That Time Some Psychiatrists Pretended to be Mentally Ill to Prove Psychiatrists Don't Know Anything

this video is brought to you by bright sellers you might be thinking simon is that just a kidnapping business where victims are held in well-lit basement well absolutely not that's not the sort of business i would partner with maybe over on business plays but certainly not an outstanding channel like this one so what does bright sellers do well they send you wine and that alone is pretty awesome but that is just the starting point their speciality is introducing you to new wines that you might not have tried otherwise but well wines you'll probably love and look i'm a pretty big wine drinker i like discovering new wines to drink and enjoy and what makes bright sellers quite so clever is that they maximize the chances that you're going to love the wines that they send so you take a super short quiz online about everything you like in a wine and there's no snobbery it's very accessible and they show you a list of wines from around the world that you're most likely to enjoy based on your responses and we're not talking about complex questions about tannins and stuff like that it's more like what's your favorite type of juice what's your favorite type of chocolate it's easy and after that bright sellers will send you wine and there's a guarantee that you'll like it and if you don't well there should be another bottle with your next delivery so you really can't lose and what else well you can choose how much they send and of course it's all delivered to you wherever you want it making everything super easy plus each box comes with wine education cards so you can learn a bit about what you're drinking like how you might correctly pair it with foods or what temperature it's best served at bryce cellars are also giving you guys 50 off your first six box bottle follow the link in the description to take the quiz and get started but first today's video [Music] in 1972 eight people presented themselves to 12 psychiatric hospitals across the united states they had seemingly nothing in common say for a very specific set of symptoms with all eight reporting hearing voices saying a single word thud empty or hollow they were all immediately admitted seven being diagnosed with schizophrenia and one with manic depression following admission all eight patients suddenly stopped hearing the voices and reported feeling entirely normal nonetheless they remained hospitalized for between 7 and 52 days being treated with a variety of antipsychotic drugs before finally being released with a diagnosis of schizophrenia in remission it was at its face little more than a curious coincidence but in january 1973 an article appeared in the journal science revealing that the eight patients were not who they appeared to be in fact they weren't patients at all but members of a secret study organized by psychiatrist david rosenhan of stanford university the results of that study now known as the rosenlen experiment would shake the psychiatric establishment to its very core the rosenhan experiment was inspired by the work of adi liang thomas says and irving goffman and other leading figures of the anti-psychiatry movement these men were concerned by the dehumanizing effects of psychiatric diagnosis and institutionalization and the use of psychiatry as a tool of social and political repression indeed in the soviet union east germany and other communist states forcible commitment to psychiatric hospitals was commonly used to silence political dissidence thomas as in particular focused on the use of psychiatric labels in western countries as a means of enforcing societal norms citing such examples as draytomania the supposed mental illness that caused slaves to flee captivity hysteria the catch-all diagnosis for misbehaving women and the fact that homosexuality was officially characterized as a mental illness until 1974. david rosenhan believed that mistaken or overzealous diagnoses indeed the very act of labeling psychiatric disorders could have serious detrimental effects at the personal and community level due to the persistent stigma associated with mental illness as he wrote in his famous 1973 article on being sane in insane places the term mental illness is of recent origin it was coined by people who were humane and wanted very much to raise the station of the psychologically disturbed from that of witches and crazies to one that was akin to the physically ill but while treatment has improved it is doubtful that people really regard the mentally ill in the same way that they view the physically ill a broken leg is something one recovers from but mental illness allegedly endures forever a broken leg does not threaten the observer but a crazy schizophrenic attitudes towards the mentally ill are characterized by fear hostility aloofness suspicion and dread the mentally ill a society's lepers a psychiatric label has a life and an influence of its own once the impression has been formed that the patient is schizophrenic the expectation is that he will continue to be schizophrenic such labels conferred by mental health professionals are as influential on the patient as they are on his relatives and friends and it should not surprise anyone that the diagnosis acts on all of them as a self-fulfilling prophecy a diagnosis of cancer that has been found to be in error is cause for celebration but psychiatric diagnoses are rarely found to be an error the label sticks a mark of inadequacy forever due to these potentially harmful effects rosenhan became concerned about the objective reliability of psychiatric diagnoses that is the ability of psychiatrists to tell the sane from the insane the seed of the idea that would become the rosanna experiment was planted in 1969 when rosenhan was teaching psychology at swarthmore college in pennsylvania when his students complained that the course was too abstract rosenhan suggested that they check themselves into the nearby haverford state hospital and interact with real people suffering from schizophrenia just to be safe however rosanna decided to check himself in first he emerged nine days later utterly traumatized by the experience and refused to subject his students to the same ordeal however he soon began thinking of an experiment to expose the deficiencies of the mental health system an experiment he would finally carry out three years later rosanna's team of eight test subjects whom he called pseudo-patients consisted of five men and three women and included a graduate student a pediatrician a painter a housewife three psychologists and rosenhan himself the 12 hospitals they were to infiltrate were similarly diverse ranging from underfunded understaffed state institutions to exclusive private hospitals so their commitment would not result in social or professional embarrassment the pseudo patients were given false names and professions but were otherwise not to change or conceal any other details of their lives or personalities they were instructed to present themselves to their assigned hospitals with a single symptom hearing a voice saying thud empty or hollow these words were selected due to their evocation of an existential psychosis a hypothetical disorder in which a patient's hallucinations reveal an inner feeling of hollowness and meaninglessness as not a single case of existential psychosis had ever been reported rosanne believed this might serve as a clue to hospital psychiatrists that the pseudo-patients were feigning their illnesses upon being admitted the pseudo-patients were to cease reporting any symptoms and act normally as they would outside the hospital their goal would then be to secure their release by convincing the staff of their sanity but without revealing their involvement in the experiment as expected rosenhan and the other pseudo-patients were immediately admitted to their respective hospitals and given diagnoses of schizophrenia and manic depression but to their surprise the immediate cessation of symptoms and resumption of normal behavior did nothing to alter these diagnoses or arouse the staff's suspicions on the contrary the pseudo-patients found their every behavior on the ward framed by the staff as a manifestation of their supposed mental illness for example many pseudo-patients took extensive notes on their fellow patients and the hospital staff an activity which the doctors clinically described as patients engaged in writing behavior not once however did a staff member inquire as to the actual nature of the patient's writing on another occasion one psychiatrist pointed to a group of patients who were sitting outside the cafeteria entrance half an hour before lunchtime to a group of young residents he indicated that such behavior was characteristic of the oral acquisitive nature of the syndrome it seemed not to occur to him that there were very few things to anticipate in a psychiatric hospital besides eating normal displays of anger were likewise interpreted as symptoms of mental illness while one pseudo-patient's fluctuating though entirely normal relationship with his parents was interpreted in his case as being intrinsically tied to his psychosis yet while all patient reports indicate that the pseudo-patients were friendly cooperative and exhibited no abnormal indications at no point did any of the staff suspect that they were not in fact mentally ill but one group very often did see through the charade the other patients many pseudo-patients described other patients accusing them of being journalists reporting on the hospital and where records were available a full 35 of 118 patients on the ward reported similar suspicions rosen attributed the doctor's inability to detect the pseudo-patient's deception to the fact that positions operate with a strong bias toward what statisticians call the type ii error this is to say that physicians are more inclined to call a healthy person sick a false positive type 2 than a sick person healthy a false negative type 1. the reasons for this are not hard to find it is clearly more dangerous to misdiagnose illness than health better to er on the side of caution to suspect illness even among the healthy thus despite acting as normally as possible the patients continued to receive regular psychiatric treatment being collectively administered over 2100 pills which they pocketed and flushed down the toilet in addition to over-analysis and extreme boredom rosenhan and the others experienced first-hand the extreme dehumanization and abuse common to life inside a psychiatric hospital the patient is deprived of many of his legal rights by dint of his psychiatric commitment he is shorn of credibility by virtue of his psychiatric label his freedom of movement is restricted he cannot initiate contact with the staff but may only respond to such overtures as they make personal privacy is minimal patient quarters and possessions can be entered and examined by any staff member for whatever reason his personal hygiene and waste evacuation are often monitored the water closets have no doors at times depersonalization reached such proportions that pseudo-patients had the sense that they were invisible or at least unworthy of account on the ward attendants delivered verbal and occasionally serious physical abuse to patients in the presence of others the pseudo-patients who were writing it all down abusive behavior on the other hand terminated quite abruptly when other staff members were known to be coming staff are credible witnesses patients are not during my own experience one patient was beaten in the presence of other patients having approached an attendant and told him i like you occasionally punishment meted out to patients for misdemeanors seemed so excessive that it could not be justified by the most rational interpretations of psychiatric cannon tempers were often short a patient who had not heard a call for medication would be roundly excoriated and the morning attendance would often wake patients with things like come on out of bed while rosenhan acknowledged the role of inadequate funds and understaffing and precipitating such abuses this was not the whole story after all civil behavior occurred even in well-funded private hospitals instead rosenhan attributed the extreme depersonalization of psychiatric patients to the severe lack of interaction between patients and staff according to the pseudo-patient's notes much of the staff's time was spent inside a glass-walled enclosure known as the cage with attendants spending only 11 percent of their shifts interacting with patients nurses were even less available briefly emerging only 11 times per shift and physicians scarce are still emerging nine times per shift that these attitudes affect the professionals who treat and deal with the mentally ill is more disconcerting both because such attitudes are self-evidently pernicious and because they are unwitting most mental health professionals would insist that they are sympathetic towards the mentally ill that they are neither avoidant nor hostile but it is more likely that an exquisite ambivalence characterizes their relations with psychiatric patients such that their avowed impulses are only part of their entire attitude negative attitudes are there too and can be easily detected such attitudes should not surprise us they are the natural offspring of the labels patients wear and the places in which they are found when rosenhan and the others were finally released they had spent an average of 19 days in hospital the diagnostic catch-22 behind their release was later described by rosenhan in an interview with the bbc i told friends i told my family i can get out when i get out that's all i'll be there for a couple of days and i'll get out nobody knew i'd be there for two months the only way out was to point out that the psychiatrists are correct they had said that i was insane i am insane but i am getting better that was an affirmation of their view of me if i was to be discharged i must naturally be in remission but i was not sane nor in the institution's view had i ever been sane on learning of rosenhan's deception the infiltrated hospitals challenged rosenhan to send more pseudo-patients confident in the ability of their doctors to spot them rosenhan agreed even sending a scoresheet with a 10-point scale on which doctors could grade their suspicion of a particular patient over the next several months the hospital scrutinized a total of 193 newly admitted patients confidently pronouncing 41 of them to be impostors but then to their utter embarrassment rosenhan dropped a bombshell he hadn't sent any when rosenin's article appeared in science in january 1973 it sent shock waves through the psychiatric community his results appeared to undermine the last great revolution and psychiatric diagnosis the american psychiatric association's diagnostic and statistical manual of mental disorders or dsm created in 1952 the dsm was intended to replace the often arbitrary and esoteric diagnoses of the psychoanalytic tradition with diagnostic criteria based on real-world statistics and clear observable symptoms no longer would a patient be diagnosed on the basis of a single symptom or their family history in order to be diagnosed with a given disorder a patient had to simultaneously display a certain number of symptoms statistically associated with that disorder while this system was meant to drastically improve the reliability and usefulness of psychiatric diagnoses the rosenan experiment revealed that in practice psychiatric labels were just as arbitrary and as harmful as ever as rosenhan explained in his article whenever the ratio of what is known to what needs to be known approaches zero we tend to invent knowledge and assume that we understand more than we actually do we seem unable to acknowledge that we simply don't know the needs for diagnosis and remediation of behavioral and emotional problems are enormous but rather than acknowledge that we are just embarking on understanding we continue to label patients schizophrenic manic-depressive and insane as if in those words we captured the essence of understanding the facts of the matter are that we have known for a long time that diagnoses are often not useful or reliable but we have nevertheless continued to use them we now know that we cannot distinguish sanity from insanity it is depressing to consider how that information will be used as a remedy rosenhan advocated to move away from the traditional institutional model of psychiatric care towards the proliferation of community mental health facilities of crisis intervention centers of the human potential movement and of behavior therapies that for all of their own problems tend to avoid psychiatric labels to focus on specific problems and behaviors and to retain the individual in a relatively non-pejorative environment the rosenan experiment was highly influential and helped to further spread the de-institutionalization movement started by the introduction of antipsychotic drugs in the 1950s by the end of the 1980s most of the large state hospitals had been emptied and shuttered with the majority of patients being treated in community health centers or psychiatric wards in regular hospitals yet despite its fame and influence the roseman experiment soon drew vehement criticism for its allegedly manipulative and unscientific methodology in the most damning of these critiques published in nature in 1975 robert spitzer outright dismisses the rosenan experiment as pseudoscience arguing that the study was designed in such a manner to invariably confirm rosenhan's own preconceptions in particular spitzer points out that despite rosanna's claims the pseudo-patients did not behave normally in the hospital had the behavior been normal they would have walked to the nurse's station and said look i'm a normal person who tried to see if i could get into the hospital by behaving in a crazy way or saying crazy things it worked and i was admitted to the hospital but now i would like to be discharged from the hospital in other words as the pseudo-patient's behavior was deliberately intended to fool the hospital staff it is hardly surprising that they succeeded after all as spitzer points out aside from cases of malingering where a patient pretends to be ill in order to for example score narcotic drugs there is little reason for doctors to doubt the authenticity of a patient's reported symptoms thus the fact that the hospital staff did not suspect the pseudo-patients of feigning their illness says little about the reliability of psychiatric diagnosis if i were to drink a quart of blood and concealing what i had done come to the emergency room of any hospital vomiting blood the behavior of the staff would be quite predictable if they labeled and treated me as having a bleeding peptic ulcer i doubt that i could argue convincingly that medical science does not know how to diagnose that condition spitzer goes on to dismantle nearly all of rosenhan's interpretations of the staff's behavior pointing out for example that nurse's notes like the infamous engages in writing behavior are not diagnostic but instead used to update other staff on a patient's daily activities he points out that the term in remission is almost never used to classify schizophrenic patients upon discharge indicating that the hospital staff had in fact acknowledged that the pseudo-patients were no longer suffering from any detectable mental illness indeed spitzer challenges rosenhan's foundational assertion that schizophrenia is a permanent lifelong diagnosis pointing out that the dsm acknowledges that the disorder can and often does go away never to return and while acknowledging that other symptoms typically present alongside hallucinations he concludes i would hope that if i had been one of the 12 psychiatrists present with such a patient i would have either been struck by the lack of other signs of the disorder but i am rather sure that having no reason to doubt the authenticity of the patient's claim of auditory hallucinations i would also have been fooled into noting schizophrenia as the most likely diagnosis more recently in a 2019 book the great pretender author susan callahan claims that the little data rosenand presents in his 1973 article conflicts with that in his original notes with key statistics such as the length of the pseudo-patient stays or the number of patients at each hospital being altered in the final publication in addition despite an extensive search she was unable to track down any of the original pseudo-patients leading her to suspect that they had in fact been invented by rosenhan and so it is that the rosenhan experiments joined the pantheon of extremely influential but fundamentally flawed psychological studies along with the likes of the milgram obedience experiment the stanford prison experiment and the robbers cave experiment yet for all its flaws it cannot be denied that rosenhan's stunt was instrumental in bringing about a more humane and personal era of mental health care and the fear of institutionalization and dehumanization perhaps best expressed by evolutionary biologist t.h huxley in 1893 are still with us to this day one of the unpardonable sins in the eyes of most people is for man to go about unlabeled the world regards such a person as the police do an unmuzzled dog not under proper control so i really hope you found that video interesting if you did please do smash that like button below don't forget to check out a fantastic sponsor bright sellers link below and thank you for watching

Channel: Today I Found Out

Views: 167,918

Rating: 4.946888 out of 5

Keywords: today i found out, tifovidz12, tifo, awesome, facts, didn't know

Id: bJ1-RP2C3PM

Length: 19min 19sec (1159 seconds)

Published: Sat Feb 27 2021

Reddit Comments

[u/Kokuei7]

Firstly I want to point out that the title is flippant and that psychiatrists definitely do an important job, please don't ignore them because of this post.

The reason I wanted to share this video is because it talks about the persistent attitude that medical professionals had/have towards patients who have a diagnosis, skewing how they perceive new complaints and are likely to put them down to an existing diagnosis. It doesn't go into a lot of detail about it, but as I was watching it I couldn't help but think about those with ME who have been forced into psychiatric care against their and their families wishes, as well as how difficult it would be to prove that you didn't need to be there once you were admitted.

It also lightly touches on a person's need to know, that if something unknown appears we first try to assign it to something we have knowledge of. Here I'm sure some of us been in the situation of our doctors trying to pin what we have on absolutely anything except ME.

This might not fit this sub and if not then I'm okay with it being removed, but I hope we one day have a shock to the system for ME like this video shows there was in psychiatry.