanity and insanity exist,

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Speaker 1: how shall we know them? That's what he says. Yeah,

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Speaker 1: He presents this quite nicely, and as we were discussing

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Speaker 1: prior to to the recording session here, the whole paper

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Speaker 1: is just so well written. It's so accessible to uh to,

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Speaker 1: to the average leader, to the average reader, it's not

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Speaker 1: it's not you know, lost in a bunch of psycho babble. Yeah,

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Speaker 1: you can find this paper online and I do highly

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Speaker 1: recommend reading it as it is. It is not just

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Speaker 1: clear and very interesting, it's a great piece of writing.

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Speaker 1: But so Rosenhan opens by pointing out the same thing

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Speaker 1: we did at the beginning of our podcast. He says

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Speaker 1: that it's common in murder trials where the defendant sanity

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Speaker 1: is under dispute, for perfectly respectable psychiatrists to testify in

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Speaker 1: direct contradiction of one another about the mental state of

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Speaker 1: the accused. And I actually went and read a couple

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Speaker 1: of articles about what happens when somebody tries to enter

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Speaker 1: an insanity polae in court, like how can the the

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Speaker 1: experts try to figure out whether they are faking it

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Speaker 1: or not? And there are various methods they have, But

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Speaker 1: one of the things that struck me about the way

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Speaker 1: that forensic psychiatrists go about trying to evaluate the mental

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Speaker 1: state of a person accused of a crime is they're

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Speaker 1: trying to see if the person fits a known diagnosis.

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Speaker 1: So they're trying to say, here the known symptoms of

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Speaker 1: schizophrenia or here the known symptoms of x known state

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Speaker 1: of psychosis as described in the literature, and can the

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Speaker 1: defendant match the description that I have here? And if

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Speaker 1: they just present sort of like an odd collection of symptoms,

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Speaker 1: it's generally ruled that they're probably faking right there. They're

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Speaker 1: they're just putting together things that seem to them like

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Speaker 1: they qualify as crazy, right, And one of the big

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Speaker 1: ones that often shows up is someone will be they'll

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Speaker 1: be trying to defend the accused by saying that they

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Speaker 1: are insane, and then the prosecution will point out something

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Speaker 1: something in their actions that is clearly premeditated and uh,

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Speaker 1: thus uh disputing any idea that this was just a

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Speaker 1: spontaneous manifestation. Oh yeah. There are often very various features

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Speaker 1: of the crime itself that make it clear that the

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Speaker 1: person was in a fairly lucid state when they committed that,

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Speaker 1: like if they try to destroy evidence and you know,

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Speaker 1: do smart, clear thinking ways of avoiding responsibility for the crime.

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Speaker 1: But anyway to investigate this question. If sanity and insanity exist,

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Speaker 1: how shall we know them? David Rosenhan staged an experiment

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Speaker 1: that's one of the most interesting I've ever come across

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Speaker 1: in the history of psychology, and it was essentially an

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Speaker 1: under cover sting operation to determine what it takes to

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Speaker 1: convince a mental health facility that a person is insane,

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Speaker 1: and then what it takes to convince them that that

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Speaker 1: same person is sane. Indeed, so this took place between

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Speaker 1: nine seventy two, So they're there as we'll discuss, uh,

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Speaker 1: their various locations that are employee. Here you have eight

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Speaker 1: same people and they're gained a secret admission to twelve

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Speaker 1: different hospitals. So we're talking three women, five men, um

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Speaker 1: one of the psychology graduate student in his twenties. The

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Speaker 1: remaining seven were older and quote unquote established. So among

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Speaker 1: them you have three psychologists, a pediatrician, a psychiatrist, a painter,

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Speaker 1: and a housewife. And uh oh, and then also rosen himself.

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Speaker 1: Rosenhan himself is involved here to Yeah, he was one

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Speaker 1: of the mental health professionals, and the mental health professionals

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Speaker 1: gave false professions in their biographies. They were describing themselves

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Speaker 1: to the these mental hospitals basically for fear of being

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Speaker 1: treated differently than other patients. And that makes sense to me,

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Speaker 1: because if if you want to know how the hospital treats,

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Speaker 1: you know, the average person who walks up, you don't

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Speaker 1: want to say hi, I'm a psychiatrist. I know, they

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Speaker 1: might sort of be on their guard when they're dealing

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Speaker 1: with you. And likewise, they went in under false names

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Speaker 1: as you might expect. Yes, Rosenhan himself was one of

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Speaker 1: the patients, um though he was not a fully clandestined

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Speaker 1: one as the other one as the other people were.

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Speaker 1: He Rosenhan himself was the first of these pseudo patients

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Speaker 1: as they're called, and his presence was quote known to

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Speaker 1: the hospital administration and the chief psychologist and so far

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Speaker 1: as he says, I can tell to them alone. So

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Speaker 1: he was known, but nobody else was known, and he

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Speaker 1: was only known to a couple of people at the

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Speaker 1: hospital and nobody else there. Yeah, there has I mean,

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Speaker 1: obviously you would have to have some sort of arrangement

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Speaker 1: employ here. You can't just They couldn't have carried out

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Speaker 1: this experiment by just doing cold blind calls on various institutions, right,

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Speaker 1: but no nobody else was known to anybody, which just him.

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Speaker 1: And so the eight patients that they went to twelve

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Speaker 1: different hospitals. So obviously some of them were admitted more

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Speaker 1: than once, and they went to twelve different hospitals in

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Speaker 1: the sample, and they were trying to cover a broad

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Speaker 1: range of the different kinds of mental facilities that you

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Speaker 1: could go to. So they were in five different states

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Speaker 1: on the east and west coast, and the hospitals were

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Speaker 1: a varying condition. Some were old and shabby, as they said,

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Speaker 1: and some were newer. They had different levels of funding,

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Speaker 1: different patients to staff ratios, and only one of the

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Speaker 1: twelve hospitals was a private hospital and that made an

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Speaker 1: interesting difference in how the diagnoses were treated. Later. But

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Speaker 1: how did the so called pseudo patients get admission to

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Speaker 1: the hospital. It was a pretty simple trick, and they

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Speaker 1: all did exactly the same thing. Yeah, they all show

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Speaker 1: up and uh claim that they are hearing voices, that

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Speaker 1: they're experiencing auditory hallucinations, Yes, which of course is is

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Speaker 1: is often a key symptom of schizophrenia, right, And so

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Speaker 1: when they were asked about what the voices said, the

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Speaker 1: participant would say that the voice was an unfamiliar voice

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Speaker 1: of the same sex as the pseudo patient and that

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Speaker 1: they were generally difficult to understand, but that they had

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Speaker 1: said the words quote, empty, hollow, and thud, and I

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Speaker 1: was like, wow, what an interesting combination of words. What

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Speaker 1: would a psychiatrist make of that? But Rosenhunt explains that

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Speaker 1: these words were chosen because they sort of went both ways,

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Speaker 1: and number one, they formed an easy association with concepts

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Speaker 1: of existential anxiety, like you could imagine somebody having thoughts

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Speaker 1: like my life is empty. I'm so you know, existence

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Speaker 1: is so hollow? Should I kill myself and land on

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Speaker 1: the floor with a thud? But they never said any

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Speaker 1: of that explicitly, just empty, hollow and thud. Those were

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Speaker 1: the only words, empty hollow, that that would be a

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Speaker 1: great name for like a nineties goth act. Oh yeah, yeah, yeah,

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Speaker 1: I love it. That's a that's a tattoo already on somebody.

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Speaker 1: But anyway, they also picked these because this type of

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Speaker 1: psychosis described in these terms did not match any in

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Speaker 1: the medical literature at the time. So this didn't match

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Speaker 1: an existing diagnosis that could be found. Okay, so it's

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Speaker 1: a little more abstract than just it was less on

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Speaker 1: the nose. If someone is showing up and saying, oh, well,

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Speaker 1: I have this symptom, the symptom in this system, and

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Speaker 1: they go, oh, those symptoms are exactly what I have

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Speaker 1: on the paper here. More, it leaves the uh, the

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Speaker 1: individual making the diagnosis, room for at least the illusion

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Speaker 1: of discovery. R So, as you would expect, the people

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Speaker 1: who showed up at the hospitals faking these symptoms were

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Speaker 1: immediately detected and sent home. Oh no, wait, that's not

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Speaker 1: the case. In fact, all twelve times they were admitted

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Speaker 1: to the hospitals, with eleven out of the twelve times

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Speaker 1: they were diagnosed with schizophrenia, and then interestingly, one out

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Speaker 1: of the twelve times they were diagnosed with manic depressive psychosis,

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Speaker 1: which Rosenhan. Rosenhan points out that the manic depressive psychosis

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Speaker 1: had at the least of the time a more favorable

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Speaker 1: prognosis than schizophrenia, so that this was a condition that

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Speaker 1: you were more likely to recover from. Things looked better

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Speaker 1: for you had a better outlook, and for whatever reason,

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Speaker 1: this one different diagnosis. The better diagnosis took place at

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Speaker 1: the one private hospital in the study, but note that

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Speaker 1: it's not necessarily a more accurate diagnosis because these people

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Speaker 1: were all faking and all said the same thing. It's

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Speaker 1: just the diagnosis that tended to turn out better for

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Speaker 1: the patient. Okay, So this is adding possibly an interesting

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Speaker 1: layer of class bias into what they found these hospitals

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Speaker 1: behave like. So they were admitted, they were put into

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Speaker 1: these hospitals, and then what did they do. Did they

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Speaker 1: continue to pretend that, oh, I'm hearing these voices that

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Speaker 1: at step, of course, is to sort of straighten up

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Speaker 1: and said and uh and resume their normal behavior, claim

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Speaker 1: that their symptoms are completely gone. But it's important to

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Speaker 1: note they're not coming clean either. They're not saying actually surprised.

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Speaker 1: This is all part of a study, right, They're just saying, oh,

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Speaker 1: I feel fine now, I'm not experiencing those auditory hallucinations

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Speaker 1: that I was talking about earlier. Right. They immediately resumed

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Speaker 1: normal behavior, claim their symptoms were entirely gone and they

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Speaker 1: were on their best behavior. So they were very good patients. Uh,

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Speaker 1: at least they tried to be, and they self reported

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Speaker 1: that they were good patients. They were described by the

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Speaker 1: nursing reports kept at the facilities as quote friendly, cooperative,

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Speaker 1: and exhibited no abnormal indications. So according to the reports,

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Speaker 1: they didn't do anything weird or disruptive. Uh that they

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Speaker 1: seemed perfectly well behaved and normal. But nobody caught on.

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Speaker 1: Well maybe not nobody. None of the people who should

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Speaker 1: have caught on caught on. The the hospital staff uh

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Speaker 1: and psychologist, psychiatrists, the attendants, the nurses. Nobody caught onto

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Speaker 1: the fact that these people were faking, but some of

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Speaker 1: the other patients did. In fact, that was fairly common.

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Speaker 1: So during the course of the of three different hospitalization records,

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Speaker 1: participants recorded that out of a hundred and eighteen fellow

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Speaker 1: patients on the admissions ward, thirty five of them quote

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Speaker 1: voiced their suspicions somewhat vigorously. You're not crazy, you're a

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Speaker 1: journalist or a professor, referring to the continual note taking

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Speaker 1: you're checking up on the hospital. So the other patients

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Speaker 1: were detecting what was going on with these people, but

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Speaker 1: the hospital staff was not. Huh, that's fascinating. So how

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Speaker 1: did the staff respond. They forced the studio pay since

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Speaker 1: first of all, to admit to having a mental illness

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Speaker 1: and made him agree to take antipsychotic drugs as a

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Speaker 1: condition of their release. So there they said, Okay, you're

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Speaker 1: doing better. You're you're not having you're not experiencing these

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Speaker 1: auditory hallucinations anymore. UM, to sign this and then agree

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Speaker 1: to this a particular drug treatment, and you can go

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Speaker 1: on your way. Okay. So how long did that take?

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Speaker 1: Was that just like two or three days before they

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Speaker 1: did that? Between let's see whether the length of the

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Speaker 1: hospital stays or between seven and fifty two days. So

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Speaker 1: an average day of nine average day of nineteen days.

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Speaker 1: So this one overnight, Yeah, a week confined to the

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Speaker 1: hospital was the shortest. Somebody was in there for fifty

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Speaker 1: two days. In fact, that might have been rosen Hunt himself.

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Speaker 1: I'm not sure, but there was a point where he said,

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Speaker 1: I didn't know how long I was going to be

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Speaker 1: in there, but I thought it would be a few days.

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Speaker 1: I didn't expect it to be two months. Um. But yeah,

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Speaker 1: an average day of nineteen days in the hospital with

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Speaker 1: no symptoms whatsoever while they're there, and then a note

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Speaker 1: on all of those anti psychotic drugs that they were

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Speaker 1: required to take as a condition of their release. Um.

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Speaker 1: The report says that the pseudo patients were administered more

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Speaker 1: than two thousand pills. It was like pills over the

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Speaker 1: course of this including the drugs uh, I don't even

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Speaker 1: know if I'm not familiar with these, elavil, stella, zine, composine, thorazine,

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Speaker 1: I know those, uh, to name a few of them.

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Speaker 1: And then Rosenhan points out in this note that quote

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Speaker 1: such a variety of medications should have been administered to

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Speaker 1: patients presenting identical symptoms is itself worthy of note? It

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Speaker 1: kind of makes you wonder about the extent to which,

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Speaker 1: at least at the time, some of the drugs prescribed

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Speaker 1: for psychological diagnoses were I don't know, perhaps somewhat arbitrary,

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Speaker 1: but anyway, that they didn't take the pills, so only

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Speaker 1: two pills over the course of the entire experiment were swallowed.

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Speaker 1: The rest they pocketed deposited in the toilet. And then

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Speaker 1: they also said that they noticed some of the real

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Speaker 1: patients doing the same thing, because I mean, and they

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Speaker 1: had to actually consume two of them in order to

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Speaker 1: set the precedent that they were taking them. Because that's

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Speaker 1: because that's a common reaction to being administered all these pills,

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Speaker 1: right that you can start start refusing to take them

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Speaker 1: or secret them away. Yeah, well, at least they for

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Speaker 1: whoever took those two pills, I guess. I mean the

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Speaker 1: fact that they could get away with not taking the

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Speaker 1: pills for so long, I mean almost nobody took the

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Speaker 1: pills and then they didn't get caught. I think that's

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Speaker 1: interesting also key to the experiment, of course, that they're

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Speaker 1: not taking all these pills and then because then you

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Speaker 1: would have to factor in, well to what effect is

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Speaker 1: this massive drug intake affecting their behavior and therefore, uh,

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Speaker 1: their reception by the staff. Right, So you had all

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Speaker 1: these diagnoses, you had these schizophrenia diagnosis, but then people

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Speaker 1: they reported their symptoms were gone and eventually were released,

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Speaker 1: though sometimes after a kind of a long stay in

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Speaker 1: the hospital that I that I know in many cases

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Speaker 1: was not pleasant for these people. Yeah, and they were

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Speaker 1: all diagnosed with schizophrenia quote in remission before their release.

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Speaker 1: And this is a really key point because Rosenhn is

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Speaker 1: careful to point out the distinction between in remission and

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Speaker 1: sane It's suggesting sort of the categorization of schizophrenia in

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Speaker 1: remission retains a level of categorical stigma that's associated with

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Speaker 1: the fact that the patient is still considered fundamentally an

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Speaker 1: insane person. They're just not showing symptoms right now. Like,

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Speaker 1: once you have been deemed insane, it almost seems as

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Speaker 1: if the hospital will not consider you sane again. Yeah,

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Speaker 1: it's it's it's as if it's affected your sort of

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Speaker 1: baseline sanity score, and it's it's forever going to be

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Speaker 1: a little lower, no matter what your particular manifestation level

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Speaker 1: is going to be. Yeah, though then again, I mean

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Speaker 1: even that might be more progressive than what was actually

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Speaker 1: displayed in practice in the hospital, because I don't know,

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Speaker 1: it seems kind of cruel to think of sanity on

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Speaker 1: a like sliding scale of numbers, like a like a

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Speaker 1: D one role. But what we have here doesn't even

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Speaker 1: seem like the sliding scale. You're just either in the

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Speaker 1: club or you're not. You're in the normal sane person club,

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Speaker 1: or you are outside that club and you don't get

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Speaker 1: to get in. You either have the star or you don't. Now,

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Speaker 1: I do want to mention as well that that in

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Speaker 1: in the paper, Rosenhan also comments on the conditions that

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Speaker 1: that they encountered, then he himself encountered a part of Yeah,

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00:21:27,320 --> 00:21:29,480
Speaker 1: just talking about like the language that was used, the

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Speaker 1: attitude that was used against the patients, as well as

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Speaker 1: just the feeling of powerlessness that that that he felt

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Speaker 1: inside these institutions. And uh and therefore the ramifications that

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Speaker 1: that that those conditions would have upon any individual that's

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Speaker 1: placed in their care, especially someone who might have some

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Speaker 1: level of of actual mental illness. But one of the

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Speaker 1: main takeaways of this, at least the first half of

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Speaker 1: this experiment, and we'll get to the very interesting second

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Speaker 1: half in a moment um, is what they called called

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Speaker 1: the uniform failure to recognize sanity. And Rosenhan points out

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Speaker 1: on the paper that that shouldn't be attributed to these

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Speaker 1: just being like bad hospitals, because they went for a

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Speaker 1: whole range of them. They went from you know, they

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Speaker 1: went to some shabby hospitals, but then also to some

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Speaker 1: very nice hospitals, and it just seemed like, you know,

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Speaker 1: once you were there and you presented a few symptoms,

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Speaker 1: they said, okay, yes you are insane. You know, given

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Speaker 1: all of this, I can imagine if I was running

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Speaker 1: a hospital at the time of rosen Hans's experiment, I

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Speaker 1: would I would respond with, well, you know what that

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00:22:41,119 --> 00:22:43,480
Speaker 1: could ever happened. Here, it never happened. Here's one thing

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Speaker 1: for these other institutions to fail to to to see

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Speaker 1: through this scheme and to properly diagnose these pseudo patients.

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Speaker 1: But you try that mess with me, buddy, and I'm

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Speaker 1: going to spot your pseudo patients and kick them right

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Speaker 1: out the door. Give me your best shot. And in fact,

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Speaker 1: there was there was one hospital that did exactly that.

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Speaker 1: There was a hospital administration that took issue with rosen

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Speaker 1: Hans findings and they put a challenge to him. They

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Speaker 1: were like, okay, okay, hold on a second, you send

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Speaker 1: us your pseudo patients and we will rout them out.

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Speaker 1: And what did Rosahn do? He agreed, he so he said,

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Speaker 1: I'll send you send them, I'll send them on beyond

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Speaker 1: your guard. And so they were on their guard. In

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Speaker 1: the following weeks, out of one new patients that the

395
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Speaker 1: staff identified, forty one as potential pseudo patients, with twenty

396
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Speaker 1: three receiving suspicion from at least one psychiatrist and nineteen

397
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Speaker 1: of these receiving suspicion from one psychiatrist and one other

398
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Speaker 1: staff member. So they were and they they upped their security.

399
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Speaker 1: They were ready for it, and they were pointing out

400
00:23:48,800 --> 00:23:51,200
Speaker 1: pseudo patients left and right, calling out of the woodwork.

401
00:23:52,040 --> 00:23:56,119
Speaker 1: Uh so how many did rosen Han actually send zero?

402
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Speaker 1: He sent nobody right. So this is an interesting because

403
00:24:00,720 --> 00:24:05,560
Speaker 1: now we have two different types of classical errors that

404
00:24:05,600 --> 00:24:09,760
Speaker 1: are being attributed to a psychiatric diagnosis in these hospitals.

405
00:24:10,240 --> 00:24:13,240
Speaker 1: We have the type two error, which is the false positive.

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00:24:13,480 --> 00:24:16,240
Speaker 1: You have somebody who comes in, uh, fakes a very

407
00:24:16,280 --> 00:24:20,560
Speaker 1: simple simple symptom, resumes normal behavior and is not detected

408
00:24:20,640 --> 00:24:23,080
Speaker 1: as a sane person. So that's a that's a false

409
00:24:23,119 --> 00:24:26,880
Speaker 1: positive identification of mental illness. Then in the second half

410
00:24:27,280 --> 00:24:30,359
Speaker 1: we've got tons of false negatives. People showing up with

411
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Speaker 1: actual complaints saying I have a mental illness, I need help,

412
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Speaker 1: and the hospital saying you faker. It's like a game

413
00:24:38,760 --> 00:24:41,600
Speaker 1: of Werewolf where you don't have an individual with the

414
00:24:41,600 --> 00:24:45,560
Speaker 1: werewolf roll. Uh do, you just end up making accusations

415
00:24:45,640 --> 00:24:48,960
Speaker 1: left and right. Okay, So what conclusions can we draw

416
00:24:49,119 --> 00:24:52,040
Speaker 1: from this experiment? Now? Remember, as we said, this was

417
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Speaker 1: back in nineteen seventy three, published in seventy three, took

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Speaker 1: place between sixty nine and seventy two, So, uh, it's

419
00:24:58,720 --> 00:25:02,000
Speaker 1: not a direct common terry on the current day. Yeah,

420
00:25:02,200 --> 00:25:04,480
Speaker 1: so this was back then, and we can at least

421
00:25:04,560 --> 00:25:08,520
Speaker 1: hope that things are to some extent largely informed by

422
00:25:08,560 --> 00:25:13,800
Speaker 1: this study better today, but at least back then. The

423
00:25:13,840 --> 00:25:18,480
Speaker 1: takeaways where that the diagnostic process for distinguishing sanity and

424
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Speaker 1: insanity is not reliable. It has shown massive errors, just

425
00:25:23,440 --> 00:25:29,760
Speaker 1: complete failure to identify correctly people's mental state going both ways,

426
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Speaker 1: the type one error and the type two error. Uh.

427
00:25:32,800 --> 00:25:35,400
Speaker 1: The other takeaway that I sort of get from this

428
00:25:35,600 --> 00:25:39,560
Speaker 1: is that sane and insane do not seem to be

429
00:25:39,680 --> 00:25:43,119
Speaker 1: helpful designations to begin with, but rather the sort of

430
00:25:43,280 --> 00:25:47,280
Speaker 1: arbitrary and likely harmful ones. They might be a completely

431
00:25:47,480 --> 00:25:52,720
Speaker 1: artificial distinction. Now, that doesn't mean that mental illness isn't

432
00:25:52,720 --> 00:25:56,480
Speaker 1: real and that you can't experience, you know, true suffering

433
00:25:56,600 --> 00:26:00,320
Speaker 1: and symptoms from afflictions that affect the mind and the psyche.

434
00:26:00,480 --> 00:26:03,120
Speaker 1: These are definitely real things, and that's acknowledged by rosen

435
00:26:03,200 --> 00:26:05,879
Speaker 1: Han in the study. But it's more that these catch

436
00:26:05,920 --> 00:26:10,240
Speaker 1: all categories that fundamentally designate a person as sane or

437
00:26:10,280 --> 00:26:13,760
Speaker 1: insane just don't make sense and they don't really work.

438
00:26:13,880 --> 00:26:17,080
Speaker 1: So I think the study provides a powerful example of

439
00:26:17,080 --> 00:26:20,280
Speaker 1: white might be best to find different ways of talking

440
00:26:20,320 --> 00:26:24,240
Speaker 1: about mental illness. Thus some you know, saying like Ted

441
00:26:24,440 --> 00:26:28,040
Speaker 1: has a mental illness rather than Ted is a mentally

442
00:26:28,119 --> 00:26:32,240
Speaker 1: ill person. Yeah, and this is very much an issue

443
00:26:32,280 --> 00:26:35,560
Speaker 1: still today, just in our attempts to try and talk

444
00:26:35,600 --> 00:26:38,680
Speaker 1: about mental illness and deal with it. And of course

445
00:26:38,720 --> 00:26:41,919
Speaker 1: this has been in the news a lot recently, uh,

446
00:26:42,000 --> 00:26:45,800
Speaker 1: in response to the gun violence in America. Totally, I

447
00:26:45,840 --> 00:26:49,640
Speaker 1: know what you mean. Whenever there's another mass shooting in America,

448
00:26:49,760 --> 00:26:51,959
Speaker 1: one of the narratives that pops up in the media

449
00:26:52,160 --> 00:26:55,399
Speaker 1: is whether or not we need to do something in quotes,

450
00:26:55,600 --> 00:26:59,679
Speaker 1: do something about mental illness to stop things like this

451
00:26:59,760 --> 00:27:02,960
Speaker 1: from happening. Now. I think there probably are a lot

452
00:27:03,000 --> 00:27:05,240
Speaker 1: of ways we could improve how we treat and care

453
00:27:05,280 --> 00:27:08,679
Speaker 1: for people with mental illnesses. But I think sometimes I

454
00:27:08,720 --> 00:27:12,080
Speaker 1: worry that a subset of the people advocating this narrative

455
00:27:12,119 --> 00:27:15,959
Speaker 1: of do something about mental illness are less focused on

456
00:27:16,040 --> 00:27:19,159
Speaker 1: specific ways we could improve treatment and more focused on,

457
00:27:19,240 --> 00:27:22,880
Speaker 1: in a kind of vague and general way, just increasing

458
00:27:22,960 --> 00:27:26,760
Speaker 1: stigma even more, which is unfounded. I mean, most people

459
00:27:26,800 --> 00:27:29,240
Speaker 1: who have a mental illness of one kind or another

460
00:27:29,320 --> 00:27:32,560
Speaker 1: are not dangerous and do not commit acts of violence.

461
00:27:33,080 --> 00:27:36,160
Speaker 1: But it's just this idea that you know that having

462
00:27:36,160 --> 00:27:38,680
Speaker 1: a mental illness makes you sort of a tainted person,

463
00:27:38,760 --> 00:27:44,200
Speaker 1: you're just automatically suspect. And that's certainly a major theme

464
00:27:44,359 --> 00:27:48,040
Speaker 1: in rosen Hans's experiment. Yes, absolutely that. The third main

465
00:27:48,119 --> 00:27:51,000
Speaker 1: takeaway that I wanted to introduce was, and I wanted

466
00:27:51,000 --> 00:27:53,440
Speaker 1: to quote rosen Hans's own words because I can't put

467
00:27:53,480 --> 00:27:57,480
Speaker 1: it any better. Quote. Having once been labeled schizophrenic, there

468
00:27:57,600 --> 00:28:01,159
Speaker 1: is nothing the pseudo patient can do to overcome the tag.

469
00:28:01,480 --> 00:28:05,480
Speaker 1: The tag profoundly colors others perceptions of him and his

470
00:28:05,600 --> 00:28:11,439
Speaker 1: behavior unquote. So instead of observing a person's behaviors to

471
00:28:11,560 --> 00:28:16,159
Speaker 1: determine mental illness, the observers use the diagnosis of mental

472
00:28:16,200 --> 00:28:21,240
Speaker 1: illness to interpret the behaviors. So the context seems to

473
00:28:21,400 --> 00:28:25,399
Speaker 1: rule how observations of behavior are interpreted. Sitting in a

474
00:28:25,400 --> 00:28:28,240
Speaker 1: coffee shop writing in a journal is considered by most

475
00:28:28,280 --> 00:28:31,919
Speaker 1: people normal behavior. Sitting in a mental institution with a

476
00:28:32,000 --> 00:28:36,720
Speaker 1: diagnosis of schizophrenia writing in a journal is considered pathological

477
00:28:36,800 --> 00:28:41,080
Speaker 1: writing behavior. The behavior is the same, but they're using

478
00:28:41,120 --> 00:28:45,240
Speaker 1: the diagnosis to to interpret the meaning of what the

479
00:28:45,240 --> 00:28:47,760
Speaker 1: person's actions are, and the same thing is reported by

480
00:28:47,840 --> 00:28:50,080
Speaker 1: Rosen Han in some of the therapy sessions and the

481
00:28:50,120 --> 00:28:52,880
Speaker 1: notes that were taken on those. So a person can

482
00:28:53,080 --> 00:28:56,200
Speaker 1: talk about the relationships in their life and say, um,

483
00:28:57,880 --> 00:29:01,000
Speaker 1: you know, my wife and I rarely argue. Every now

484
00:29:01,040 --> 00:29:03,520
Speaker 1: and then we get angry with one another, but most

485
00:29:03,560 --> 00:29:06,680
Speaker 1: of the time we have a very loving relationship. Okay,

486
00:29:06,720 --> 00:29:09,240
Speaker 1: so that sounds perfectly normal. But if you're trying to

487
00:29:09,400 --> 00:29:12,440
Speaker 1: look at this with a kind of with an eye

488
00:29:12,480 --> 00:29:16,560
Speaker 1: for instability and and you know, problems in one's personal life,

489
00:29:16,600 --> 00:29:18,800
Speaker 1: you can just latch onto the part where you said, well,

490
00:29:18,840 --> 00:29:21,720
Speaker 1: every now and then we get angry and argue, and say,

491
00:29:21,880 --> 00:29:25,560
Speaker 1: you know has issues with angry arguments at home, and

492
00:29:25,840 --> 00:29:29,520
Speaker 1: that becomes a part of this psychological diagnosis. I mean,

493
00:29:29,640 --> 00:29:33,160
Speaker 1: everybody gets angry with people that they love every now

494
00:29:33,200 --> 00:29:36,640
Speaker 1: and then. It happened, it's totally normal. Now to just

495
00:29:36,800 --> 00:29:39,440
Speaker 1: to put this in a certain uh in the framework

496
00:29:39,440 --> 00:29:41,280
Speaker 1: of the time and sort of in the timeline of

497
00:29:41,320 --> 00:29:46,240
Speaker 1: American um psychiatric care, I found this pretty helpful. So,

498
00:29:46,920 --> 00:29:51,000
Speaker 1: according to American psychiatrist Alan Francis, who was a chair

499
00:29:51,040 --> 00:29:54,600
Speaker 1: on the task force that created the American Psychiatric Association's

500
00:29:54,680 --> 00:29:57,680
Speaker 1: Diagnostic and Statistics Manual four or the d s M

501
00:29:57,760 --> 00:30:02,080
Speaker 1: four UM in war Uh. He said that the predominant

502
00:30:02,160 --> 00:30:05,840
Speaker 1: post war, post World War two model and psychiatry was

503
00:30:05,920 --> 00:30:10,600
Speaker 1: psychoanalytic with an extremely confident focus on treatment. So it's

504
00:30:10,640 --> 00:30:12,640
Speaker 1: out there, we can treat it, and we can treat

505
00:30:12,680 --> 00:30:15,120
Speaker 1: it well. That was kind of according to Francis, that

506
00:30:15,280 --> 00:30:17,600
Speaker 1: was we know what we're doing here. Step back, Yeah,

507
00:30:17,680 --> 00:30:20,120
Speaker 1: let the professionals handle it. The institutions can handle it.

508
00:30:20,600 --> 00:30:23,720
Speaker 1: But then of course came rosen Han's experiment, and along

509
00:30:23,760 --> 00:30:26,800
Speaker 1: with some other revelations, it really took the wind out

510
00:30:26,800 --> 00:30:32,120
Speaker 1: of everyone's sales, right, exposing the unreliability of psychiatric diagnosis.

511
00:30:32,160 --> 00:30:34,240
Speaker 1: And I can imagine if you worked in the field

512
00:30:34,280 --> 00:30:36,800
Speaker 1: of psychiatry or psychology at the time, this would come

513
00:30:36,840 --> 00:30:41,000
Speaker 1: as a huge blow to you. Yeah. Indeed. Uh. In

514
00:30:41,080 --> 00:30:44,120
Speaker 1: his book Saving Normal and Insiders Revolt against Out of

515
00:30:44,120 --> 00:30:47,600
Speaker 1: Controlled Psychiatric Diagnosis ds M five, Big Pharma and the

516
00:30:47,640 --> 00:30:52,000
Speaker 1: Medicalization of Ordinary Life, Francis writes that before d s

517
00:30:52,160 --> 00:30:55,880
Speaker 1: M three, which very much previous edition, yeah, but but

518
00:30:56,000 --> 00:30:59,760
Speaker 1: still comes after rosen Hans experiments UM, he said that

519
00:31:00,040 --> 00:31:04,440
Speaker 1: psychiatry was quote pure art forms, something brilliant, sometimes brilliant

520
00:31:04,720 --> 00:31:10,200
Speaker 1: usually idiosyncratic and always chaotic. Yeah, I mean, I have

521
00:31:10,320 --> 00:31:13,880
Speaker 1: heard this charge before. H And I don't want to

522
00:31:14,360 --> 00:31:17,400
Speaker 1: make judgments against psychiatry or psychology. I mean, I don't

523
00:31:17,440 --> 00:31:20,720
Speaker 1: have any relevant expertise that can let me stand in

524
00:31:20,800 --> 00:31:23,080
Speaker 1: judgment of them. But I've definitely heard people make the

525
00:31:23,120 --> 00:31:27,600
Speaker 1: accusation than in some ways, especially historically, psychology is more

526
00:31:27,640 --> 00:31:30,360
Speaker 1: of an art than a science. I could see where

527
00:31:30,360 --> 00:31:32,479
Speaker 1: one could make a case for that. Yeah. And then

528
00:31:32,520 --> 00:31:35,040
Speaker 1: of course another feature of it is that seemingly, at

529
00:31:35,040 --> 00:31:38,480
Speaker 1: this time at least, there is a lot that it

530
00:31:38,480 --> 00:31:42,479
Speaker 1: seems to grow out of an expert's intuitions, you know,

531
00:31:43,200 --> 00:31:49,120
Speaker 1: like that you can't it's difficult to do very accurate,

532
00:31:49,240 --> 00:31:54,560
Speaker 1: unbiased quantitative measurements of a person's psychological state. So you

533
00:31:54,920 --> 00:31:58,000
Speaker 1: I mean, I guess you can derive sort of standard

534
00:31:58,080 --> 00:32:02,560
Speaker 1: batteries like of of question errors and and psychological tests.

535
00:32:02,600 --> 00:32:04,200
Speaker 1: But still in the field, I think you're going to

536
00:32:04,320 --> 00:32:06,960
Speaker 1: have a lot of intuition coming into play. You're having

537
00:32:07,000 --> 00:32:11,080
Speaker 1: an expert who knows something about the field, has read

538
00:32:11,080 --> 00:32:14,440
Speaker 1: the medical literature, knows what the standard diagnoses and the

539
00:32:14,480 --> 00:32:17,240
Speaker 1: descriptions of them are, and then sort of looks at

540
00:32:17,360 --> 00:32:20,360
Speaker 1: what he or she sees and gets a feeling or

541
00:32:20,400 --> 00:32:25,280
Speaker 1: intuition about what's going on here. Then then again, I

542
00:32:25,280 --> 00:32:28,200
Speaker 1: think you could probably also say sometimes medical doctors, you know,

543
00:32:28,280 --> 00:32:32,200
Speaker 1: somatic illness doctors, would do the same thing, say, you know,

544
00:32:32,280 --> 00:32:34,360
Speaker 1: I'm just kind of looking at your symptoms and getting

545
00:32:34,360 --> 00:32:36,680
Speaker 1: a feel for the fact that you've probably just have

546
00:32:36,840 --> 00:32:41,240
Speaker 1: some virus infect viral infection of the upper respiratory system. Well,

547
00:32:41,280 --> 00:32:43,640
Speaker 1: you know, that actually leads me to one of the

548
00:32:43,680 --> 00:32:46,920
Speaker 1: big criticisms that was leveled against rosen Hans experiment at

549
00:32:46,920 --> 00:32:50,680
Speaker 1: the time, um and uh. And one of the individuals

550
00:32:50,680 --> 00:32:54,040
Speaker 1: doing this was the Columbia psychiatrist and DASM three chair

551
00:32:54,320 --> 00:33:00,080
Speaker 1: Robert Spitzer, And that is that psychiatric diagnosis relies on

552
00:33:00,160 --> 00:33:04,360
Speaker 1: the patient honestly reporting what they feel, and rosen Hans

553
00:33:04,400 --> 00:33:07,240
Speaker 1: experiment would seem to bend, if not break that right

554
00:33:07,280 --> 00:33:11,680
Speaker 1: because each pseudo patient story is a lie. And and

555
00:33:11,760 --> 00:33:14,479
Speaker 1: let's not forget that a healthy person can still enter

556
00:33:14,520 --> 00:33:17,760
Speaker 1: a hospital emergency room complain of non existent pain and

557
00:33:17,800 --> 00:33:22,560
Speaker 1: received treatment. That might be a useful criticism, But then again,

558
00:33:22,720 --> 00:33:24,720
Speaker 1: I think a lot of the point of rosen Han's

559
00:33:24,760 --> 00:33:29,000
Speaker 1: experiment was about the hospital not catching on over time,

560
00:33:29,800 --> 00:33:34,040
Speaker 1: So I can maybe understand the original admission to the hospital,

561
00:33:34,120 --> 00:33:36,560
Speaker 1: especially if the hospital is strapped for time, they can't

562
00:33:36,560 --> 00:33:39,800
Speaker 1: spend a lot of time with the patient. Um, but

563
00:33:39,920 --> 00:33:45,240
Speaker 1: they didn't have complex, fake psychological personas that were designed

564
00:33:45,360 --> 00:33:49,920
Speaker 1: cleverly to trick the psychologist. They just said empty, hollow thud,

565
00:33:50,440 --> 00:33:53,040
Speaker 1: heard a voice said it. That's it. They get in

566
00:33:53,200 --> 00:33:57,280
Speaker 1: and then they completely all symptoms went away, normal behavior,

567
00:33:57,320 --> 00:34:00,000
Speaker 1: and then they couldn't get out for a long time. Yeah.

568
00:34:00,000 --> 00:34:03,880
Speaker 1: And and to your point, they're judging the individual who

569
00:34:03,960 --> 00:34:08,000
Speaker 1: is no longer claiming to have any kind of auditory hallucinations.

570
00:34:09,000 --> 00:34:13,839
Speaker 1: They are diagnosing them as something other than saying yes

571
00:34:13,960 --> 00:34:18,840
Speaker 1: absolutely and again playing on that that really problematic distinction,

572
00:34:18,960 --> 00:34:23,360
Speaker 1: the overall categorical distinction between sane and insane. But I

573
00:34:23,400 --> 00:34:26,359
Speaker 1: think this is a really strong indication that it is

574
00:34:26,440 --> 00:34:29,880
Speaker 1: not good for us to use these categories of sane

575
00:34:29,960 --> 00:34:33,239
Speaker 1: person and insane person. Just a fact I want to

576
00:34:33,280 --> 00:34:36,240
Speaker 1: mention is that according to the U s National Institute

577
00:34:36,239 --> 00:34:40,560
Speaker 1: of Mental Health in there were an estimated forty three

578
00:34:40,560 --> 00:34:44,040
Speaker 1: point eight million adults aged eighteen or older in the

579
00:34:44,120 --> 00:34:47,680
Speaker 1: United States with any mental illness. So that's just any

580
00:34:47,680 --> 00:34:51,080
Speaker 1: mental illness of all the kinds recognized in the past year,

581
00:34:51,560 --> 00:34:56,919
Speaker 1: and this represented eighteen point five of all US adults.

582
00:34:56,960 --> 00:35:01,600
Speaker 1: So there's a huge chunk of people in any given country.

583
00:35:01,600 --> 00:35:04,320
Speaker 1: But we have the stats here for the United States

584
00:35:04,360 --> 00:35:08,399
Speaker 1: that at any given time will experience a mental illness.

585
00:35:08,440 --> 00:35:11,280
Speaker 1: But this doesn't mean they've always had it. It doesn't

586
00:35:11,320 --> 00:35:13,879
Speaker 1: mean they always will have it. It doesn't mean they're

587
00:35:13,920 --> 00:35:16,799
Speaker 1: a bad or suspect person for having it. I mean,

588
00:35:16,840 --> 00:35:19,920
Speaker 1: we don't think that about people who have illnesses of

589
00:35:19,920 --> 00:35:23,320
Speaker 1: the body. We don't label somebody who has a somatic

590
00:35:23,400 --> 00:35:27,480
Speaker 1: body illness as a sick person who from thereafter is

591
00:35:27,520 --> 00:35:30,239
Speaker 1: known as a person who has been sick. Yeah. I

592
00:35:30,239 --> 00:35:32,280
Speaker 1: mean it's like we end up treating the human mind

593
00:35:32,560 --> 00:35:37,160
Speaker 1: as this fixed state that is not susceptible to change

594
00:35:37,200 --> 00:35:40,000
Speaker 1: and influence. Yeah, it's almost as if we're importing a

595
00:35:40,080 --> 00:35:43,680
Speaker 1: kind of magical thinking. They're too, Like the having a

596
00:35:43,680 --> 00:35:47,040
Speaker 1: mental illness is in a very unfair way treated like

597
00:35:47,200 --> 00:35:50,080
Speaker 1: being in a state of sin or being in uh,

598
00:35:50,520 --> 00:35:52,960
Speaker 1: having some kind of magical taint to you that makes

599
00:35:53,000 --> 00:35:54,840
Speaker 1: people afraid of you. This is a thing that was

600
00:35:54,880 --> 00:35:57,359
Speaker 1: described in the part of the report where rosen Han

601
00:35:57,440 --> 00:35:59,640
Speaker 1: talks about the conditions inside the hospital, which is a

602
00:35:59,760 --> 00:36:01,920
Speaker 1: very also a very salient part of the report and

603
00:36:02,239 --> 00:36:04,400
Speaker 1: another great reason you should read it. But one of

604
00:36:04,440 --> 00:36:07,960
Speaker 1: the things he talks about is the lack of contact

605
00:36:09,080 --> 00:36:12,400
Speaker 1: between the staff and the patients, like that there's just

606
00:36:12,520 --> 00:36:16,879
Speaker 1: really very little interaction, and that sometimes it's as if

607
00:36:17,040 --> 00:36:20,680
Speaker 1: people who don't claim to suffer from a mental illness

608
00:36:20,680 --> 00:36:24,240
Speaker 1: were afraid that they could catch it by being near

609
00:36:24,440 --> 00:36:27,120
Speaker 1: or interacting with the people who did have a mental illness.

610
00:36:27,120 --> 00:36:31,400
Speaker 1: There was like a like an aversion that drove them away.

611
00:36:31,440 --> 00:36:35,480
Speaker 1: And this was partially explaining the lack of interaction between

612
00:36:35,480 --> 00:36:38,320
Speaker 1: the staff and the patients. Yeah, and I can definitely

613
00:36:38,360 --> 00:36:41,359
Speaker 1: imagine an unwillingness to have to look at and think

614
00:36:41,400 --> 00:36:46,359
Speaker 1: about this thing that we UH often have an inability

615
00:36:46,480 --> 00:36:50,960
Speaker 1: to to talk about and to to even quantify in

616
00:36:51,000 --> 00:36:54,400
Speaker 1: a in a meaningful sense. There was one last paragraph

617
00:36:54,480 --> 00:36:57,440
Speaker 1: I wanted to read from rosen Hans studied because I

618
00:36:57,480 --> 00:37:01,080
Speaker 1: just found it absolutely fascinating. I wonder what you thought

619
00:37:01,080 --> 00:37:03,400
Speaker 1: about this, Robert, but let me read it first. The

620
00:37:03,480 --> 00:37:08,439
Speaker 1: quote is conceivably when the origins of and stimuli that

621
00:37:08,520 --> 00:37:12,520
Speaker 1: give rise to a behavior are remote or unknown or

622
00:37:12,600 --> 00:37:17,040
Speaker 1: when the behavior strikes us as immutable, trait labels regarding

623
00:37:17,080 --> 00:37:20,719
Speaker 1: the behavior arise the trait labels like insane that we

624
00:37:20,719 --> 00:37:24,080
Speaker 1: were talking about. When, on the other hand, the origins

625
00:37:24,120 --> 00:37:28,319
Speaker 1: and stimuli are known and available, discourse is limited to

626
00:37:28,400 --> 00:37:32,720
Speaker 1: the behavior itself. Thus, I may hallucinate because I am sleeping,

627
00:37:33,160 --> 00:37:36,600
Speaker 1: or I may hallucinate because I have ingested a peculiar drug.

628
00:37:37,120 --> 00:37:41,000
Speaker 1: These are termed sleep induced hallucinations or dreams or drug

629
00:37:41,040 --> 00:37:45,760
Speaker 1: induced hallucinations, respectively. But when the stimuli to my hallucinations

630
00:37:45,800 --> 00:37:50,680
Speaker 1: are unknown, that is called craziness or schizophrenia. As if

631
00:37:50,719 --> 00:37:55,880
Speaker 1: that inference were somehow as illuminating as the others. I

632
00:37:55,920 --> 00:38:00,600
Speaker 1: thought that was absolutely fascinating because it almost uh tracks

633
00:38:00,800 --> 00:38:04,560
Speaker 1: this this problem we have in dealing with mental illness

634
00:38:05,120 --> 00:38:07,560
Speaker 1: as a function of our lack of understanding. Like, like,

635
00:38:07,680 --> 00:38:11,200
Speaker 1: we think we're very advanced or much more advanced than

636
00:38:11,239 --> 00:38:14,520
Speaker 1: we used to be in fields like psychiatry and psychology

637
00:38:15,239 --> 00:38:17,600
Speaker 1: because we're I guess we're a lot better than we

638
00:38:17,680 --> 00:38:19,320
Speaker 1: used to be. I mean, we no longer think people

639
00:38:19,360 --> 00:38:23,080
Speaker 1: have demons in them. Uh, we understand that that there

640
00:38:23,120 --> 00:38:26,120
Speaker 1: are conditions that can affect the mind, that can cause

641
00:38:26,160 --> 00:38:29,440
Speaker 1: people suffering and distress or cause people abnormal behavior, and

642
00:38:29,560 --> 00:38:33,520
Speaker 1: that there are hopefully physical or or at least like

643
00:38:33,719 --> 00:38:36,760
Speaker 1: you know, talk based ways of treating those and helping

644
00:38:36,840 --> 00:38:40,319
Speaker 1: get people get relief and and fix the problem that's

645
00:38:40,320 --> 00:38:45,239
Speaker 1: affecting them. But we're still very imprecise with psychology, aren't we.

646
00:38:45,320 --> 00:38:47,720
Speaker 1: I mean, it's not like in many ways of treating

647
00:38:47,760 --> 00:38:51,360
Speaker 1: body illnesses where we've come up with extremely just laser

648
00:38:51,520 --> 00:38:55,120
Speaker 1: targeted ways of fixing the problems that arise. If you

649
00:38:55,200 --> 00:38:57,840
Speaker 1: get a broken bone, you know, you can get a

650
00:38:58,239 --> 00:39:00,600
Speaker 1: surgery or a splint put on. You know, there there

651
00:39:00,600 --> 00:39:02,759
Speaker 1: are ways of fixing it that we're pretty sure are

652
00:39:02,800 --> 00:39:05,680
Speaker 1: gonna work and aren't gonna have too many weird side effects.

653
00:39:06,000 --> 00:39:08,400
Speaker 1: And you can do the same thing with say antibiotics

654
00:39:08,480 --> 00:39:10,960
Speaker 1: or other you know, drug treatments that we have for

655
00:39:11,040 --> 00:39:15,960
Speaker 1: body illnesses. And there is just a fundamental lack of

656
00:39:16,000 --> 00:39:20,520
Speaker 1: precision and lack of technological advancement we have in treating

657
00:39:21,120 --> 00:39:24,640
Speaker 1: illnesses that affect the mind. Yeah, and it it definitely

658
00:39:24,640 --> 00:39:27,840
Speaker 1: reminds me of content that looked at in the past,

659
00:39:27,920 --> 00:39:30,440
Speaker 1: just talking about like what is in the same way

660
00:39:30,480 --> 00:39:32,360
Speaker 1: we're talking about what is saying and what is insane,

661
00:39:32,760 --> 00:39:35,440
Speaker 1: um and and as flawed as those categories are, But

662
00:39:35,480 --> 00:39:38,560
Speaker 1: then you know what is what is an actual experience

663
00:39:38,600 --> 00:39:42,719
Speaker 1: of reality versus a skewed experience of reality, especially when

664
00:39:42,760 --> 00:39:46,239
Speaker 1: you start thinking of any human perception of reality is

665
00:39:46,360 --> 00:39:51,040
Speaker 1: essentially flawed. It's imperfect, it's based, it's it's not it's

666
00:39:51,080 --> 00:39:54,400
Speaker 1: not one for one, you know, So, so how do

667
00:39:54,400 --> 00:39:56,520
Speaker 1: you start There is no objective Yeah, there is no

668
00:39:57,400 --> 00:40:01,880
Speaker 1: objective reality. All reality is a subjective reality, and the

669
00:40:01,920 --> 00:40:05,480
Speaker 1: individual on the other side of the glass, their experience

670
00:40:05,960 --> 00:40:10,319
Speaker 1: of of subjective reality is just different. So then how

671
00:40:10,360 --> 00:40:13,279
Speaker 1: do you treat it? How do you quantify it? Uh?

672
00:40:13,320 --> 00:40:16,560
Speaker 1: You end up falling back on these false terms. Yeah, absolutely,

673
00:40:16,600 --> 00:40:19,840
Speaker 1: And I think that point Rosenhan makes uh still largely

674
00:40:19,840 --> 00:40:22,680
Speaker 1: applies today. Even though we may have come somewhere since

675
00:40:23,040 --> 00:40:26,400
Speaker 1: since the nineteen seventies, we still are at this place

676
00:40:26,440 --> 00:40:30,680
Speaker 1: where the fact that we don't understand the origins of

677
00:40:30,680 --> 00:40:33,359
Speaker 1: of of somebody's problem makes us treat it with less

678
00:40:33,400 --> 00:40:38,160
Speaker 1: compassion than we should. And so, if there's one takeaway

679
00:40:38,239 --> 00:40:42,080
Speaker 1: from today's episode, try to ditch the concepts of sane

680
00:40:42,239 --> 00:40:46,120
Speaker 1: and insane. And I know they're deeply ground into us,

681
00:40:46,160 --> 00:40:48,399
Speaker 1: but I say, do your best to chuck them out.

682
00:40:48,440 --> 00:40:50,960
Speaker 1: I mean, when you encounter somebody who has a mental

683
00:40:51,000 --> 00:40:53,680
Speaker 1: illness and has symptoms, think about what can be done

684
00:40:53,719 --> 00:40:57,719
Speaker 1: to help the person's symptoms or there or alleviate the

685
00:40:57,760 --> 00:41:01,120
Speaker 1: problems in their direct experience, rather than saying, this is

686
00:41:01,160 --> 00:41:03,960
Speaker 1: an insane person. Yeah, or even if you just go

687
00:41:04,000 --> 00:41:06,319
Speaker 1: back your daily life, it's so easy to fall into

688
00:41:06,600 --> 00:41:09,200
Speaker 1: the mindset of just walking down the street and going

689
00:41:09,400 --> 00:41:12,000
Speaker 1: that person saying that one's that one's insane, that one's crazy,

690
00:41:12,040 --> 00:41:15,000
Speaker 1: that one's crazy, that one maybe a little crazy, that

691
00:41:15,080 --> 00:41:17,919
Speaker 1: one's sane. Uh. But but again that's just falling upon

692
00:41:18,000 --> 00:41:23,560
Speaker 1: this this this this false dichotomy of a mental experience. Yeah.

693
00:41:23,560 --> 00:41:26,400
Speaker 1: So anyway, I think that's a very fascinating paper, but

694
00:41:26,520 --> 00:41:29,120
Speaker 1: really highly recommended. You can find it online. There are

695
00:41:29,160 --> 00:41:30,919
Speaker 1: copies you can find you can read the whole text

696
00:41:30,920 --> 00:41:32,920
Speaker 1: for will make sure to link to it as well

697
00:41:33,120 --> 00:41:36,400
Speaker 1: on the landing page for this episode. So fantastic in

698
00:41:36,440 --> 00:41:40,120
Speaker 1: the in the history of psychology and science, and really

699
00:41:40,120 --> 00:41:44,000
Speaker 1: in the history of human empathy. I think. Yeah. All right,

700
00:41:44,719 --> 00:41:46,800
Speaker 1: So in the meantime, check us out at stuff to

701
00:41:46,800 --> 00:41:48,560
Speaker 1: Blow your mind dot com. That's where you'll find all

702
00:41:48,560 --> 00:41:52,120
Speaker 1: the episodes, various videos, blog post links out to social

703
00:41:52,120 --> 00:41:54,839
Speaker 1: media accounts like Twitter and Facebook. Will Blow the Mind

704
00:41:54,880 --> 00:41:56,759
Speaker 1: on both of those and I tumbling. We're stuff to

705
00:41:56,760 --> 00:41:58,719
Speaker 1: blow your mind. And if you want to write us

706
00:41:58,719 --> 00:42:01,240
Speaker 1: and let us know your feet back about today's episode

707
00:42:01,320 --> 00:42:04,279
Speaker 1: or what you thought about the topic of the categories

708
00:42:04,280 --> 00:42:07,279
Speaker 1: of sanity and insanity and how we diagnose them, you

709
00:42:07,320 --> 00:42:09,600
Speaker 1: can email us at will the Mind at how stuff

710
00:42:09,640 --> 00:42:22,080
Speaker 1: works dot com for more on this and thousands of

711
00:42:22,080 --> 00:42:30,040
Speaker 1: other topics. Is it how stuff works dot com. Remember