WEBVTT - Sanity/Insanity: The Rosenhan Experiment 0:00:03.120 --> 0:00:05.840 Welcome to stuff to Blow your Mind from house stop 0:00:05.920 --> 0:00:14.520 works dot com. Hey, who wasn't disposed to blow your mind? 0:00:14.560 --> 0:00:18.040 My name is Robert Lamb and I'm Joe McCormick. So, Robert, 0:00:18.680 --> 0:00:20.720 I've got a scenario for you. Throw it at me. 0:00:20.960 --> 0:00:24.880 Imagine you are on a jury. Okay, so you have 0:00:25.000 --> 0:00:26.520 been picked. You're not one of the people who got 0:00:26.520 --> 0:00:29.280 sent home early and normally get out of it. Yeah, 0:00:29.680 --> 0:00:31.600 but you're there on the jury and you're hearing the 0:00:31.640 --> 0:00:35.360 trial of a man who ran a muck in a 0:00:35.400 --> 0:00:38.640 bowling alley and so he went nuts. He took his 0:00:38.680 --> 0:00:41.600 bowling shoes off, he started throwing bowling balls at people, 0:00:42.040 --> 0:00:44.920 and fortunately no one was killed, but several people were 0:00:44.960 --> 0:00:48.640 seriously injured. And now this man is standing trial for 0:00:48.920 --> 0:00:54.000 his bowling ball rampage. And at trial, the man's attorney 0:00:54.040 --> 0:00:57.480 attempts to mount a defense based on the insanity plea, 0:00:58.080 --> 0:01:01.480 the claim that the accused did commit the acts in question, 0:01:02.000 --> 0:01:05.240 but is not responsible for his actions because his mental 0:01:05.280 --> 0:01:09.080 state prevents him from understanding them. Uh. And then the 0:01:09.160 --> 0:01:13.119 prosecution brings out an expert witness who is a highly 0:01:13.160 --> 0:01:17.800 respected and very confident sounding forensic psychiatrist who testifies that 0:01:17.880 --> 0:01:21.560 he has interviewed the defendant and found that the defendant 0:01:21.560 --> 0:01:24.280 shows all the normal signs of a person in perfect 0:01:24.319 --> 0:01:28.080 command of his actions. But then the defense brings forth 0:01:28.240 --> 0:01:33.240 another highly respected and confident sounding forensic psychiatrist who testifies 0:01:33.360 --> 0:01:37.320 exactly the opposite, that the defendant symptoms are consistent with 0:01:37.360 --> 0:01:40.480 those of a person who is disconnected from reality and 0:01:40.560 --> 0:01:44.640 cannot tell right from wrong. If you have no psychiatric 0:01:44.720 --> 0:01:48.600 expertise yourself, how are you supposed to tell which one 0:01:48.800 --> 0:01:52.960 of these expert witnesses is correct. This is the problem 0:01:53.000 --> 0:01:55.840 that one encounters with a number of these trials, right, 0:01:55.920 --> 0:01:59.320 because it ultimately comes down to a who can either 0:01:59.360 --> 0:02:02.640 who can make the better case for insanity or insanity, 0:02:02.920 --> 0:02:05.800 or if they both kind of make equally pressing cases, 0:02:05.960 --> 0:02:08.800 then it comes down to something as simple as a 0:02:08.480 --> 0:02:11.920 as a character judgment on the part on your part 0:02:12.120 --> 0:02:15.799 of the accused. Yeah, now, I might say that it's 0:02:15.840 --> 0:02:18.360 possibly true that this scenario I've come up with it's 0:02:18.440 --> 0:02:21.440 kind of contrived. It might be worth saying that apparently 0:02:21.560 --> 0:02:25.440 less than one percent of defendants in US cases plead insanity, 0:02:25.800 --> 0:02:27.919 and then for those that do enter such a plea, 0:02:28.000 --> 0:02:31.320 the rates of success are low, so pleading insanity typically 0:02:31.360 --> 0:02:36.200 doesn't get you very far in the US legal system. 0:02:36.240 --> 0:02:39.400 But the example does raise a few questions about how 0:02:39.520 --> 0:02:44.760 we deal with concepts of mental uh, let's say, mental 0:02:44.919 --> 0:02:50.840 normality and mental abnormality, as as the lay public understands them. 0:02:51.160 --> 0:02:54.120 Throughout this episode, we're gonna be using the words sane 0:02:54.320 --> 0:02:57.040 and insane to give a sense of the way that 0:02:57.080 --> 0:02:59.480 they're used in the milieu of the experiment we're going 0:02:59.520 --> 0:03:01.760 to talk ab out in this episode. But every time 0:03:01.840 --> 0:03:04.239 you hear those words, you should imagine that we're putting 0:03:04.280 --> 0:03:08.480 some huge, big finger quotes around them, because, as we 0:03:08.560 --> 0:03:10.920 discussed at the end, these are probably not the most 0:03:11.040 --> 0:03:15.400 useful terms or concepts for describing or helping people in 0:03:15.440 --> 0:03:19.800 the real world, but they still are salient concepts too 0:03:19.840 --> 0:03:23.480 many people. Like if you take the average person and 0:03:23.560 --> 0:03:26.480 ask them if they think the difference between sane and 0:03:26.639 --> 0:03:30.519 insane is a real, actual thing and they can tell 0:03:30.560 --> 0:03:34.119 the difference, they'll say, yeah, right, yeah, I mean, we 0:03:34.120 --> 0:03:36.280 we encountered this all the time, right The just the 0:03:36.320 --> 0:03:39.480 basic idea that I'm here on this side of the wall, 0:03:39.960 --> 0:03:42.320 and then there are people inside the hospital, there are 0:03:42.360 --> 0:03:46.120 people receiving care, there are people that are incarcerated. That's 0:03:46.160 --> 0:03:49.520 the insane side of the wall, and there's a bearer 0:03:49.520 --> 0:03:52.680 between us. It's kind of a Sneeches and star Belt. 0:03:52.680 --> 0:03:56.280 He'd sneeches approach to mental health. You can easily divide 0:03:56.280 --> 0:03:59.440 everybody into one of two categories. Either those that have 0:03:59.560 --> 0:04:01.960 it all thegether and are seeing everything straight and have 0:04:02.120 --> 0:04:07.760 an acceptable understanding of reality, and in those who do not. Yeah, 0:04:07.840 --> 0:04:11.080 And so today we want to talk about a landmark 0:04:11.240 --> 0:04:15.160 experiment in the history of psychology, one that's been written 0:04:15.160 --> 0:04:18.200 about and talked about a lot for years, often celebrated. 0:04:18.279 --> 0:04:22.520 It's highly cited, and it concerns the question of how 0:04:22.560 --> 0:04:28.440 do we know precisely what constitutes normality or mental illness? 0:04:29.000 --> 0:04:33.320 And if there is a difference between sanity and insanity, 0:04:33.360 --> 0:04:40.000 can anybody tell the difference? Even professionals, Yeah, especially professionals 0:04:40.040 --> 0:04:42.200 that because this uh, I mean, that's what this whole 0:04:42.200 --> 0:04:46.840 experiment hinges on is is how do our professionals, how 0:04:46.839 --> 0:04:50.800 do our mental health professionals judge uh and and evaluate 0:04:50.880 --> 0:04:54.240 individuals that are entering the system. Yeah. So the experiment 0:04:54.279 --> 0:04:57.359 in question was carried out by the Stanford professor and 0:04:57.400 --> 0:05:01.960 psychologist David Rosenhan, who lived from nineteen twenty nine to 0:05:02.120 --> 0:05:05.640 two thousand twelve, And I found this in an obituary 0:05:05.640 --> 0:05:09.440 of him, that his education path seemed to be interestingly varied. 0:05:09.480 --> 0:05:12.440 So he got a BA in mathematics in nineteen fifty 0:05:12.440 --> 0:05:15.920 one from Yeshiva College, and then and then a master's 0:05:15.960 --> 0:05:20.960 in economics, and then a PhD in psychology from Colombia, 0:05:21.279 --> 0:05:24.240 and then he went on to sort of branch into 0:05:24.400 --> 0:05:27.800 two different fields and work on unifying concepts between them. 0:05:27.800 --> 0:05:30.880 So he's a professor of law and of psychology. And 0:05:30.920 --> 0:05:33.279 according to his Stanford obituary which I read, he he 0:05:33.360 --> 0:05:37.880 was sort of known for applying psychology to legal practices 0:05:37.960 --> 0:05:43.120 like jury selection and jury consultation. And he held various 0:05:43.120 --> 0:05:45.640 honors during his lifetime, like being the head of the 0:05:45.680 --> 0:05:47.920 A p A and and stuff like that. So he 0:05:48.000 --> 0:05:53.240 was very respected psychologist and jurist, one might say. But 0:05:53.360 --> 0:05:57.520 in nineteen seventy three, rosen Hand published in the journal 0:05:57.680 --> 0:06:02.280 Science a piece that was old on being sane in 0:06:02.279 --> 0:06:06.200 insane places. And it begins with this question that we 0:06:06.279 --> 0:06:10.560 talked about a minute ago. If sanity and insanity exist, 0:06:10.920 --> 0:06:14.520 how shall we know them? That's what he says. Yeah, 0:06:14.520 --> 0:06:16.880 He presents this quite nicely, and as we were discussing 0:06:16.920 --> 0:06:20.279 prior to to the recording session here, the whole paper 0:06:20.520 --> 0:06:24.760 is just so well written. It's so accessible to uh to, 0:06:24.760 --> 0:06:27.400 to the average leader, to the average reader, it's not 0:06:27.720 --> 0:06:30.680 it's not you know, lost in a bunch of psycho babble. Yeah, 0:06:30.720 --> 0:06:32.719 you can find this paper online and I do highly 0:06:32.720 --> 0:06:35.280 recommend reading it as it is. It is not just 0:06:35.520 --> 0:06:38.000 clear and very interesting, it's a great piece of writing. 0:06:38.560 --> 0:06:42.080 But so Rosenhan opens by pointing out the same thing 0:06:42.120 --> 0:06:44.560 we did at the beginning of our podcast. He says 0:06:44.600 --> 0:06:48.680 that it's common in murder trials where the defendant sanity 0:06:48.800 --> 0:06:53.599 is under dispute, for perfectly respectable psychiatrists to testify in 0:06:53.760 --> 0:06:57.719 direct contradiction of one another about the mental state of 0:06:57.800 --> 0:07:00.920 the accused. And I actually went and read a couple 0:07:00.920 --> 0:07:05.159 of articles about what happens when somebody tries to enter 0:07:05.320 --> 0:07:08.880 an insanity polae in court, like how can the the 0:07:08.960 --> 0:07:11.880 experts try to figure out whether they are faking it 0:07:12.000 --> 0:07:14.440 or not? And there are various methods they have, But 0:07:14.520 --> 0:07:18.280 one of the things that struck me about the way 0:07:18.320 --> 0:07:21.800 that forensic psychiatrists go about trying to evaluate the mental 0:07:21.920 --> 0:07:25.560 state of a person accused of a crime is they're 0:07:25.560 --> 0:07:30.440 trying to see if the person fits a known diagnosis. 0:07:31.840 --> 0:07:34.560 So they're trying to say, here the known symptoms of 0:07:34.800 --> 0:07:39.360 schizophrenia or here the known symptoms of x known state 0:07:39.400 --> 0:07:44.240 of psychosis as described in the literature, and can the 0:07:44.320 --> 0:07:48.800 defendant match the description that I have here? And if 0:07:48.840 --> 0:07:53.520 they just present sort of like an odd collection of symptoms, 0:07:53.560 --> 0:07:56.360 it's generally ruled that they're probably faking right there. They're 0:07:56.400 --> 0:07:59.600 they're just putting together things that seem to them like 0:07:59.680 --> 0:08:03.920 they qualify as crazy, right, And one of the big 0:08:03.960 --> 0:08:06.440 ones that often shows up is someone will be they'll 0:08:06.440 --> 0:08:09.680 be trying to defend the accused by saying that they 0:08:09.840 --> 0:08:14.560 are insane, and then the prosecution will point out something 0:08:14.880 --> 0:08:20.440 something in their actions that is clearly premeditated and uh, 0:08:20.480 --> 0:08:24.440 thus uh disputing any idea that this was just a 0:08:24.440 --> 0:08:29.160 spontaneous manifestation. Oh yeah. There are often very various features 0:08:29.200 --> 0:08:31.480 of the crime itself that make it clear that the 0:08:31.480 --> 0:08:34.679 person was in a fairly lucid state when they committed that, 0:08:34.800 --> 0:08:37.600 like if they try to destroy evidence and you know, 0:08:37.720 --> 0:08:43.440 do smart, clear thinking ways of avoiding responsibility for the crime. 0:08:44.080 --> 0:08:48.320 But anyway to investigate this question. If sanity and insanity exist, 0:08:48.440 --> 0:08:52.959 how shall we know them? David Rosenhan staged an experiment 0:08:53.160 --> 0:08:56.079 that's one of the most interesting I've ever come across 0:08:56.120 --> 0:08:59.960 in the history of psychology, and it was essentially an 0:08:59.800 --> 0:09:04.440 under cover sting operation to determine what it takes to 0:09:04.480 --> 0:09:08.080 convince a mental health facility that a person is insane, 0:09:08.640 --> 0:09:10.760 and then what it takes to convince them that that 0:09:10.880 --> 0:09:15.240 same person is sane. Indeed, so this took place between 0:09:15.600 --> 0:09:20.800 nine seventy two, So they're there as we'll discuss, uh, 0:09:20.840 --> 0:09:25.200 their various locations that are employee. Here you have eight 0:09:25.240 --> 0:09:29.520 same people and they're gained a secret admission to twelve 0:09:29.679 --> 0:09:34.360 different hospitals. So we're talking three women, five men, um 0:09:34.400 --> 0:09:36.960 one of the psychology graduate student in his twenties. The 0:09:36.960 --> 0:09:40.800 remaining seven were older and quote unquote established. So among 0:09:40.840 --> 0:09:44.600 them you have three psychologists, a pediatrician, a psychiatrist, a painter, 0:09:45.400 --> 0:09:49.800 and a housewife. And uh oh, and then also rosen himself. 0:09:50.080 --> 0:09:52.520 Rosenhan himself is involved here to Yeah, he was one 0:09:52.559 --> 0:09:56.160 of the mental health professionals, and the mental health professionals 0:09:56.520 --> 0:10:01.319 gave false professions in their biographies. They were describing themselves 0:10:01.360 --> 0:10:05.640 to the these mental hospitals basically for fear of being 0:10:05.679 --> 0:10:08.480 treated differently than other patients. And that makes sense to me, 0:10:08.559 --> 0:10:12.880 because if if you want to know how the hospital treats, 0:10:13.040 --> 0:10:15.079 you know, the average person who walks up, you don't 0:10:15.120 --> 0:10:17.960 want to say hi, I'm a psychiatrist. I know, they 0:10:18.040 --> 0:10:20.280 might sort of be on their guard when they're dealing 0:10:20.320 --> 0:10:22.840 with you. And likewise, they went in under false names 0:10:22.840 --> 0:10:26.200 as you might expect. Yes, Rosenhan himself was one of 0:10:26.240 --> 0:10:30.160 the patients, um though he was not a fully clandestined 0:10:30.200 --> 0:10:32.280 one as the other one as the other people were. 0:10:32.320 --> 0:10:35.600 He Rosenhan himself was the first of these pseudo patients 0:10:35.640 --> 0:10:38.560 as they're called, and his presence was quote known to 0:10:38.600 --> 0:10:41.920 the hospital administration and the chief psychologist and so far 0:10:42.000 --> 0:10:45.480 as he says, I can tell to them alone. So 0:10:46.080 --> 0:10:48.520 he was known, but nobody else was known, and he 0:10:48.559 --> 0:10:50.440 was only known to a couple of people at the 0:10:50.480 --> 0:10:52.760 hospital and nobody else there. Yeah, there has I mean, 0:10:52.760 --> 0:10:54.680 obviously you would have to have some sort of arrangement 0:10:54.720 --> 0:10:57.600 employ here. You can't just They couldn't have carried out 0:10:57.600 --> 0:11:02.880 this experiment by just doing cold blind calls on various institutions, right, 0:11:02.920 --> 0:11:06.679 but no nobody else was known to anybody, which just him. 0:11:06.720 --> 0:11:08.920 And so the eight patients that they went to twelve 0:11:08.960 --> 0:11:11.840 different hospitals. So obviously some of them were admitted more 0:11:11.880 --> 0:11:14.040 than once, and they went to twelve different hospitals in 0:11:14.040 --> 0:11:16.240 the sample, and they were trying to cover a broad 0:11:16.400 --> 0:11:19.480 range of the different kinds of mental facilities that you 0:11:19.520 --> 0:11:22.520 could go to. So they were in five different states 0:11:22.559 --> 0:11:25.199 on the east and west coast, and the hospitals were 0:11:25.200 --> 0:11:29.280 a varying condition. Some were old and shabby, as they said, 0:11:29.320 --> 0:11:32.559 and some were newer. They had different levels of funding, 0:11:32.640 --> 0:11:35.800 different patients to staff ratios, and only one of the 0:11:35.800 --> 0:11:39.400 twelve hospitals was a private hospital and that made an 0:11:39.400 --> 0:11:43.920 interesting difference in how the diagnoses were treated. Later. But 0:11:44.040 --> 0:11:47.840 how did the so called pseudo patients get admission to 0:11:47.880 --> 0:11:50.360 the hospital. It was a pretty simple trick, and they 0:11:50.400 --> 0:11:53.440 all did exactly the same thing. Yeah, they all show 0:11:53.520 --> 0:11:56.679 up and uh claim that they are hearing voices, that 0:11:56.720 --> 0:12:00.520 they're experiencing auditory hallucinations, Yes, which of course is is 0:12:00.920 --> 0:12:04.400 is often a key symptom of schizophrenia, right, And so 0:12:04.520 --> 0:12:06.840 when they were asked about what the voices said, the 0:12:06.880 --> 0:12:09.959 participant would say that the voice was an unfamiliar voice 0:12:10.200 --> 0:12:13.400 of the same sex as the pseudo patient and that 0:12:13.640 --> 0:12:16.360 they were generally difficult to understand, but that they had 0:12:16.440 --> 0:12:22.840 said the words quote, empty, hollow, and thud, and I 0:12:22.960 --> 0:12:26.040 was like, wow, what an interesting combination of words. What 0:12:26.040 --> 0:12:29.720 would a psychiatrist make of that? But Rosenhunt explains that 0:12:29.760 --> 0:12:33.079 these words were chosen because they sort of went both ways, 0:12:33.120 --> 0:12:36.960 and number one, they formed an easy association with concepts 0:12:36.960 --> 0:12:40.960 of existential anxiety, like you could imagine somebody having thoughts 0:12:41.000 --> 0:12:44.120 like my life is empty. I'm so you know, existence 0:12:44.160 --> 0:12:46.560 is so hollow? Should I kill myself and land on 0:12:46.559 --> 0:12:48.959 the floor with a thud? But they never said any 0:12:49.000 --> 0:12:52.000 of that explicitly, just empty, hollow and thud. Those were 0:12:52.040 --> 0:12:54.320 the only words, empty hollow, that that would be a 0:12:54.400 --> 0:12:59.560 great name for like a nineties goth act. Oh yeah, yeah, yeah, 0:13:00.000 --> 0:13:02.840 I love it. That's a that's a tattoo already on somebody. 0:13:02.880 --> 0:13:06.960 But anyway, they also picked these because this type of 0:13:07.000 --> 0:13:10.040 psychosis described in these terms did not match any in 0:13:10.080 --> 0:13:12.959 the medical literature at the time. So this didn't match 0:13:13.000 --> 0:13:16.840 an existing diagnosis that could be found. Okay, so it's 0:13:16.840 --> 0:13:21.120 a little more abstract than just it was less on 0:13:21.160 --> 0:13:24.040 the nose. If someone is showing up and saying, oh, well, 0:13:24.240 --> 0:13:26.120 I have this symptom, the symptom in this system, and 0:13:26.120 --> 0:13:27.839 they go, oh, those symptoms are exactly what I have 0:13:27.920 --> 0:13:31.760 on the paper here. More, it leaves the uh, the 0:13:31.800 --> 0:13:36.640 individual making the diagnosis, room for at least the illusion 0:13:36.679 --> 0:13:39.920 of discovery. R So, as you would expect, the people 0:13:40.120 --> 0:13:43.160 who showed up at the hospitals faking these symptoms were 0:13:43.200 --> 0:13:46.719 immediately detected and sent home. Oh no, wait, that's not 0:13:46.840 --> 0:13:51.120 the case. In fact, all twelve times they were admitted 0:13:51.200 --> 0:13:55.319 to the hospitals, with eleven out of the twelve times 0:13:55.320 --> 0:14:00.560 they were diagnosed with schizophrenia, and then interestingly, one out 0:14:00.600 --> 0:14:04.800 of the twelve times they were diagnosed with manic depressive psychosis, 0:14:04.840 --> 0:14:09.880 which Rosenhan. Rosenhan points out that the manic depressive psychosis 0:14:09.920 --> 0:14:12.400 had at the least of the time a more favorable 0:14:12.440 --> 0:14:16.200 prognosis than schizophrenia, so that this was a condition that 0:14:16.240 --> 0:14:18.960 you were more likely to recover from. Things looked better 0:14:19.000 --> 0:14:22.400 for you had a better outlook, and for whatever reason, 0:14:22.840 --> 0:14:26.320 this one different diagnosis. The better diagnosis took place at 0:14:26.320 --> 0:14:30.280 the one private hospital in the study, but note that 0:14:30.320 --> 0:14:34.000 it's not necessarily a more accurate diagnosis because these people 0:14:34.040 --> 0:14:36.840 were all faking and all said the same thing. It's 0:14:36.880 --> 0:14:40.760 just the diagnosis that tended to turn out better for 0:14:40.800 --> 0:14:44.800 the patient. Okay, So this is adding possibly an interesting 0:14:44.880 --> 0:14:48.800 layer of class bias into what they found these hospitals 0:14:49.200 --> 0:14:52.440 behave like. So they were admitted, they were put into 0:14:52.480 --> 0:14:55.360 these hospitals, and then what did they do. Did they 0:14:55.480 --> 0:14:59.640 continue to pretend that, oh, I'm hearing these voices that 0:14:59.760 --> 0:15:02.440 at step, of course, is to sort of straighten up 0:15:02.520 --> 0:15:05.720 and said and uh and resume their normal behavior, claim 0:15:06.000 --> 0:15:09.520 that their symptoms are completely gone. But it's important to 0:15:09.520 --> 0:15:14.120 note they're not coming clean either. They're not saying actually surprised. 0:15:14.160 --> 0:15:16.920 This is all part of a study, right, They're just saying, oh, 0:15:17.000 --> 0:15:20.960 I feel fine now, I'm not experiencing those auditory hallucinations 0:15:21.080 --> 0:15:23.960 that I was talking about earlier. Right. They immediately resumed 0:15:24.000 --> 0:15:27.440 normal behavior, claim their symptoms were entirely gone and they 0:15:27.440 --> 0:15:31.360 were on their best behavior. So they were very good patients. Uh, 0:15:31.720 --> 0:15:34.800 at least they tried to be, and they self reported 0:15:34.800 --> 0:15:36.720 that they were good patients. They were described by the 0:15:36.800 --> 0:15:40.760 nursing reports kept at the facilities as quote friendly, cooperative, 0:15:41.120 --> 0:15:46.160 and exhibited no abnormal indications. So according to the reports, 0:15:46.200 --> 0:15:49.800 they didn't do anything weird or disruptive. Uh that they 0:15:49.840 --> 0:15:55.440 seemed perfectly well behaved and normal. But nobody caught on. 0:15:56.440 --> 0:16:00.280 Well maybe not nobody. None of the people who should 0:16:00.280 --> 0:16:04.120 have caught on caught on. The the hospital staff uh 0:16:04.160 --> 0:16:08.640 and psychologist, psychiatrists, the attendants, the nurses. Nobody caught onto 0:16:08.640 --> 0:16:13.280 the fact that these people were faking, but some of 0:16:13.320 --> 0:16:17.560 the other patients did. In fact, that was fairly common. 0:16:17.600 --> 0:16:21.920 So during the course of the of three different hospitalization records, 0:16:22.200 --> 0:16:25.320 participants recorded that out of a hundred and eighteen fellow 0:16:25.360 --> 0:16:29.240 patients on the admissions ward, thirty five of them quote 0:16:29.640 --> 0:16:34.000 voiced their suspicions somewhat vigorously. You're not crazy, you're a 0:16:34.120 --> 0:16:37.720 journalist or a professor, referring to the continual note taking 0:16:38.000 --> 0:16:41.280 you're checking up on the hospital. So the other patients 0:16:41.840 --> 0:16:45.040 were detecting what was going on with these people, but 0:16:45.160 --> 0:16:50.520 the hospital staff was not. Huh, that's fascinating. So how 0:16:50.560 --> 0:16:53.840 did the staff respond. They forced the studio pay since 0:16:54.080 --> 0:16:56.280 first of all, to admit to having a mental illness 0:16:56.840 --> 0:17:00.240 and made him agree to take antipsychotic drugs as a 0:17:00.280 --> 0:17:04.160 condition of their release. So there they said, Okay, you're 0:17:04.160 --> 0:17:06.600 doing better. You're you're not having you're not experiencing these 0:17:06.880 --> 0:17:12.600 auditory hallucinations anymore. UM, to sign this and then agree 0:17:12.600 --> 0:17:15.719 to this a particular drug treatment, and you can go 0:17:16.280 --> 0:17:18.560 on your way. Okay. So how long did that take? 0:17:18.640 --> 0:17:20.439 Was that just like two or three days before they 0:17:20.440 --> 0:17:23.320 did that? Between let's see whether the length of the 0:17:23.320 --> 0:17:26.800 hospital stays or between seven and fifty two days. So 0:17:26.880 --> 0:17:29.480 an average day of nine average day of nineteen days. 0:17:29.520 --> 0:17:32.199 So this one overnight, Yeah, a week confined to the 0:17:32.200 --> 0:17:35.560 hospital was the shortest. Somebody was in there for fifty 0:17:35.600 --> 0:17:37.960 two days. In fact, that might have been rosen Hunt himself. 0:17:38.000 --> 0:17:40.320 I'm not sure, but there was a point where he said, 0:17:40.400 --> 0:17:42.000 I didn't know how long I was going to be 0:17:42.040 --> 0:17:43.720 in there, but I thought it would be a few days. 0:17:43.760 --> 0:17:47.280 I didn't expect it to be two months. Um. But yeah, 0:17:47.280 --> 0:17:50.960 an average day of nineteen days in the hospital with 0:17:51.080 --> 0:17:54.280 no symptoms whatsoever while they're there, and then a note 0:17:54.320 --> 0:17:56.679 on all of those anti psychotic drugs that they were 0:17:56.720 --> 0:18:01.000 required to take as a condition of their release. Um. 0:18:01.119 --> 0:18:05.240 The report says that the pseudo patients were administered more 0:18:05.280 --> 0:18:08.720 than two thousand pills. It was like pills over the 0:18:08.720 --> 0:18:12.360 course of this including the drugs uh, I don't even 0:18:12.440 --> 0:18:17.920 know if I'm not familiar with these, elavil, stella, zine, composine, thorazine, 0:18:18.040 --> 0:18:21.320 I know those, uh, to name a few of them. 0:18:21.359 --> 0:18:24.560 And then Rosenhan points out in this note that quote 0:18:24.760 --> 0:18:27.800 such a variety of medications should have been administered to 0:18:27.880 --> 0:18:32.520 patients presenting identical symptoms is itself worthy of note? It 0:18:32.600 --> 0:18:35.000 kind of makes you wonder about the extent to which, 0:18:35.040 --> 0:18:37.920 at least at the time, some of the drugs prescribed 0:18:38.119 --> 0:18:44.320 for psychological diagnoses were I don't know, perhaps somewhat arbitrary, 0:18:44.960 --> 0:18:48.160 but anyway, that they didn't take the pills, so only 0:18:48.200 --> 0:18:51.840 two pills over the course of the entire experiment were swallowed. 0:18:51.880 --> 0:18:54.600 The rest they pocketed deposited in the toilet. And then 0:18:54.640 --> 0:18:56.560 they also said that they noticed some of the real 0:18:56.600 --> 0:19:00.359 patients doing the same thing, because I mean, and they 0:19:00.400 --> 0:19:03.680 had to actually consume two of them in order to 0:19:03.720 --> 0:19:06.199 set the precedent that they were taking them. Because that's 0:19:06.240 --> 0:19:08.960 because that's a common reaction to being administered all these pills, 0:19:09.040 --> 0:19:11.679 right that you can start start refusing to take them 0:19:11.760 --> 0:19:13.960 or secret them away. Yeah, well, at least they for 0:19:14.040 --> 0:19:16.760 whoever took those two pills, I guess. I mean the 0:19:16.800 --> 0:19:19.240 fact that they could get away with not taking the 0:19:19.280 --> 0:19:22.119 pills for so long, I mean almost nobody took the 0:19:22.119 --> 0:19:26.359 pills and then they didn't get caught. I think that's 0:19:26.760 --> 0:19:29.520 interesting also key to the experiment, of course, that they're 0:19:29.560 --> 0:19:32.840 not taking all these pills and then because then you 0:19:32.840 --> 0:19:35.639 would have to factor in, well to what effect is 0:19:35.720 --> 0:19:40.720 this massive drug intake affecting their behavior and therefore, uh, 0:19:40.840 --> 0:19:44.000 their reception by the staff. Right, So you had all 0:19:44.000 --> 0:19:47.000 these diagnoses, you had these schizophrenia diagnosis, but then people 0:19:47.200 --> 0:19:50.280 they reported their symptoms were gone and eventually were released, 0:19:50.320 --> 0:19:52.560 though sometimes after a kind of a long stay in 0:19:52.600 --> 0:19:55.080 the hospital that I that I know in many cases 0:19:55.200 --> 0:19:57.760 was not pleasant for these people. Yeah, and they were 0:19:57.800 --> 0:20:02.080 all diagnosed with schizophrenia quote in remission before their release. 0:20:02.200 --> 0:20:04.920 And this is a really key point because Rosenhn is 0:20:04.960 --> 0:20:08.479 careful to point out the distinction between in remission and 0:20:09.280 --> 0:20:14.520 sane It's suggesting sort of the categorization of schizophrenia in 0:20:14.640 --> 0:20:19.600 remission retains a level of categorical stigma that's associated with 0:20:19.640 --> 0:20:22.960 the fact that the patient is still considered fundamentally an 0:20:23.080 --> 0:20:28.199 insane person. They're just not showing symptoms right now. Like, 0:20:28.280 --> 0:20:32.520 once you have been deemed insane, it almost seems as 0:20:32.520 --> 0:20:36.240 if the hospital will not consider you sane again. Yeah, 0:20:36.240 --> 0:20:39.199 it's it's it's as if it's affected your sort of 0:20:39.280 --> 0:20:43.119 baseline sanity score, and it's it's forever going to be 0:20:43.160 --> 0:20:47.359 a little lower, no matter what your particular manifestation level 0:20:47.480 --> 0:20:50.000 is going to be. Yeah, though then again, I mean 0:20:50.359 --> 0:20:53.120 even that might be more progressive than what was actually 0:20:53.160 --> 0:20:56.560 displayed in practice in the hospital, because I don't know, 0:20:56.640 --> 0:20:58.840 it seems kind of cruel to think of sanity on 0:20:58.880 --> 0:21:01.800 a like sliding scale of numbers, like a like a 0:21:01.880 --> 0:21:05.200 D one role. But what we have here doesn't even 0:21:05.240 --> 0:21:07.560 seem like the sliding scale. You're just either in the 0:21:07.640 --> 0:21:11.000 club or you're not. You're in the normal sane person club, 0:21:11.160 --> 0:21:13.600 or you are outside that club and you don't get 0:21:13.640 --> 0:21:16.480 to get in. You either have the star or you don't. Now, 0:21:16.560 --> 0:21:19.080 I do want to mention as well that that in 0:21:19.080 --> 0:21:23.480 in the paper, Rosenhan also comments on the conditions that 0:21:23.480 --> 0:21:27.200 that they encountered, then he himself encountered a part of Yeah, 0:21:27.320 --> 0:21:29.480 just talking about like the language that was used, the 0:21:29.480 --> 0:21:34.520 attitude that was used against the patients, as well as 0:21:34.600 --> 0:21:38.560 just the feeling of powerlessness that that that he felt 0:21:39.200 --> 0:21:43.440 inside these institutions. And uh and therefore the ramifications that 0:21:43.440 --> 0:21:47.920 that that those conditions would have upon any individual that's 0:21:47.960 --> 0:21:51.719 placed in their care, especially someone who might have some 0:21:51.840 --> 0:21:54.280 level of of actual mental illness. But one of the 0:21:54.320 --> 0:21:56.919 main takeaways of this, at least the first half of 0:21:56.960 --> 0:21:59.399 this experiment, and we'll get to the very interesting second 0:21:59.440 --> 0:22:03.000 half in a moment um, is what they called called 0:22:03.040 --> 0:22:08.880 the uniform failure to recognize sanity. And Rosenhan points out 0:22:08.880 --> 0:22:11.440 on the paper that that shouldn't be attributed to these 0:22:11.520 --> 0:22:14.240 just being like bad hospitals, because they went for a 0:22:14.240 --> 0:22:16.879 whole range of them. They went from you know, they 0:22:16.960 --> 0:22:20.000 went to some shabby hospitals, but then also to some 0:22:20.160 --> 0:22:23.760 very nice hospitals, and it just seemed like, you know, 0:22:23.840 --> 0:22:26.480 once you were there and you presented a few symptoms, 0:22:26.560 --> 0:22:30.800 they said, okay, yes you are insane. You know, given 0:22:30.840 --> 0:22:33.080 all of this, I can imagine if I was running 0:22:33.080 --> 0:22:37.919 a hospital at the time of rosen Hans's experiment, I 0:22:37.960 --> 0:22:41.080 would I would respond with, well, you know what that 0:22:41.119 --> 0:22:43.480 could ever happened. Here, it never happened. Here's one thing 0:22:43.520 --> 0:22:47.080 for these other institutions to fail to to to see 0:22:47.119 --> 0:22:50.560 through this scheme and to properly diagnose these pseudo patients. 0:22:50.600 --> 0:22:53.760 But you try that mess with me, buddy, and I'm 0:22:53.800 --> 0:22:56.040 going to spot your pseudo patients and kick them right 0:22:56.080 --> 0:22:58.320 out the door. Give me your best shot. And in fact, 0:22:58.440 --> 0:23:01.480 there was there was one hospital that did exactly that. 0:23:01.640 --> 0:23:04.560 There was a hospital administration that took issue with rosen 0:23:04.600 --> 0:23:08.320 Hans findings and they put a challenge to him. They 0:23:08.320 --> 0:23:11.160 were like, okay, okay, hold on a second, you send 0:23:11.280 --> 0:23:13.919 us your pseudo patients and we will rout them out. 0:23:15.000 --> 0:23:18.040 And what did Rosahn do? He agreed, he so he said, 0:23:18.080 --> 0:23:20.920 I'll send you send them, I'll send them on beyond 0:23:21.000 --> 0:23:24.560 your guard. And so they were on their guard. In 0:23:24.600 --> 0:23:28.679 the following weeks, out of one new patients that the 0:23:28.720 --> 0:23:33.080 staff identified, forty one as potential pseudo patients, with twenty 0:23:33.119 --> 0:23:37.880 three receiving suspicion from at least one psychiatrist and nineteen 0:23:37.920 --> 0:23:42.080 of these receiving suspicion from one psychiatrist and one other 0:23:42.119 --> 0:23:46.760 staff member. So they were and they they upped their security. 0:23:46.800 --> 0:23:48.800 They were ready for it, and they were pointing out 0:23:48.800 --> 0:23:51.200 pseudo patients left and right, calling out of the woodwork. 0:23:52.040 --> 0:23:56.119